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J Dacher

Publications and source records attributed to J Dacher.

5 recordsLinked to original sources
PubMed2000

Total bilateral ureteral replacement for stenosing ureteritis in Henoch-Schönlein purpura.

Stenosing and calcified ureteritis occurring in Henoch-Schönlein purpura remains a rare urological complication. The authors describe their own experience of the diagnosis and treatment of this rare pathology along with a review of the literature. Recognition and early surgical management may prevent serious renal outcome. In cases of ureteral replacement, different procedures using ileal segment have been proposed. We report the results of the Cockett and Goodwin procedure with a follow-up of more than 25 years.

Child↗
PubMed2000

[MRI of the brain in the evaluation of children with developmental delay].

PURPOSE: To analyze the diagnostic value of MRI in children with developmental delay. Materials and Methods. From 1991 to 1997, 224 examinations were performed. Retrospective analysis of clinical findings and diagnostic yield was carried out. RESULTS: MRI was abnormal in 109 cases. It never resulted in any patient care modification. 55 malformations, 12 cases of cerebral atrophy, 7 cases of white matter disease and 2 patients with phakomatose were identified. Myelination delay (26 cases), increased signal of posterior white matter on T2-weighted images (9 cases) or widened Virchow-Robin spaces (3 cases) were frequently encountered, but it remained unclear whether they represented normal variants or true abnormalities. Post ischemic lesions were identified in 10 cases. Frequency of abnormal studies was significantly lower in children with developmental delay and behavioral disorders than in patients with other clinical presentation. CONCLUSION: Diagnostic yield of cerebral MRI can justify its performance by comparison to other imaging modalities. It should be correlated with other investigations performed in a specialized unit. Its main interest is for classification and research. Risk of sedation or anesthesia should also be taken in account. Risk can be lowered using adequately equipped MR units and organizing procedures in collaboration with anesthesiologists.

Adolescent↗
PubMed1999

Shortcomings of diuresis scintigraphy in evaluating urinary obstruction: comparison with pressure flow studies.

BACKGROUND: In at least 15 % of dilated urinary tracts, diuresis renography fails to assess the presence or absence of urinary obstruction. OBJECTIVE: To determine the shortcomings of (99 m)Tc-DTPA frusemide diuresis renography by reference to pressure flow studies. MATERIALS AND METHODS: Thirty-four patients, aged 1 month to 20 years, with questionable obstruction were evaluated by diuresis renography and pressure flow studies (the Whitaker test) as the reference method during the same short period of time. Discrepancies were analysed. RESULTS: In patients with type I or IIIa renographic response, pressure flow studies never led to any change in management. Poor function, major dilatation and prior surgery were found to be risk factors of inaccurately obstructive pattern (type II) on renography (n = 6). In patients with type IIIb response, pressure flow studies could show low-grade (n = 3) or intermittent obstruction (n = 2). Intermittent obstruction was also demonstrated in two patients with type II response. CONCLUSION: In patients with risk factors, type II response was sometimes inaccurate, and urodynamic evaluation showed absence of obstruction and led to conservative management. Type IIIb response should be considered equivocal rather than partially obstructive, and pressure flow studies could be considered in such patients.

Adolescent↗
PubMed1998

Iodixanol in paediatric excretory urography: efficiency and safety compared to iohexol.

BACKGROUND: Iodixanol (Visipaque, Nycomed Imaging AS, Oslo, Norway) is a new non-ionic and isotonic X-ray contrast medium. OBJECTIVE: To assess its safety and efficacy for paediatric excretory urography. MATERIALS AND METHODS: A three-centre trial in which 72 patients were randomised into three parallel groups: iodixanol 270 mgI/ml, iodixanol 320 mgI/ml and iohexol 300 mgI/ml (Omnipaque, Nycomed Imaging, Oslo, Norway). Doses ranging from 1 to 3 ml/kg never exceeded 50 ml. Pulse rate and blood pressure were recorded before, during, and after the examination. Adverse events, including injection associated discomfort, were recorded during and up to 24 h after the examination. The diagnostic quality of the urograms was assessed on a four-level scale. RESULTS: No serious adverse event occurred in any of the three groups. One patient who was given iodixanol 270 mgI/ml, three who received iodixanol 320 mgI/ml, and one who received iohexol 300 mgI/ml experienced transient adverse events. More than 80 % of the urograms in all three groups were rated "good" or "excellent". CONCLUSION: Iodixanol, either 270 mgI/ml or 320 mgI/ml, is well tolerated and efficacious for excretory urography in children.

Adolescent↗