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Biomedical subjects

F Ferro

Publications and source records attributed to F Ferro.

At least 55 records · Page 3Linked to original sources

The gliding testis: minor degree of true undescended testis?

The gliding testis is located below the external ring; it can be manipulated to the upper scrotum but tends to ascend to its original position. Histologic changes can be detected in these gonads by 7 years of age. We evaluated 427 consecutive prepubertal boys referred for cryptorchidism. One hundred and twenty-three had classical undescended testes: 71 ectopic, 55 retractile, and 178 (mean age 6 yrs. 2 mos.) gliding testes. The gliding testes were smaller than controlaterals in 24% of boys. All gliding testes were unilateral, whereas bilaterality was 85% in the retractile group (P < 0.0001), 17.5% in the undescended (P < 0.001), and 10% in the ectopic group (P < 0.01). There was a history of one or more of the following conditions: orchidopexy (3), hormonal treatment (5) late testicular descent (9), spermatic cord torsion (5), testicular pain (10), actual retractile testes (20) or actual gliding testis (58), was present in 93 (52.2%) of the fathers of the gliding group. Forty-seven (81%) paternal gliding testes were hypotrophic. Seventy-five boys with gliding testis underwent initial hormonal therapy with transient benefit, and 57 were operated on. Two anatomical findings are typical of the gliding testis: (i) the absence of the gubernaculum, and (ii), a processus vaginalis partially patent from the upper scrotum to the mid groin area. This latter feature explains the mobility of the gliding testis from the external ring to the upper scrotum. The absence of the gubernaculum may be responsible for a higher incidence of spermatic cord torsion in this population.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗

Prenatal diagnosis and clinical outcome of ovarian cysts.

Technical refinements of ultrasound (US) have greatly affected the antenatal diagnosis and treatment of ovarian cysts. From 1985 to 1990 25 consecutive fetuses with ovarian cysts were followed-up by US both during pregnancy and postnatally. All cases were diagnosed between the 28th and 39th weeks of gestation. Deliveries were all at term; cesarean section was required only for obstetric complications. Eight fetuses (32%) showed US patterns of cyst torsion, a finding confirmed at surgery in all. In five patients US patterns suggested complications postnatally that were also confirmed at operation. In six cases cysts increased or remained unchanged in size after 15 days of life: in 50% of these surgery showed ovarian torsion. In the remaining six cases spontaneous resolution occurred within 1 to 4 months. One patient required intrauterine needle aspiration. There were two cases of intestinal obstruction. To date, more than 60% of newborns with ovarian cysts require oophorectomy; however, different treatments (cystectomy, needle aspiration, uncapping) combined with a close US follow-up are likely to reduce this percentage.

Female↗

Prevalence of HTLV infection in the Dominican Republic: association with neurological disease.

The presence of the human T-cell leukemia virus (HTLV) in Dominican blood donors and patients with tropical spastic paraparesis (TSP) was first detected in 1987. To define further the seroprevalence in the country, nearly 4,000 samples from high- and low-risk populations, as well as patients with neurological disease and with leukemia or lymphoma were tested for HTLV antibodies. A 1-2% seropositivity rate was found among the low-risk population, a 2-5% in the high-risk, and at least 87% in those with TSP. A few patients with malignancy also had antibodies to HTLV. An increase in seropositivity with age and a predominance of female seropositive individuals were found. Infectious virus was isolated from TSP patients, prostitutes, and family members of index patients. These data indicate the substantial level of HTLV infection in another Caribbean country and its relation to neurologic disease.

Adolescent↗

Impact of primary surgical approach in the management of the impalpable testis.

There is no univoque opinion about the place of preoperative studies in non-palpable testes. During a 6.5-year period, we operated on 296 impalpable testes in prepubertal boys. A combined inguinal-abdominal approach was used in all cases verifying the eventual abdominal testis and its exact vascular anatomy before any manipulation of the cord was undertaken. Forty-five testes (15.2%) were canalicular, 142 (48%) were abdominal, 5 (1.7%) dysgenetic and 104 (34.1%) absent (agenesis or vanishing testis). Of the abdominal testes, 122 underwent a standard orchidopexy in dartos pouch, 11 a staged repair, 8 a Fowler-Stephens operation and 1 orchiectomy. All means of investigation for impalpable testes are either unreliable, too expensive or too invasive for routine use, and in most cases, a surgical exploration has to be performed anyway. The primary surgical approach has the most favorable cost/benefit ratio, being diagnostic and therapeutic at one time. Provided the exploration is performed correctly, all the advantages of previous laparoscopy can be achieved with surgery alone.

Adolescent↗

Testicular prosthesis in children: a simplified insertion technique.

A simplified technique for testicular prosthesis insertion in children is presented. The prosthetic testicle is inserted through an inguinal incision and slid into the scrotum. It is kept in position by closing the scrotal entrance with one suture applied through a small skin incision at the scrotal root. This technique has proved to be safe and reliable with regard to extrusions and migrations of the prostheses, as well as other complications.

Child↗

Frequent isolation of HHV-6 from saliva and high seroprevalence of the virus in the population.

Human herpesvirus-6 (HHV-6) was recovered at high frequency (greater than 85%) from the saliva of both healthy individuals and those infected with the human immunodeficiency virus (HIV). The level of isolation mirrored the high prevalence of antibodies to HHV-6 found in sera obtained from residents of diverse areas of the world. Seroconversion occurred between 1 and 3 years of age; seroprevalence ranged between 80% and 100% among adults under 40 and decreased to 35% between ages 62 and 88. Serum titres in healthy individuals remained stable during periods of virus shedding. Immune cellular dysfunction in patients was associated with high geometric mean HHV-6 antibody titres. These observations suggest that HHV-6 infection takes place within the first 3 years of life, and strongly implicate oral shedding as a common means of transmission of this newly described herpesvirus.

Acquired Immunodeficiency Syndrome↗

Characterization of a new strain of HHV-6 (HHV-6SF) recovered from the saliva of an HIV-infected individual.

An isolate of the human herpesvirus-6 (HHV-6SF) recovered from the saliva of an HIV-infected individual differs in its cellular host range and certain genomic properties from other HHV-6 strains described. HHV-6SF replicates in adult peripheral blood mononuclear cells (PMC) substantially better than in fetal cord blood PMC and can be grown only in the MT-4 established T cell line. It preferentially infects CD4+ lymphocytes but can replicate in CD8+ cells and peripheral blood macrophages. It also infects neuroblastoma cells and cell lines derived from the gastrointestinal tract. These latter results suggest that this herpesvirus could play a role in disorders affecting these tissues. Finally, the restriction enzyme pattern of HHV-6SF differs from that of other HHV-6 strains. The identification of this distinct HHV-6 strain could indicate an unusual biologic variation among viral isolates thus far not observed with other herpesviruses.

Acquired Immunodeficiency Syndrome↗

[Epidermoid cyst of the spleen in a newborn infant. Prenatal diagnosis and partial splenectomy].

Non parasitic splenic cysts are an uncommon clinical and pathologic entities, out of these, epitelias splenic cysts (ESC) occurred in 10% of cases. Until recently the treatment of choice for the large ESC consisted of splenectomy. Splenic preservation, for avoiding risks of sepsis, is a modern concept uniformly accepted for treating childhood splenic injury and benign pathology. The Authors report a case of prenatal diagnosis of large left upper quadrant mass that was apparent at Ultrasonography (US) at 32th week of gestational age. Laparotomy at 3rd day of life: a large cyst splenic mass was found (7 x 7 cm), it was situated all in lower pole. Partial splenectomy was performed; cysts were not found in other organs. Histology of specimen: ESC. The postoperative course was uneventful. Postoperative (6 months) Scintigraphy demonstrated the good vascularization of the spleen.

Epidermal Cyst↗

[Evaluation of esophageal involvement by pHmetry in patients with progressive systemic sclerosis].

The authors studied 16 patients with progressive systemic sclerosis to whom it was performed ph-metry, acid clearance and oesophageal electromanometry, compared the results with a control group of 20 patients. The oesophageal basal ph showed significative difference (p greater than 0.001) at the same as acid clearance (p greater than 0.01). It was not found correlation between the manometric alterations and acid clearance changes. (F 5%); at same as the last one and the clinical evolution period. (r = 0.16). Gastroesophageal reflux was positive in all the patients. The authors considered that intra-esophageal ph-metry and acid clearance was two methods with high sensibility to evaluate the oesophageal deterioration in systemic disease.

Adult↗

Endoscopic injection sclerosis of oesophageal varices in children--indications and techniques.

Endoscopic injection sclerosis (EIS) of oesophageal varices is a valuable alternative treatment of recurrent variceal haemorrhage in childhood, since derivative treatment is not always possible; the spontaneous regression of varices occurring in some cases could also be promoted by EIS. A modified technique using a specially designed silicone rubber tube around the pediatric-type fiberscope in order to compress the injected varix is described. Eight children aged between 15 months and 12 years were treated with this method and 2 to 4 varices were sclerosed at each procedure using the Olympus NM3K injector. A constant reduction of the volume of the treated varices was observed, and the risks of variceal bleeding diminished significantly.

Child↗

Renal vein thrombosis and adrenal hemorrhage in the newborn: ultrasound evaluation of 4 cases.

Renal vein thrombosis and adrenal hemorrhage can both be encountered in the neonatal period and they may occur at the same time. Inferior vena cava thrombosis can complicate some cases. These diseases can be easily diagnosed by means of ultrasound. The authors present 4 cases in which newborns were affected by renal vein thrombosis associated with adrenal hemorrhage and caval thrombosis, evaluated by means of ultrasound. The echographic aspect of renal, adrenal and caval involvement is described.

Adrenal Gland Diseases↗

Antisperm antibodies in young boys.

The authors report the results of antisperm antibody tests carried out on a group of 159 pre-pubertal boys suffering from various testicular pathologies. The data show that 21% of the patients' sera showed antibody activity against antigens on the sperm of healthy fertile donors. None of the control sera was ASA positive. Some differences were observed in pathology and age distribution of positivity.

Adolescent↗

Role of prenatal diagnosis in the treatment of congenital obstructive megaureter in a solitary kidney.

Congenital megaureter in a solitary kidney (CMSK) is a life-threatening disease. From January 1988 to December 1993, we treated 9 patients for CMSK (2 cases with unilateral renal dysplasia and 7 with unilateral renal agenesis). In 7 cases, the malformation was detected by prenatal ultrasonography and urological counseling. The ages at first postnatal observation ranged from 24 h to 5 years (mean = 8 months). The postnatal urological workup included: serum renal function screening, urinary system ultrasonography, a micturition cystogram, intravenous pyelography and a nuclear renal scan. The therapy of choice was decided on the basis of renal function. One emergency divertive procedure was performed after birth, in 3 cases of renal failure in the first 2 weeks of life. The remaining cases were operated electively at an average age of 20 months. In 2 cases that underwent delayed surgical elective correction and in 1 of the 3 cases that underwent an emergency diversion, some degree of renal failure still persists. In our opinion, prenatal diagnosis, accurate postnatal urological workup and strict postoperative follow-up are fundamental to avoid the devastating consequences of CMSK on the affected child.

Female↗