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Biomedical subjects

G P Fioretti

Publications and source records attributed to G P Fioretti.

13 recordsLinked to original sources
PubMed1998

Antisperm antibodies in cryptorchidism before and after surgery.

PURPOSE: We verified the prevalence of serum antisperm antibodies at diagnosis in a large group of cryptorchid boys, and determined whether it may be influenced by orchiopexy. MATERIALS AND METHODS: We prospectively evaluated serum antisperm antibodies in 186 and 23 boys 0.67 to 14.25 years old with unilateral and bilateral cryptorchidism, respectively, before, and 3, 12 and 24 months after surgery. At diagnosis Tanner stage was 1 and 2 or 3 in 188 and 21 cases, respectively. During the 2-year followup 23 boys entered puberty. A total of 111 normal prepubertal (Tanner stage 1) and 54 pubertal (Tanner stage 2 or 3) boys served as controls. Antisperm antibodies were detected using the tray agglutination and indirect immunobead tests. RESULTS: At diagnosis 29 cryptorchid boys (13.8%) were antisperm antibody positive, including 21 of the 188 prepubertal (11.1%) and 8 of the 21 pubertal (38%) boys (significantly different, chi-square test p <0.001). In 27 cases the tray agglutination test was positive with titers between 1:16 and 1:512, in 18 the indirect immunobead test was positive for IgG with titers between 1:10 and 1:100, and in 16 both tests were positive. There was no statistical difference when antisperm antibody results were analyzed for unilateral and bilateral cryptorchidism or testis location. All normal boys were antisperm antibody negative. During the 2-year followup antisperm antibodies appeared in 1 previously negative case, and the antibody titer increased to 128 to 512 in the tray agglutination and to 1:100 in the indirect immunobead tests in 4 positive cases. In all of these cases pubertal changes were also observed. CONCLUSIONS: Our study indicates that cryptorchidism may elicit an autoimmune response against sperm antigen in childhood independent of testis location and orchiopexy. Moreover, patients of pubertal age appear to be at higher risk for antisperm antibody development.

Adolescent↗
PubMed1983

Out-of-hospital pulmonary edema: diagnosis and treatment.

Sixty-two patients diagnosed by paramedics as having acute cardiac pulmonary edema out of the hospital were studied. The paramedic prehospital diagnosis as confirmed by an emergency physician, chest film, and hospital admission evaluation was correct in 55 of 62 patients (89%). In the group with acute cardiac pulmonary edema, 64% demonstrated cardiac dysrhythmias, including cardiac arrest, prior to the patient's hospitalization. Therapy administered by the paramedics was beneficial in that most patients had improved on arrival at the hospital. Six of the 10 patients (60%) sustaining cardiac arrest were successfully resuscitated. Acute cardiac pulmonary edema occurring outside the hospital is commonly associated with significant complications, including life-threatening arrhythmias. Well-trained paramedics are capable of quickly diagnosing and treating acute cardiac pulmonary edema outside the hospital setting.

Adult↗
PubMed1983

Acute dissection of the ascending aorta. Initial presentation as acute lower GI bleeding.

We present the unusual case of a 56-year-old man with acute dissection of the ascending aorta (DeBakey type I) whose presenting symptoms were those of lower gastrointestinal (GI) bleeding. Surgical repair was successfully accomplished with resection of the aorta with a Dacron tubular graft combined with aortic valvular replacement after obtaining bowel viability.

Aortic Dissection↗
PubMedDate not supplied

[Megarectum in childhood].

The criteria employed in the classification of megarectum in infancy are briefly reviewed and its diagnosis is discussed. Stress is laid on the importance of clyster radiology and rectal manometry. Biopsy extended to the point of true sphincteromyectomy may also prove resolutive. Lastly, infantile neuropsychiatry is unmistakably indicated in diagnosing the psychological origin of many of these forms. Aganglionic forms are quickly described and attention is directed to those due to fibrosis of the inner sphincter. Most of such cases are shown to be of secondary, reactive, rather than primary congenital, origin on histological inspection after surgery. Lastly, consideration is given to essentially psychogenic forms. The picture observed in a case treated by sphincteromyectomy with histological evidence of interstitial fibrosis with muscle and nerve regression suggested that affective disturbances lead first to persistent constipation, followed by abnormal distension of the last segments of the intestine. Subsequent regression results in an organic evolution independent of the original disturbance, so that surgery must be resorted to, as well as neuropsychiatric treatment.

Child↗