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Biomedical subjects

G Mosiello

Publications and source records attributed to G Mosiello.

36 records · Page 2Linked to original sources
PubMed1996

Early detection of bladder dysfunction following posterior urethral valves ablation.

Urinary incontinence following Posterior Urethral Valves (PUV) ablation has been attributed in the past to sphincter injury, but it is nowadays accepted that bladder dysfunction (BD) plays a determinant role. In order to assess BD evolution, we have evaluated, from 1982 to 1994, 48 boys with PUV by urodynamics (UD) studies. Age of the patients ranged from 10 months to 15 years. A total of 65 examinations were performed. We considered four groups: 0-3 years; 4-7 years; 8-12 years and > 12 years. Uninhibited detrusor contractions (instability), end filling pressure (EFP), bladder capacity and voiding detrusor pressure were evaluated in order to assess the presence of BD distinguishing it in: hypercontractility, hypocontractility and low-compliant bladder. The results collected confirm a high percentage of BD in PUV boys (71%) and the evolution of hypercontractility versus hypocontractility in 60% of patients considered.

Adolescent↗
PubMed1996

Continuous (6 hour) urodynamic monitoring in children with neuropathic bladder.

In adults the development of modern equipment for ambulatory monitoring permits long-term evaluation of the lower urinary tract which is more accurate than standard urodynamics (SUD). In children continuous urodynamic monitoring (CUM) has been used infrequently and therefore standardisation of the method has not been previously achieved, nor have the techniques and difficulties of performing 24-hour monitoring been solved. The aim of this study was to identify a technical method of CUM in children which was feasible and to verify its usefulness. For this purpose, we reviewed our preliminary experiences of CUM in children with neuropathic bladder. From March to November 1995 we made an outpatient study of the neuropathic bladders of 11 myelodysplastic children aged 1 to 18 years (average age 10.2 years). 7 of them were males and 4 females. All underwent SUD. With the children resting in bed, a 6-hour CUM (Lectromed MPR-2) was performed using a 4 Fr. microtip intravesical catheter (suprapubic in 3 infants and transurethral in 8 children) and an intrarectal catheter. The parents and/or a nurse monitored the fluid intake and micturition events and recorded the data in a diary. Based on the CUM experience in infants with non-neurogenic bladder dysfunction, the 3 suprapubic studies were done after 12 hours of urethral drainage in order to prevent leakage of urine. In all of the patients we were able to study 2 to 4 bladder fillings during a period of 6 to 8 hours (average 6.5 hours) observation. In 9 of the 11 children the CUM pattern was comparable to the SUD one but in the 2 remaining patients CUM showed uninhibited contractions. Higher uninhibited voiding contraction pressures were recorded in hyper-reflexic bladders. Our preliminary results show that it is feasible to perform CUM in children and that it has advantages over standard cystometry in the investigation of children with neuropathic bladder even if it is carried out for short term (6 hours).

Adolescent↗
PubMed1996

Long-term urological follow-up of occult spinal dysraphism in children.

From 1980 to 1996 we followed up 65 children with occult spinal dysraphism (OSD) out of 85 observed in our urodynamic laboratory. The average age at diagnosis was 4.7 years (range: 1-21 years). In 19 cases (22%) the OSD was associated with anorectal anomalies (ARA). Urinary incontinence or voiding anomalies with urinary tract infection were the presenting symptom in 34 children (49%). At diagnosis all children underwent complete neuro-urological and urodynamic evaluation. Thirty-eight patients underwent neurosurgical correction. Vesicoureteral reflux (VUR) was present or developed in 17 patients: 15 underwent endoscopic procedures and 2 required surgery; 2 needed bladder augmentation because of upper tract and renal function deterioration. Urinary incontinence was treated mainly by intermittent catheterization and anticholinergic drugs, but endoscopic treatment was performed in 3 children. At long-term follow-up (2 to 14 years), socially acceptable continence was achieved in 78% of 57 children (8 could not be assessed because they were less than 4 years old). Upper urinary tract deterioration occurred in 15% and renal failure in 7.5%.

Adolescent↗
PubMed1996

[Surgical therapy of chronic constipation in pediatric age].

The authors report their experience in the treatment of the chronic constipation in paediatric age. During the last 3 years (1991-1994), 230 children presenting chronic constipation have been studied at the Strumental Gastroenterologic Department of Children Hospital Bambino Gesù; 19 of them (8%), 10 male and 9 female, were studied with anorectal manometry, defecography and Intestinal Transit test. All the patients had a overtone (high squeeze) of the anal sphincter and the medical treatment was unsuccessful. They underwent sphincteromyectomy by posterior approach. In 17 patients it has been obtained a notable improvement of the symptomatology with regularization of the evacuations. The simplicity of the surgical technique, the absence of complications and the obtained results confirm the validity of sphinteromyectomy in the therapy of the chronic constipation in paediatric age. Interoperating anorectal manometry proved to be essential both in modulating sphincteromyectomy and in its eventual complications.

Adolescent↗
PubMed1990

[Experience in the prophylactic use of ceftriaxone in pediatric surgery].

Authors report on their experience about ceftriaxone in surgical prophylaxis in childhood. 30 patients have been treated, suffering from surgical diseases, either thoracic or abdominal ones, including malignancies. Ceftriaxone was administered once a day; patients received ceftriaxone only once preoperatively: Results have been very satisfactory, the only two complications having been found in two severely immunocompromised patients.

Abdomen↗
PubMed1990

[Clinico-hematological evaluation of 57 patients undergoing antiaggregant treatment with indobufen].

A long-term administration of Indobufen, 400 mg daily, was evaluated in 57 patients with cardiovascular diseases. Aggregation waves induced by ADP, collagen and epinephrine showed a significant and persistent inhibition of platelet function. Minor side effects were observed and in 6 patients the drug was withdrawn: 4 patients began to experience gastric troubles, 1 patient had positive occult test for blood, 1 patient developed an allergic rush. Clinical evaluation and platelet aggregation study before starting indobufen and during the follow up period seem to be useful in the evaluation of effectiveness, safety, compliance and suitable daily dose.

Cardiovascular Diseases↗
PubMed1989

[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↗
PubMedDate not supplied

Postmastectomy breast reconstruction: current techniques.

BACKGROUND: The techniques of breast reconstruction have evolved and matured over the past 25 years. Recent studies have proven the benefit of breast reconstruction for breast cancer patients. METHODS: The authors reviewed the recent literature on the techniques of breast reconstruction and the effects of reconstruction on patients following surgery for breast cancer. The findings in recent studies are correlated with the experience of the authors. RESULTS: A better understanding has been gained regarding surgical techniques of breast reconstruction as well as the proper indications for the various methods. The criteria of patient benefit have been defined by recent long-term studies. CONCLUSIONS: Breast reconstruction following mastectomy has been proven to be a safe and beneficial procedure.

Breast↗
PubMedDate not supplied

[Indications for the surgical treatment of cavernous angioma of the liver in adults. Report of a case].

The authors report a case of giant cavernous hemangioma of the liver, almost entirely extrahepatic, bulging from the inferior surface of the right lobe into the abdomen, treated surgically on account of worsening symptoms referable to continuing growth. A thorough search of the literature allows a critical review of the surgical indication in this benign pathology, rarely complicated by significant clinical events. Surgery is indicated, in lack of relevant complications, only when significant symptoms, continuing or worsening, are undoubtedly referable to the presence of the angioma.

Female↗
PubMedDate not supplied

Recurrent intussusception of the sigmoid colon caused by a transanal protruding sessile tubulo-villous malignant polyp.

We report a case of a 35 year-old woman with a large malignant sessile tubulo-villous polyp of the proximal end of a dolico-sigmoid colon causing intussusception and transanal prolapsing. The diagnosis presented some difficulties being the intussusception intermittent. The clinical feature had been initially misdiagnosed for a very large bleeding polyp (5 cm in size), protruding out of the anus with a long pedicle in the rectum. The histology of multiple bioptic samples of the lesion revealed malignancy. Conventional radiologic studies (plain x-rays, barium enema) after metal clips had been placed on the head of the polyp before it rose up the colon, led to the correct diagnosis without, nevertheless, documenting intussusception. An elective surgical resection of the dolico-sigmoid colon allowed the correct diagnosis and the curative treatment of the colonic intussusception and the malignancy.

Adult↗
PubMedDate not supplied

Cysts of the adrenal gland: revision of a 15-year experience.

Ten specimens of adrenal cyst resected during the period 1984-1999 were re-examined. Thorough examination of multiple sections and the use of immunohistochemistry allowed to change the recorded diagnosis in 8 cases: three epithelial cysts and five pseudocysts were redefined as endothelial cysts. All 10 cysts were of the endothelial type. A synthetic review of the current knowledge about the pathogenesis, the classification and the clinical aspects of this rare disease is presented.

Adrenal Gland Diseases↗
PubMedDate not supplied

[Malignant pheochromocytoma. Personal experience, review of the literature].

Pheochromocytoma is a catecholamine-producing tumor of the sympathetic nervous system which in 4-14% of the cases may be malignant. The differentiation between benign and malignant phoechromocytomas is very difficult, the presence of metastatic lesions and gross invasion into surrounding tissues are the lonely accettable parameters to confirm malignancy. Since the patients with malignant pheochromocytomas have a very poor survival rate, care must be taken for an early detections and a careful follow up. Three cases of malignant pheochromocytoma are reported. In one of these cases the tumor was a functioning mass; the other two cases presented by a hemorrhagic complication. A careful review of the pertinent literature allows to outline the correct approach to this rare pathology as for the diagnosis and the treatment, also including the actual criteria to establish its malignancy.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

[Ascariasis as a cause of acute abdomen: a case report].

Ascaris Lumbricoides Infestation (ALI) is one of the most common helmintic disease of the gastrointestinal tract, and may cause severe surgical complications, especially in children. ALI is frequent in tropical and subtropical countries. We present our experience with a case of a 5-years old pakistan girl treated in Italy for acute abdomen in which ALI was detected during surgical exploration.

Abdomen, Acute↗
PubMedDate not supplied

[Accidents in childhood. Experiences at the Emergency Department of the Bambino Gesù Hospital of Rome].

Considering the clinical and statistical data about injured children coming to the emergency department in the years between 1990 and 1995, the Authors hope better information, identification of risks, use of safety devices in order to successfully implement precautionary measures and the assistance in accidents which still are the first reason for death in children.

Abdominal Injuries↗
PubMedDate not supplied

[Total agenesis of the sacrum and neurogenic bladder dysfunction].

Total Sacral Agenesis (TSA) is a rare congenital anomaly of the lower vertebral column, frequently associated with bladder dysfunction. The diagnosis is often delayed until the evidence of neurological disorders addresses at neuro-radiological examination. In the last 9 years we observed 7 children, 3 males and 4 females, with TSA. The average age at diagnosis was 8 years (range: 1-15 years). Maternal diabetes was present only in one case. In 5 patients, urological ones have been the symptoms of presentation. In one case, TSA has been discovered because of the presence of a sacral mass (lipoma) and the subsequent development of club-foot. The neurological screening, performed in all patients with anorectal anomalies, led to the diagnosis of total sacral agenesis in a child with anteriorized anus. All patients have been evaluated by means of Magnetic Resonance Imaging, renal ultrasound, voiding cystography, renal nuclear scan and urodynamics. The functional evaluation of the lower urinary tract has shown a pattern of neurogenic bladder dysfunction in all children, while bilateral vesico-ureteral reflux has been detected in 2 cases. Intermittent clean catheterization (ICC) has been instituted at the diagnosis in all children. Surgery for continence and protection of upper urinary tract (bladder augmentation and bilateral ureteral reimplantation) has been performed in one patient. At a medium follow-up of 3 years (range: 1-5 years) 2 patients have been lost, normal renal function and urinary continence have been achieved in 4 and one child is continent but has renal failure. An early diagnosis and a correct neuro-urological evaluation and treatment are necessary to prevent urinary tract damage and achieve urinary continence in these patients. Symptoms, clinical findings and relationship with maternal diabetes are discussed. The diagnosis can be enough early if physicians pay attention to maternal diabetes, subtle neurological symptoms (voiding disturbance, constipation, club-foot) and careful physical examination of the back.

Adolescent↗
PubMedDate not supplied

[Vertebral schisis in enuretic children: preliminary results of a statistical analysis].

It is well known that vertebral schisis is frequent in enuretic children but the true incidence in the normal population is not clear, because all series published are referred to children with associated urinary anomalies, who were submitted to voiding cystography and or intravenous pyelography. This determine a statistical bias. The aim of our study was to compare the prevalence of vertebral schisis in enuretic children and in the general pediatric population. Therefore, we chose 142 enuretic children without associated urological or neurological anomalies and a control group of 152 children, assumed as general population, who were submitted to spinal X-rays during screening for scoliosis or congenital dysplasia of the hip. Vertebral schisis was found in 65% (93/142) of enuretics and in 18% (28/152) of control group children. Maximum association between enuresis and vertebral schisis was found in primary monosymptomatic nocturnal enuresis (82%), while minimum association was found in children with secondary enuresis (57%). The difference in percentage of association enuresis-schisis was statistically significant between enuretics and control group and between primary monosymptomatic and secondary enuresis (p < 0.001). The results of this paper are simply add knowledges on the prevalence of the sacral schisis in enuretic children. But, to speculate the different prevalence in different types of enuresis, the results should confirm that the phenomenon of enuresis is multifactorial and the primary monosymptomatic and secondary enuresis have different etiological factor.

Adolescent↗