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Biomedical subjects

A Rippa

Publications and source records attributed to A Rippa.

17 recordsLinked to original sources
PubMed1998

[Improvement of endoscopic resection procedures in relation to the volume of prostatic adenoma].

First choice therapy of obstructive prostatic hyperplasia is still represented by endoscopic transurethral resection of the prostate, despite new techniques for tissue ablation have being proposed. The issue aims to answer to the questions arising about indications of this procedure, and introduces to the knowledge of physical laws which regulate irrigation during and after operation and to the different techniques of irrigating flow derivation whose application reduced morbidity depending on tissue volume and "resection time". Moreover, the new technique of continuous resection with simultaneous suprapubic evacuation of tissue chips (Turbo-TUR) will be illustrated in details, as it permitted to extend indications and advantages of endoscopic surgery to bulky adenomas, electively submitted to open surgery up to now.

Endoscopy↗
PubMed1996

[0.15 mg clonidine as oral premedication in retrobulbar anesthesia].

BACKGROUND: In the present clinical study, oral premedication of 0.15 mg clonidine has been explored with view to anxiolytic effects and physiological stress parameters. METHODS: The study involved 44 patients of ASA-class I-III, all scheduled to undergo ophthalmological surgery under retrobulbar anesthesia (RBA). One hour before RBA 22 patients received 0.15 mg clonidine and 22 patients placebo p.o. The following parameters were assessed at different times perioperatively: oxygenation (SpO2), heart rate, blood pressure, intraocular pressure and anxiety. Anxiolysis was determined using the Erlanger Anxiety Scale. RESULTS: There were no significant differences among the groups in SpO2 and heart rate. Significantly decreased blood pressures were measured after clonidine premedication (p < 0.01). In contrast to clonidine after placebo the preoperative anxiety increased. Right before operation anxiety was decreased significantly (p < 0.01) by clonidine compared to placebo. CONCLUSIONS: In our opinion, oral clonidine (0.15 mg) is useful for premedication of surgery under RBA.

Administration, Oral↗
PubMed1996

Case report of a monoclonal gammopathy in a patient with chronic hepatitis: effects of beta-IFN treatment.

A sixty-one-year-old woman, with cirrhosis, presented with a monoclonal gammopathy of uncertain significance (MGSU). Often in a condition of cirrhosis is present a benign M component hypergammaglobulinemia. The electrophoresis and the immunophoresis showed a dense papraprotein in the gamma-region, an IgG with K light chain, an uncertain Bence-Jones proteinuria, a medullary plasmacytosis (9%), and a following growth of paraprotein were present. Lymphoblastic plasma cell were absent. Treatment with beta-IFN 6 MU for a period of six months and 3 MU for a further period of three months proved ineffective for hepatic disease, but produced a quantitative reduction in gamma-G globulin, the Bence-Jones proteinuria was absent, a reduction in M component and in medullary plasmacytosis. Electrophoresis showed a polyclonal evolution of the gammopathy. Suspension of treatment was followed by de novo rise of monoclonal immunoglobulin. The authors report the use of beta-IFN in the therapy of multiple myeloma.

Antiviral Agents↗
PubMed1995

[Initial experiences in the treatment of benign prostatic hypertrophy with laser (side firing)].

After a short literature review about the topic, the AA. present a 6 months follow up of 15 patients treated with prolase II fiber (cytocare) for BPH. In 80% we got good results about the symptom score and urinary flow, but at the endoscopic control in some cases we found an irregularity in the prostatic urethral as there was some prostatic residual tissue. 20% of the patients were submitted to TURP to relieve the symptoms.

Aged↗
PubMed1994

Urolume in urethral stenosis: Italian Club of Minimally Invasive Urology experience.

A multicenter study of the patients in whom the Urolume has been implanted has been among the actions undertaken by the Italian Club of Minimally Invasive Urology (UMICLUB). For each patient, a computer information format has been prepared containing evaluation data related to the preoperative period, the endoscopic procedure, and follow-up. The collected data were computerized through unifunctional and multifunctional analysis. Of the 82 patients recruited, 76 were followed for a period ranging from 1 to 40 months. Urinoflow results dramatically improved after implantation of the endoprosthesis: peak flow rates increased by 310%, while mean flow rates increased by 294%. Incontinence and dribbling were found in 4% and 20% of the patients, respectively, and were independent of the distance between the external sphincter and the Urolume prosthesis and of the stent number and length. The cross-data elaboration seems to indicate a statistically significant relation between urethral preparation before Urolume implantation and stricture recurrence, with recurrence being more frequent after dilation. Significant correlations have not been noticed between stenosis etiology, urinary infection, type of anesthesia, and recurrence; between the type of anesthesia, stent length, and duration of hospitalization; or between stent number and position and pain. The impact of the Urolume prosthesis on sexual activity was marginal by all three measures considered (pain during erection, coitus, and ejaculation).

Adult↗
PubMed1991

[Conservative endoscopic treatment of urothelial cystic dysplasia of the upper urinary tract].

We highlight the importance of the new diagnostic possibilities afforded by ureterorenoscopy and nephroscopy in the differential diagnosis of single or multiple cystic dysplasia of the upper excretory tract. Moreover, endoscopic treatment was performed in the two cases reported herein. In the first case the biopsy procedure was also therapeutic and in the second case cyst removal resolved the ureteral obstruction. Because the disease is detected infrequently and because treatment may be required even less frequently, several technical solutions have been applied to assess efficacy and reliability. Diathermy coagulation has proved to be the safest, fastest and the most effective. Follow-up has documented the absence of recurrence and good reepithelialization of the ureteral wall without progression to stricture. In those cases with single cyst, one-stage diathermy loop resection permits obtaining biopsy material and radical removal of the neoformation.

Carcinoma, Transitional Cell↗
PubMed1991

[Endoscopic surgery of bladder diverticula].

The most frequent method utilized in the treatment of bladder diverticula is by open surgery using the extravesical, transvesical or combined approach. The endoscopic techniques consisting of electrocoagulation of the diverticular mucosa alone (Orandi) or opening the diverticular neck by electroresection (Post-Vitale) constitute a therapeutic alternative not widely used to date. We have attempted to combine both techniques and, since 1985, we have treated 21 patients with bladder diverticula via the transurethral approach using the following technique: 1. The diverticular neck is opened wide by incision or electroresection. 2. Complete electrocoagulation of the diverticular mucosa. 3. Resolution of cervico-urethral obstruction by cervico-prostatic incision or electroresection of the prostate. We have achieved good results and no complications have been observed. Reduction of the diverticulum was not achieved in only one case. In our view, failure was due to the fact that treatment of the diverticulum had not been combined with prostate resection which the patient refused. The technique is described and the indications and possible complications are discussed. The results achieved by the authors indicate that this technique should be used more widely.

Cystoscopy↗
PubMed1989

[Biological tumor markers].

The classification of tumor markers can at present be only provisional since in this field new acquisitions are reported daily. Nevertheless, during the last few years, a number of monographs and chapters in oncology texts have become available for students and physicians in which certain parameters (sensitivity, specificity, predictive value of individual markers) are illustrated, thus allowing for a more accurate evaluation of their diagnostic efficacy and offering indications as to which of these markers are most useful in relation to the site of the tumor. Although tumor markers are present throughout the organism, the above review is limited to those found in blood. Clinical results obtained to far have already lead to the conclusion that tumor markers are useful above all for the diagnostic and therapeutic follow-up of patients rather than for the diagnosis of tumors. The present tendency is for the association of several markers since a higher percentage of positive results is achieved both for diagnostic purposes and for the detection of residual foci after apparently successful treatments and for the precocious detection of recurrences, as well as for the evaluation of the efficacy of ongoing therapies.

Adult↗
PubMed1982

[Use of hyperbaric oxygen therapy in a case of inguino-genital gangrene].

A case of inguinogenital gangrene in a 63 years old man is reported. The patient was admitted to the hyperbaric medicine centre in a serious general condition. The use of HOT, antibiotics and selective surgery as treatment of metabolic disturbances effectively improved the patient's general condition, and HOT also proved effective in the treatment of hepatic insufficiency.

Gangrene↗
PubMedDate not supplied

Low-dose oral clonidine as premedication before intraocular surgery in retrobulbar anesthesia.

PURPOSE: We investigated whether low-dosed oral clonidine premedication before elective intraocular surgery in retrobulbar anesthesia is effective in terms of anxiolysis, sedation, stable hemodynamics, lower intraocular pressure and perioperative endocrine stress response. METHODS: In a prospective, randomised, double-blind study, 44 patients scheduled for elective intraocular surgery received either 0.15 mg clonidine (n=22) or a matched placebo (n=22) orally 60 minutes before retrobulbar anesthesia. The main study parameters were sedation, anxiolysis, hemodynamics and intraocular pressure. Additionally, mediators of endocrine stress responses were measured five times, in 13 patients after clonidine and 12 after placebo. RESULTS: After clonidine 86% of the patients showed sedation and after placebo 90.9% showed no sedation (p<0.01). Clonidine produced effective anxiolysis (Erlanger-Anxiety-Scale: 31.6 +/- 2.6 points vs. 38.1 +/- 8.5 points) before the operation (p<0.01). Systolic blood pressure was significantly lower after clonidine. Effects on mean and diastolic blood pressure were small but statistically significant. Norepinephrine and cortisol plasma concentrations were significantly lower after clonidine. Intraocular pressure was significantly lower too (p<0.05). No clinically relevant adverse effects were observed e.g. inappropriate sedation, hypotension (<100 mmHg), bradycardia (<50 bpm) or hypoxemia (SpO2<90%). CONCLUSIONS: Oral low-dose clonidine produces light sedation, significant anxiolysis and stable hemodynamics, and attenuates the endocrine response to perioperative stress. Thus, clonidine seems sufficient to increase patient comfort for intraocular surgery and might even offer clinically worthwhile benefits such as stable hemodynamics and a reduced response to perioperative stress.

Administration, Oral↗