Search PubMed⌕ Search

Biomedical subjects

D A Bloom

Publications and source records attributed to D A Bloom.

At least 127 records · Page 7Linked to original sources
PubMed1988

A bladder pressure management system for myelodysplasia--clinical outcome.

A program for the management of neurogenic bladder in patients with myelodysplasia was instituted in July 1983. Of the 114 patients entered into the program who have been followed for a minimum of 18 months 42 per cent required treatment for high intravesical pressures. None of this group or the larger group with low bladder pressures showed progressive upper urinary tract deterioration. In 8 children (17 per cent of those with high pressure bladder dysfunction) high intravesical pressure persisted despite anticholinergic medication and intermittent catheterization, and they required an operation to achieve a low pressure bladder. These results confirm the findings in other studies that about 40 per cent of myelodysplastic children are at high risk for the development of upper tract changes, and that approximately 6 to 8 per cent will not respond sufficiently to anticholinergic agents and intermittent catheterization.

Adolescent↗
PubMed1988

The role of laparoscopy in management of nonpalpable testes.

Laparoscopy is the ideal first operative step in management of boys with nonpalpable testes. No other investigation is as reliable in locating a nonpalpable testis or in confirming its absence. Whatever the laparoscopic findings, further operative intervention is generally necessary and the laparoscopic findings determine the subsequent operative steps. Laparoscopy also permits endoscopic manipulation such as application of a spermatic vessel clip for staged Fowler-Stephens orchidopexy. Herein we report our experiences with laparoscopy in 30 patients with nonpalpable testes.

Adolescent↗
PubMed1986

Stomal construction and reconstruction.

Urinary diversion plays an important role in the therapeutic repertoire of urologists. The stoma is often the weak link of any diversionary procedure. Some of the more common stomal problems include peristomal dermatitis, stomal stenosis, parastomal hernias, malposition, prolapse, and retraction. Depending on the nature and severity of the problem, it may be treated by local wound care, urinary appliance adjustment, dilatation, or surgical intervention. Careful site selection and stomal creation will keep stomal problems to a minimum.

Dermatitis↗
PubMed1985

Cost-effective uroflowmetry in men.

A simple method of timed urine flow measurement performed at home by the patient is compared to instrumental measurements of peak flow rate. The timed method correlates well with the peak flow rate. Timed uroflowmetry is free, can be done in the privacy of the home and provides multiple measurements. This is a valid technique to document a weak stream and is a useful screening test for patients with lower urinary tract obstruction.

Adult↗
PubMed1983

Leiomyosarcoma of the inferior vena cava presenting as a suprarenal mass.

Leiomyosarcoma of the inferior vena cava is a rare disease with protean manifestations related to the location of the tumor. Urological manifestations of the disease are rare and include renal vein thrombosis and renovascular hypertension. Approximately 63 cases have been reported in the literature, with a striking female predominance. Presentation as an isolated suprarenal mass has not been reported previously. We discuss this unusual tumor and report a case that presented as an asymptomatic suprarenal mass.

Diagnosis, Differential↗
PubMed1983

The Turnbull loop stoma.

The stoma is the weak link of external urinary diversion. Improper stomal position or configuration produces the unnecessary burden of leakage for the patient with diversion. Stomal bleeding, incrustation and peristomal dermatitis cause inconvenience and expense. Stomal stenosis is the most common reason for repeat operation of an ileal conduit. The Turnbull loop stoma obviates many of these problems. We have performed 100 urinary diversions using this stoma with minimal stomal complications and no episodes of stomal stenosis from 1 to 7 years postoperatively. The significant complication has been parastomal hernia. Minor modifications of the technique have lowered the incidence of hernia. Loop stomas are our principal form of stomal construction.

Abdominal Muscles↗
PubMed1982

The significance of lymph nodal involvement in renal angiomyolipoma.

Renal angiomyolipoma, a benign tumor, can involve regional lymph nodes. Although this phenomenon has been reported previously followup information has been scant. We have treated 3 patients who had renal angiomyolipoma with nodal involvement and all had further evidence of tuberous sclerosis. Each patient had hematuria with flank pain and required nephrectomy. In the ensuing 3 to 11 years none of these patients has had evidence of further disease progression. Nodal involvement may reflect the multicentricity of angiomyolipoma or may represent a form of "benign metastasis" but it does not appear to be a harbinger of disease progression.

Adult↗
PubMed1981

Management of malignant hyperthermia.

A case of malignant hyperthermia in a young girl with vesicoureteral reflux and multiple congenital abnormalities is discussed. Malignant hyperthermia is a relatively newly defined problem that is associated with anesthesia. It is being recognized with increasing frequency, particularly in children with multiple musculoskeletal anomalies. The term itself is a misnomer. It is a drug-induced syndrome of hypermetabolism that may represent an inborn error of metabolism. Recognition, prophylaxis and crisis management are reviewed, and the use of dantrolene sodium in the care of patients with malignant hyperthermia is discussed. Because recognition of malignant hyperthermia is an important concern for the practicing urologist, the principles of identifying the patient at risk, as well as managing the crisis, should be familiar to the clinician.

Abnormalities, Multiple↗
PubMed1980

Ileal ureter: current status.

Use of the ileum as a substitute for the ureter should be taken into consideration when urinary tract continuity cannot be restored by using urinary tract tissue. Another important indication for this procedure is recurrent renal calculi, to permit the free passage of stones. It is essential to reserve this operation for those patients whose renal function is relatively adequate. Chronic renal insufficiency with a serum creatinine level above 2.0--2.2 mg% is a contraindication for the operation. Another prerequisite for the operation is that the patient is able to empty his bladder; otherwise deterioration of renal kidney function may occur. The present article gives a review on the ileal ureter, with emphasis on the indications and operative technique.

Aged↗
PubMed1980

Variants of the exstrophic complex.

In the split symphysis variant, a rare anomaly of bladder exstrophy, the bladder is closed with varying degrees of skin covering it. A good prognosis does exist for surgically produced continence in patients with a single bladder, although patients with bladder duplication have a greater risk of renal damage.

Bladder Exstrophy↗
PubMed1976

Malignant hyperpyrexia during anesthesia in childhood.

Malignant hyperpyrexia is a highly lethal complication of general anesthesia. It occurs with sufficient frequency, particularly in children and young adults, to justify use of continuous temperature monitoring during adminnstration of general anesthesia. Fever may be a late manifestation of the malignant hyperpyrexia syndrome, and it is important to be aware of the early signs. Prompt recognition and aggressive management should lower the high mortality known to occur with this complication. Family members should be screened for CPK elevations to determine possible susceptibility to malignant hyperpyrexia. Two case reports illustrate these points of diagnosis and management.

Anesthesia, General↗