Biomedical subjects

Gennady Bratslavsky

Publications and source records attributed to Gennady Bratslavsky.

4 recordsLinked to original sources

PubMed2005

Febrile urinary tract infections in infants: renal ultrasound remains necessary.

PURPOSE: Current guidelines from the American Academy of Pediatrics recommend voiding cystourethrography (VCUG) and renal ultrasound for the radiographic evaluation of infants after a febrile urinary tract infection. Some recent studies have suggested that ultrasound is not necessary in the era of prenatal ultrasound. We reviewed our experience to ascertain the influence that ultrasound has on the treatment of these infants. MATERIALS AND METHODS: We reviewed retrospectively the charts of 282 consecutive patients (5 days to 6 months old, 98 males and 184 females) who underwent radiographic evaluation for a febrile urinary tract infection between October 1995 and August 2001. All patients were evaluated at our institution with VCUG and renal ultrasound. RESULTS: Of 203 patients with normal VCUG ultrasound was abnormal in 32 (16%). Subsequent evaluation demonstrated 1 case each of significant ureteropelvic junction obstruction, ectopic ureter in a bilaterally duplicated system, renal duplication, renal duplication with calculus, ectopic ureter, renal cysts, multicystic dysplastic kidney and renal scarring. In addition, there were 3 cases of ureterovesical obstruction. No significant renal pathology was identified in the other cases. Two of these patients underwent operative intervention. Treatment or parental counseling was altered in 7 others, for a total of 9 of the 203 patients (4.4%). CONCLUSIONS: In our population renal ultrasound adds information to the radiographic evaluation of infants after a febrile urinary tract infection. This information alters treatment and parental counseling in a significant number of patients.

Female↗

PubMed2004

Current trends in ureteroscopy.

The advances of technology are having substantial ramifications in medicine and in urology, in particular. This article discusses these advances and explores current trends in ureteroscopy.

Equipment Design↗

PubMed2004

Recurrence risk in infants with urinary tract infections and a negative radiographic evaluation.

PURPOSE: Infants with urinary tract infections (UTI) and no abnormality on radiological evaluation are usually discharged from urological followup but the natural history of these children is unknown. We evaluate the rate of and potential risk factors for UTI recurrence in this specific population. MATERIALS AND METHODS: We reviewed retrospectively charts of children evaluated for first UTI before age 6 months between January 1996 and February 2001. Only patients with a normal ultrasound and voiding cystourethrogram were included in this study. A telephone questionnaire was administered to the parents, which inquired about the UTI, duration of breast-feeding, type of formula, family history of UTI, neurological problems, history of constipation or recurrent fevers, as well as social status. Chi-square test was performed for statistical analysis. RESULTS: We identified 264 children with UTIs, of whom 119 (45%) had a negative ultrasound and voiding cystourethrogram. Followup was available on 68 girls (81%) and 16 boys (19%) of the 119 children (71%). Of the 84 children 16 (19%) had recurrent UTI. Mean followup was 4.4 years (range 1.9 to 7.0). No factors had a statistically significant correlation for UTI recurrence. The p value for gender and history of undiagnosed fevers was 0.077 and 0.082, respectively. CONCLUSIONS: About 20% of children will have recurrent UTIs despite negative radiological evaluation. Although not statistically significant, there was a trend for an increased risk in girls and those with recurrent febrile illnesses. History of daytime dryness and/or constipation was not predictive of recurrent UTIs in our series.

Child↗

PubMed2002

The functional and structural response to distention of the rabbit whole bladder in vitro.

PURPOSE: We investigated the effects of distention on intravesical pressure generation in response to stimuli in relation to its effects on bladder wall thickness and morphology. MATERIALS AND METHODS: A total of 25 New Zealand White rabbits were separated into 5 groups of 5 each. Each in vitro whole bladder preparation was filled with saline to 5% (undistended), 25%, 50%, 100% or 125% capacity (60 ml.). The effects of field stimulation, adenosine 5'-triphosphate, carbamylcholine chloride (carbachol) and KCl on intravesical pressure generation were determined. Additional bladders were similarly distended (3 at each percent of capacity), fixed in formalin and evaluated by semiquantitative morphometry. RESULTS: Pressure generation in response to field stimulation was maximal at 5% of capacity and it decreased progressively thereafter. Compared with the responses of undistended bladders, at 25% capacity the response to carbachol increased and then decreased progressively above 25%. Distention had no significant effect on the response to KCl. Interestingly pressure generation in response to adenosine 5'-triphosphate was increased more than 4-fold at 25% bladder capacity compared with 5% and it did not change significantly thereafter. Bladder wall thickness was decreased more than 50% at 25% capacity and by an additional 12% at 125% capacity. The greatest thinning was observed in the mucosa compared with the submucosa and muscularis. CONCLUSIONS: Bladder distention significantly reduced pressure generation in response to field stimulation only, indicating that distention reduced the effectiveness of synaptic transmission without altering muscarinic receptor function or membrane depolarization. The greatest change (decrease) in the response to field stimulation occurred between 5% (undistended) and 25% capacity, which was the change in distention that most affected bladder wall thinning.

Adenosine Triphosphate↗