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Biomedical subjects

L B Talner

Publications and source records attributed to L B Talner.

At least 19 recordsLinked to original sources
PubMed1992

Symptomatic renal obstruction or urosepsis during pregnancy: treatment by sonographically guided percutaneous nephrostomy.

Seven pregnant women with symptomatic hydronephrosis had sonographically guided percutaneous nephrostomy for pyosepsis (five patients) or for pain with azotemia (two patients with renal transplants). Antibiotics had been ineffective in controlling pyosepsis in each patient; retrograde ureteral catheterization via cystoscopy was unsuccessful in one patient. After percutaneous nephrostomy, prompt clinical improvement was observed in all patients (i.e., sepsis was relieved and pain abated). Labor was not induced in any of the patients, and no adverse effects occurred to any fetus or mother. Eleven (eight percutaneous nephrostomy, three catheter exchanges) of the 12 procedures were done without conventional radiography and with sonographic guidance alone. After percutaneous nephrostomy, maneuvers to obtain a diagnosis and to treat the obstruction (if necessary) were delayed until after delivery. The causes of ureteral obstruction were calculi (four patients) and a gravid uterus (three patients). After delivery, stones were removed either percutaneously (one patient) or cystoscopically (two patients) or passed spontaneously (one patient); resolution of obstruction by the gravid uterus was proved by Whitaker test after delivery. Sonographically guided percutaneous nephrostomy is an effective and safe method to treat pregnant women who have symptomatic obstructive hydronephrosis associated with either pyosepsis or azotemia. The procedure is rapid, requires minimal anesthesia, has no radiation, and is safe for the fetus. The technique is a useful and perhaps preferable alternative to more invasive surgical therapy or retrograde stenting.

Adult↗
PubMed1991

Lacunae: a urographic finding in chronic obstructive uropathy.

Lacunae, small spaces in the renal sinus that communicate with the caliceal fornices, have been mentioned rarely in the radiologic literature. These lesions have been reported to opacify during excretory urography in patients with current or previous urinary obstruction. Lacunae have been presumed to form in response to urine extravasation through the fornices, but there has never been gross anatomic or histologic proof of their existence. In two patients with obstructive uropathy, urographic-pathologic correlation confirmed the existence and nature of lacunae. On excretory urography, the appearance is likely to be confused with papillary necrosis.

Chronic Disease↗
PubMed1988

Protective effects of corticosteroids in contrast material anaphylaxis.

A prospective, randomized study of the potential protective effects of corticosteroids administered as pretreatment against contrast material (CM) reactions is reported. Patients (n = 6,763) from multiple institutions received either a single dose of steroids (32 mg of oral methylprednisolone, approximately 2 hours before CM challenge), a double dose (32 mg approximately 12 hours and 2 hours before CM challenge), or placebo. All contrast injections were with ionic media and were given intravenously. The two-dose (but not the one-dose) corticosteroid regimen provided significant protection. The effect on reaction incidences of a number of historical variables is also tabulated.

Anaphylaxis↗
PubMed1987

Pretreatment with corticosteroids to alleviate reactions to intravenous contrast material.

The x-ray contrast mediums used over the past three decades have been salts of iodinated acids administered in highly hypertonic concentrations. We conducted a multiinstitutional randomized study of the protective effects of pretreatment with corticosteroids against reactions to intravenous contrast material. We gave 6763 patients two doses of oral corticosteroids (methylprednisolone, 32 mg) approximately 12 hours and 2 hours before challenge with contrast material, one dose of oral prednisolone approximately 2 hours before challenge, or placebo in the same dosages. The two-dose corticosteroid regimen, but not the one-dose regimen, significantly reduced the incidence of reactions of all types (P less than 0.05) except a category of reactions dominated by hives, for which the reduction approached significance (P = 0.055). In recent years, several relatively expensive monomeric nonionic iodinated compounds having approximately half the osmolality of the corresponding ionic compounds and a lower reaction rate have become available. With our two-dose corticosteroid regimen, the incidence of reactions necessitating therapy in patients receiving the ionic medium approximated that reported in an unblinded nonrandomized study of patients receiving a newer intravenous nonionic medium without corticosteroid pretreatment. We conclude that the much less expensive ionic medium, if administered with corticosteroid pretreatment, may serve as a reasonable alternative to intravenous nonionic medium, without loss of safety.

Administration, Oral↗
PubMed1979

Congenital giant hydroureteronephrosis.

Four patients with giant hydroureteronephrosis are reported to emphasize the massive proportions attained by a dilated ureter. Ureteral obstruction was congenital in each case; duplication with ectopic insertion was present in three of the four patients. In three patients the massively dilated ureter caused partial obstruction of the contralateral ureter. If ultrasound and/or computed tomography demonstrate a huge, septate, cystic structure crossing the midline, massive megaureter should be suspected. Antegrade puncture can be used to confirm the diagnosis.

Adult↗
PubMed1979

Gray scale ultrasound and the genitourinary tract. A review of clinical applications.

Diagnostic ultrasound has many well established indications in the evaluation of genitourinary tract disease. Musch of this information complements or corroborates findings derived from other investigations. The role of ultrasound as a primary diagnostic modality is still evolving, but it appears to be useful in a variety of clinical situations, especially in azotemia, suspected hydronephrosis, and renal transplantation. Ultrasound also has a place in the evaluation of the retroperitoneum, the perirenal space, and the adrenal glands, and preliminary work suggests a role in prostatic and testicular abnormalities as well. State of the art prospective comparisons with computed tomography need to be made in many of these areas before the precise role of ultrasound can be defined.

Adrenal Gland Diseases↗