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M Hertz

Publications and source records attributed to M Hertz.

At least 73 records · Page 4Linked to original sources
PubMed1989

The natural history of reflux in the lower pole of duplicated collecting systems: a controlled study.

Thirty two children with reflux into the lower pole of duplicated collecting systems, followed non-operatively for one to five years, were compared to a carefully selected control group of similar children who had reflux into a single collecting system. There were no significant differences between the two groups, either in the outcome of reflux or in the incidence of new renal scars. We conclude that reflux into the lower pole of a duplex kidney does not in itself constitute an indication for early surgical treatment.

Child↗
PubMed1989

Femoral neuropathy: the role of computed tomography in diagnosis and management in 27 patients.

The computed tomography findings in 27 patients with an ultimate diagnosis of femoral neuropathy were reviewed. Haemorrhagic disorders were responsible for the neuropathy in 10 patients, neoplasia in eight, infection in five and in the remaining four patients no abnormality was noted on CT and the aetiology remained uncertain. Unilateral enlargement of the iliopsoas muscle or a soft tissue mass involving the iliopsoas compartment was noted in the 23 patients with positive studies. The exact nature of the mass could not be determined by CT alone, but, when considered together with clinical history and examination, a definitive diagnosis was possible in most instances. Whenever necessary, percutaneous needle biopsy or drainage was performed. Computed tomography should be performed at an early stage in all patients suspected of femoral neuropathy. It accurately demonstrates and delineates retroperitoneal masses causing this condition and allows further definitive diagnostic procedures such as biopsy or drainage to be performed when necessary.

Adolescent↗
PubMed1989

Imaging of children with urinary tract infection: a tailored approach.

We reviewed the initial imaging studies of 283 children with urinary tract infection in order to decide on the most effective approach. A voiding cystogram was performed in all, complemented by either urography (147 patients), ultrasonography (65), or both (71 patients). In the latter group there was good correlation between sonographic and urographic findings, except for a more accurate delineation of renal scars and anomalies on urography, all in children with vesicoureteral reflux and/or abnormal sonograms. From these data we derived two imaging sequences tailored to the clinical circumstances: cystography as the initial study in ambulatory patients after infection has subsided, and sonography followed by cystography in children hospitalised with severe infection. The upper tracts are studied by ultrasonography and/or urography in patients with significant vesicoureteral reflex or an abnormal sonogram. Both these sequences reduce radiation by omitting the urogram in roughly half of the patients.

Adolescent↗
PubMed1989

Vesicoureteral reflux in boys: review of 196 cases.

To determine the frequency of vesicoureteral reflux (VUR) in boys, the authors retrospectively studied 724 boys who underwent voiding cystourethrography for the first time. VUR was identified in 196 of these patients (27.0%). Urinary tract infection was the indication for cystourethrography in 188 patients (25.9%), 80 of whom (42.5%) had VUR. Hypospadias was the second most frequent indication (179 patients [24.7%]), with VUR present in 32 (17.8%). A significant frequency of VUR was demonstrated in boys studied for various other conditions. Excretory urography in 588 boys revealed congenital anomalies of the upper urinary tract in 72, with VUR in 26 (36.1%), which was significantly higher than that in boys with hypospadias (P greater than .01). There was no significant difference between the frequency of VUR in boys with hypospadias with or without meatal stenosis (P greater than .9) and in boys with meatal stenosis with or without hypospadias (P greater than .9); thus, VUR seems to be independent of mild urethral obstruction and hypospadias. VUR was more frequent in boys with posterior urethral valves (62.5%, P less than .002). VUR in boys with urinary tract infection is as common as in girls. In most cases, its frequency in many apparently unrelated conditions is suggestive of its primary nature.

Adolescent↗
PubMed1989

Acute myocardial infarction in pregnancy and puerperium.

Myocardial infarction during pregnancy and puerperium is very rare. Increased awareness of its possible occurrence is important for diagnosis. A young woman who developed acute myocardial infarction 14 days after labor is described. She had no coronary risk factors; coronary angiography was not done, but ergometric test involving maximal stress done 22 months after confinement did not reveal signs or symptoms of disease. An additional 62 women with myocardial infarction, 51 during pregnancy and 11 in puerperium, reported in the literature were reviewed. The following points were observed: (1) Hypertension was present in 25% of cases. (2) Four out of 6 coronary angiograms performed after the infarct were normal. (3) Fifteen patients died (24% mortality). (4) Coronary atherosclerosis was the main finding in 7 out of 9 post-mortem examinations.

Adult↗
PubMed1988

An ethological description of depression.

During the last 20 years ethological psychiatric research has developed a working method for the systematic and quantitative recording and analysis of the nonverbal behaviour of psychiatric patients in their actual hospital environment. In this study this method was used to follow changes in the behaviour pattern of 5 depressed, hospitalized patients during their entire hospital stay. Parallel to ethological recording, patients were rated according to Hamilton twice a week. The patients who were most depressed at admission showed the greatest behavioural changes; the changes were most conspicuous in the behavioural elements representing social contact and communication. One patient who obviously developed a new depression during the observation period without this being recognized by the Hamilton rating or the clinical control, seemed to have been better described by the behaviour recording. This study shows that ethological psychiatric methods are very suitable for obtaining a better basis for the observations of the staff in the ward environment.

Aged↗
PubMed1988

An ethological analysis of depression: comparison between ethological recording and Hamilton rating of five endogenously depressed patients.

Five patients who had all been diagnosed as endogenously depressed at admission were rated twice a week and observed ethologically for 4 h/week during the entire hospitalization (4-11 weeks). Observations were carried out in the actual social environment of the ward. Data were analysed based on the parameters of behaviour diversity, behaviour activity, and marker elements. Depression was scored as low values of diversity and activity; improvement corresponded to higher values of these parameters. As possible markers of improvement, 8 behavioural elements have been singled out. One patient constituted a special case: at discharge she was rated as completely recovered; however, the ethological data indicated a serious aggravation. The day after discharge the patient attempted to commit suicide. It is concluded that ethological psychiatric research may be able to supplement traditional psychiatry with decisive information in the areas of diagnosis and treatment assessment.

Aged↗
PubMed1987

Urethral strictures in boys.

While common in adult males, urethral strictures are comparatively rare in boys. We report our experience with this condition in 19 boys. Ten of the strictures were iatrogenic, seven traumatic, and three inflammatory in origin. Dilation is reportedly unsatisfactory for the management of most urethral strictures in children. In our series, however, 9 patients (47.3%) underwent urethral dilation as the only definitive form of treatment, while urethroplasty was successfully performed in the other 10 cases.

Child↗
PubMed1987

Vesicoureteral reflux in adults: a review of 95 patients.

Ninety-five adult patients with primary vesicoureteral reflux were reviewed concerning the presenting symptoms, radiological findings, associated renal damage, treatment and results of follow-up. We found a relatively high incidence of reflux in adult males. Although urinary tract infection and flank pain were the most common presentation, others had a wide variety of complaints not directly attributable to reflux. Renal anomalies were present in 37 patients. We found surgical correction of reflux useful in preventing infection, and recommend it especially in young women who may become pregnant.

Adolescent↗
PubMed1986

Familial vesicoureteral reflux: a study of 16 families.

Siblings of patients with vesicoureteral reflux (VUR) are reported to have an increased incidence of reflux. We present 16 families with 33 affected children out of a total of 493 patients with VUR. Twenty-seven had urinary tract infection and 6 were asymptomatic and were examined because a sibling had VUR. Renal scarring was present in 19 cases; reflux was more marked and more often bilateral in the siblings than in sporadically affected children. In view of our findings we suggest that siblings of patients with VUR be screened early for reflux to prevent renal damage from untreated VUR.

Adolescent↗
PubMed1986

Ultrasonography in the staging of Hodgkin's disease: lymphangiographic correlation.

The contribution of ultrasonography (US) to the staging of Hodgkin's disease was studied in 45 patients. US findings were compared with lymphangiograms (LAG) performed in the same period. In 93% of the patients there was good correlation between the two examinations. In 7% (three patients) there was a discrepancy: LAG showed retroperitoneal node involvement while with US this was negative. There were no false-positive US examinations. We therefore suggest that US be used as the primary method in the initial evaluation of Hodgkin's disease and LAG be performed only when US is negative.

Hodgkin Disease↗
PubMed1986

A new skeletal dysplasia syndrome with rhizomelia of the humeri and other malformations.

An Arab family is reported in which the proband and two affected sibs had bilateral rhizomelia of the humerus and other skeletal, craniofacial and cardiac abnormalities. Since all three affected sibs died during early childhood, this may be a lethal condition. We believe this constellation of findings which has not been previously described represents a new syndrome, most probably transmitted as an autosomal recessive disorder.

Abnormalities, Multiple↗
PubMed1986

Skull x-rays in head trauma: are they still necessary? A review of 1000 cases.

One thousand consecutive skull x-rays in patients with head trauma were reviewed. Only eighteen (1.8%) showed a fracture. Four of these were depressed. Thirteen of the 18 patients were below 15 years of age and 15 were males. Two patients had evidence of intracranial trauma on computed tomography (CT). The outcome was favorable in all patients. In view of the extremely low yield of skull x-rays for trauma, we believe that this examination is no longer indicated as a routine procedure. Patients with a suspected intracranial injury should be evaluated by CT study.

Adolescent↗
PubMed1985

Urinary bladder tumors following cyclophosphamide therapy: a report of two cases with a review of the literature.

Sterile hemorrhagic cystitis following cyclophosphamide (Cph) therapy is a relatively frequent and well-documented phenomenon. On the other hand, cancer of the urinary bladder associated with Cph therapy is rarely observed. We present two cases and summarize 32 patients reported in the literature. Thirty patients had malignant disease elsewhere, 27 of them nonsolid tumors. The other four patients received treatment with Cph for nonmalignant disease (systemic lupus erythematosus--3; rheumatoid arthritis--1). The bladder tumor developed several months to years after treatment. In 20 patients hemorrhagic cystitis antedated the tumors. We conclude that hemorrhagic cystitis in patients on Cph therapy should indicate at least temporary withdrawal of the drug. The decision to resume treatment should be taken with extreme caution considering the risk of the development of bladder cancer.

Adolescent↗
PubMed1985

Ureterocutaneous fistulas secondary to urinary calculous disease.

Fistulas of the ureter are uncommon and are usually secondary to trauma or iatrogenic in nature. Spontaneous rupture of the ureter is rare, usually ending in a periureteral abscess. Two cases of spontaneous rupture of the ureter secondary to calculous disease resulting in ureterocutaneous fistulas are described.

Aged↗