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Biomedical subjects

J R Sotolongo

Publications and source records attributed to J R Sotolongo.

14 recordsLinked to original sources
PubMed1992

Nifedipine pretreatment for prevention of autonomic hyperreflexia during anesthesia-free extracorporeal shock wave lithotripsy.

Nifedipine, a calcium channel blocker, has been used to treat autonomic hyperreflexia in quadriplegics undergoing invasive urological procedures. We present a case of autonomic hyperreflexia triggered by extracorporeal shock wave lithotripsy in which nifedipine was used successfully to treat the hypertensive crisis on 1 occasion and subsequently it was used prophylactically to prevent the crisis in the same patient.

Humans↗
PubMed1991

Analgesia in anesthesia-free extracorporeal shock wave lithotripsy: a standardized protocol.

We treated 101 patients at our stone facility with the Dornier HM3 lithotriptor modified with the anesthesia-free design upgrade. A protocol designed by our anesthesiologists consisting of intravenous and intramuscular injections for sedation was used without any general or regional anesthesia required. Pre-medication with intramuscular meperidine and promethazine, and oral diazepam was sufficient sedation in 43 patients, while 37 required additional intravenous meperidine and/or midazolam during the procedure, 16 were treated with intraprocedural medication alone and 5 required no medication at all. Care before, during and after the procedure was rendered by the urology staff for patients in American Society of Anesthesiologists risk category I or II. Treatment was successfully completed in all patients without complications. We compared this group to the 99 patients treated consecutively before the modification. Voltage used, number of shocks and stone burden were comparable in the 2 groups but average treatment time was prolonged with the upgraded equipment (39.2 versus 27.1 minutes) to a significant degree (p less than 0.001).

Analgesia↗
PubMed1990

The effect of an alpha-2 agonist on bladder function and cord histology after spinal cord injury.

Spinal injury in cats is accompanied by urinary bladder and hind limb dysfunction. Ten cats subjected to spinal contusion at the ninth thoracic segment were treated with guanabenz (an alpha-2 agonist) intraperitoneally (0.65 mg./kg.) three hours after injury, and twice daily for eight weeks. An additional six spinal cats were untreated and served as controls. Urodynamic studies were performed on a weekly basis on all animals. Guanabenz modified the vesico-somatic reflex: detrusor-sphincter dyssynergia was either ablated or abolished. In contrast, the controls demonstrated detrusor-sphincter dyssynergia, high residual urine, and spasticity below the lesion. Histological evaluations of the spinal cords revealed that the six paraplegic animals (untreated) suffered marked cavitation of the cord and complete destruction of the grey matter. The five incomplete paraplegic animals (treated) showed minimal cavitation with some preservation of the grey matter. The five ambulators (treated) demonstrated some distortion of grey matter with preservation of white matter. Treatment with guanabenz post traumatic cord injury results in decreased cord cavitation. Detrusor-sphincter dyssynergia is diminished and hind limb function is improved in treated animals.

Adrenergic alpha-Agonists↗
PubMed1990

Significance of asymptomatic bacteriuria in spinal cord injury patients on condom catheter.

A total of 56 male spinal cord injury patients on condom catheter drainage was studied prospectively within 6 months of the injuries for 5 years. Low bladder pressures (filling maximum 35 cm. water and voiding maximum 70 cm. water) were ascertained with video-urodynamics. External sphincterotomy was performed when necessary for detrusor-sphincter dyssynergia. Yearly upper tract imaging, serum creatinine levels and urine cultures were obtained. All patients had colonized urine (asymptomatic) during the entire study period. No patient sustained deterioration of the urinary tract on imaging or by serum creatinine determinations during the 5-year interval. We conclude that asymptomatic bacteriuria is of no consequence to the integrity of the upper urinary tract when low pressures are operant.

Bacteriuria↗
PubMed1985

Penile denudation injuries after circumcision.

We present 3 cases of iatrogenic phallic denudation that were managed successfully nonoperatively. The concept of conservative, nonoperative management should be considered in denudation injuries.

Adult↗
PubMed1984

Successful treatment of lupus erythematosus cystitis with DMSO.

Systemic lupus erythematosus patients sometimes present with pathologically confirmed lupus interstitial cystitis. Treatment with prednisone has not been observed to be successful. Two patients are presented who were successfully treated with intravesical dimethyl sulfoxide (DMSO).

Adult↗
PubMed1983

Female phallic urethra and persistent cloaca.

Accessory phallic urethra in the female newborn with a persistent cloaca is a rare entity. We present a variant with a cloaca that contained rectal, vaginal and bladder neck openings, as well as the proximal origin of the phallic urethra. The literature is reviewed.

Abnormalities, Multiple↗
PubMedDate not supplied

Bladder neck dysynergia in spinal cord injury.

Urodynamic evaluations were performed in 43 male patients with spinal cord injuries, before any therapeutic decisions, and a minimum of 5 mo following the injury. Results were subdivided according to level of injury. Mean detrusor contraction pressures, incidence of detrusor-sphincter dysynergia (DSD), and incidence of detrusor-bladder neck dysynergia (DBND) were calculated. The incidence pattern of DBND was found to follow closely the incidence pattern of DSD, with the highest incidence among the upper thoracic injuries, considerably more than among the cervical injuries. A significantly higher resting detrusor pressure differential was found among the patients with DBND. This was felt to represent sympathetic dysfunction and poor accommodation and is proposed to be secondary to adrenergic detrusor neoinnervation.

Humans↗