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Biomedical subjects

A Battino

Publications and source records attributed to A Battino.

9 recordsLinked to original sources
PubMed1989

[Diagnosis of varicocele by Doppler effect].

Varicoceles, which may produce oligo-astherospermia are a curable cause of subfertility in the male. Doppler velocimetry of the anterior spermatic venous plexus or pampiniform plexus allows the diagnosis of clinical and infraclinical varicoceles to be confirmed. It can also assess and quantify the spontaneous increase in flow due to venous distension and Valsalva reflux related to valvular incompetence. 50 patients investigated for conjugal infertility and suffering of oligo-astherospermia were included in this study. All underwent clinical examination by an andrologist, spermatic venography and Doppler examination before and after embolization. Doppler examination was performed with patients in the dorsal decubitus position using an 8 MHz transducer. Varicocele was confirmed in 84% of patients suffering of oligo-astherospermia. --Comparison with the results on clinical examination demonstrated a specificity of 100% but a sensitivity of only 66%. --Compared with venography taken as a reference, Doppler had a sensitivity and specificity of 94% and 100% for the examinations carried out after embolization. In the hands of a suitably trained doctor, Doppler examination is today the most rapid, simplest, least costly and most reliable non invasive method for diagnosis of varicoceles. In recent months Doppler hemodynamic data have been complemented by ultrasonographic images obtained using a high resolution apparatus emitting at 7.5 MHz. In the presence of varicocele, the pampiniform plexus has an alveolar appearance and the diameter of the principal draining vein is greater than 3 mm. These dates should be compared with those obtained on venography.

Embolization, Therapeutic↗
PubMed1989

[Management of patients with varicose veins presenting with a history of deep venous thrombosis].

The notion of a history of deep venous thrombosis in patients with varicose veins has often been at the origin of a contemplative attitude toward this pathology. What used to be an act of vigilance has now become plain negligence, if not a therapeutic error. Indeed, the difficulty in diagnosing an acute episode explains the many false positive results obtained; moreover, the variability of the evolution of true venous thrombosis should no longer cause one to adopt a monolithic attitude. In this indication, noninvasive investigating procedures allow distinguishing quite different situations occurring in these patients. In a substantial number of cases, no deep vein circulatory abnormality can be found. Treatment should address primary varicose veins. For those patients with deep venous thrombosis sequelae, such studies allow us to differentiate between occlusion/restriction states from devalvulation, and to detect the precise location of such sequelae, as well as their impact on circulatory function. When occlusion is found, varicose veins, which may be supplementary veins, are left untouched. When devalvulation occurs as an isolated phenomenon, superficial vein insufficiency is of primary importance. Treatment is the more complete that deep reflux will promote relapse through all existing leakage points. If, regardless of this treatment, deep reflux causes significant disturbances, surgical revalvulation should be recommended. More complex cases combining persisting occlusion with devalvulation call for a graded attitude. Noninvasive investigating procedures coupled with phlebography allow us to assess the part played by the various anomalies in causing the disorders.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1988

[Scanner and carotid artery surgery].

The utility of CT scan imaging in patients with hemispheric cerebrovascular accidents suspected of being of carotid artery origin was investigated by analysis of case reports of 57 patients treated recently. A low density image was found in 38.5% of cases, superficial and deep localizations being of equal number. A silent infarct was detected in 13.6% of the patients and a meningioma was able to be diagnosed by the scanner. CT scan imaging is indispensable for care of these patients: --dissuasive in case of cerebral tumor, severe infarction or extensive cerebral destruction; --persuasive in case of major carotid artery lesions and/or those threatening with normal scanner image. Carotid artery surgery can then protect cerebral capital; --directive in case of "watershed" infarct, of enhancement, of silent infarct or an occurring accident. In all such cases, it appears indispensable.

Aged↗
PubMed1985

[Non-invasive exploration of the deep veins. Therapeutic implications in varicose patients].

The functional investigation of patients with varicose veins allows essential varicose veins to be distinguished from secondary varicose veins, so that appropriate therapy can be instituted. These investigations include global evaluation of the venous function, plethysmography and segmental ultrasonography. The authors propose a protocol combining Doppler with photoplethysmography: - if the deep channels are normal on the Doppler examination and the filling time of the PPG is normal after a venous tourniquet has been applied, the varicose veins are essential; - if the deep channels are abnormal: in the case of an obstructive or restrictive syndrome, the PPG can determine whether the varices act as collaterals and should be left intact or whether saphenous incontinence is partially or totally responsible for the disorders, in the case of reflux diagnosed on the Doppler, the PPG can decide whether or not this deep reflux is pathological. This simple, non-invasive protocol can be proposed in the majority of patients with varicose veins. It allows a better evaluation of the pathogenic influence of deep reflux, which is currently an subject of debate.

Hemodynamics↗
PubMed1983

[Acute ischemia of the lower limbs. Clinical diagnosis].

Acute ischemia of lower limbs is severe: 25% lethality, 34% amputations (mean of 42 recent statistics). Initial clinical examination is the main point: it diagnoses acute ischemia, localizes the point of occlusion, picks up etiologic informations, assesses the repercussion of ischemia on the local and general status. The therapeutic decision is an emergency. Some particular aspects are pointed out: diagnostic between embolization and thrombosis, arterial spasm, distal ischemia with present pulses ("blue toe syndrom"), arterial dissections, complications of aneurysms. Prognosis depends on age, general condition, localization of ischemia, status of the limb, multiplicity or recurrence of embolization, but above all on early diagnostic and therapeutic.

Acute Disease↗
PubMed1982

[Continuous emission Doppler ultrasonography in the study of varicoceles].

Because of their anatomical situation and their physiology, spermatic veins are a privileged site for Doppler ultrasonography examinations. By applying an 8 MHz sound above the testis at the level of the hilum before the entrance into the inguinal canal, recordings can be made by means of the respiratory phases, of spermatic vein blood flow rate. Reflux can be demonstrated by employing Valsalva's manoeuvre. Normal spermatic veins can be differentiated from loops, varicoceles with reflux and spermatic and/or iliac spermatic vein thromboses of 95 patients with oligo-asthenospermia examined in this way, 77 (81%) had a reflux to Doppler, and 55 (nearly 75%) had a bilateral reflux.

Humans↗