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Biomedical subjects

R Perale

Publications and source records attributed to R Perale.

16 recordsLinked to original sources
PubMed1991

[Diagnostic role of echography in acute appendicitis in children].

Eighty-seven pediatric patients with suspected acute appendicitis underwent high-resolution US with graded abdominal compression. The study was limited to the patients with a questionable clinical diagnosis, accounting for about 40% of the patients examined for acute appendicitis in our Institution. US had 87.3% accuracy, 81.5% sensitivity, and 90% specificity. The main US findings in the positive cases were: visualization of the appendix as a tubular non-compressible structure, with a diameter of 5 mm or more, symmetric/asymmetric wall thickening, possible presence of appendicoliths and variable appearance of the central echogenic layer (preserved, doubled for lumen dilatation, partially/totally lost). The above US findings were grouped in 3 basic patterns: type I (thickened appendix with no structural abnormalities) appeared to be related to non-suppurative and phlegmonous acute appendicitis; type II (detectable appendiceal abnormalities) was observed both in phlegmonous and in suppurative acute appendicitis; type III (pericecal complex mass, frequently with appendicoliths) was found in all cases of periappendiceal abscess. In our experience, the use of US in the diagnosis of acute appendicitis in children allowed a reduction by about 2/3 in the rate of unnecessary laparotomies. Such a finding emerges from the comparison with the results obtained in the 2 years prior to the use of US. The technique also allowed an unquestionable diagnosis of acute appendicitis or periappendiceal abscess to be made in a number of clinically equivocal cases, thus avoiding potentially harmful delays in diagnosis. On the other hand, the incidence of false-negatives on US is not negligible, which calls for a cautious clinical and US evaluation of all equivocal cases following no typical US pattern.

Acute Disease↗
PubMed1988

Agenesis of the bladder: a case report and review of the literature.

Agenesis of the bladder is a rare congenital anomaly, recorded most often in stillborn infants. Renal agenesis and other severe malformations are frequently associated. An apparent failure of the infraureteral tissue of the mesonephric duct to develop into trigone and proximal urethra seems to be the cause of this anomaly. We report a case of bladder agenesis with anal atresia, left renal dysplasia, and bicornuate uterus.

Female↗
PubMed1979

[Anatomy of papilla and intra-renal reflux: microradiographic and histologic investigations (author's transl)].

After a group of autoptic kidneys, taken from new-born babies, had been injected via the ureter with micronised barium at various pressures, they were examined micro-radiographically and histologically in order to observe the appearance of intra-renal reflux and the anatomical structures involved. The radiological patterns, clinically observed during cysto-uretrography, were also considered. The intra-renal reflux is tubular, when injection is carried out at a low pressure, whereas at higher pressures one can observe the erosion of the fornices of the calyces and the following sino-lymphatic and/or venous drainage.

Histological Techniques↗
PubMed1978

Clinical and aortographic assessment of the complications of arterial catheterization.

Catheterization of the umbilical artery for the treatment of critically ill neonates provides a convenient method for monitoring blood gas tension and chemistry. The most important complications are thrombotic. Thirty eight aortographs were carried out in infants who underwent umbilical artery catheterization. 17/38 of the aortographs were pathological. Bacterial cultures were positive in 11/17, but only 4 coincided with pathological aortographs. Clinical signs indicating complications due to the presence of the catheter wwere observed in 10 cases. Post-mortem examination of eight subjects--three of whom had pathological aortographs--during the course of the investigation revealed only one case of thrombosis. This baby was considered to have died as a direct result of a thrombotic complication. In our experience the clinical signs of vascular complications and evaluation of the peripheral circulation in the ipsilateral leg remain the most important ways of assessing the indication for catheter-withdrawal.

Aorta, Abdominal↗
PubMedDate not supplied

[Comparison of radiology and 24-hour esophageal pH-monitoring in the diagnosis of gastro-esophageal reflux in various pediatric age groups].

We retrospectively examined the 24 hour oesophageal pH study and the upper gastrointestinal (UGI) series of 67 children aged 5 weeks to 15 years. Thirty-seven were suffering from gastro-oesophageal reflux (GER) and 27 from other diseases. Nineteen of them were younger than 6 months, 22 older than 18 months and the remaining 26 ranged from 6 to 18 month old. We found a high incidence of false positive and false negative results of the UGI series in all age groups. The number of false positive results was much higher in infants younger than 6 months (67%) than in the older children studied (27% between 6 and 18 months and 14% after 18 months). On the contrary, false negative results were absent in the first 6 months of life, but their number increased with age, up to 40% in children older than 18 months. Moreover, the 24 hour ph monitoring was found to have a high sensitivity (100%) and specificity (82-100%) in all age groups. For this reason, we believe than this examination could be used as the first line of investigation for the diagnosis of GER in all children, independently of their age.

Adolescent↗