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Biomedical subjects

E Piro

Publications and source records attributed to E Piro.

At least 19 recordsLinked to original sources

One-trocar transumbilical laparoscopic-assisted appendectomy in children: our experience.

The authors report their experience with one-trocar transumbilical laparoscopic assisted appendectomy (TULAA). From January 1998 to June 2000, 150 patients underwent appendectomy using this technique. Ages ranged from 2.5 to 17.4 years. The procedure was completed using only one trocar in 116 cases (77.3%); in 28 patients (18.7%) one or two additional cannulas were needed. Conversion to open surgery became necessary in 6 cases (4%). Mean operative time was 35 minutes, mean hospital stay 3.5 days. There were no major complications and no mortality in this series. The advantages of a one-trocar appendectomy compared with open surgery are the same as those reported for conventional laparoscopic appendectomy: i.e., excellent exploration of the abdominal cavity, the possibility of discovering extra-appendiceal lesions, easy and rapid localization of the appendix and a shorter hospital stay. The additional advantages of TULAA compared with conventional laparoscopic appendectomy are a low rate of intraoperative incidents, minimal scarring, less postoperative pain and a more rapid return to unrestricted activities.

Acute Disease↗

Kabuki make-up (Niikawa-Kuroki) syndrome: clinical and radiological observations in two Sicilian children.

The Authors describe two patients aged 5 and 8, a female and a male, affected by a condition of polymalformations known as Kabuki make-up or Niikawa-Kuroki syndrome, having a neonatal incidence of 1:32,000 in Japan. There are two hypothesis about the apparent rarity of the syndrome in the rest of the world, including the Asian Continent: the first is that it exists, but is infrequently recognized outside Japan and the second is that it is really more frequent in those parts of the world, where ethnic exchanges are uncommon, as it happens in Japan.

Abnormalities, Multiple↗

Growth charts of Down syndrome in Sicily: evaluation of 382 children 0-14 years of age.

We present the results of a study performed on a Sicilian population of children with Down syndrome (DS) 0-14 years of age, observed between 1977 and 1988. Data from the present report concern 382 subjects with nonmosaic 21 trisomy, including 239 males (62.6%) and 143 females (37.4%). We excluded all DS children observed in the same period with associated pathology (congenital heart defects, gastrointestinal malformations, malabsorption, hypothyroidism, and thalassemia). Overall, 1,464 measurements were performed of length or height, weight, and head circumference. Means and standard deviation (SD) were calculated for all of these parameters. Our data confirm a trend toward a progressive improvement of growth in children with DS, as shown in other recent reports. The purpose of this study was also to create a "normal growth pattern" useful to evaluate DS children and also to diagnose early pathologic conditions affecting growth, such as autoimmune diseases.

Adolescent↗

[Use of mini-laparoscopy in intraoperative diagnosis of contralateral inguinal hernia in children].

Laparoscopy has been considered by some Workers an useful means of diagnosing patent processus vaginalis in children. This technique is effective in evaluating patency of contralateral internal inguinal ring and requires only five minutes of additional operative time to elective inguinal herniorrhaphy. The Authors report their experience with fifty-six children to whom this procedure was offered. Their age ranged from three to ten years--mean 6.5 years-. Congenital unilateral hernia was right-sided in eighteen and left-sided in thirty-eight patients. Overall, the contralateral processus vaginalis was patent in 44.6%, with 27.7% and 52.2% patency on the nonclinical right and left sides, respectively. Low abdominal pressure-insufflation with CO2 to a pressure of 4 mmHg and shortened operative time have permitted to avoid endotracheal intubation. We confirm great utility of laparoscopic examination in determining the need for contralateral inguinal exploration in pediatric patients.

Child↗

[The follow-up of malformation uropathies diagnosed "in utero"].

Prenatal diagnosis and postnatal follow-up of urinary tract congenital malformations are discussed. Among 9501 overall births, 25 newborns with urinary tract congenital malformations were born (2.6 x 1,000). Twenty cases had been diagnosed "in utero" by ultrasound scan (4 cases of Potter sequence, 2 cases of prune-belly anomaly, 3 cases of polymalformed infants with urinary involvement, 10 cases of hydronephrosis, 1 case of ectopic kidney). In 8 newborns a surgical treatment was successfully performed. Eight newborns died and in other 4 cases clinical and ultrasonographic are not yet fulfilled. In 2 cases the prenatal diagnosis of urinary tract malformations was not confirmed by the postnatal evaluation. Our experience shows that the prenatal diagnosis of congenital malformations of urinary tract is particularly useful, even considering the opportunities of perinatal management and postnatal surgical treatment in several cases.

Abnormalities, Multiple↗

[Congenital megacystis in a female fetus. Case report].

The Authors report a case of congenital megacystis without other anomalies, diagnosed in a 27GW female fetus. At prenatal counselling the diagnostic hypothesis formulated were obstructive uropathy (cloacal malformation, uro-genital sinus, urethral atresia), functional alteration (neurogenic bladder, primitive myopathies) or Prune Belly Syndrome (rare in females). The outcome following treatment suppose a visceral myopathy, for this condition, however definitive etiology is obscure.

Counseling↗

[Changes in the incidence of coronary vasculopathy in the Cosentina hospital population in the 3-year periods of 1950-52, 1956-58, 1963-65, 1966-68, 1969-71].

The incidence of admissions for coronary disease in relation to age, sex, diet, occupation and place of origin was examined for five 3-yr periods ('50-'52, '56-'58, '63-'65, '66-'68, and '69-'71). There was a marked increase in admissions and a greater incidence among middle-aged subjects and males. The percent frequency differences between urban and montane districts noted in the fifties were less apparent later in the last three-year period.

Adult↗

[Use of radionuclides in the evaluation of intestinal transit time in children with idiopathic constipation].

Colonic transit times, in patients with chronic idiopathic constipation, in the past were estimated using radiopaque markers. Currently they are evaluated with colonic scintigraphy, which employs 111In DTPA orally, added to the usual children's breakfast in a 0.05 mCi dose. Anterior views of the abdomen are obtained at 6th, 24th, 30th, 48th, 54th, 72nd hour using a gamma camera on a 128 x 128 matrix and stored on hard disk. These images are processed in successive times, and the colon is divided in three main segments: right-, left- and recto-sigmoid-colon. Total and segmental percentage retentions are evaluated in each interval time. 58 children (35 males and 23 females), aged 1-12 years (mean 8.13), referred for chronic idiopathic constipation at Pediatric Surgery Department of Siena, were studied between January 1990 and September 1996. This group was compared with a control group formed by 15 patients (9 males and 6 females) aged 3-14 years (mean 8.53). Cutoff values, obtained in this control group, allowed us to distinguish, among the 58 children with idiopathic constipation, 6 symptomatic patients with normal colonic transit times and 52 symptomatic patients with pathologic ones. In this last group the evaluation of segmentary colonic transit times allowed us to identify 13 patients (25%) with increased right colonic transit time, 19 (36.5%) with increased left colonic transit time and 20 (38.5%) with increased recto-sigmoidal colonic transit time. Statistical survey allowed to distinguish significantly pathological subjects from control group ones.

Adolescent↗