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S Boero

Publications and source records attributed to S Boero.

12 recordsLinked to original sources
PubMed2001

The demographics of pelvic floor disorders: current observations and future projections.

OBJECTIVE: Our aim was to assess current demand for care of pelvic floor disorders and create projections for future demand for care. We also sought to better understand the characteristics of women seeking care. STUDY DESIGN: Current demand for care was calculated by comparing those women seeking care through the female pelvic floor disorders clinic with those women of the same age range at risk within an integrated health care delivery program. Patients underwent complete urogynecologic evaluation including cystometry. Women seeking care were compared with regard to age, distribution of conditions (pelvic organ prolapse, stress conditions, urge conditions), and probability of undergoing surgery. Modeling the study population by use of data from the US Census Bureau, which projects population changes over the next 30 years, created predictions of future demand. RESULTS: Data were available on 2070 consecutive patients with an age range of 30 to 89 years normally distributed around a median age of 61.5 years drawn from an at-risk population of 149,000 women aged 30 to 89 years. Older women generated more consults per 1000 woman years than did the younger cohorts (1.7 vs 18.6 consults per 1000 woman years for those 30-39 years old vs those 70-79 years old; P <.05). Estimates of growth in demand at 30 years indicate a 45% increase in demand while net growth of the same population segment should be 22%. Stress conditions were more common among younger women and urge conditions were more common among older women. Pelvic organ prolapse was equally distributed throughout the age ranges. CONCLUSIONS: Over the next 30 years, growth in demand for services to care for female pelvic floor disorders will increase at twice the rate of growth of the same population. Demand for care for pelvic floor disorders comes from a wide age range of women, although mature age groups generate 10 times the number of consults per 1000 woman years as do their younger counterparts. Age plays a major role in the distribution of conditions with which patients present. These findings have broad implications for those responsible for administering programs to care for women, allocating research funds in women's health and geriatrics, and training physicians to meet this rapidly escalating demand.

Adult↗
PubMed1995

[The echographic follow-up of patients treated with an external fixator in childhood and adolescence].

In the last few years external fixation has started to be extensively used in pediatric orthopedics and traumatology and ultrasound (US) monitoring has been adopted. The role of US was investigated in a study on 64 patients aged 2 to 30 years treated from November, 1989, to December, 1993. Some patients underwent several interventions with different methods and therefore belong to more than one of the three considered groups. In case of surgical lengthening (group A), the role of US was investigated in a study on 54 patients aged 2 to 26 years. The following variables were studied with US: diastasis entity, stump axis and the evolution of regenerated tissue within 10 days of the beginning of lengthening (first follow-up), at 20 days (second follow-up) and at 30 days (third follow-up). Ilizarov and Wagner fixators and one external fixation reduction fixator were used on 54 patients in 83 segments (43 femurs, 39 tibias and 1 humerus). In all, 104 corticotomies were performed. In fractures treated with external fixators (group B), US allowed the study of the hematoma surrounding the lesion and of its progressive evolution from fibrous tissue to bone callus, within 30 days of external fixation (first follow-up), at 60 days (second follow-up) and at 90 days (third follow-up). Eight patients were treated. The segments treated were 9 femurs and 2 tibias, 11 fixators in all. Patients age ranged 9 to 19 years. Five patients underwent corrective osteotomies with external fixators (group C), in which group US follow-up exams were not standardized. For all 252 US examinations, performed in real time, an Acuson 128 unit with a 5-MHz linear probe was used and anterior, median and lateral longitudinal scans were acquired.

Adolescent↗
PubMed1994

[Surgical limb lengthening in patients of short stature. Indications, complications and results].

PURPOSE OF THE STUDY: The authors report their experience in limb lengthening in 55 patients with short stature. MATERIALS AND METHODS: Surgical treatment must begin at the age of 13-15 years to obtain better collaboration from the patient which is necessary to obtain a good result. The general indication for surgery includes short stature between 110 and 150 cm. The major indication is disproportionate short stature. The authors have operated on some cases of short stature in which there was a disproportion between thighs and legs and other short stature without disproportion. In these patients they have tried to obtain the greatest lengthening compatible with good appearance. RESULTS: Examining the complications, the authors have noted that the rate of bone infections is clearly decreased, whereas non union, a frequent complication of the original Wagner method, has completely disappeared. The use of a circular device has not caused an increase of neurological complications, which on the contrary have diminished. DISCUSSION: Surgical lengthening of the lower limbs in disproportionate dwarfism can lead to cosmetic, functional and psychological benefits. The treatment is long and demanding, for the surgeon and especially for the patient. For this reason it is necessary to carefully evaluate the motivations of the patient, who must be well aware of the achievable results as well as of the possible complications. CONCLUSION: Such a treatment must be undertaken in specialized centers, not only owing to surgical difficulties, but especially because it requires a continuous clinical check and a strong post-operative physiotherapy.

Adolescent↗
PubMed1993

Comparison between colposcopic, cytologic, and histologic findings in women positive and negative for human papillomavirus DNA.

Little is known about the role of detection of human papillomavirus (HPV) DNA in exfoliated cells of the cervix in aiding the colposcopic diagnosis of cervical lesions. The purpose of our study was to compare the colposcopic findings of young women who were positive and negative for HPV DNA. Eighty-four women aged 13-22 years attending family planning clinics were examined colposcopically with the aide of acetic acid and Lugol's solution and without knowledge of HPV DNA status. Lesions identified were given scores based on the severity of observed colposcopic changes. Samples for cytology and HPV DNA testing, which included types 6, 11, 16, 18, 31, 33, and 35, were obtained at the time of the examination. Biopsies were performed on women with significant lesions identified on examination or with cytology suggestive of neoplasia. Students t-test and chi 2 analysis were performed to compare colposcopic variables and HPV DNA type. Of the 84 women examined, 17 were positive for HPV DNA; 9 had type 16/18. The average length of sexual activity was 2.7 years. Women with HPV 16/18 had a mean of 1.7 lesions visible at colposcopy compared to 0.7 lesions visible in those negative for HPV 16/18 (this included HPV DNA negative women and women positive for HPV types 6, 11, 31, 33, and 35) (p < 0.001). Women who were positive for HPV 16/18 also had higher lesional scores than the HPV 16/18-negative group (3.4 versus 1.0, respectively, p < 0.001). All four women who had dysplasia either on cytology or histology were positive for type 16/18.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Surgical treatment of Legg-Calve-Perthes disease.

Thirty-two patients (out of 52 undergoing surgery) with Legg-Calvé-Perthes disease (LCP) were examined retrospectively to assess the efficacy of surgical treatment on epiphyseal morphology at the primary healing. The analysis of the clinical results of the 33 hips considered indicated that it is necessary to operate above all on 3rd grade hips. For these the most frequent operation indicated is osteotomy of the pelvis. Femoral osteotomy must be limited to cases with only a slightly deformed femoral epiphysis in patients below the age of 7-8 years.

Arthrography↗
PubMed1989

The modified Wagner method for surgical lengthening of the limbs.

The method proposed by Wagner in 1971 for surgical lengthening of the limbs was widely used by the authors for the treatment of dysmetria and (since 1976, for the first time in Italy) for disharmonic hypometria. The limitations of this method were revealed, however, by increasing knowledge in this field and the advent of new biological concepts of bone regeneration. The authors report 51 lengthenings carried out between 1982 and 1987 according to their own modification of the Wagner method. They conclude that the Wagner external fixator associated with corticotomy achieves excellent results, decreasing the number of surgical stages as well as the risk of infection and delay in consolidation.

Adolescent↗
PubMedDate not supplied

Congenital pseudarthrosis of the tibia associated with neurofibromatosis-1: treatment with Ilizarov's device.

We reexamined 21 patients with congenital pseudarthrosis of the leg (congenital pseudoarthrosis of the tibia; CPT) associated with neurofibromatosis-1 (NF-1), > or =2 years after the termination of treatment, for a statistical study of the results obtained by using Ilizarov's external fixator. Of the 21 tibias operated on, 17 consolidated after the first treatment, whereas four did not. Of the 17 consolidated tibias, four refractured and were retreated by using a variety of methods. Only one healed. At follow-up, which occurred > or =2 years after the removal of the fixator, the results were nine consolidations without deformities or with shortening <2 cm, five consolidations with axial deviation, and seven nonconsolidations. The statistically significant results were that (a) patients who were aged 5 years or older at operation had better results, and (b) the assembly II (resection of CPT stumps and their short-term compression possibly associated with corticotomy or epiphyseal distraction to correct limb discrepancy) gave better final results compared with the other device assemblies. We conclude that treatment with Ilizarov's fixator allows (a) a good percentage of healing over time (66.7%), especially in cases of normotrophic and cystic CPT; (b) further operations with or without the fixator to correct secondary or residual axial deviation; and (c) correction of limb discrepancy. This treatment avoids risking injury to the healthy contralateral leg. Additionally, for treatments that do not achieve satisfactory results, other treatment methods are not excluded. The CPT still remains a difficult problem for the orthopedic surgeon to solve.

Adolescent↗
PubMedDate not supplied

Benign tumors of the pediatric spine: statistical notes.

A group of 50 pediatric patients affected with tumors or pseudotumors of the spine were studied with the purpose of determining the interval between the onset of symptoms and definitive diagnosis, the incidence of various symptoms, the statistical frequency based on age, sex, histologic type, localization, site. Also studied were diagnostic procedures adopted, therapy, recurrence, complications. The child affected with benign tumor pathology of the spine is rarely submitted early to appropriate diagnostic testing. Tumors are more frequently localized in the lumbar and thoracic spine and there is predilection for the vertebral arch. The most frequent histologic types are in decreasing order: histiocytosis X, osteoid osteoma, and aneurysmal cyst. Treatment is constituted by simple curettage in histiocytosis X, complete resection of the neoplasm in osteoid osteoma and osteoblastoma, partial resection associated with radiotherapy or selective embolization in aneurysmal bone cyst.

Adolescent↗