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Biomedical subjects

G Menardi

Publications and source records attributed to G Menardi.

At least 19 recordsLinked to original sources
PubMed1992

Occurrence of suppurative lymphadenitis after a change of BCG vaccine.

BCG vaccines are the oldest vaccines in use today, but the protective effect of the vaccination is still controversial. The risk of contracting tuberculosis is low compared with the possible complications after this vaccination. In Austria the formerly used BCG vaccine was not available in the required amount and another vaccine was released by the drug authorities. This product, with a more virulent strain, was used between August and December 1990, and this increased the incidence of complications. Eighty four of 1950 vaccinated newborn babies developed severe suppurative lymphadenitis three to 28 weeks after the vaccination, and surgical treatment was found to be necessary. Isoniazid treatment did not prove to be successful when the lymph node exceeded a certain size. Culture was successful in 46% up to week 20; after 20 weeks no culture became positive. All cultured bacteria were isoniazid sensitive. The question of general vaccination is raised and several points were considered before we came to the conclusion that except for high risk groups a general vaccination programme for neonates is not justified in Western countries.

Austria↗
PubMed1992

Prevalence of HCV antibodies in a uraemic population undergoing maintenance dialysis therapy and in the staff members of the dialysis unit.

We studied, by both 1st and 2nd generation assay, the prevalence rate of HCVAb in a population of 141 dialysis patients, 37 transplanted patients and 55 staff members. From this study emerges a higher sensitivity of the 2nd generation HCVAb test (15.38 versus 36.79% of positive responses, respectively), and a significant positive correlation between lengths of dialysis period. We have not found a significant difference between HCVAb-positive and -negative patients in relation to the blood transfusions. None of the 21 CAPD patients (home dialysis) resulted positive, even if transfused. Two nurses were positive. In our experience, the environmental factor seems more important. Since the isolation of the positive patients is an effective but not feasible measure, it is necessary to improve the operating management of the hemodialysis sessions, avoiding any contact between patients via material (instrumentation, monitors) and teaching the staff members to use severe preventive standards with all hemodialysis patients.

Cross Infection↗
PubMed1991

The morphometric histopathology of undescended testes and testes associated with incarcerated inguinal hernia: a comparative study.

The underlying injury to undescended testes may be hormonal, a transient perinatal form fruste of hypogonadotropic hypogonadism characterized by blunting of the surge in gonadotropins normally seen at age 60 to 90 days. Ischemia is the underlying injury to testes associated with incarcerated inguinal hernias. To determine if the histopathology of these 2 injuries is different histomorphometric analyses were performed on semithin microscopic sections of biopsies of 21 control testes, 17 undescended testes and 13 intrascrotal testes associated with incarcerated inguinal hernias. The infants in all groups were 30 to 120 days old. The results showed that, as in previous studies, undescended testes at this age are characterized by hypoplasia of Leydig cells, normal germ cell counts and defective maturation of gonocytes into adult dark spermatogonia. In contrast, testes associated with incarcerated inguinal hernias were characterized by hyperplasia of Leydig cells, reduced germ cell counts and normal maturation of gonocytes into adult dark spermatogonia. One might conclude that the underlying injury of undescended testes, presumably the blunted surge of gonadotropins, causes a primary hypoplasia and hypofunction of Leydig cells, which in turn causes a secondary defect in transformation of gonocytes into spermatogonia. In contrast, ischemia may primarily cause a tubular epithelial lesion leaving the hypothalamic-pituitary-gonadal axis intact and allowing normal transformation of gonocytes into spermatogonia. Reduced gonadotropins and ischemia appear to produce distinctly different primary and secondary pathophysiological effects on the testes.

Biopsy↗
PubMed1991

[Multiple liver abscesses in chronic granulomatosis].

We report on a case of a three year old boy, suffering from chronic granulomatosis disease, which led to repeated bacterial infections and finally to multiple liver abscesses. Diagnosis was based on the nitroblue-tetrazolium-test and histology. Antibiotic therapy over many weeks was not successful in spite of an adequate choice of medication against staphylococcal microorganisms and of good intracellular penetration, applicated parenterally. Only treatment by chloramphenicol after previous surgical drainage of the abscesses led to a dramatic clinical improvement and regression of the liver abscesses. The subsequent chemoprophylaxis with trimethoprim/sulfamethoxazole for at lest two years left the patient without clinical symptoms.

Anti-Bacterial Agents↗
PubMed1991

[Circumcision--yes or no?].

The indication for a circumcision is critically reviewed. Two different operations are shown. In babies the foreskin should not be retracted because a certain conglutination is physiological at this age.

Child↗
PubMed1990

[The diagnosis and therapy of esophageal perforation or rupture in infancy and childhood].

Oesophageal perforation or rupture is rare in childhood; recently there has been an increase, mostly due to the more frequent use of endoscopy in neonates. The prognosis depends largely on early diagnosis and the type of treatment. The author has seen eight children, aged between one day and nine years, with oesophageal lesions. Of these, six had a perforation and two a rupture of the oesophagus. The problems of diagnosis and treatment and their complications are discussed with reference to these patients. Stress is laid on the importance of early diagnosis. In children, contrary to the case in adults, conservative treatment is often possible.

Child↗
PubMed1989

[Invagination as a complication of malignant lymphoma].

Benign or malignant neoplasms are usually the underlying pathological factor initiating intussusception in the older child. Two cases of non-Hodgkin lymphoma are reported. The surgical procedure and chemotherapy are discussed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Treatment of traumatic splenic rupture in children].

The introduction of new techniques for reducing blood loss in operations on parenchymatous organs and of ultrasonography for screening the traumatized spleen and monitoring therapeutic management have made it possible to preserve this organ following injuries in childhood with increasing success over the past few years. An analysis of a sample of 48 children with splenic rupture (33 boys, 15 girls, aged between eleven months and four years) treated in our department between 1974 and 1989 illustrates this change of approach. 26 patients were splenectomized, in 14 cases the spleen was partly preserved, and 8 were just monitored.

Child, Preschool↗
PubMed1989

Total colonic aganglionosis.

A rare complication after ileorectostomy for total aganglionosis of the colon is demonstrated. Eight years after the operation fistulae between rectum and sacrum appeared. Other cases from the literature are mentioned.

Child↗
PubMed1989

[Germ cell tumors in childhood].

This report concerns 33 infants and children with germ cell tumours = teratomas treated between 1968 and 1986. The primary site of the tumour was sacrococcygeal in 12 and the ovaries in 10. Malignancy occurred in 9 out of 33 (= 27%) patients. To prevent malignant transformation, early surgical intervention has to be performed in benign tumours. For immature subtypes as well as incomplete tumour extirpation a short-term follow-up should be mandatory. The recent change of treatment in malignant teratomas (protochemotherapy, delayed tumour extirpation, improved drugs, second-look operation)--based on cooperative interdisciplinary therapy studies--is discussed. Ultrasound and tumour markers are recommended as good indicators for diagnostic and follow-up studies.

Adolescent↗
PubMed1989

[Infections of the cerebrospinal fluid shunt].

The treatment of infectious complications of implanted foreign bodies into the CNS is unsatisfactory. In the majority of these patients staphylococci are responsible for these infections which elicit only a smoldering inflammatory response with poor penetration of antibiotics into the CSF. It is also very difficult to eradicate staphylococci from the surface of silastic material by antibiotics. Fosfomycin was investigated in the treatment of CSF infections in patients with infected ventriculoatrial shunts. Fosfomycin exhibits a potent antimicrobial activity against staphylococci; this drug also showed a favourable penetration into the CSF in moderately inflamed meninges. A 10 days therapeutic course with fosfomycin plus oxacillin or cefamandole and gentamycin in combination with external drainage of the CSF into a closed system made it possible to exchange all parts of the system in one session without reinfection. This procedure was followed by the same antibiotic regimen postoperatively for 10-14 days. Under this treatment schedule therapeutic results have been considerably better compared to previous treatment modalities.

Cerebrospinal Fluid Shunts↗
PubMed1989

[Anomalies associated with ano-rectal malformations. Apropos of 67 cases].

Anorectal malformations are accompanied by associated anomalies in about 75%; their frequency and variety influence prognosis and survival rate. All kinds of associated anomalies are possible, but there are some typical combinations (like the Vater-association). In our series of 67 neonates (43 low and 24 high or intermediate atresias) we observed 64% of associated anomalies. They were more frequent in high or intermediate atresias (21 out of 24 cases). A low birth weight which is typical for this group affects the prognosis as well as the associated anomalies. 11 out of our 67 patients (= 16%) died; 11 of these weighed less than 2,500 g, and 3 even less than 1,800 g. Prematurity was the reason for the death of 4 neonates, 7 died because of associated anomalies.

Anal Canal↗
PubMed1987

[Diagnosis and therapy of non-parasitic splenic cysts in children].

Splenic cysts of various types are rare surgical abnormalities. The diagnostic and therapeutic procedures are discussed with special reference to the author's clinical material consisting of six children with non-parasitic cysts. Sonography and, in special cases, CT are the most important methods of examination. The desirability of conserving the spleen, while removing the cyst, is stressed.

Adolescent↗