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M Grunebaum

Publications and source records attributed to M Grunebaum.

At least 19 recordsLinked to original sources
PubMed2001

Malposition of catheters during voiding cystourethrography.

The aim of this study was to report catheter malposition during voiding cystourethrography. Eight hundred forty-three voiding cystourethrography (265 males and 578 females, aged 1 week to 12 years, mean age 2 years) were performed during a period of 4 years. The conventional standard procedure was applied. In 3 cases with passed history of urinary tract infection the catheter entered directly into the ureter. In all these cases the uretero-vesical reflux was present on the same side where the catheter entered. It appears that insertion of a catheter into the ureter is possible only in the presence of an anomaly or pathology at the vesicoureteric junction.

Child, Preschool↗
PubMed2001

Minimal pelvic fluid in blunt abdominal trauma in children: the significance of this sonographic finding.

PURPOSE: The aim of this study was to evaluate the significance of the ultrasonographic finding of pelvic fluid after blunt abdominal trauma in children as a predictor of an abdominal organ injury. METHODS: The clinical and imaging data of 183 children with blunt abdominal trauma were reviewed retrospectively. All children had an abdominal sonography as the primary screening study. The ultrasound results were divided into 3 groups: group A, normal examination; group B, pelvic fluid only; group C, peritoneal fluid outside the pelvis. The results of the initial ultrasound examinations were compared with the findings of the CT scan, or a second ultrasound examination or the clinical course during the hospitalization. RESULTS: Group A included 87 children; group B, 57, and group C, 39. Four abdominal organ injuries were missed by the ultrasound examination. The sensitivity and specificity of the ultrasound examinations to predict organ injury in presence of peritoneal fluid outside the pelvis were, respectively, 89.5% and 96.6%; the positive and negative predictive value were 87.2% and 97.3%. No statistically significant difference was seen between group A and group B, whereas the presence of peritoneal fluid outside the pelvic cavity (group C) was associated strongly with an organ injury (P <.001). CONCLUSIONS: A normal ultrasound examination or the presence of pelvic fluid are associated with a low probability of an organ injury. In the presence of peritoneal fluid outside the pelvis, the probability of an organ injury is very high.

Abdominal Injuries↗
PubMed2001

Pyelocalyceal diverticulum: the imaging spectrum with emphasis on the ultrasound features.

Clinical and imaging data of 11 patients with pyelocalyceal diverticulum were retrospectively examined. Four patients suffered from ipsilateral flank pain, one from recurrent urinary tract infection and the other six from unrelated symptoms. All patients underwent ultrasound as the initial imaging study. In two cases ultrasound was the only examination performed. Additional imaging studies were obtained in the other nine patients (abdominal radiography in six cases, intravenous urography (IVU) in five and CT in four). Ultrasound suggested the diagnosis of pyelocalyceal diverticulum in eight cases owing to the presence of echogenic and mobile material within the cyst-like lesion. In three cases the ultrasound appearance was similar and indistinguishable from a simple cyst and the diagnosis was made by another imaging study IVU in two cases and CT in one). We suggest that ultrasound examination is the best imaging method for the diagnosis of a pyelocalyceal diverticulum, and no further imaging modalities are required when mobile echogenic material is seen. In uncertain cases, another relatively inexpensive imaging study should be added such as abdominal radiography or IVU.

Abdominal Pain↗
PubMed1999

Predictors of management problems in supported housing: a pilot study.

The study examined predictors of management problems among residents of a supported single room occupancy hotel (SRO) for persons with severe and persistent mental illness (SPMI). Case workers completed questionnaires on the prior six months. We found that medication-compliant residents without drug abuse were rarely disruptive, while those with co-morbid substance abuse were often disruptive. Residents non-compliant with medication also tended to cause management problems whether or not they abused drugs. Supported residences should be staffed and organized to minimize medication non-compliance and substance abuse which are associated with behavioral disruptiveness.

Adult↗
PubMed1997

Iron overload following bone marrow transplantation in children: MR findings.

OBJECTIVE: The purpose of this study was to determine the incidence of post-transfusional iron overload in children after bone marrow transplantation by reviewing their magnetic resonance imaging (MR) findings. MATERIALS AND METHODS: We reviewed the abdominal MR studies of 13 children after autologous bone marrow transplantation. Nine of the children had also undergone MR prior to transplantation. Iron deposition in the liver, spleen and bone marrow was graded semi-quantitatively on both T1- and T2-weighted images. Serum ferritin levels and number of blood units given after bone marrow transplantation were recorded. RESULTS: None of the pre-transplantation MR studies revealed iron overload. After bone marrow transplantation, three children showed normal liver and spleen. Iron overload in the liver was noted in ten patients (77 %), six of whom also showed iron overload in the spleen (46 %) and five in the bone marrow (38.5 %). The degree of hepatic iron overload was correlated significantly and splenic iron overload was correlated weakly with the number of blood transfusions (P = 0.01 and P > 0.01, respectively), but neither was correlated with the serum ferritin level. CONCLUSION: Iron overload commonly accompanies bone marrow transplantation. The observed pattern of iron deposition, in which the spleen was uninvolved in 40 % of patients demonstrating iron overload, is not typical of post-transfusional hemochromatosis.

Abdomen↗
PubMed1996

MRI in acute poliomyelitis.

MRI can be used in the diagnosis of anterior horn infection and for assessing the extent of disease. There are no specific MRI signs to differentiate between the various possible pathogens. This is demonstrated in the present case of poliomyelitis, in which MRI of the spine played an important role in establishing the diagnosis.

Anterior Horn Cells↗
PubMed1996

Predictors of missed appointments for psychiatric consultations in a primary care clinic.

OBJECTIVE: The purpose of the study was to determine predictors of missed appointments for psychiatric consultations among patients in a general medical clinic. METHODS: The charts of 180 patients consecutively referred for psychiatric consultations at a university-affiliated primary care clinic were reviewed. Ninety patients missed appointments for these consultations. Parametric and nonparametric tests were used to compare patients who missed and did not miss appointments on demographic and clinical variables, as well as measures related to patients' interactions with the clinic and the referring clinician. RESULTS: Logistic regression analysis revealed three significant predictors of missed appointments. Patients with mild distress and those with significant resistance to seeing a psychiatrist were more likely to miss appointments, as were those who had to wait longer between the referral and the appointment date. CONCLUSIONS: The results suggest that shortening the wait for a psychiatric consultation, reserving consultation for more severe cases, and working to reduce patients' resistance to consultation will reduce the number of missed appointments.

Adolescent↗
PubMed1996

The natural history of osteonecrosis of the femoral head in children and adolescents who have Gaucher disease.

We reviewed the cases of eight patients (thirteen hips) with Gaucher disease who had had osteonecrosis of the femoral head and had been managed with bed rest and non-weight-bearing with crutches only in the symptomatic stage of the bone crisis. The mean age of the patients at the onset of the first crisis in each hip was ten years (range, six to fourteen years). The mean age at the most recent follow-up examination for the six living patients (ten hips) was twenty-three years (range, nineteen to thirty-three years). The Mose rating was good for one hip, fair for two, and poor for seven. Despite the over-all unfavorable radiographic ratings, the six patients were asymptomatic and did not need assistance with daily activities. There is no known treatment that effectively prevents the development of deformities of the femoral head. Thus, we recommend symptomatic management for osteonecrosis of the femoral head in Gaucher disease with bed rest and analgesics followed by non-weight-bearing on the involved limb, if it makes the patient more comfortable, during the symptomatic stage of bone crisis.

Adolescent↗
PubMed1995

Central precocious puberty: evaluation by neuroimaging.

To evaluate the incidence of abnormal intracranial findings in children with central precocious puberty, 62 children (51 girls, 11 boys) were examined by computerized tomography and/or magnetic resonance imaging (MRI) of the brain. Forty-four had normal examinations; 18 (11 girls, 7 boys) showed intracranial pathologies, including hamartoma of the tuber cinereum (8 cases), parenchymal loss (3 cases), hypothalamic-chiasmatic lesions (2 cases), lesions of the corpus callosum (2 cases), suprasellar cyst (1 case), and pineal cyst and mesiotemporal sclerosis (1 case each). Based on the correlation between the clinical and the imaging results of this series, the authors recommend MRI as the imaging method of choice in the investigation of precocious puberty.

Brain Diseases↗
PubMed1994

A rare coexistence of a multicentric hepatic hemangioendothelioma with a large brain hemangioma in a preterm infant.

A preterm infant with a rare association of a multicentric hepatic hemangioendothelioma (MHH) and a large brain hemangioma is described. The imaging investigations and their findings are discussed. It is recommended that whole-body radionuclide imaging with 99mTc-labeled red blood cells is employed immediately following ultrasonography to confirm the suspected diagnosis of MHH and to detect other unsuspected hemangiomas.

Brain Neoplasms↗
PubMed1993

Bronchiectasis in children: assessment by CT.

The prevalence of bronchiectasis (BR), in general, is decreasing, yet the disease can produce significant morbidity in children. In the pediatric age group the classical investigation by bronchography implies general anaesthesia, thus carrying an additional risk of complications. CT has proved highly accurate in the diagnosis of BR in adults. It is also considered a reliable modality for the diagnosis of BR in children. This conclusion was reached by analysing the radiographic and the CT findings in 40 children with the clinical suspicion of BR in 25 of whom the CT examination was positive. Nine patients of this last group had bronchography as well. There was complete correlation in the diagnosis and location between the CT and the bronchographic findings. Thus, it seems that the occurrence of this disease is still high in the pediatric population in the appropriate clinical and radiological setting. The imaging evaluation of BR should include chest radiographs, computerized tomography and, if surgery is planned, bronchography as well.

Adolescent↗
PubMed1992

The bubble sign in the gasless abdomen of the newborn.

The bubble sign (BS) in the gasless abdomen of the newborn is a helpful clue in the diagnosis of an upper gastrointestinal obstruction. The already swallowed air serves as the natural contrast agent. The single, double and triple BS are described in view of 23 cases indicating the level of the obstruction, and its differential diagnosis is discussed. The presence of BS in the gasless abdomen of the newborn is an indication for surgery until proved otherwise. With the increasing experience by ultrasonography, this modality should be considered as the first bed-side procedure when suspecting upper gastrointestinal obstruction, and then be confirmed by radiograms.

Air↗