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Biomedical subjects

A Pfau

Publications and source records attributed to A Pfau.

At least 55 records · Page 3Linked to original sources
PubMed1987

Shock-wave treatment for stones in the kidney and ureter. The Jerusalem experience.

We report on our first 6 months' experience with the extracorporeal shock-wave lithotripter (ESWL). During this period, 410 treatments were given to 350 kidneys and ureters. Our series was characterized by a particularly high proportion (40%) of multiple and large calculi and included 25 complete staghorns. The latter required multiple treatments (up to five), but no adjunct percutaneous nephrolithotomies were used in this series. A percutaneous nephrostomy was inserted in 20 cases. Thirty-six ureteric calculi above the pelvic level were treated in situ, with 95% success. The presence of a ureteric catheter is useful in these cases. Posttreatment pain was graded, and 61% of the patients did not require any analgesia. High-frequency jet ventilation was used in 91% of the 172 patients receiving general anesthesia and was of great value in minimizing respiratory-stone movement. The principal complication encountered was ureteric obstruction due to impacted particles. Temperature greater than 38 C occurred in 8.5% of the cases. It is suggested that the availability of the ESWL should encourage the early treatment of both renal and ureteric calculi, as well as enable the treatment of certain patients rejected for conventional surgery.

Adolescent↗
PubMed1986

Congenital varicella causing neurogenic bladder and anal dysfunction.

An infant with congenital varicella syndrome due to maternal varicella zoster is presented. Unlike other reports in which such infection caused multiple congenital defects, our patient suffers from atonic bladder and anal dysfunction as the sole manifestation of congenital varicella syndrome. Attention is called for maternal varicella as a possible cause for limited neurologic damage in the fetus.

Anus Diseases↗
PubMed1986

Prostatitis. A continuing enigma.

After all is said and done, prostatitis is still a syndrome often difficult to interpret and with an unclear etiology and pathogenesis in many patients. However, if approached intelligently by an interested, knowledgeable, and honest physician, prostatitis in its different variations can be diagnosed correctly and the adequate treatment adjusted accordingly wherever possible. When no specific treatment is available, reassurance and general supportive measures will often alleviate the condition remarkably.

Anti-Bacterial Agents↗
PubMed1984

A randomized comparison of 1-day versus 10-day antibacterial treatment of documented lower urinary tract infection.

We randomized 58 women with lower urinary tract infection diagnosed on bilateral ureteral catheterization studies to a 1-day or 10-day treatment regimen. The study revealed that 1-day adequate antibacterial treatment was as effective as 10-day treatment for lower urinary tract infection. Sterile urine was obtained in all 27 women (100 per cent) given 1-day treatment and in 30 of 31 (97 per cent) given 10-day therapy. Three weeks after the 1-day treatment significantly more postmenopausal women had infected urine than premenopausal women. This difference was not seen in the 10-day group. We conclude that 1-day treatment is sufficient for the cure of lower urinary tract infection in women.

Adolescent↗
PubMed1984

Management of ureteropelvic junction obstruction associated with lower polar vessels.

Four cases of hydronephrosis due to ureteropelvic junction (UPJ) obstruction by lower polar vessels are presented. Regular propagation of peristaltic waves across a patent UPJ and rapid emptying of the pelvis were the basic conditions before accepting the lower polar vessels as the primary cause of the hydronephrosis. Transposition or division of the lower polar vessels, accompanied sometimes by a limited lower polar nephrectomy dependent on the resultant ischemia, without any pyeloplasty was the selected procedure in each of the cases. No hypertension and no immediate or delayed postoperative complications occurred in any of our patients. Relief of symptoms, a remarkably improved postoperative pyelogram, and a sterile urine were achieved in all our cases. Detection of every case in which the lower polar vessels play a primary role in the establishment of UPJ obstruction is urged since transposition or division of these vessels in such cases is a superior procedure to pyeloplasty.

Adult↗
PubMed1983

Recurrent urinary tract infections in premenopausal women: prophylaxis based on an understanding of the pathogenesis.

We studied 56 sexually active premenopausal women with a normal genitourinary tract but with persistent introital colonization by enteric gram-negative bacteria who were prone to suffer recurrent urinary tract infections. Sexual intercourse was revealed as a major factor in inducing recurrent urinary tract infections, usually within 24 hours, by transferring the pre-existing introital bacteria into the bladder. Abstention from sexual activity without any additional treatment prevented the development of new urinary tract infections in these women despite persistent introital enteric bacterial flora. Urinary tract infections occurred after onset of sexual activity in all but 2 of the premenopausal women in this study. The 25 premenopausal women with recurrent urinary tract infections were subjected to early postcoital prophylaxis consisting of bladder voiding and the administration of a single tablet of either cotrimoxazole (80 mg. trimethoprim plus 400 mg. sulfamethoxazole), nalidixic acid (500 mg.), nitrofurantoin (50 or 100 mg.) or sulfonamides (500 mg. sulfisoxazole or 250 mg. sulfamethizole). Whereas 70 urinary tract infections occurred during a mean 8-month followup before treatment only 4 occurred during the mean 12.5-month followup after introduction of post-coital prophylaxis (none occurred on co-trimoxazole or nalidixic acid therapy and only 1 infection occurred on nitrofurantoin therapy). Sulfonamides are not recommended as post-coital prophylaxis because of the higher incidence of breakthrough infections. Post-coital prophylaxis with co-trimoxazole, nalidixic acid or nitrofurantoin proved to be simple, economical and efficient, and is recommended in the prevention of recurrent urinary tract infections in otherwise normal premenopausal women.

Adult↗
PubMed1983

Changes in the electrolytes of serum and urine with heat exposure in the bovine.

Six mature Friesian bulls with an average body weight of 562 kg were kept - after a preparatory period - in a controlled climatic barn at 30 degrees C and 70% relative humidity for three weeks. They were fed 3.6 kg concentrates and 4 kg hay and water ad libitum. The rectal temperature remained unchanged under heat exposure. Na+, K+, and Ca++ increased in the blood serum, but decreased in the urine. Whereas PO4---increased in the serum and in the urine, the values for SO4--decreased in the serum and in the urine. The serum value for Cl- did not change, but the Cl- value decreased in the urine. The changes in the electrolyte metabolism at high environmental temperatures are important means of extending the discovery procedures for heat stress in cattle.

Animals↗
PubMed1981

The bacterial flora of the vaginal vestibule, urethra and vagina in premenopausal women with recurrent urinary tract infections.

Gram-negative enteric bacteria, mainly Escherichia coli, form the predominant microbial flora of the introitus, vagina and urethra in women with a normal genitourinary tract but who are prone to suffer recurrent urinary infections. The infections in these women tend to occur in greater numbers and persist for long intervals, compared to normal control women who never experience urinary infections and in whom the main introital, vaginal and urethral microbial flora consists of lactobacilli and staphylococci. The appearance of gram-negative enterobacteria in the normal and control subjects usually is a rare and transitory event. The majority of urinary tract infections that developed in our population during this study was preceded by a persistent similar gram-negative vulvovaginal and urethral microbial flora. However, prolonged spontaneous intervals occurred occasionally during which the introital, vaginal and urethral cultures were free of gram-negative bacteria, with simultaneous intervals free of infection. Nevertheless, all of these intervals ended with documented urinary tract infections. The introital culture is a reliable mirror of the vulvovaginal and urethral microbial flora and, therefore, it is adequate in the study of urinary infections in women.

Enterobacteriaceae↗
PubMed1980

Orthotopic renal autotransplantation in the treatment of renovascular hypertension.

Severe hypertension non-responsive to medical therapy was discovered in a 27-year-old woman in the third trimester of pregnancy. Renal arteriography after delivery revealed bilateral renal artery stenosis. The right kidney was smaller than the left one. The differential renal function studies, rather than the renal vein renin measurements, identified which side was causing the hypertension. An attempt at primary repair of the right renal artery failed. Orthotopic renal autotransplantation, using saphenous vein grafts that were interposed between the renal veins and the inferior vena cava, and between the segmental renal arteries and the abdominal aorta, reduced the blood pressure to normal values.

Adult↗
PubMed1978

Unilateral chronic pyelonephritis and hypertension: coincidental or causal relationship?

Three patients with well documented unilateral chronic pyelonephritis (UCP) of bacterial origin, one hypertensive and two normo-tensive, were presented. Removal of the contracted kidney in the hypertensive patient did not eradicate the hypertension. An attempt was made to define UCP as closely as possible. The clinical, roentgenologic, bacteriologic, functional and pathologic criteria of UCP was described. But, as other conditions may mimic the roentgenologic, functional and pathologic picture of UCP, a history of recurrent urinary tract infection accompanied by a documented unilateral renal bacteriuria is the basic requirement for a sustained diagnosis of UCP. In view of these more exacting criteria in the diagnosis of UCP, and its water and salt-losing functional pattern, UCP is a rare cause of hypertension, in the majority of cases the association of UCP with hypertension is merely coincidental.

Adolescent↗
PubMed1978

Pharmacologic management of postoperative overdistention of the bladder.

Postoperative bladder distention, accompanied by serious difficulties in micturition, is not a rare occurrence in surgical patients. Two similar groups of patients undergoing surgical treatment were studied. In one group of 21 patients who received phenoxybenzamine prophylactically only one patient had urinary retention develop; nine of 22 patients in the control group who did not receive prophylactic phenoxybenzamine postoperatively had urinary retention develop. All of the latter patients who then received phenoxybenzamine were ultimately relieved of voiding difficulties. Phenoxybenzamine, an alpha adrenergic blocker, is recommended as an effective and safe drug in diminishing or abolishing obstructive urinary symptoms postoperatively.

Aged↗
PubMed1977

The bacterial flora of the vaginal vestibule, urethra and vagina in the normal premenopausal woman.

A study of 100 healthy, premenopausal women demonstrated that lactobacilli and staphylococci are the predominant normal bacterial flora in the vaginal vestibule, urethra and vagina, with diphtheroids, streptococci and micrococci occurring in decreasing order. Gram-negative enterobacteria are a rare occurrence in the normal bacterial flora of the vaginal vestibule (7 per cent), urethra (9 per cent) and vagina (6 per cent). A second study of 10 healthy premenopausal women in whom serial examinations were done confirmed the findings of the first study and revealed that when gram-negative enterobacteria do colonize the normal vaginal vestibule, urethra and vagina colonization is of a transitory nature since enterobacteria tend to disappear spontaneously.

Bacteria↗