Biomedical subjects
C Pesce
Publications and source records attributed to C Pesce.
[New cases of the subclavian steal syndrome].
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[Angiosarcoma of the heart. Report of a case].
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[Bronchial leiomyoma. Case report].
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[Medullary sponge kidney with severe renal function impairment: a case report].
The term medullary sponge kidney refers as a renal parenchymal malformation characterized by cystic dilatation of the collecting ducts. Although medullary sponge kidney is a congenital disease, it is rarely identified in childhood and is usually discovered in adulthood. We report a child with bilateral medullary sponge kidney who, in addition to typical urographic findings, presented an unfavorable evolution that ended in renal chronic insufficiency. This outlook is uncommon and is described in only 10% of affected subjects.
[Varicocele in childhood and adolescence and other testicular anomalies: an epidemiological study].
Although in the last years varicocele has being recognized with increasing frequency in the adolescents, it is still neglected in pediatric age. Recently several epidemiologic studies revealed an increasing incidence of varicocele in patients between 10 and 16 years, as high at the end of puberty as that of the adult male population. Our study has been carried out on 9861 students, aged between 11 and 18 years, in order to evaluate the effective incidence of the varicocele in pediatric and adolescent age and, at the same time, disclose other possible testicular anomalies in so called "normal" boys. Our study showed that the incidence of varicocele is related to sexual maturation and is time-related with a final incidence of 16%. Left testicular hypotrophy is rather common in primary varicocele and is also time and grade related. Cryptorchidism has been found in 2% of the examined students; 0.4% of them have not been yet operated on. We have been able to discover a rather high incidence of retractile testes (4.7%), always associated with testicular hypotrophy. Finally 7.5% of our examined students presented an unilateral testicular hypotrophy (volume less than 30% of the contralateral normal testis) in complete absence of local pathology.
[Cryptorchidism and fertility: an assessment in adulthood].
Impairment of fertility rate has been found to be associated with cryptorchidism. In this study we assessed the fertility of 172 adult subjects with unilateral and bilateral cryptorchidism who underwent surgical correction in pediatric age. Fertility has been evaluated by sperm analysis. Moreover test of function of spermatozoa membrane (swelling-test) and the research of antisperm antibodies (spermmar test) were carried out. The report presents data demonstrating that the fertility rate in patients with bilateral cryptorchidism is markedly reduced if compared with subjects affected by unilateral cryptorchidism. Azoospermia is present in 18% of bilateral cryptorchids. The timing of surgery and the anatomical position of the cryptorchid testes do not seem to affect the fertility rate.
[Mesenteric lymphangioma: report of a case].
Lymphangiomas are benign tumours that appears to arise from congenital malformation of the lymphatics. They are most commonly reported in the head and neck regions. The clinical presentation, diagnosis and treatment of a rare case of mesenteric lymphangiomas are reviewed. Ultrasound and computed tomography are most useful in the intraabdominal cystic lesions for confirming the diagnosis. Intestinal and mesenteric resection, as soon as diagnosis is established, is the procedure of choice and results in an excellent outcome.
[True hermaphroditism in crossed testicular ectopy: report of a case].
Crossed testicular ectopia is a congenital anomaly characterized by the presence of both testes in the same hemiscrotum and may be associated in 20% of the cases with genitourinary developmental abnormalities. This review underscores the complexities of assessment and surgical management of an uncommon case in which crossed testicular ectopia and true hermaphroditism are simultaneously described.
[Spontaneous and traumatic rupture of the renal parenchyma in primary obstructive megaureter: a report of 2 cases].
Urinary extravasation in infants may occur secondary to a variety of congenital obstructive uropathic conditions. This condition has been reported most often in infants with posterior urethral valves and pelviureteral junction obstruction. We present two cases of perirenal urinary extravasation from the kidney due to primary obstructive megaureter. Clinical presentation, evaluation and treatment of this rare entity are discussed.
[Symptomatic renal candidiasis with multiple mycetomas: a case report].
Candida albicans is the most prevalent and pathogenic fungal infection of the urinary tract. Although fungal urinary tract infection occur less frequently than bacterial infections, their incidence has increased during the last decades. Parenteral nutrition, corticosteroids, immunosuppressive drugs and prolonged antibiotic therapy are often predisposing factors. We report a case of renal pelvic fungus balls in a 6-month old female who developed candidal infection after surgical treatment for bilateral vesico-ureteric reflux; the renal candidiasis was treated successfully with fluconazole.
[Cryptorchidism and fertility: evaluation in adult age].
Impairment of fertility rate has been found to be associated with cryptorchidism. In this study we assessed the fertility of 172 adult subjects with unilateral and bilateral cryptorchidism who underwent surgical correction in pediatric age. Fertility has been evaluated by sperm analysis. Moreover test of function of spermatozoa membrane (swelling-test) and the research of antisperm antibodies (spermmar test) were carried out. The report presents data demonstrating that the fertility rate in patients with bilateral cryptorchidism is markedly reduced if compared with subjects affected by unilateral cryptorchidism. Azoospermia is present in 18% of bilateral cryptorchidism. The timing of surgery and the anatomical position of the cryptorchid testes do not seem to affect the fertility rate.
[Non-palpable testis: modern diagnostic and therapeutic trends].
Management of the nonpalpable testis is controversial and can be difficult as shown by the multiple modalities for evaluation and proposed treatment. In our opinion, laparoscopy is the ideal first step in the management of patients with a nonpalpable testis, having a great reliability in locating or confirming absence of an occult testis. Accurate preoperative assessment and localization will assist in selecting the appropriate surgical approach either laparoscopic, laparoscopic-assisted, or open procedure. Laparoscopy was performed on 74 patients with 86 nonpalpable testis. The technique has been demonstrated to be extremely safe and lead to diagnosis in 100% of cases. Surgical management of nonpalpable testis was directly performed by laparoscopy identifying intra-abdominal vanishing testis and locating an intra-abdominal or inguinal testis. The two-stage Fowler-Stephens orchiopexy was performed in 41 patients. The first stage consisted of laparoscopic clip ligation of the spermatic vessels. Of these, 32 underwent the second stage by vas-based orchiopexy; all testes, but one, showed a normal size and consistency. To conclude, we advocate the use of laparoscopy in all boys with nonpalpable testis.
[Severe chronic constipation: limitations of medical therapy and indications for surgical intervention. II].
Severe chronic constipation is a common problem in children. Most patients have functional constipation, only few (approximately 5%) have an underlying organic disease who requires surgical treatment. Anatomic problems with a painful defecation (anal rhagades, fistulas, hemorrhoids) or with difficult defecation (anal stenosis, tumor) require only a careful physical examination. Other organic problems due to neurogenic and myogenic colonic abnormalities require extensive investigations, including histological and histochemical study, for diagnosis. Ultrashort Hirschprung's disease, neuronal intestinal dysplasia type B and hypoganglionosis represent different levels of a developmental problem of the enteric nervous system. Surgical treatment is recommended in these cases. After surgery is recommended a long period of medical treatment to avoid a functional constipation.
[Progress in the surgical treatment of congenital and acquired broncho-pulmonary pathology].
Surgery is the cornerstone in the management of congenital bronchopulmonary diseases. This term include a wide spectrum of malformative anomalies subdivided clinically into cystic and solid lesions. Bronchogenic cyst (BC), cystic adenomatoid malformation (CAM) and congenital lobar overinflation (CLO) are congenital cystic lesions. Pulmonary sequestration (PS) and pulmonary arteriovenous malformation (PAM) are congenital solid lesions. As a group, congenital bronchopulmonary diseases require removal in order to reduce potentially life-threatening infection and respiratory distress. Bronchopulmonary infections and neoplasms constitutes acquired bronchopulmonary diseases. Improvement in antibiotic therapy has reduced the place of surgery in the current treatment of bronchopulmonary infections. At present, the failure of medical therapy and the appearance of complications are the most common indications for operative treatment. Although these problems are not as common now, at times they required surgical intervention. Finally bronchopulmonary neoplasms are unusual in the pediatric age group. As a result, experience with the diagnosis, management and prognosis is limited. However, the complete surgical resection offers the best chance for survival in the large majority of cases.
[Primary omental torsion in children: report of 2 cases and review of the literature].
The primary torsion of the omentum is a rare cause of acute abdomen. The clinic features may mimic closely acute appendicitis, with acute onset of right lower quadrant pain. The Authors, after reporting two cases recently observed, discuss the aetiopathogenetic aspects, point out the problems of diagnosis and finally suggest the most correct surgical approach.
[The non-palpable testis: modern diagnostic and therapeutic approaches].
Management of the nonpalpable testis is controversial and can be difficult as shown by the multiple modalities for evaluation and proposed treatment. In our opinion, laparoscopy is the ideal first step in the management of patients with a nonpalpable testis, having a great reliability in locating or confirming absence of an occult testis. Accurate preoperative assessment and localization will assist in selecting the appropriate surgical approach either laparoscopic, laparoscopic-assisted, or open procedure. Laparoscopy was performed on 74 patients with 86 nonpalpable testis. The technique has been demonstrated to be extremely safe and lead to diagnosis in 100% of cases. Surgical management of nonpalpable testis was directly performed by laparoscopy identifying intra-abdominal vanishing testis and locating an intra-abdominal or inguinal testis. The two-stage Fowler-Stephens orchiopexy was performed in 41 patients. The first stage consisted of laparoscopic clip ligation of the spermatic vessels. Of these, 32 underwent the second stage by vas-based orchiopexy; all testes, but-one, showed a normal size and consistency. To conclude, we advocate the use of laparoscopy in all boys with nonpalpable testis.