Biomedical subjects

E Gremmo

Publications and source records attributed to E Gremmo.

13 recordsLinked to original sources

PubMed1999

[Hemorrhagic complications during percutaneous nephrolithotomy. Retrospective studies of 772 cases].

OBJECTIVES: To evaluate the haemorrhagic complications of PCNL, to analyse their management and to identify predisposing factors. MATERIAL AND METHODS: Out of a series of 772 cases of PCNL, 18 patients developed severe haemorrhage requiring a haemostatis procedure (2.3%): 13 males and 5 females with a mean age of 57 years (38-79), and one case on a solitary kidney. The mean time to onset of haemorrhage was 18 days (--48 days). RESULTS: Three nephrectomies for haemostatis were performed at the beginning of our experience. Renal arteriography was performed in 15 patients and was abnormal in 13 patients, showing 3 arteriovenous fistulas, 8 false aneurysms, 3 arteriolar injuries. All these vascular abnormalities were successfully treated by highly selective embolization. In 2 cases, arteriography was normal with a spontaneously favourable course. Comparison of the 2 groups of PCNL, with haemorrhage versus without haemorrhage, failed to demonstrate any risk factors. CONCLUSION: Severe haemorrhage following PCNL is a rare complication, but impossible to predict. Selective embolization allows control of bleeding and currently constitutes the treatment of choice.

Adult↗

PubMed1997

Patient tolerance of transrectal ultrasound-guided biopsy of the prostate.

OBJECTIVES: To determine the acceptability by patients of ultrasound-guided prostatic biopsy without anaesthesia. PATIENTS AND METHODS: From January 1995 to January 1996, 81 patients in our department undergoing transrectal ultrasound-guided prostate biopsy were asked to assess the tolerability of the procedure using an immediate post-operative questionnaire including a 10 cm linear visual analogue scale (VAS). RESULTS: The mean VAS score was 3 (standard error 0.24) and 16% of the patients had a VAS score of > or = 5. Responses to the questionnaire showed that 6% of patients judged that the procedure should have been performed under general anaesthesia, while 19% would not agree to undergo it again without some form of anaesthesia. CONCLUSIONS: Even when anaesthesia-free, transrectal ultrasound-guided prostatic biopsy was felt to be only mildly uncomfortable by most patients, but 19% judged that it should be accompanied by some form of anaesthesia. Consequently, local anaesthetic techniques to enhance tolerance to this type of intervention without sacrificing the advantages of the current out-patient setting should be reassessed.

Aged↗

PubMed1995

[Simplified vesico-urethral anastomosis after radical retropubic prostatectomy for cancer. A preliminary comparative study].

The authors have done a prospective non randomized study to compare two methods of radical retropubic prostatectomy, without bladder neck preservation (Group 1 = 30 patients) or with bladder neck preservation (Group 2 = 15 patients). Anastomosis was simplified for the 15 patients with bladder neck preservation according to the Vest suture procedure. A comparative urodynamical study was performed with each group. Selection for one or the other technique was made by the personal choice or every surgeon. Results were similar for pre operative clinical staging, Gleason score with both groups. There was no significant difference in survival, progression of the disease and three month PSA level as those of the last follow-up visit (18-96 months). There was no difference between the 2 groups regarding operative time, blood loss, urethral catheterization time, drainage output and mean hospitalisation time. The only significant difference was the number of post operative transfused blood units in the Vest suture group (p < 0.001). There were no positive margin on the preserved bladder neck in group 2, even if there was finally an understaging or another apical positive margins. Complications were not significantly different in the two groups with 10 bladder neck strictures in the group 1 (33%) and only 2 in the group 2 (14.2%) (NS). Complete continence rate was 73.3% and 64.2% respectively (NS). Bladder neck incision was never followed by incontinence. On urodynamical study, 9 cases in each group were compared and both were similar but there was a tendency to a higher urethral pressure in group 2. Comments pointed out that bladder neck preservation and simplified Vest traction suture did not give more post operative nor carcinological complications than classical technique with direct separate stitches sutures. Disease progression, continence and bladder neck stricture rates were compared to literature. The urodynamical results were the same as those observed by others studies.

Aged↗

PubMed1995

[Multiple myeloma of the testis].

The testis is a rare site of multiple myeloma. The authors report such a case in a patient with a 7-year history of multiple myeloma. Transinguinal castration was performed. Six months after the operation, the patient did not have any other extramedullary sites, but the disease progressed rapidly with diffuse bone pain and end-stage renal failure. The diagnosis and management are discussed in the light of a review of the literature.

Humans↗

PubMed1994

[Vesico-urethral anastomosis after radical prostatectomy in cancer: Vest-Mayo's simplified technique].

The authors describe the technique of anastomosis without vesicourethral suture after radical prostatectomy for cancer. The operative details are described with a brief analysis of the principal complications observed in the first 14 patients operated with preservation of the bladder neck. These results are compared with the in the literature concerning this old technique recently revised by the Mayo Clinic surgical team in 1988.

Anastomosis, Surgical↗

PubMed1989

Microemulsions as topical delivery vehicles: ocular administration of timolol.

The topical administration of timolol as an ion-pair with octanoate was achieved by use of an oil-in-water microemulsion containing lecithin as a surfactant. The microemulsion, a solution of the ion-pair and a solution of timolol alone were instilled in the conjunctival sac of rabbits. A rapid method for the separation and determination of timolol in aqueous humour by HPTLC was used. The bioavailability of timolol from the microemulsion and the ion-pair solution was higher than that obtained from timolol alone. The areas under the curve for timolol in aqueous humour after administration of the microemulsion and the ion-pair solution were 3.5 and 4.2 times higher, respectively, than that observed after the administration of timolol alone.

Absorption↗

PubMed1987