[Cholecystectomy with laparoscopy and laparotomy. Analysis of the complications].

Laparoscopic cholecystectomy (LC) has been adopted by many as the treatment of choice for uncomplicated biliary lithiasis; since an increasing number of surgeons use LC even in complicated cases, we examined our series in order to see if this is the correct procedure. We report on the results of our first 252 LC and compare them with our latest 66 open cholecystectomies, in order to evaluate number and importance of postoperative complications. Besides we compare complications in patients below and over 60 years of age to verify if age bears any significance.

[Schistosomiasis: possible cause of ectopic pregnancy. Four clinical cases].

The Authors describe 4 cases of ectopic pregnancy associated with foci of schistosomiasis and point out the relevance of mass screening on urine, stool and vaginal secretions in those areas where schistosomiasis is endemic and frequent the involvement of female genital tract. Utilization of laparoscopy in all cases where as adnexal mass and/or a history of unexplained infertility is found is finally advocated.

Clinical outcome of fetal uropathy. II. Sensitivity of echography for prenatal detection of obstructive pathology.

Among 8,579 neonates born between February 1, 1981 and March 31, 1987, and cleared by prenatal sonography for significant urinary tract abnormality 158 subsequently were hospitalized because of signs or symptoms of urinary tract disease, predominantly urinary tract infection. Evaluation of these 158 patients revealed 24 with vesicoureteral reflux, 7 with duplicated systems (2 of which showed reflux), 1 with the syndrome of Fraley, 1 with pyelectasis and 5 with mild hydronephrosis (3 secondary to reflux and 2 with diethylenetriaminepentaacetic acid renal scans considered to be nonobstructed). There was no incidence of significant obstructive uropathy that had been missed by the previous prenatal sonography and that surfaced subsequently to cause morbidity in this series.

Clinical outcome of fetal uropathy. I. Predictive value of prenatal echography positive for obstructive uropathy.

Clinical followup was performed in 73 neonates with a prenatal echographic suspicion of uropathy. Of 42 patients with a prenatal suspicion of unilateral hydronephrosis only 15 had pathological obstruction and 2 had multicystic dysplastic kidneys. Among 10 infants with a prenatal suspicion of bilateral hydronephrosis only 1 had true bilateral obstruction and 2 had unilateral obstruction.

Improving patient flow in ambulatory care through computerized evaluation techniques.

The Authors describe the application of Patient Flow Analysis (P.F.A.