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Biomedical subjects

R Natale

Publications and source records attributed to R Natale.

62 records · Page 4Linked to original sources
PubMed1978

Use of a topical antibiotic spray in vaginal surgery.

During vaginal hysterectomy with or without colporrhaphy a topical aerosol spray containing neomycin sulfate, polymyxin B sulfate and zinc bacitracin was used in 50 patients to decrease the change of postoperative pelvic infection; a placebo spray was used in another 50 patients. All patients were treated preoperatively with povidone iodine and postoperatively with nitrofurantoin and an antibacterial irrigating solution for the bladder if catheter drainage was necessary. The frequency of postoperative pelvic infection was 16% in the group sprayed with the antibiotic combination and 34% in the group sprayed with the placebo, a significant difference (P less than 0.05).

Administration, Topical↗
PubMedDate not supplied

[Zenker's diverticulum. Apropos a case].

The authors report a case of Zenker's diverticulum in a patient 72 years old who underwent surgery. The pharyngoesophageal function was investigated before and after cricopharyngeal myotomy and diverticulopexy, with oesophageal manometry. Preoperative manometry showed an incomplete relaxation of the upper oesophageal sphincter and increased of pharyngeal pressure. This diverticulum has a pulsion pathogenesis and in this case is not associated with gastroesophageal reflux. It is important to check whether an associated oesophageal pathology exist once Zenker's diverticulum has been diagnosed: X-ray examination of oesophagus and stomach are capable of identifying the presence of diverticulum as well as other pathological association. In the case showed the clinical manifestation are represented by: cervical dysphagia, sensation of foreign body while eating due to the accumulation of ingested food in the diverticulum, and noisy deglutition. The surgical treatment in this case consist of diverticulopexy with cricopharyngeal myotomy. This case is treated with diverticulopexy for two reason: because is not very big and to reduce post-operative period. In conclusion the authors shows the importance of this surgery for not very large sized pouches, and emphasise the importance of manometric and radiographic control in pre and post-operative period. This kind of surgery reduce post-operative complication and the period to stay in bed.

Aged↗
PubMedDate not supplied

[Post-traumatic diaphragmatic hernia with late diagnosis. Report of a clinical case].

Starting from the observation of a case of late diagnosed left-side hernia after traumatic rupture of diaphragma, the authors consider the increasing incidence of this pathology during the years. The increased frequency of thoraco-abdominal traumas and the more sophisticated diagnostic tools, permit an earlier diagnosis nowadays. In our patient the diagnosis was made late on the basis of the standard x-ray of the thorax. The CT scan of the thorax and of the abdomen gave more informations. Left thoracotomy enabled a wide exposure of the herniated viscera; the breakthrough of the diaphragm was repaired by means of interrupted suture and it was necessary to apply two prostheses of synthetic material.

Adult↗
PubMedDate not supplied

Clinical experience with Tc-99m labeled (N2S2) anti-melanoma antibody fragments and single photon emission computed tomography.

We evaluated the imaging capability of murine Tc-99m-labeled antimelanoma Fab fragments in 12 patients with clinical stage II and III melanoma. Tc-99m-NRX118.7 antimelanoma Fab fragment, 10.0 to 27.2 mCi (370-1, 006 MBq), was injected IV 30 min after irrelevant nonspecific intact antibody and 5 min after intact specific antibody were given. In all patients, whole-body scans and spot views were obtained. Single photon emission computed tomography (SPECT) was additionally performed in eight of the patients. The procedure was well tolerated, and 31 of 38 known foci of melanoma were detected (sensitivity, 82%). SPECT aided in detecting and better localizing lesions in the head, neck, and chest. The specificity of the technique was satisfactory when interpretation was performed with a knowledge of normal sites of accretion and excretion of technetium-99m activity such as the kidneys and gut. In several instances, lesions were discovered by means of the antibody scan before detection by other methods, and in two instances, the lack of visualization on antibody scan of a palpable mass correctly indicated that no melanoma was present in the mass. Scan results in three patients led to alterations in patient care; including preventing aggressive surgical and nonsurgical treatments. Although these data are encouraging, evaluation in additional patients will be essential to determine the clinical utility of this antibody scan in the management of patients with melanoma.

Adult↗
PubMedDate not supplied

[The diagnostic capacities of transvaginal echography and hysteroscopy in the characterization of endometrial pathology].

The diagnostic accuracy of transvaginal sonography (TVS) and hysteroscopy in the assessment of endometrial pathology was studied comparing retrospectively both methods with the results of histologic findings after dilatation and curettage (D&C) performed in the last four years on 467 patients, 155 of whom were in postmenopause. Endometrial thickness, tissue texture, myometrial invasion and haemodynamic characteristics were studied with TVS. Uterine cavity, endometrial patterns and superficial vascularization were evaluated by hysteroscopy. For the purpose of this study all histologic findings were subdivided to a) normal (206 cases); b) benign lesions (240 cases); c) atypical hyperplasia or adenocarcinoma (21 cases). In our experience hysteroscopy was superior to TVS in detecting endometrial pathology. Both techniques were more sensitive in detecting premalignant and malignant lesions. Considering endometrial thickness evaluated with TVS as a single parameter in patients in postmenopause, we found that the most sensitive cut-off for defining normality was 3 mm; nevertheless, in the group of patients that had an endometrial thickness equal to or less than 3 mm there were 2 cases of malignancy. Therefore, neither TVS nor hysteroscopy are sufficiently reliable to replace curettage in the diagnosis of endometrial pathology.

Adult↗