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Biomedical subjects

M Pittelli

Publications and source records attributed to M Pittelli.

7 recordsLinked to original sources
PubMed2000

[Histopathologic examination of the intervertebral lumbar disk. Evaluation of its usefulness and limitations].

A retrospective clinical-pathological review of 192 lumbar intervertebral discs removed via an interlaminar approach or percutaneous nucleotomy from patients suffering from sciatic pain was carried out in order to assess if routine examination is useful. Only for a case of our series, which showed ill defined features at preoperative neuroradiologic imaging, an intraoperative pathologic examination was necessary. Immunohistochemical study was never required. A routine examination with a hematoxilin-eosin stain was sufficient also to recognize postoperative scar in patients reoperated. In conclusion we think that routine examination of the intervertebral disc is a procedure which is not expensive and useful to assess the nature of the lesion in reoperated patients and in rare cases showing unclear radiologic pattern.

Female↗
PubMed1995

Ultrasound-guided aspiration of endometriomas: possible applications and limitations.

OBJECTIVES: To evaluate the role of needle aspiration in the management of endometriomas. DESIGN: Retrospective evaluation of the activity of the section of interventional ultrasound in a single tertiary care institution. SETTING: Department of Obstetrics and Gynecology, Ospedale S. Gerardo, Monza, University of Milan, Italy. PATIENTS: Two hundred nine premenopausal patients underwent aspiration for diagnostic purpose (n = 166), for relief of symptoms (n = 25), or with therapeutic intent (n = 18). RESULTS: Adequate material was obtained by all punctures. Early complications (self-limiting vagal symptoms or pain) occurred in eight cases. Short-term complications consisted of acute abdominal pain in three cases and infection in one. Three women required surgical treatment of the complication. At first examination after aspiration, persistence of the cyst was observed in all but four cases, including all cases who had undergone therapeutic aspiration. Nine patients reported relief of symptoms but six other patients referred onset or worsening of pelvic discomfort after aspiration. CONCLUSIONS: Ultrasound-guided aspiration of endometriomas is feasible. The transvaginal route reduces early complication but implies a risk of infection of 1.3%. However, drainage alone is ineffective as a therapeutic procedure and the applications of aspiration of endometriomas appear limited to some cases with diagnostic intent.

Adult↗
PubMed1994

Ultrasound in the follow-up of young patients with malignant ovarian tumors after conservative surgery.

Ultrasound examinations were performed us a step in the follow-up of 62 patients previously treated with conservative surgery for malignant ovarian tumors. With a minimal follow-up period of 36 months (range 36-129) 12 recurrences of disease were observed in nine patients. When compared to other routine follow-up procedures, ultrasound examination proved to be the most effective procedure in the monitoring of these patients, correctly detecting ten recurrences. Physical and gynecological examinations detected seven, tumor marker measurements detected six and chest X-rays detected one. Ultrasound examination was 83% sensitive, 99% specific and 99% accurate in the detection of recurrent disease. In four recurrences leading to death, the diameters of the tumors at first detection were 25, 50, 50 and 100 mm, significantly higher (p = 0.03) than in seven recurrences followed by complete response of the tumor (range 15-35 mm, median 30 mm). Ultrasound appears to be superior to physical and gynecological examination in early detection of recurrence; considering that smaller burdens of tumor at the time of recurrence seem to imply a better prognosis, ultrasound should be considered us a useful additional procedure in the follow-up of these patients.

Journal Article↗
PubMed1994

Transvaginal ultrasound-guided fine needle sampling of deep cancer recurrences in the pelvis: usefulness and limitations.

The usefulness of fine needle sampling (FNS) under transvaginal ultrasound guidance in gynecologic oncology patients is evaluated in this study. Between 1990 and 1993, 101 FNS under transvaginal ultrasound guidance were performed in 88 sessions. All targets were located deep in the pelvis and their median diameter was 30 mm. All procedures were performed on an outpatient basis. Sampling consisted of 46 cytologic aspirates and 55 biopsies. No false-positive result was obtained when cytologic results were correlated with both clinical outcome and surgical biopsy. For aspirates and biopsies, sensitivity was respectively 76 and 91%, while accuracy was 83 and 91%. Inadequate results were recorded in 11 aspirates and in 9 biopsies. In 7 of 12 sessions where both aspiration and biopsy were performed, false-negative or inadequate cytologic result was overcome by true-positive biopsies. No moderate or severe complication was observed. FNS under transvaginal ultrasound guidance is a safe procedure with limited invasiveness and extremely high specificity even when performed on small targets. Whenever possible, biopsies should be preferred. A negative FNS obtained from a clinically suspicious lesion requires a repeat sampling.

Adenocarcinoma↗
PubMed1993

Early and short-term complications after US-guided puncture of gynecologic lesions: evaluation after 1,000 consecutive cases.

PURPOSE: To ascertain the complication rate associated with ultrasound (US)-guided puncture of gynecologic lesions. MATERIALS AND METHODS: Between 1986 and 1992, 878 transabdominal and 122 transvaginal US-guided punctures of gynecologic lesions were performed in 893 patients. Most of the procedures were performed in adnexal cysts (n = 838); the rest, in solid tumors (n = 66), mixed tumors (n = 56), or lymphoceles, abscesses, or fluid collections (n = 40). No anesthesia or antibiotic prophylaxis was routinely used. RESULTS: No life-threatening complication was recorded. Early complications (defined as complications that occurred within 24 hours after puncture) were recorded in 31 patients and consisted mainly of transient vagal symptoms or pain. Short-term complications (within 5 days after puncture) were recorded in 10 patients, six of whom required surgery. CONCLUSION: US-guided puncture of gynecologic lesions is safe in selected patients. Complication rates depend on the type of lesion and are very high in dermoid cysts, which should not be punctured, and extremely low in serous cysts, solid tumors, and mixed tumors.

Abdominal Pain↗
PubMedDate not supplied

Calf pseudohypertrophy in a patient with double neurogenic pathology.

A pseudohypertrophy of the calf can be rarely associated with neurogenic pathologies as S-1 radiculopathy, poliomyelitis, spinal muscular atrophy, traumatic lesions of peripheral nerves, intraspinal neurinoma. The causes of this particular phenomenon are unknown. The authors present the case of a 52-year-old man with an enlargement of the left calf suffering from a mild form of spinal paralytic poliomyelitis in the early childhood and episodes of severe left sciatica in the last four years. Electromyography demonstrated a pattern of denervation in both legs and an H-reflex absent when the left tibial nerve was stimulated. An open muscle biopsy of the left calf was performed. Light microscopic and ultrastructural examination of the muscle confirmed the presence of a pattern of "neurogenic type" pseudohypertrophy. Our results could be interesting for the understanding of the mechanism of neurogenic pseudohypertrophy. This case suggests that timing of stimulus or "dose" of denervation may be important factors in such a phenomenon.

Electromyography↗