PubMed Health⌕ Search

Biomedical subjects

L Franch

Publications and source records attributed to L Franch.

At least 19 recordsLinked to original sources
PubMed1998

[Improvement of endoscopic resection procedures in relation to the volume of prostatic adenoma].

First choice therapy of obstructive prostatic hyperplasia is still represented by endoscopic transurethral resection of the prostate, despite new techniques for tissue ablation have being proposed. The issue aims to answer to the questions arising about indications of this procedure, and introduces to the knowledge of physical laws which regulate irrigation during and after operation and to the different techniques of irrigating flow derivation whose application reduced morbidity depending on tissue volume and "resection time". Moreover, the new technique of continuous resection with simultaneous suprapubic evacuation of tissue chips (Turbo-TUR) will be illustrated in details, as it permitted to extend indications and advantages of endoscopic surgery to bulky adenomas, electively submitted to open surgery up to now.

Endoscopy↗
PubMed1996

[The diagnosis of mental disorders by the primary care physician].

OBJECTIVES: To determine the percentage of psychiatric disorders recognised by primary care doctors and what influence the reason for consultation exerts on the psychiatric diagnosis. DESIGN: A crossover study of the prevalence of psychopathology. A two-phase study was performed, with systematic sampling of one in every four visits. The GHQ-28 was used in the first phase and Goldberg's CIS in the second; a diagnosis was assigned in line with the criteria of the DSM-III-R. This diagnosis was compared with the general practitioner's, if this existed. SETTING: "Maluquer Salvador" Health Centre in Girona. PATIENTS: A sample of 400 patients between 15 and 65 who attended the centre. 2.9% were lost (2.1% in the first phase and 0.8% in the second). MEASUREMENTS AND MAIN RESULTS: The GP diagnosed 36.7% of the psychiatric disorders of those attending his/her clinics, mainly because only half the patients "suggested" their problem. In 21.2% of the cases when patients "suggested" their psychopathology, they left the consultation without a diagnosis. This was particularly serious in the case of major depression. CONCLUSIONS: Given the high prevalence of psychopathology, the low diagnostic percentages of the general practitioner's and the difficulty the patient has in suggesting his/her problem, primary care clinics clearly require improvement in case-finding and the use of the GHQ-28 as an instrument in case-finding.

Adolescent↗
PubMed1995

[Initial experiences in the treatment of benign prostatic hypertrophy with laser (side firing)].

After a short literature review about the topic, the AA. present a 6 months follow up of 15 patients treated with prolase II fiber (cytocare) for BPH. In 80% we got good results about the symptom score and urinary flow, but at the endoscopic control in some cases we found an irregularity in the prostatic urethral as there was some prostatic residual tissue. 20% of the patients were submitted to TURP to relieve the symptoms.

Aged↗
PubMed1995

[Prevalence of psychopathology at a primary care center].

OBJECTIVES: To determine the prevalence of psychopathology among those attending a primary care centre and discover its diagnostic distribution using the criteria of the DSM-III-R. DESIGN: A crossover study of the prevalence of psychopathology. A two-phase study was performed by systematic sampling of one of every four visits. In the first phase the GHQ-28 was used. For those with suspected psychopathology (cut-off point 5/6) a semi-structured interview, Goldberg's CIS, was performed. They were assigned a diagnosis from the DSM-III-R. SETTING: Maluquer Salvador Health Centre, Girona. PATIENTS: A sample of 400 patients between 15 and 65 who attended the Centre for any reason. There were only 2.9% losses (2.1% in the first phase and 0.8% in the second). MEASUREMENTS AND MAIN RESULTS: Overall prevalence of psychopathology was 38.8% (Cl 34.05-43.55), with depression accounting for 10.3% (major depression 6% and dysthymia 4.3%), anxiety 13.8% (generalised 7.3%, panic 3% and obsessive/compulsive 3%) and adaptive disorder 9.5%. CONCLUSIONS: One of every three patients attending a health centre suffers from some kind of psychiatric disorder.

Adolescent↗
PubMed1994

Urolume in urethral stenosis: Italian Club of Minimally Invasive Urology experience.

A multicenter study of the patients in whom the Urolume has been implanted has been among the actions undertaken by the Italian Club of Minimally Invasive Urology (UMICLUB). For each patient, a computer information format has been prepared containing evaluation data related to the preoperative period, the endoscopic procedure, and follow-up. The collected data were computerized through unifunctional and multifunctional analysis. Of the 82 patients recruited, 76 were followed for a period ranging from 1 to 40 months. Urinoflow results dramatically improved after implantation of the endoprosthesis: peak flow rates increased by 310%, while mean flow rates increased by 294%. Incontinence and dribbling were found in 4% and 20% of the patients, respectively, and were independent of the distance between the external sphincter and the Urolume prosthesis and of the stent number and length. The cross-data elaboration seems to indicate a statistically significant relation between urethral preparation before Urolume implantation and stricture recurrence, with recurrence being more frequent after dilation. Significant correlations have not been noticed between stenosis etiology, urinary infection, type of anesthesia, and recurrence; between the type of anesthesia, stent length, and duration of hospitalization; or between stent number and position and pain. The impact of the Urolume prosthesis on sexual activity was marginal by all three measures considered (pain during erection, coitus, and ejaculation).

Adult↗
PubMed1991

[Conservative endoscopic treatment of urothelial cystic dysplasia of the upper urinary tract].

We highlight the importance of the new diagnostic possibilities afforded by ureterorenoscopy and nephroscopy in the differential diagnosis of single or multiple cystic dysplasia of the upper excretory tract. Moreover, endoscopic treatment was performed in the two cases reported herein. In the first case the biopsy procedure was also therapeutic and in the second case cyst removal resolved the ureteral obstruction. Because the disease is detected infrequently and because treatment may be required even less frequently, several technical solutions have been applied to assess efficacy and reliability. Diathermy coagulation has proved to be the safest, fastest and the most effective. Follow-up has documented the absence of recurrence and good reepithelialization of the ureteral wall without progression to stricture. In those cases with single cyst, one-stage diathermy loop resection permits obtaining biopsy material and radical removal of the neoformation.

Carcinoma, Transitional Cell↗
PubMed1991

[Endoscopic surgery of bladder diverticula].

The most frequent method utilized in the treatment of bladder diverticula is by open surgery using the extravesical, transvesical or combined approach. The endoscopic techniques consisting of electrocoagulation of the diverticular mucosa alone (Orandi) or opening the diverticular neck by electroresection (Post-Vitale) constitute a therapeutic alternative not widely used to date. We have attempted to combine both techniques and, since 1985, we have treated 21 patients with bladder diverticula via the transurethral approach using the following technique: 1. The diverticular neck is opened wide by incision or electroresection. 2. Complete electrocoagulation of the diverticular mucosa. 3. Resolution of cervico-urethral obstruction by cervico-prostatic incision or electroresection of the prostate. We have achieved good results and no complications have been observed. Reduction of the diverticulum was not achieved in only one case. In our view, failure was due to the fact that treatment of the diverticulum had not been combined with prostate resection which the patient refused. The technique is described and the indications and possible complications are discussed. The results achieved by the authors indicate that this technique should be used more widely.

Cystoscopy↗
PubMed1991

[Prevalence of cognitive deterioration in a geriatric urban population].

A descriptive study was carried out in Salt (Gerona) to evaluate the prevalence of cognitive impairment in a geriatric urban population and its relation with several variables which might have an influence on it. The cognitive status was evaluated with the score in the Mini-Mental State Examination (MMSE). A representative sample of 392 individuals was obtained out of an overall population of 2,394 registered persons above 65 years of age; 354 of them were interviewed. The overall rate of intellectual deterioration (MMSE less than 24) was 26.5%, and it was 8% for the important deterioration (MMSE less than 18). The presence of cognitive impairment was significantly correlated in multivariate analysis with advanced age, low educational level and limited personal autonomy.

Aged↗
PubMed1991

[Clinical observations on 38 cases of inflammatory aneurysm of the abdominal aorta out of a total of 2014 operated cases].

The paper reviews 2014 cases of aneurysm of the abdominal aorta treated over the past 10 years at the Institute of General and Cardiovascular Surgery of the University of Milan directed by Prof. Ugo Ruberti, and analyses 38 which showed inflammatory characteristics. In spite of the low frequency of this type of aneurysm (1.8%), preoperative diagnosis is important since surgery entails greater technical difficulties than surgery for an atherosclerotic aneurysm of the abdominal aorta. In this respect the study of preoperative ESR and white blood cell levels is important: the review showed an increased ESR in 71% of cases in which the aneurysm was clearly inflammatory (a percentage which was twice that found in patients with atherosclerotic aneurysms) and increased white blood cells in 32% of cases compared to 2.6% in atherosclerotic aneurysms. Contrary to previous reports, CAT and abdominal echography were not particularly important. However, in those cases where the aneurysm was thought to be inflammatory on the basis of these findings, the Authors chose to operate once the diagnosis had been made without waiting for steroid therapy to reduce the extent of inflammation due to the well-known risk of rupture and the controversial efficacy of medical therapy.

Aged↗
PubMed1988

Digital subtraction angiography of the kidney.

Intravenous and intra-arterial digital subtraction angiography (DSA) was performed in 88 patients: 34 with tumours, 10 with renal trauma, 26 with suspected renovascular hypertension, 6 with vascular impression on the renal pelvis, 8 with nephrolithiasis and 4 with sonographically abnormal kidneys. Venous and arterial DSA always gave diagnostically useful images. Intravenous DSA is valuable in patients with suspected renovascular hypertension or after vascular surgery, percutaneous transluminal angioplasty and transcatheter embolisation. Arterial DSA is preferable to venous DSA in other clinical situations, particularly in the evaluation of renal tumours, and may be recommended in preference to conventional angiography.

Adult↗
PubMed1981

[The role of penile Doppler sonography in impotent diabetics].

Penile systolic pressure has been evaluated by the Doppler-sonographic method in 15 diabetic patients suffering from erectile impotence. Urodynamic tests have also been carried out in some patients for a diagnosis of neurological impotence. The results obtained show the possibility of a double or sole origin (neurogenic or vascular, or both) in the pathogenesis of this symptom in diabetic subjects.

Adult↗
PubMed1981

[The role of penile Doppler sonography in the diagnosis of vascular impotence. Preliminary studies].

Normal, potent arteriopathic and impotent arteriopathic subjects have been studied by means of the Doppler method for the determination of penile systolic pressure. A penile systolic pressure value less than 75 mmHg and a penisarm pressure index of than 0.55 were always associated with impotence. If present in the arteriopathic, impotence is not always caused by vascular factors.

Auscultation↗