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Vernon M Pais

Publications and source records attributed to Vernon M Pais.

6 recordsLinked to original sources
PubMed2007

Urolithiasis in pregnancy.

The presentation of urolithiasis is often dramatic, but rarely is it more anxiety provoking than during pregnancy. The evaluation and the intervention are often approached with trepidation as the health of the mother and the fetus must be taken into account. The typical diagnostic course and surgical management used in the nonpregnant population must be reevaluated in the expectant mother. Failure to promptly diagnose and manage urolithiasis during pregnancy may have adverse consequences for mother and child. The authors present a review of the relevant anatomic and physiologic changes of pregnancy as they affect stone disease and outline options for radiologic evaluation and surgical management.

Female↗
PubMed2006

Xanthine urolithiasis.

Xanthine calculi are uncommonly encountered stones. When they occur, they typically do so in association with inborn metabolic disorders such as hereditary xanthinuria or Lesch-Nyhan syndrome. They may also occur in association with states of profound hyperuricemia such as myeloproliferative disease after treatment with allopurinol. If the underlying disorder is not addressed, a high risk of stone recurrence exists. Therefore, to raise clinical awareness, we reviewed and report our experience in the treatment of patients with these stones, discussing the underlying pathophysiology and approach to treatment.

Adolescent↗
PubMed2005

Pitfalls in the management of patients with primary hyperoxaluria: a urologist's perspective.

The primary hyperoxalurias are rare, inherited diseases which commonly manifest early in life as urolithiasis. As these patients often present to the urologic surgeon, it is imperative that urologists understand the typical presentation, diagnosis, and management of urolithiasis associated with primary hyperoxaluria. In this review, the pertinent epidemiology and pathogenesis as they relate to the diagnosis and natural history of the disease are discussed. The literature on therapeutic options for primary hyperoxaluric patients with calculi is examined, and treatment strategies are suggested.

Humans↗
PubMedDate not supplied

Repetitive ureteral stenting for management of transplant graft ureteral obstruction.

PURPOSE: To review the use of repetitive stenting in the management of patients with ureteral obstruction after renal transplantation, with an emphasis on technique and functional graft outcome. MATERIALS AND METHODS: Five adult renal allograft recipients with ureteral obstruction were managed with repetitive ureteral stenting. Their hospital records, office notes, and operative reports were reviewed. RESULTS: All patients were successfully managed with retrograde ureteral stenting. They underwent an average of 8.8 stent changes over a mean 34.5 month follow up. No decline in renal function was observed. CONCLUSIONS: Repetitive stenting is a viable treatment option for select patients with renal allograft ureteral obstruction.

Adult↗
PubMedDate not supplied

A malignant aldosteronoma.

OBJECTIVE: To describe a case of primary aldosteronism due to an adrenocortical carcinoma (ACC) and highlight the need for thorough long-term follow-up. METHODS: We present the clinical, laboratory, radiologic, and pathologic findings in a patient with ACC and review the related literature. RESULTS: A 52-year-old woman with a history of hypertension and hypokalemia was referred for evaluation of a 6-cm adrenal mass. Her biochemical studies revealed a serum aldosterone-to-renin ratio of 52 without evidence of cortisol, catecholamine, or androgen excess. She underwent surgical resection of this mass, and histologic analysis showed a focally brisk mitotic rate but no evidence of capsular or vascular invasion. In light of these findings, the biologic nature of the tumor was difficult to predict. Thus, it was thought to be an adrenocortical neoplasm. The patient underwent follow-up clinically, biochemically, and with interval computed tomography. Nine years later, hypertension and hypokalemia redeveloped, and she was found to have metastatic ACC. CONCLUSION: ACC can generally be reliably diagnosed; however, in some cases, the true biologic behavior is difficult to predict. We emphasize the importance of careful clinical, biochemical, and radiologic surveillance in these difficult cases because surgical resection provides the best opportunity for cure in patients with adrenal cancer.

Adrenal Cortex Neoplasms↗