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Biomedical subjects

A Miselli

Publications and source records attributed to A Miselli.

At least 19 recordsLinked to original sources
PubMed1991

[Recanalization with laser and angioplasty of atherosclerotic lesions of the legs. Personal experience with 31 treated lesions].

From January to November 1989, 31 iliac and femoro-popliteal atherosclerotic lesions were treated in 29 patients (age range: 33-80 years) by means of percutaneous laser-assisted angioplasty. The lesions were 6 iliac tubular stenoses, 6 iliac occlusions and 19 femoro-popliteal occlusions, 2-20 cm long. The laser equipment employed was in 10 cases a Cardiolase 4000 Nd:YAG "hot tip" unit, and in 21 cases a Nd:YAG "sapphire contact probe" unit. Initial success was achieved in 23/31 lesions (74%); the follow-up, by clinical examination, Doppler US, and ankle-arm pressure index performed every 4th month, showed 1-year actuarial patency of 80% for femoro-popliteal occlusion and 100% for iliac lesion, with 87% cumulative patency. Overall complication rate was 22.5%. There were 6 local complications, 4 of which were hematomas at the arterial puncture site, and 2 were performation of the superficial femoral artery, all without any clinical sequelae; one patient developed rethrombosis within 72 hours from treatment, which needed amputation after an emergency bypass. Our preliminary results show no significant improvement when compared with conventional balloon angioplasty results both in immediate success rate and in short-to-midterm patency; furthermore, laser therapy was burdened by a higher complication rate. We believe that laser angioplasty should be employed only in arterial occlusion uncrossable with angiographic guidance alone.

Adult↗
PubMed1990

[Ultrasonography in the diagnosis of deep venous thrombosis of the legs].

One hundred consecutive inpatients with clinically suspected deep venous thrombosis (DVT) were examined by US; the last 19 cases were studied also by means of color-Doppler US. In order to evaluate the method reliability, US results were compared with those obtained with contrast venography, which was performed on all patients. The studied region included the femoro-popliteal vein, while no attempt was made to image the calf veins, which are difficult to evaluate with US. In our series, venographic results were in substantial agreement with US findings, with 99% and 100% sensitivity and specificity, respectively. Diagnosis was based only on noncompressibility of the thrombotic vein, despite the absence of visible clots; pulsed Doppler information supported diagnosis by evaluating blood flow. Further diagnostic progress was provided by color-Doppler US, which allows flow lumen to be defined in color. US also allowed the detection of the conditions mimicking DVT, such as muscular ruptures, hematomas, popliteal cysts, or compressive tumors. In conclusion, US and color-Doppler US prove to be valid alternatives to contrast venography in the diagnosis of proximal DVT of the lower limbs.

Adolescent↗
PubMed1989

[Fractures of the pelvis and associated abdominal lesions].

106 cases of pelvic fracture and blunt abdominal trauma are reported and relationships between type of fracture, associated lesions and prognosis assessed. The presence of associated lesions, with the exception of urologic types, would appear to be correlated to the extent and prevalent application site of the trauma rather than to fracture morphology. The prognosis for patients with pelvic fractures is related to the frequency of associated lesions of intra-abdominal viscera and urological or retroperitoneal vascular structures.

Abdominal Injuries↗
PubMed1989

[Reliability of ultrasonic diagnosis in hypertrophic stenosis of the pylorus].

Ultrasound diagnosis of pyloric stenosis depends on the typical "target" and "cervix" pictures, respectively in transverse and longitudinal scan. Furthermore, pyloric dimensions can be considered pathologic when the muscular wall is greater than or equal to 4 mm. in width, having a maximum diameter greater than or equal to 5 mm. and the pyloric canal is greater than or equal to 18 mm in length. At the Department of Paediatric Surgery of Parma, from 1986 to 1988, 34 infants were studied by ultrasound, basing on clinical suspect of pyloric stenosis. 22 of them were subsequently operated on. Pyloric ultrasound was diagnostic in 20 cases, negative in 1 and doubtful in 1, confirming its reliability in 90-95% of cases. No false positive findings were recorded. Basing on these results, the Authors believe that ultrasound must be the first choice in case of clinical suspect of pyloric stenosis in infancy, because of its high diagnostic value and safety. X-ray studies should be indicated only in doubtful cases.

Evaluation Studies as Topic↗
PubMed1988

Diagnostic problems in a Wilms' tumour of the horseshoe kidney.

The authors report on a case of Wilms' tumour in a horseshoe kidney in a child with correct preoperative diagnosis. They emphasise the superiority of the ultrasound and CT scan studies. A brief discussion of the surgical approach in the different presentations is made. The authors suggest, because of the predisposition of the horseshoe kidney to develop Wilms' tumour to perform, an annual ultrasound study for its surveillance.

Child, Preschool↗
PubMed1988

Rapid sequence of events in gallstone formation in man.

A prospective analysis was carried out on 19 adult patients who had undergone total gastrectomy for gastric cancer with truncular vagotomy and postoperative TPN, to evaluate the gallstone formation sequence in man. The patients underwent gallbladder ultrasonography before surgery, then at least once a day during the period of postoperative fasting and TPN (about 15 days) and during the first days after oral refeeding. No patients showed cholelithiasis or biliary sludge at preoperative ultrasonography; none showed cholesterol crystals at preoperative duodenal drainage. 10 of the 19 patients were sludge-positive during the first two weeks of TPN (2 after 3 days, 7 at day seven, 9 at day nine). 6 patients who were initially sludge-positive developed microlithiasis: 1 after 7 days, 2 during TPN and 3 after oral refeeding. These results lead the authors to suggest that human lithogenesis in particular conditions may be faster than that observed so far in animal models, and that the very rapid events in gallstone formation observed in this study concern the formation of pigment stones.

Adult↗
PubMed1987

[Hepatic abscesses secondary to peritonitis: puncture and ultrasonically guided transparieto-hepatic drainage].

The Authors describe one case of duplex and separated hepatic abscesses secondary to perforated appendicitis and peritonitis. A contemporary literature review confirms the actual rarity of this entity. The patient was treated by percutaneous and transhepatic puncture and drainage of abscesses under sonographic control in two different stages. Material and methods of this technique are herein reported, in particular those concerning the management of the smaller of the two abscesses, located posteriorly into the lower segment of the right lobe of the liver, having a more difficult approach. The therapeutic results were excellent: either few days later percutaneous treatment than two months later after the patient was discharged, the clinical and sonographic controls confirmed a successful recovery.

Child↗
PubMed1987

Sludge and microlithiasis of the biliary tract after total gastrectomy and postoperative total parenteral nutrition.

We have evaluated the incidence and evolution of sludge, microlithiasis and lithiasis formation of the biliary tract in 12 patients who underwent total gastrectomy and postoperative total parenteral nutrition (TPN) beginning immediately after operation. To this end, serial ultrasonographic studies are carried out every 72 hours during TPN and every seven days after oral refeeding and then once a month for three months. Sludge of the gallbladder was demonstrated in five of the 12 patients after a minimum period of nine days after the operation, and in four of these, microlithiasis of the biliary tract was subsequently revealed. In two of these four patients, the stones dissolved spontaneously, while in the remaining two patients, no change occurred in dimension after intervals of six and seven months, respectively. In all instances, sludge and microcalculi were completely "silent." This study was done to underline the high incidence of biliary tract sludge and microlithiasis in the patients examined and to indicate the necessity for preventive measures against the possible and serious complications of this disease as well as acute pancreatitis.

Adult↗
PubMed1985

[Radiological diagnosis of neoplasms of the small intestine (personal contribution on 60 cases)].

The authors reviewed critically the radiologic diagnosis and the investigation methods (plain abdomen, barium follow-through, small bowel enema, angiography, lymphography, abdomen c.t.), of 60 patients operated for small bowel tumors, either benign or malignant. They compare the radiologic diagnosis with the surgical findings and discuss the validity of the different methods on the basis of the results obtained.

Barium Sulfate↗
PubMed1985

[Villous adenoma of the duodenum].

The authors study the diagnostical problems, especially those involved in the preoperative diagnosis of malignancy, of four cases of duodenal villous adenoma. A more frequent use of endoscopy can allow the observation of this lesion in early stage, such as to ensure recovery through an intervention as scarcely demolishing as possible. However, surgeons plotting the strategy of operation should bear in mind the potential malignancy of duodenal villous adenoma.

Adenoma↗
PubMed1984

Ultrasonic detection of colonic carcinoma in emergency.

The role of ultrasound scanning in the diagnosis of cancer of the colon under emergency conditions such as intestinal obstruction, perforation or, more rarely, heavy colonic bleeding, is discussed. In any case, ultrasound scanning can quickly and rationally indicate choices for further assessment when possible. Characteristic ultrasonic images are described, and possible differential diagnoses are discussed briefly. The method seems significantly sensitive, although nonspecific, as it can give analogous images in cases of inflammatory pseudo-tumors, Crohn's disease, and adult intussusception.

Adult↗
PubMed1983

[Double-contrast enema in the diagnosis of colonic diseases. Contribution on 3.500 examinations].

The Authors expose the technical aspects of the double contrast enema in the colonic diseases. They describe the patient preparation, the use of hypotonic agents and the radiographic technique. They discuss also the accuracy of the method and its diagnostic value. On the bases a four year program 3.500 patients were examined; the ichonography enclosed demonstrated the efficaciousness of this method, particularly in the diagnostic of small parietal lesions.

Colonic Diseases↗
PubMed1983

[Value of angiography and echotomography in injuries of the spleen].

In all the patients was performed angiography, while only 11 were studied by the means of Abdominal Ultrasonography. The Authors' aim is to evaluate the accuracy of these two methods and to define a correct diagnostic procedure. The results obtained with Angiography were 15 correct diagnosis and 1 false positive, whereas those obtained with Sonography were 7 correct diagnosis, 2 indicative diagnosis and 2 false negative. Therefore, when a patient is clinically suspected of having a traumatic spleen injury, the Authors suggest to perform an Abdominal Sonography at first. In case of evident spleen lesion, laparatomy will be directly carried out. However, if the sonographic result is negative or aspecific, it will be necessary for the patient to undergo Angiography in order to rule out possible false negative or establish the origin of endoabdominal bleeding correctly.

Angiography↗