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D Pode

Publications and source records attributed to D Pode.

64 records · Page 4Linked to original sources

Diagnosis and management of renal angiomyolipoma.

Renal angiomyolipoma (hamartoma) is an uncommon benign tumor of the kidney. Although about 400 cases of renal angiomyolipoma have been reported, it still causes difficulties in diagnosis and treatment. Until a few years ago it was almost impossible to arrive at a correct diagnosis preoperatively, and most of the cases underwent nephrectomy with the wrong diagnosis of renal carcinoma. More recently, abdominal computerized tomography and renal sonography have made it possible to reach the correct preoperative diagnosis in many cases, and thus to avoid unnecessary nephrectomies. We report on our experience with 13 cases of renal angiomyolipoma, and our conservative approach in a number of cases, which has enabled us to preserve renal tissue and function.

Adolescent↗

Serum lactic dehydrogenase: a tumor marker of ovarian dysgerminoma in a female pseudohermaphrodite.

A case of a female pseudohermaphrodite who presented with a large ovarian dysgerminoma is reported. Preoperatively, markedly elevated levels of serum lactic dehydrogenase (LDH) were noted. After complete excision of the tumor, serum levels of LDH returned to normal levels. Only five other cases of dysgerminoma with elevated serum LDH have been reported. In each case, as in the present one, LDH levels were significantly higher than in any other ovarian tumor. LDH can be considered as an enzymatic tumor marker of ovarian dysgerminoma, for diagnosis, prognosis, and surveillance.

Adult↗

A simplified method for repeated nasotracheal suction.

The use of a Tiemann curved tip urethral catheter for repeated nasotracheal suction in 120 instances of postoperative pulmonary complications was proved to be more efficient than the use of a regular suction catheter. The curved tip is better adapted to the anatomy of the nasotracheobronchial tract and allows easy selective catheterization of the trachea and major bronchi.

Catheterization↗

Busulfan-induced hemorrhagic cystitis.

We report a case of severe hemorrhagic cystitis induced by prolonged busulfan therapy. The clinical course and pathological results were similar to irradiation and cyclophosphamide cystitis. Only 1 such case has been described previously. Although hemorrhagic cystitis induced by busulfan is a rare complication it should be considered in the differential diagnosis and busulfan should be discontinued immediately.

Adult↗

Colonic complications of ventriculoperitoneal shunts.

Late perforation of the large bowel by the abdominal catheter of a ventriculoperitoneal (VP) shunt is extremely rare. Four of the five reported patients subsequently died. We report here three patients who presented with this complication and were treated successfully. Bowel perforation by a VP shunt catheter should be considered when a shunt infection is secondary to gram-negative enteric organisms. It can occur without evidence of peritonitis, and the abdominal catheter can be removed percutaneously, thus avoiding a laparotomy.

Bacterial Infections↗

Percutaneous nephrostomy for assessment of functional recovery of obstructed kidneys.

The use of percutaneous nephrostomy to evaluate the recoverability of function of the obstructed kidney is described and examined as a practical clinical method. Long-term drainage was used to assess the functional status of four kidneys and found to be of great value. The use of percutaneous nephrostomy to evaluate function has been mentioned previously but has not become established. In view of inaccuracy of other methods of assessment, we consider percutaneous nephrostomy to be the most accurate predictive test available today and suggest criteria for its use.

Adolescent↗

Screening for prostate cancer.

In an attempt to detect prostate cancer when the tumor is still confined to the prostate, a screening program was established. We studied the efficacy of digital rectal examination (DRE) and serum prostate-specific antigen (PSA) in the early detection of prostate cancer. One thousand men aged 50-75 years underwent DRE and serum PSA determination. Transrectal ultrasound-guided biopsies were obtained in each case of a suspicious DRE. Six systematic biopsies were performed if the PSA level was > 10 ng/ml, even if DRE and transrectal ultrasonography revealed no areas suspicious of cancer. A suspicious DRE was noted in 11.5% of the subjects; 16% had elevated levels of serum PSA (> 4 ng/ml) and 3.9% had serum PSA > 10 ng/ml. Biopsies were obtained from 90 patients, of which 31 were positive for prostate cancer. The cancer detection rate was 2.2% for DRE, 2.0% for PSA > 10 ng/ml, and 3.1% for the two methods combined. Clinical staging revealed that in 29 of the 31 patients with prostate cancer, the tumor was confined to the prostate: Stage A in 9 cases and stage B in 20 cases. Only two patients had clinically advanced cancer, and 22 patients underwent radical prostatectomy. Pathological examination disclosed biologically significant tumors in 91% of the cases in terms of tumor volume and grade. Although there is little evidence that screening will result in the reduction of the disease-specific mortality rate, early detection of prostate cancer by DRE, serum PSA, and transrectal ultrasound should be encouraged.

Aged↗