Trimethoprim-sulfamethoxazole induced recurrent aseptic meningitis.
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Biomedical subjects
M St Lezin
Publications and source records attributed to M St Lezin.
Percutaneous nephrolithotomy in the elderly.
OBJECTIVES: To evaluate the success and morbidity of percutaneous nephrolithotomy (PNL) performed in patients aged 65 years and older. METHODS: A retrospective review of 42 PNLs performed on 33 patients aged 65 years and older was compared with a cohort of 160 PNLs performed on younger patients over the same time period. RESULTS: The presence of complete staghorn calculi (17 of 36 renal units [47%] versus 88 of 160 renal units [55%], p = 0.46) and average stone size (3.8 cm versus 4.3 cm, p = 0.2) were similar for the 2 groups. Eighty-two percent of patients (27 of 33) were stone-free or left with fragments < 5 mm at 3 months after surgery. Elderly patients had a higher transfusion rate after PNL despite similar preoperative hemoglobin levels (11 of 42 PNLs [26%] versus 22 of 160 PNLs [14%], p < 0.01). Serious complications were infrequent and there were no deaths. CONCLUSIONS: Percutaneous nephrolithotomy is a safe and effective therapy for elderly patients with complex stone disease; however, awareness of an apparent increased requirement for blood transfusion is warranted.
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Monitoring of body weight during transurethral resection of the prostate: preliminary report.
The fear of vascular overload by irrigant during transurethral resection of the prostate is a reason for an incomplete resection. With continuous measurement of the patient's body weight and, thus, body water, irrigant entrance is immediately identified. We present a scale of proved accuracy and reliability, allowing more effective resection while eliminating the possibility of TUR syndrome.
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Pyonephrosis: diagnosis and treatment.
A series of 23 confirmed cases of pyonephrosis initially treated by percutaneous nephrostomy drainage were reviewed. Presentation was extremely variable, ranging from sepsis to asymptomatic bacteriuria. Fever, flank pain and leukocytosis were often absent. Ultrasonography was diagnostic in only 3 of 12 patients. In all, 17 patients had associated nephrolithiasis, and 5 patients ultimately required nephrectomy. Renal urine cultures were positive in 16 of 21 instances, with multiple organisms found in 8 of 21, and added bacteriological data not provided by bladder urine cultures in 11 cases. A pre-existing history of urinary tract infection, hypertension and malignancy was common. Percutaneous drainage was a safe, quick and effective diagnostic and therapeutic method.
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