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Biomedical subjects

M I Resnick

Publications and source records attributed to M I Resnick.

At least 181 records · Page 10Linked to original sources
PubMed1988

Extracorporeal shock wave lithotripsy in traumatic quadriplegic patients: can it be safely performed without anesthesia?

A total of 5 traumatic quadriplegic patients underwent 10 extracorporeal shock wave lithotripsy treatments with either a local (bupivacaine 0.25 per cent) field block or no anesthesia. Significant intraoperative hypertension as determined by the anesthesiologist occurred in 2 patients and responded to intravenous hydralazine. The complete clinical syndrome of autonomic dysreflexia did not occur. Three patients are free of stones and 2 have insignificant residual caliceal fragments. Extracorporeal shock wave lithotripsy may be performed safely in traumatic quadriplegic patients without the added risk of general or regional anesthesia. It is recommended that during therapy these patients should be monitored closely by an anesthesiologist for the signs and symptoms of autonomic dysreflexia.

Adult↗
PubMed1988

Transrectal ultrasound guided versus digitally directed prostatic biopsy: a comparative study.

A total of 45 patients was evaluated with palpable prostatic nodules by digitally directed and ultrasonically guided biopsies. Of 14 patients with carcinoma tumor was detected by both techniques in 11. Of the remaining 3 patients 2 had positive findings only with the digitally directed biopsy and 1 only with the ultrasound guided biopsy. The study indicates that ultrasound guided prostatic biopsy is not necessary as a routine procedure when a distinct nodule is palpable.

Adenocarcinoma↗
PubMed1988

A new approach to the study of urinary macromolecules as a participant in calcium oxalate crystallization.

Despite intense investigation, the relationship of urinary proteins to urinary stone matrix formation remains poorly understood. In an attempt to gain more information regarding this interaction, the binding of urinary proteins to calcium oxalate crystals formed in urine in vitro was studied. 0.1 M calcium chloride and 0.1 M sodium oxalate were added to an aliquot of urine collected from five non-infected, non-stone forming males. The resulting calcium oxalate crystals were centrifuged and the pellet demineralized with 5% EDTA. Gel filtration chromatography was used to isolate the protein fraction from the urine samples before and after crystallization of calcium oxalate. The proteins recovered from the crystals and urine were separated by two-dimensional polyacrylamide gel electrophoresis. Many, but not all of the urinary proteins were bound by the crystals. Albumin, seen to the most abundant urinary protein, was absent or markedly diminished in all instances, and the second most abundant urinary protein, PC-30, became the predominant protein component of the crystals. An unidentified protein with approximate molecular weight of 22,000 daltons and isoelectric point of 6.4 was highly concentrated by the crystals even when undetected in the urine. The study suggests that the binding of urinary proteins to calcium oxalate crystals formed in urine in vitro is not a random event but rather a selective phenomenon.

Adult↗
PubMed1988

Prostate ultrasound.

Transrectal ultrasonic imaging of the prostate gland has proved a valuable tool in determining the stage of carcinoma of the prostate and in monitoring the effectiveness of endocrine and radiation therapies. Ultrasonography has been useful in prostatic biopsy, too, but there is debate over its routine use in patients with palpable prostatic abnormalities.

Biopsy↗
PubMed1988

Office urologic ultrasound.

Advances in technology have made ultrasound equipment available for office use. The indications for examination vary depending on the region of the body where disease is suspected. For some conditions, ultrasound may not be an appropriate diagnostic modality. It is the responsibility of the physician to decide whether office ultrasonography is of value. As the equipment is assimiliated into the diagnostic armamentarium, more information on the cost effectiveness and efficacy of office ultrasound for the urologist will become available. Ultrasonography should be performed by the clinician only after appropriate training. Office-based, urologist-operated ultrasound should not replace the proper evaluation of the patient by a radiologist who is trained specifically to make diagnoses using this modality. However, for quick, efficient evaluation of the patient to uncover a disease process, office ultrasonography may supplement the information available through routine history, physical examination, and laboratory studies.

Ambulatory Care↗
PubMed1988

Injection therapy for impotence.

Injection of vasoactive drugs is an effective form of treatment for selected patients with impotence from virtually all causes. The two most commonly employed drugs in the United States are either papaverine alone or various combinations of papaverine and phentolamine. Patients with organic and mixed impotence are best suited for injection treatment, but selected patients with psychogenic impotence also benefit from therapy. After the patient is selected for injection therapy, he undergoes a series of trial injections in the physician's office. The incidence of priapism will be minimized if the initially administered doses are low and the patient is titrated to an appropriate dose level. Uncontrolled trials have revealed that injection treatment produces a satisfactory erection in 65 to 100 per cent of patients for a follow-up period of as long as 2 years with minimal side effects, but the dropout rate is high. If priapism does occur, it almost always responds readily to treatment with aspiration, low doses of an alpha-adrenergic agent, or both. The other common side effects are bruising or ecchymosis and nodule formation at the injection site. This latter complication has not been noted to cause significant abnormal penile curavature necessitating cessation of the program.

Clinical Trials as Topic↗
PubMed1988

Prevention of the development of a vesicovaginal fistula.

The cause of vesicovaginal fistulas after hysterectomy is not clearly understood. In an attempt to determine its cause, the records of 12 patients who had vesicovaginal fistula develop (after total abdominal hysterectomy) were compared with 12 consecutive patients who underwent total abdominal hysterectomy without fistula formation. Most of the patients who had vesicovaginal fistulas develop had excessive postoperative abdominal pain, distension or paralytic ileus, or both. Hematuria and symptoms of irritability of the bladder were also noted in the fistula group and prolonged postoperative fever and increased white blood cell count occurred more often. In contrast, the postoperative course was uncomplicated in the nonfistula group. The clinical course observed in many of the patients with vesicovaginal fistulas suggests that the patients had an unrecognized injury to the bladder resulting in urinary extravasation. It is postulated that the fistula develops when the urinoma drains into the vaginal cuff which is dependent and usually not closed. It may be possible to abort the development of many vesicovaginal fistulas by early recognition and treatment of an unsuspected bladder injury. It is suggested that patients with severe abdominal pain, distension, paralytic ileus, hematuria or symptoms of severe irritability of the bladder after abdominal hysterectomy be investigated early for a possible bladder injury.

Adult↗
PubMed1988

Retrograde percutaneous nephrostomy.

Retrograde percutaneous nephrostomy puncture to aid in stone removal is a safe and acceptable alternative to antegrade techniques. For urologists with expertise in endoscopic instrumentation and technique, it is easy to learn and does not require the presence of a skilled interventional radiologist. The advantages of the technique are that it can be performed in a non-dilated collecting system and can result in more accurate and less traumatic puncture. We have found it difficult to use in the presence of staghorn calculi filling the kidney, and its application is obviously limited if access to the lower urinary tract and ureter cannot be obtained. If the technique is unsuccessful, it does not preclude or complicate immediate antegrade percutaneous or open stone removal.

Humans↗
PubMed1987

Clinical comparison of piperacillin and cefamandole in treatment of complicated urinary tract infections.

The efficacy and safety of piperacillin were compared with those of cefamandole in 72 patients (mean age: 63 years) with complicated urinary tract infections. Efficacy was evaluable in 25/34 piperacillin-treated patients (12 Gm/day) and in 23/38 cefamandole-treated patients (6 Gm/day). Clinical cure or improvement was noted in all patients who were given piperacillin and in 96 per cent (22/23) of those who received cefamandole. Seventy-one per cent (41/58) of the organisms cultured pretherapy were gram-negative aerobic bacteria. Escherichia coli was the most frequently isolated organism (15/58, or 26%), followed by Pseudomonas species (8/58, or 14%), and Proteus species (8/58, or 14%). Adverse clinical experiences were few, and none was directly attributed to therapy with either antibiotic. The changes noted in the results of laboratory tests were considered to be unrelated to the antibiotics administered. Thus, both piperacillin and cefamandole were safe and effective in the treatment of patients with complicated urinary tract infections.

Cefamandole↗
PubMed1987

Acquired infundibular stenosis.

Acquired infundibular stenosis is an unusual complication resulting in pancalyceal obstruction. We have cared for 6 patients with acquired infundibular stenosis not associated with tuberculosis. All patients had urinary diversion with ileal conduits for a minimum of eleven years and documented ileal-ureteral reflux and chronic urinary tract infections. The clinical, radiographic, and pathologic characteristics of this syndrome are described and therapeutic guidelines suggested.

Adult↗
PubMed1987

Urinary lithiasis in the black population: an epidemiological study and review of the literature.

A retrospective review of 199 black patients with urinary calculi and review of the census figures of the index hospitals revealed that white patients had urinary calculi 3 to 4 times as often as black subjects. The black male-to-female ratio was 1 to 1.55 compared to a ratio for white patients of 2.3 to 1. Calculi in black male subjects occur at a younger age than in black or white female or white male patients. The most common organisms cultured in black patients with stones were Escherichia coli and Proteus mirabilis. In contrast to the white population the most common type of stone formed in black patients was struvite/carbonate apatite. Stones of this type accounted for a third of all stones in male and 44 per cent in female subjects. We conclude that nephrolithiasis is an uncommon but not rare disease in the American black population.

Adult↗
PubMed1987

The application of intracavernous injection of vasoactive medications for erection in men with spinal cord injury.

Obtaining and sustaining an erection that is firm enough and adequate for vaginal penetration and satisfactory completion of intercourse are common problems for the male spinal cord injury patient. Intracavernous injection of vasoactive substances offers a new treatment option but it must be approached with caution in this population. During the last year we placed 20 spinal cord injury men (16 paraplegics and 4 quadriplegics) on self-injection of papaverine alone or with phentolamine. Of the patients 19 were able to obtain an erection adequate for penetration. The patient who did not obtain an adequate erection had anomalous penile venous drainage. Six episodes of priapism occurred in 3 patients: 1 had a surgical shunt placed elsewhere before he entered our program, and 2 were treated with aspiration of the corpora and injection of epinephrine. All 3 patients subsequently have been able to obtain satisfactory erections with use of lower doses of papaverine alone.

Adult↗