Biomedical subjects

Stefania Ferretti

Publications and source records attributed to Stefania Ferretti.

4 recordsLinked to original sources

PubMed2006

A prospective randomized multicentric study comparing stented vs non-stented ureteroscopic lithotripsy.

OBJECTIVE: We compared postoperative pain, short and long-term complications after ureteroscopic (URS) treatment of stones followed or not by placement of a double J stent. MATERIALS AND METHODS: from July 2000 to September 2001 we recruited a total of 56 patients with ureteric stones amenable of endoscopic treatment by URS. Mean age was 48 years (22-70) average stone diam was 9.17 x 6.91 mm (15-7 x 10-5 mm). Patients were classified into obstructed or non obstructed on the basis of the intravenous pielography, and thereafter prospectively randomized in stented (6 ch DJ) or non-stented patients. 26 patients were classified as obstructed, whilst 30 as non obstructed. Therefore we have 13 patients in each branch (stented/non stented) of the obstructed group and 15 in each branch (stented/non stented) in the non obstructed group). Procedures were carried out with rigid or semirigid ureteroscopes up to 8.5 Ch and in all cases ballistic lithotripsy was used. Stented patients had the double J removed between postoperative day 3 and 10 (mean 7). By means of a visual analogic scale (VAS), postoperative pain was assessed. Patients underwent an ultrasound assessment a month 1-3 and 6 post operatively. Also early complications, if present, were recorded and analysed. RESULTS: No statistically significant differences were reported between the groups regarding postoperative pain (p > 0.5) or persisting or newly established hydronephrosis (p > 0.5) unregarding the preoperative presence of urinary tract obstruction. In 2 cases residual fragments were present necessitating in 1 case of a second URS. In 1 case, randomized as non stented, a double J was positioned in day 1 postoperative with the aim to reduce persisting pain. CONCLUSIONS: Ureteroscopy is a safe, minimally invasive procedure, actually the optimal treatment for ureteric stones. The positioning of a double J stent after the procedure does not have, with the actual ureteroscope size and lithotripsy devices, as is evident from our study, anymore indication.

Adult↗

PubMed2005

A case report of a "smouldering" uretero-vascular fistula.

Uretero-vascular fistulae are rare. As compared to aortic, uretero-iliac fistulae are by far more frequent according to a 1:8 ratio. We present one case of uretero-prosthetic fistula in a man operated upon the resection of an aortobisiliac aneurysm and Dacron prosthetic graft; six years later, a blunt trauma to the body was followed by a threatening shock, resistant to medical measures. Two subsequent emergency operations allowed to a difficult diagnosis and a life-saving repair of the fistula. Some hypotheses on the pathogenesis of the condition are discussed as well as its clinical problems.

Aged↗

PubMed2004

Randomized comparison of loops for transurethral resection of the prostate: preliminary results.

PURPOSE: To evaluate the comparative efficacy and morbidity of standard transurethral resection of prostate (TURP) and transurethral vaporesection (TUVRP) using four types of loops. PATIENTS AND METHODS: In a one-to-one randomized study, 50 patients with lower urinary-tract symptoms suggestive of bladder outlet obstruction and benign prostatic enlargement underwent TURP. Clinical data were collected using digital rectal examination, transrectal ultrasonography for evaluation of prostate volume, IPSS and IIEF-5 questionnaires, and serum prostate specific antigen concentrations. Intraoperative blood loss and fluid absorption were evaluated by measuring serum hemoglobin and respiratory alcohol concentration. Patients were followed at 3 and 18 months with evaluation of clinical symptoms, flow rates, residual urine volumes, and complications. RESULTS: There were no significant differences in blood loss, intraoperative fluid absorption, procedure time, or weight of the resected tissue between standard TURP and TUVRP with the various loops. No significant complications (infections, urethral stricture, reintervention) were seen. CONCLUSIONS: In this comparison of the clinical outcome and morbidity of standard TURP versus different loops for TUVRP, there were no significant differences in any of the parameters evaluated.

Aged↗

PubMed2003

Evidence of autoimmunity in chronic periaortitis: a prospective study.

BACKGROUND: Chronic periaortitis includes idiopathic retroperitoneal fibrosis, inflammatory aneurysms of the abdominal aorta, and perianeurysmal retroperitoneal fibrosis. It is considered to be due to advanced atherosclerosis, but is often associated with systemic autoimmune disorders. METHODS: We studied 16 consecutive patients who were diagnosed with chronic periaortitis by computed tomography. Each patient underwent a physical examination, routine laboratory tests, measurement of autoantibodies, thyroid echotomography, and chest radiography. Aortic wall or periaortic retroperitoneal samples from 9 patients who underwent surgery were available for histologic examination and immunohistochemical characterization of the inflammatory infiltrate. RESULTS: Twelve patients had constitutional symptoms, 14 had an elevated erythrocyte sedimentation rate, and 13 had an elevated C-reactive protein level. Antinuclear antibodies were positive in 10 patients. Three patients had autoimmune thyroiditis, and 1 had seropositive rheumatoid arthritis. Antineutrophil cytoplasmic antibodies were positive in 3 patients who presented with rapidly progressive renal failure. Pathologic examination of the aortic and periaortic specimens revealed moderate to severe inflammatory infiltration, mainly consisting of B cells and CD4(+) T cells. Vasculitis with fibrinoid necrosis involving the aortic vasa vasorum and the small and medium retroperitoneal vessels was found in seven of the nine histologic samples. CONCLUSION: These clinical and pathologic features support the hypothesis that, at least in some patients, chronic periaortitis is a systemic autoimmune disease, perhaps involving a vasculitic process of small and medium vessels.

Adult↗