Biomedical subjects

A Liard-Zmuda

Publications and source records attributed to A Liard-Zmuda.

6 recordsLinked to original sources

PubMed2006

[Peritonitis as a first manifestation of Neisseria type C meningitis].

A 15-year-old boy was first referred for a clinical presentation of revealed peritonitis. Abdominal endoscopy showed normal appendix but the presence of purulent peritoneal fluid. Antibiotics were immediately administered. Ten hours later clinical signs of meningitis occurred, and lumbar puncture was performed. CSF bacterial meningitis characteristics were present but no bacteria was observed. However Neisseria meningitidis type C was detected by direct peritoneal fluid examination and by 24(th) hour blood culture. Peritoneal and the CSF fluid culture were negative, but DNA analysis from peritoneal fluid was positive.

Adolescent↗

PubMed2004

[Laparoscopic surgery for undescended testicles].

PURPOSE: Impalpable and undescended testis is a very common preoccupation for specialized pediatric surgery teams. The laparoscopy as the single most accurate modality for diagnosis and localization of impalpable undescended gonad is well established by all authors. However the therapeutic attitude and the technique are still a matter of debate. MATERIAL AND METHODS: A series of 122 boys presenting an impalpable and undescended testis was studied. All the children beneficiated of a primary laparoscopic exploration. During this exploration, when a testis was found, the clamping of the spermatic vessel was made and the final descent took place few months later. RESULTS: In our study the testis was found in 60 cases and the spermatic vessel's clamping assured the descent of a well vascularized testis in about 80% of cases. CONCLUSION: Clamping the spermatic vessel during the laparoscopic exploration assured, thanks to the development of a supply, a good vascularisation of the testis during its second step descent. Our retrospective study has showed the good reliability of laparoscopic surgery as primary treatment in front of impalpable undescended testicles in comparison to the one-step classical orchiopexy.

Adolescent↗

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↗

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↗

PubMed1999

The usefulness of a minimal urodynamic evaluation and pelvic floor biofeedback in children with chronic voiding dysfunction.

OBJECTIVE: To report our experience of assessing children with chronic voiding dysfunction (>6 months' duration) using a minimal urodynamic evaluation, and the management of detrusor-sphincter dyscoordination (DSdc) using pelvic floor biofeedback. PATIENTS AND METHODS: From 1994 to 1997, 120 children (mean age 7.5 years) with three predominant and associated symptoms were referred to one urologist; they had nocturnal enuresis (28 children), urge incontinence (42) or urinary tract infection (50). All patients were assessed by urinary culture, renal ultrasonography and a minimal urodynamic evaluation, i.e. urinary flowmetry with sphincter electromyography (EMG) using perineal surface electrodes. If they had urinary tract infection and/or renal dilatation, they underwent voiding cysto-urethrography. In children with DSdc, urinary training with frequent voiding was instituted initially, with subsequent pelvic floor biofeedback exercises if the improvement was deemed unsatisfactory. RESULTS: DSdc was diagnosed in 33 children (28%), none of whom had isolated nocturnal enuresis. Pelvic floor biofeedback was undertaken by 15 children (12 girls and three boys); it was well accepted because it was administered as a computer game. In all affected patients the DSdc resolved on EMG and there was a significant clinical improvement. Vesico-ureteric reflux was detected in 24 patients, associated with DSdc in 10. The reflux resolved spontaneously on antibiotic prophylaxis in six children and after urinary re-education in four. CONCLUSION: A minimal urodynamic evaluation seems to be useful in the diagnosis of DSdc which caused urinary tract infection and/or bladder overactivity. The results with pelvic floor biofeedback were excellent in these children.

Biofeedback, Psychology↗

PubMed1998

[The value of examination and treatment using laparoscopy in non-palpable testes: apropos of a series of 48 cases].

OBJECTIVES: Laparoscopy now constitutes the reference technique for the diagnosis and treatment of cryptorchid testes. We report our experience over the last three years (1993-1996). MATERIAL AND METHODS: 48 strictly impalable testes were investigated in 46 boys between the ages of 11 months and 14.5 years (mean age: 40 months). The intraperitoneal investigation assessed both deep inguinal regions looking for gonads, vas deferens and pedicles. Intra-abdominal gonads were ligated and their pedicle was sectioned laparoscopically allowing transinguinal descent 6 months later according to the Fowler-Stephens technique. RESULTS: We found 21 cases of typical antenatal torsion, including one bilateral case (pedicle and vas deferens present, but gonad absent), one case of total unilateral agenesis and 3 cases of incomplete agenesis (only the vas deferens was detected) and performed three resections of the gonadal rest for histological examination. The first-stage of cryptorchid testis descent was performed in 20 cases, by laparoscopy in 19 cases (1 failure of insufflation). Definitive descent was possible in 13 cases, with early onset of atrophy in only one case. CONCLUSION: Laparoscopy is therefore a simple technique, allowing a definitive diagnosis and two-stage descent without increasing the risk of testicular atrophy.

Adolescent↗