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Biomedical subjects

F Sacco

Publications and source records attributed to F Sacco.

At least 19 recordsLinked to original sources
PubMed1996

[Unstable bladder and Sjögren syndrome. Clinical case].

A female patient developed severe detrusor instability years after a diagnosis of Sjogren syndrome. A common etiology could be possible if an association with viral demyelinization in Sjogren patients is confirmed. Vaginal Sicca syndrome was present and responded to a topical androgen-oestriol association with definite cytologic improvement. Anticholinergics were tolerated and moderately effective. Low initial dose were slowly increased (over three months) to avoid excessive mouth dryness and avoid gastrooesophageal symptoms.

Female↗
PubMed1993

[Ultrasonographic and urodynamic evaluation in stress incontinence].

Transvaginal sonography can show partial urinary penetration in the urethra in patients with no clinical incontinence. The Fluid Bridge Test-Pressure urodynamically demonstrates the same phenomenon. We compared these two technics in women with stress urinary incontinence (SUI). 49 patients underwent urodynamic testing and transvaginal sonography; 18 had SUI, 20 were asymptomatic postoperatively (Burch procedure) and 11 were normal controls. Urodynamics consisted of filling cystometry with saline (infusion speed: ml 70/min) using transurethral Foley catheter (n degree 14 Fr), and a profilometric-pressure Bard catheter (10 Fr); micturitional cystometry; uroflowmetry; clino- and orthostatic urethral pressure profile (UPP) (extraction speed: cm 0.5-1/sec; infusion speed: cm 1.2/min); sphincteric electromyography (EMG); FBT-P with the Bard catheter only. During extraction patients were requested to cough (stress condition). If the urethra is incompetent pressure is transmitted to the water column connected to the pressure transducer, and a "spike" is observed. A competent urethra shows little pressure variation. Ultrasound (US) equipment consisted in a General Electric (RT 3600) sonograph with an electronic transvaginal probe (7.5 MHz) inserted in a gel-lubricated condom. The probe was positioned in the vaginal vestibule in direct proximity to the urethra. Axial and coronal scannings were performed. Echo-imagings were submitted to "post-processing" on US recording equipment. Fluid penetration in the urethra was evident if iperchogenic "turbulence" was observed on playback of the dynamic sonogram on a videocassette recorder (VCR) connected to the sonograph. The SUI group shows leakage of water under stress without detrusorial activity and dynamic UPP with reduced transmission of abdominal pressure on the urethra.(ABSTRACT TRUNCATED AT 250 WORDS)

Electromyography↗
PubMed1993

[Comparison of methods for the diagnosis of urinary obstruction in women].

The International Continence Society does not offer secure guidelines for the diagnosis of micturitional obstruction. The problem has been extensively addressed in relation to male voiding difficulties. Little is known on the subject in female patients. Two criteria for the diagnosis of obstructed micturition are in clinical use. The Sussett formula divides the maximum micturitional pressure by the square of the corresponding maximum urinary flow rate. Two cutoffs, corresponding approximately to the 90th and 95th centiles can be used (0.15, and 0.5). A more complex graphic nomogram developed by Schafer plots maximum flow versus maximum detrusor pressure, identifying obstruction and detrusor dysfunction simultaneously according to the author. We feel that these methods, extensively tested on a male population, can both be used on a female population. We noticed that in some instances the results were different. 469 women referred for micturitional disturbances underwent pressure/flow studies. 62 (13.2%) were obstructed according to the Schafer nomogram, 103 (21.9%) and 31 (6.6%) respectively using the Sussett mathematical formula using two different cutoffs (0.15 and 0.5). The two methods identify the same patients only if micturitional pressures are normal (40 to 60 cmH2O) to high (over 60 cmH2O) and the Sussett formula is used with a higher (95th centile) cutoff. This means that both methods are clearly insufficient in the diagnosis of obstruction if detrusor function is impaired. This can happen in case of chronic retention due to detrusor failure after a long-standing obstruction or for primary failures due to central nervous system lesions. Extreme care should be exercised if pressure-flow studies indicate obstruction at low micturitional pressures.(ABSTRACT TRUNCATED AT 250 WORDS)

Algorithms↗
PubMed1993

[Acute urinary obstruction in pregnancy].

Five cases of acute urinary obstruction during pregnancy are presented. A complete urodynamic workup, including pressure-flow studies showed high micturitional pressures with little or no flow, with at least 60% residual urine. Filling cystometry, urethral profilometry (static and dynamic), pelvic electromyography were normal. Two cases were due to uterine pelvic incarceration. One of these cases happened very early during pregnancy, because of extensive fibroids. Any cause of abnormal uterine enlargement can lead to early obstruction. Three cases were associated with paraurethral abscess (skenitis in 2 cases, urethral diverticulum in 1). Manual reduction in case of pelvic incarceration or surgical draining and antibiotic therapy in case of abscess were effective in all cases. Immediate catheterization is possible and indicated as soon as urinary obstruction is diagnosed. This prevents neuromuscular dysfunction due to excessive bladder distention. The transurethral catheter might work as a stent, and periurethral surgical drainage is probably safer with a catheter in place. Suprapubic catheterization is probably less useful in this respect. An indwelling catheter removes any urgency in treatment. Voiding difficulties can persist for some days after surgical treatment. Urodynamic testing performed in all indicated acute micturitional obstruction. Anyway, it added little to the clinical understanding of the problem, which was obvious, and the Authors feel that extensive urodynamic testing should be limited to cases presenting with a complex preexisting dysfunction or performed after treatment if symptoms do not disappear completely. All clinically doubtful cases should likewise be investigated. If periurethral abscess or incarceration are evident, simple evaluation of residual urine percentage should be sufficient in establishing the diagnosis.

Acute Disease↗
PubMed1990

[Transvaginal estrogen therapy in urinary stress incontinence].

Thirty-four postmenopausal stress incontinence patients were divided in two groups: 17 were treated with 0.5 mg oestriol vaginal cream for 90 days, 17 controls were treated with moisturizing cream. All had low urethral pressures and dystrophy. Treated patients showed improvement of maximum urethral pressure, urethral closure pressure, and volume at first sensation of fullness. Dystrophy was cured in most patients; in 17% incontinence was cured and in 41% subjectively improved.

Estriol↗
PubMed1984

Platelet activation in patients with benign and malignant ovarian diseases.

Plasma concentration of beta-thromboglobulin (beta-TG) and platelet factor 4 (PF4) were measured by radioimmunoassay in 45 patients with benign and malignant ovarian diseases. All patients with ovarian carcinoma showed increased beta-TG and PF4 levels. Among benign ovarian diseases the patients with serous cystadenoma more frequently showed signs of platelet activation, whereas those with endometriotic cyst and mucinous cystadenoma generally had normal beta-TG and PF4 values. These results indicate that an increased platelet activation is consistently associated with malignant tumors of the ovary, whereas benign tumors show a different capacity to induce platelet activation.

Adult↗
PubMed1981

The treatment of 48 patients affected by ovarian carcinoma at stages III and IV F.I.G.O.

The Authors analyzed the treatment of 28 patients in stage III (FIGO) and 20 patients in stage IV affected by epithelial ovarian cancer. In these cases, surgery was based on the criterion of cytoreduction and, where possible, maximum radicality. Within a month from surgery, all patients underwent a program of combined chemotherapy (VCR + 5 FU + CTX) envisaging successive cycles, every four weeks. Minimal side effects were generally observed. 13/28 (46.4%) responses were recorded in stage III and 4/14 (28.6%) in stage IV. The highest percentage of responses, 80%, was obtained in patients with a residual tumor less than 2 cm, all belonging to stage III. Stage III and stage IV patients with a residual tumor greater than 2 cm responded in 45% and 33% of the cases respectively. Patients who underwent explorative laparotomy showed negligible responses. There was a statistically significant difference survival between stage III and stage IV patients (p less than 0.001), among patients with a similar residual tumor greater than 2 cm, but in different stages (p less than 0.05), and among stage III patients who responded or not to chemotherapy (p less than 0.001).

Adenocarcinoma, Mucinous↗
PubMed1981

Sertoli cell adenoma in Morris syndrome.

An unusually large Sertoli cell adenoma was detected in a patient with Morris syndrome and there is a description of the uncommon hormonal data found in this particular case which are not typical for this kind of neoplasia. The patient is alive and well at the present time which is now three years after surgical intervention.

Androgen-Insensitivity Syndrome↗
PubMed1981

Sertoli cell adenoma in Morris syndrome.

An unusually large Sertoli cell adenoma was detected in a patient with Morris syndrome and there is a description of the uncommon hormonal data found in this particular case which are not typical for this kind of neoplasia. The patient is alive and well at the present time which is now three years after surgical intervention.

Androgen-Insensitivity Syndrome↗
PubMed1981

Urinary diversion by ileal conduit in gynecologic oncology.

In the decade 1967-1977, 663 patients with different gynecologic neoplasms were admitted and treated at our Department. Because of the involvement of the urinary tract, urinary diversion was required in 41 cases. Ileal conduit was performed in 25 patients (20 affected by carcinoma of uterine cervix, 4 by adenocarcinoma of endometrium, 1 by carcinoma of vulva). In 19 patients such procedure was performed immediately after radical surgical therapy; in 6 patients ileal conduit was indicated because of post irradiation fistulas. Few complications were observed and all of them successfully cured. Authors conclude that Bricker operation is still an effective procedure in gynecologic oncology, both as a complement to radical surgery (in selected patients), and as a complementary treatment of recurrences and complications of radiation therapy.

Adenocarcinoma↗