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A Pampaloni

Publications and source records attributed to A Pampaloni.

At least 19 recordsLinked to original sources
PubMed2002

[Esophageal atresia with distal tracheo-esophageal fistula. Evolution of the treatment in the period of 1955-2000 at the Anna Meyer Children's Hospital of Florence].

BACKGROUND: Over the past decades the esophageal atresia (EA) has represented the greatest challenging malformation encountered by the pediatric surgeon. Since then, there have been considerable advancements in the treatment of EA. In this paper the experience at the "Anna Meyer Children's Hospital of Florence" in regards to the surgical treatment of the EA from 1955 to present day is reported, so that the analysis of the various medical and surgical choices followed by the authors and their predecessors in this long period, can be an important learning tool for the EA management. METHODS: From 1955 to 2000, 223 newborns affected by EA with tracheoesophageal fistula (TEF) have been operated on out of a total of 250 cases of EA. Our experience has been subdivided into periods on the basis of homogeneous medical and surgical treatment adopted in that determined time. We have analyzed particularly the data of the last period 1995-2000, where there has been a well standardized protocol of treatment from the medical, surgical and intensive care points of view. RESULTS: The mortality rate has decreased from 44.8 to 3.4% with a significant reduction (p<0.001) between the years 1979-1983 and 1984-2000, due to the introduction of a perioperative treatment in the newborn intensive care unit. Moreover, a significant correlation (p<0.05) has been shown between low birthweight and associated malformations, two risk factors that however do not negatively influence the results of the treatment in the last period 1995-2000. CONCLUSIONS: A full integration between the surgeon and neonatologist is necessary in order to guarantee a good result. The risk connected to EA is not as much the surgical procedure as the presence or absence of associate malformations that are undetected in the prenatal diagnosis. It is suggested that, in order to further reduce the mortality and morbidity rate after EA correction, the number of prenatal diagnoses should be increased.

Esophageal Atresia↗
PubMed1996

Resection of primary tumor at diagnosis in stage IV-S neuroblastoma: does it affect the clinical course?

PURPOSE: To determine whether resection of primary tumor has a favorable influence on outcome of infants (age 0 to 11 months) with stage IV-S neuroblastoma. PATIENTS AND METHODS: Between March 1976 and December 1993, 97 infants with previously untreated neuroblastoma diagnosed in 21 Italian institutions were classified as having stage IV-S disease. Seventy percent were younger than 4 months. Adrenal was the primary tumor site in 64 of 85 patients with a recognizable primary tumor. Liver was the organ most often infiltrated by the tumor (82 patients), followed by bone marrow and skin. RESULTS: The overall survival (OS) rate at 5 years in 80% and event-free survival (EFS) rate 68%. In 24 infants, the effect of resection of primary tumor could not be evaluated because of rapidly fatal disease progression (n = 8), absence of a primary tumor (n = 12), or partial resection (n = 4). Of 73 assessable patients, 26 underwent primary tumor resection at diagnosis: one died of surgical complications, one relapsed locally and died, and two others relapsed (one of these two locally) and survived, for a 5-year OS rate of 92% and EFS rate of 84%. Of the remaining 47 patients who did not undergo primary tumor resection at diagnosis 11 suffered unfavorable events, of whom five died, for an OS rate of 89% and EFS rate of 75% (no significant difference from previous group). Disease recurred at the primary tumor site in only one five who died, and in only one of six survivors of progression or relapse; in these patients, the primary tumor, located in the mediastinum, was successfully resected. CONCLUSION: Infants who underwent resection of the primary tumor at diagnosis had no better outcome than those in whom the decision was made not to operate.

Adrenal Gland Neoplasms↗
PubMed1995

[Hydrocephalus in the pediatric age group: considerations on a series of 245 shunted patients].

A series of 245 hydrocephalic patients in the pediatric age group who underwent 544 surgical shunting procedures is reviewed in this paper. The subsequent average of 1.5 operations per patient appears therefore significantly low, when compared with the Literature data. The authors emphasize that this result may be due mainly to the fact that all the surgical procedures were performed by the same surgeons, even if two other concepts appear extremely important in this regard: the great care in prevention of shunt infections and the use of one-piece shunting devices. A pattern for the "clinical surveillance" of hydrocephalic children is proposed and the neuropsychological follow-up of the series is described in the paper. Authors conclude that serious damage to cerebral parenchyma due to intracranial hypertension related to the hydrocephalic condition may be avoided by an accurate selection of patients to be operated on, a correct surgical timing and a careful postoperative control.

Cerebrospinal Fluid Shunts↗
PubMed1994

[Congenital anomalies of the penis in children. A few consideration about 92 cases].

The authors present their experience of 92 cases of anomalies of the penis, hypospadias excepted, occurring in children between 12 months and 10 years old, during the last 5 years, in their Pediatric Surgical Department. In the literature, there are reported only many single cases of these anomalies, for the most part associated in serious multiple malformations, or with hypospadias. The children included in this report present the anomalies of the penis as a sole malformations. The classification of these anomalies was made by embryological criteria and by the frequency of occurrence. In 41 cases there was congenital curvature of the penis, in 9 cases there was a webbed penis, in 6 cases a concealed penis. Torsion of the penis occurred in 6 cases (in 5 anticlockwise) the microphallus in 5 cases. The "hypospadias without hypospadias" occurred in 5 cases, in the others there was an association among these anomalies. The authors emphasize the importance of these malformations for the children and their families, also in order to prevent, also serious, psychological effects.

Child↗
PubMed1991

Skin substitutes in the treatment of deep partial skin thickness burns in children: clinical experience and long-term results.

This report describes the use of skin substitutes in the treatment of deep partial skin thickness burns in childhood. These are lesions that, if treated inadequately, can result in severe scarring. However, if treated appropriately, they can heal without any sequelae, which is obviously crucial for aesthetic and psychological reasons. This review contains children admitted to the authors' Burn Unit over a 5-year period (1984-88) with deep partial skin thickness lesions which were treated with synthetic and/or biosynthetic skin substitutes and without surgical procedures. This group of children has been compared with another group hospitalized for burns of the same depth and treated with conventional closed wound management. First, short-term results are presented, highlighting healing time, followed by the long-term results from an aesthetic and functional viewpoint.

Biocompatible Materials↗
PubMed1985

Spermatic and peripheral venous plasma concentrations of testosterone, 17-hydroxyprogesterone, androstenedione, dehydroepiandrosterone, delta 5-androstene-3 beta,17 beta-diol, dihydrotestosterone, 5 alpha-androstane-3 alpha,17 beta-diol, 5 alpha-androstane-3 beta,17 beta-diol, and estradiol in boys with idiopathic varicocele in different stages of puberty.

Serum testosterone (T), 17-hydroxyprogesterone (17P), androstenedione (delta 4-dione), dehydroepiandrosterone (DHA), delta 5-androstene-3 beta, 17 beta-diol (delta 5-diol), estradiol (E2), dihydrotestosterone (DHT),5 alpha-androstane-3 alpha,17 beta-diol (3 alpha diol), and 5 alpha-androstane-3 beta,17 beta-diol (3 beta diol) were measured in the peripheral and spermatic venous blood of 21 boys undergoing surgery for idiopathic left varicocele. The boys were divided into 3 groups according to their pubertal development: prepubertal (group 1 or P1; n = 8), pubertal stage 2 (group II or P2; n = 6), and pubertal stages 3-4 (group III or P3-4; n = 7). The testes of the prepubertal boys secreted T, 17P, DHA, delta 5-diol, DHT, and 3 alpha diol, but not delta 4-dione, E2, and 3 beta diol. In pubertal stage P2, the mean spermatic-peripheral secretory gradients of T, 17P, DHA, delta 5-diol, DHT, and 3 alpha diol were significantly higher than those in the prepubertal stage, and there was testicular secretion of delta 4-dione, E2, and 3 beta diol. In pubertal stage P3-4, the mean spermatic-peripheral secretory gradients of most of these steroids, even if increased, were not significantly different from those in stage P2 (with the exception of 17P, delta 5-diol, and DHA). We suggest that after the important modifications of testicular secretion occurring in pubertal stage P2, the testicular secretory pattern of the pubertal testis is similar to the pattern of the adult testis. We suggest also that these results, obtained in boys with idiopathic varicocele, can probably be extended to the secretory activity of the testes of normal pubertal boys.

17-alpha-Hydroxyprogesterone↗
PubMed1983

Steroid secretion by the prepubertal human testis.

It has been demonstrated that the human testis secretes testosterone and, to a smaller extent and less constantly, also androstenedione. Testosterone, progesterone, 17 alpha-hydroxyprogesterone and 20 alpha-dihydroprogesterone have been measured in the spermatic and peripheral venous blood of prepubertal boys undergoing surgery for undescended testis or inguinal hernia repair. The spermatic plasma levels of testosterone and progesterone were significantly higher than peripheral levels. A significant spermatic-peripheral gradient was not found for 17 alpha-hydroxyprogesterone and 20 alpha-dihydroprogesterone. These studies demonstrate that the secretory pattern of the human prepubertal testis is different from that of the adults.

Androgens↗
PubMed1981

Testosterone concentrations in spermatic venous blood plasma of prepubertal boys.

Testosterone concentration has been measured in spermatic and peripheral venous plasma obtained during surgery from a total of 25 prepubertal boys affected either by inguinal hernia (Group I; N = 6; age range 2-8 years) or unilateral undescended testis (Group II; N = 19; age range 5-11 years). Median spermatic venous testosterone level was 58.7 ng/dl) (range 14.0--120.8 ng/dl) in Group I and 43.2 ng/dl (range 12..2-267.5 ng/dl) in Group II; median peripheral testosterone level was 4.9 ng/dl (range 2.3-15.4 ng/dl) and 5.6 ng/dl (range 1.1-89.3 ng/dl) in Group I and II, respectively. The difference between the spermatic and peripheral level was statistically significant in both groups (P less than 0.01 in Group I and P less than 0.001 in Group II). These results indicate that the prepubertal human testis secretes testosterone, even if in a very low amount. It is also suggested that this secretion can be responsible for LH inhibition in prepubertal boys.

Child↗