Biomedical subjects
Publications and source records attributed to A Calisti.
The role of radionuclide investigation of urinary tract pathology in pediatric patients (computerized radionuclide urography and radionuclide cystogram) is discussed. Advantages of reliable morphological and functional study with a non invasive, low radiation procedure are emphasized.
Results of US study in 30 children with various renal lesions are reported, and compared with clinical and surgical features. Different ultrasonographic aspects are discussed with special interest on cogenital abnormalities. US is proposed as first choice investigation in newborns with antenatal ultrasonographic demonstration of renal lesions and in all patients where a mass of renal origin is suspected. Renal function, nevertheless, must be investigated with radiologic and/or radioisotopic techniques. US have still a large indication in short term follow-up of renal lesions where surgical treatment is not indicated.
135 non tumoral hydrocephalic children have been operated on trough a V-P shunt in the period January 1975-June 1981. Of them, 10 (7.4%) presented an inguinal hernia or hydrocele in the postoperative period. Such complications required in 9 cases a specific surgical treatment, which was not followed by recurrence in any case; in one child the hydrocele subsided spontaneously. No relation was found with the type of shunt device inserted and the side of the operation.
A large series of malignant and benign conditions are generally collected under the term of abdominal masses. Their common aspect is the lack, in most of the cases, of peculiar clinical features which may help early differential diagnosis. In many cases the mass is detected late after a long period of vague, aspecific symptoms. 40% of these space occupying lesions of the abdomen are of malignant origin and delayed detection and investigation affect clinical course. Preoperative study of abdominal masses is a problem of primary importance in pediatric surgical practice. A changing attitude is registered towards many diagnostic procedures and the role of largely diffused techniques like angiography is controversial. The introduction of ultrasonography makes in many cases intensive radiologic investigation unwarranted and academic. The Authors discuss the real role and targets of preoperative investigations of abdominal masses and refer on their experience based on 52 cases, to underline some clinical aspects and analyse their diagnostic approach to this pathology.
Neonatal adrenal gland hemorrhage is not uncommon. Its etiology is still questionable, though hypoxia (antenatal, labor-induced, or neonatal) seems to be usually associated with the event. Symptoms include acute shock associated with severe blood loss. Milder cases exhibit anemia and jaundice associated with a suprarenal mass. Ultrasonography (US) has replaced urography in the diagnosis of this condition, demonstrating site and size of the lesion and allowing an accurate follow-up. The authors report on a series of 11 patients; US was performed on 9 of them. In 10 cases the lesion was unilateral and in one case bilateral. Antenatal US diagnosis was possible in 2 cases and confirmed neonatally. The extant 9 infants developed a palpable abdominal mass or were diagnosed while examined for other conditions. All cases were evident by the 2nd week of life. Eight patients exhibited spontaneous hemorrhage resolution, as shown by repeated US and/or urographic exams. Three patients underwent surgery because the lesion seemed stable. In these 3 instances, CT scans were inconclusive. This paper is aimed at reporting on the radiologic and US features we observed, with a special emphasis on the changes in size, shape and US features in the cases which resolved spontaneously. The first US examination is not conclusive and does not allow an unquestionable differential diagnosis. Only lesion evolution with progressive decrease in its size (changes in US features are less useful) allows unquestionable US diagnosis and prevents unnecessary surgery.