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Z L Barbaric

Publications and source records attributed to Z L Barbaric.

At least 19 recordsLinked to original sources
PubMed1991

Percutaneous nephrostomy tube placement: an outpatient procedure?

The authors report their experience with 56 percutaneous nephrostomies (PCNs) performed on an outpatient basis on 55 patients. Complications included pain that required use of parenteral medication in four patients, bleeding in three that resolved spontaneously, and shaking chills or fever in 12. This last complication, considered to be a sign of sepsis and treated with antibiotics, occurred more frequently than the 1.4%-4.5% infectious complication rate reported in the literature. Antibiotic use during and after PCN significantly decreased the likelihood of sepsis. In the high-risk group, antibiotic administration during and after PCN decreased the risk of developing signs of sepsis from 50% to 9%. On the basis of the authors' results and the findings in the literature about antibiotic prophylaxis, guidelines are recommended to improve the safety of PCN as an outpatient procedure. In the majority of instances PCN should still be considered to be more safely performed as an inpatient procedure at this time.

Adult↗
PubMed1989

MR imaging: vascular anatomy of the abdomen.

In support of the thesis that MRI may replace more invasive angiography in some applications, a total of 28 MR sections are presented to illustrate the vascular anatomy of the abdomen in coronal, transverse and sagittal planes. More than 20 vessels are identified ranging in size from the aorta to the left inferior adrenal vein and the spermatic veins. There is no anatomic continuity in sections made in the coronal and transverse planes; sequential sections of a single patient are presented in sagittal and parasagittal planes, however. The polarity of the images is reversed for ease of comparison with angiograms.

Abdomen↗
PubMed1988

Percutaneous nephrostomy in conjunction with ESWL in treatment of nephrolithiasis.

The use of percutaneous nephrostomies (PCNs) in 1456 patients (1660 kidneys) treated with extracorporeal shock-wave lithotripsy (ESWL) was evaluated. In this group, 138 PCNs (130 patients) were performed in 133 kidneys. Forty-seven percent of PCNs were placed in patients with staghorn calculi; 24% were for stones in the renal pelvis, and 20% for ureteral stones. The most common indication for PCN was fever and obstruction (57%). In 15%, the indications were failure to decompress an obstructed system from a retrograde direction, clogged double-J ureteral stents, and perforation of the ureter. Prophylactic PCN placement in the treatment of staghorn calculi and large stones in the renal pelvis accounted for 12%. Five percent were placed for miscellaneous other reasons, and for 11% there was no documentation of the indication because they were placed before the patients came to our center. Localization of the collecting system for optimal placement of PCN is unique in ESWL patients because the residual stone fragments provide natural contrast. This eliminates the need for administration of contrast material in 50% of the patients. Twenty-six percent of PCN tracts were subsequently used for other procedures (e.g., percutaneous nephrolithotomy, fragment irrigation, ureteral stone manipulation). Bleeding complications from PCN occurred in 7%. Other minor complications occurred in 12% of cases. PCN is a useful adjuvant to ESWL treatment of kidney stones. Although its major use is to relieve urinary tract obstruction, it is also used as a preliminary step in planning other percutaneous interventional procedures. This is particularly the case in the treatment of large bulky stones in the renal pelvis and staghorn calculi.

Adolescent↗
PubMed1988

Evaluation of lopamidol and diatrizoate in excretory urography: a double-blind clinical study.

Image opacification, patients' tolerance, and clinical and laboratory findings were evaluated in patients having excretory urography at three centers. In a double-blind, parallel study, iopamidol was compared with diatrizoate (50-ml dose), and in an open-label trial, the administration of a 100-ml dose of iopamidol was evaluated. In the double-blind study, a total of 84 patients received 50 ml of either iopamidol or diatrizoate. In the open-label study, another 42 patients received a 100-ml dose of iopamidol. Image opacification scores after the administration of the 50-ml doses showed better opacification with iopamidol than with diatrizoate in the renal calices (p less than .05) and in the composite kidney (p less than .05). Opacification scores were higher for 100-ml doses of iopamidol than for 50-ml doses in all anatomic regions as well as in the composite kidney (p = .0001). Patients' tolerance to iopamidol was significantly better than their tolerance to diatrizoate (p less than .025). Investigators observed adverse drug reactions in a total of 10 patients. In the double-blind study, one of 43 patients had transient bradycardia after the administration of iopamidol. In the same study, four of 41 patients who received diatrizoate had five minor adverse drug reactions. With 100-ml doses of iopamidol, five of 42 patients had adverse reactions. No adverse side effects required therapy in either study. There were no significant changes in vital signs or laboratory values after drug administration. The results of this study show that iopamidol is a suitable agent for excretory urography at doses of 50 and 100 ml. Patients report fewer unpleasant side effects with iopamidol than with diatrizoate. Overall image quality was better with iopamidol than with diatrizoate. Overall evaluation of drug performance was better with iopamidol than with diatrizoate.

Adolescent↗
PubMed1987

Extracorporeal shock wave lithotripsy: impact on the radiology department of a stone treatment center.

Extracorporeal shock wave lithotripsy (ESWL) was performed on 925 patients (1,222 treatments) for 446 calyceal, 345 pelvic, 172 ureteral, and 108 staghorn calculi. ESWL necessitated 6.3 KUB and 1.2 renal ultrasound studies per treatment session. Intravenous urography was required in 6% of patients after ESWL. Percutaneous nephrostomy tube placement was performed by the radiologists in 10% of patients. Procedures related to nephrostomy tube placement included percutaneous nephrolithotripsy, tube changes, nephrostography, and stone fragment irrigations and retrievals. Staghorn calculi treatment with ESWL required the most procedures by radiologists (34% for partial staghorn and 56% for complete staghorn) compared with 3%, 8%, and 11% for calyceal, pelvic, and ureteral stones, respectively. In all, 8,478 radiologic examinations and procedures were performed pertaining to ESWL. This is approximately 35 studies per day. While this number may be high because it represents the early experience of the authors with ESWL, the impact on the radiology department can be substantial.

Adolescent↗
PubMed1986

Nephrocolic fistula: a complication of percutaneous nephrostolithotomy.

Percutaneous nephrostolithotomy has proved to be a safe and effective approach to the management of upper tract calculi, which is associated with a low rate of significant complications. Bowel perforation is an unusual complication of this technique. We report a case of a nephrocolic fistula following percutaneous nephrostolithotomy, and discuss the diagnosis and management of this rare complication.

Adult↗
PubMed1979

Nephromegaly in hyperalimentation.

Nephromegaly associated with hyperalimentation and its effect on renal function were studied. Renal size was determined in 44 patients receiving total parenteral nutrition (TPN). Of 26 patients in whom kidney size could be determined before and during TPN, all but one had normal-size kidneys before TPN. Six had no increase in renal size, and kidneys increased in size in 20. One or both kidneys became abnormally large in 9 patients. There was no detectable change in renal function and kidneys decreased in size upon discontinuation of hyperalimentation. Abnormal renal size bore no relation with weight gain or liver function tests.

Adolescent↗
PubMed1979

Augmentation enterocystoplasty.

The anatomy and radiographic appearance of five types of augmentation enterocystoplasty (ileocystoplasty, cecocystoplasty, ileocecocystoplasty, sigmoidocystoplasty, and enterourethroplasty) are described. Retrograde cystrography is the procedure of choice for optimal visualization of an augmented bladder and most complications. Excretory urography is useful for following concurrent upper tract disease and ureteral stenosis. Critical factors in a optimal examination are maximal filling of the bladder and radiographs in multiple projections.

Cecum↗
PubMed1978

Anterior transperitoneal approach for treatment of urolithiasis.

An anterior transperitoneal incision was used to remove stones from 20 kidneys in 18 patients (2 bilateral). Our experience with 35 kidneys operated upon by this method (15 previously reported) has been favorable. Use of percutaneous nephropyelostomy tubes to drain obstructed kidneys in septic patients has permitted all procedures to be done under non-emergency conditions. Careful alignment of x-ray equipment and adjustment of exposure technique in the operating room before induction of anesthesia result in consistently good quality preoperative and intraoperative roentgenograms. The transperitoneal approach has afforded good access to the anterior portion of the renal pelvis even in those patients who have had previous operations on the kidney by the flank approach. Additional intra-abdominal procedures done at the same operation have included urinary diversion by ileal loop, revision of previous ileal loop, ureterolithotomy, pyeloureteroplasty, partial nephrectomy, cholecystectomy and appendectomy. The procedures done with the patients in the supine position have been well tolerated even in patients with serious coincident medical diseases.

Abdomen↗
PubMed1978

Percutaneous nephropyelostomy in the management of obstructed renal transplants.

Five percutaneous nephropyelostomies were performed on 4 patients with obstructed renal allografts. In all instances the procedure significantly influenced further management of these patients. It allowed pressure measurement within the obstructed collecting system, assessment of renal function after prolonged drainage, and anatomical delineation of the site of the obstruction using antegrade pyelography. Percutaneous pyelonephrostomy and drainage is a useful means to determine whether obstruction or rejection is the major contributor to renal failure following renal transplantation.

Adult↗
PubMed1978

Urinary tract after abdomino-perineal resection.

Uroradiological examinations on 33 patients subjected to abdomino-perineal resection were analyzed. The most common finding was medial displacement of both ureters, with the right one frequently crossing the midline. Bladder deformity, sometimes severe, was present in all patients. Localized ureteral narrowing due to stricture or recurring neoplasm was found in 30% of the patients examined. Other common complications included retrovesical abscesses, periurethral abscesses, urethral fistulas and strictures, and bladder retention. All these findings were more prominent in men.

Abdomen↗
PubMed1978

The use of percutaneous nephrostomy and urinary alkalinization in the dissolution of obstructing uric acid stones.

Two patients are described who presented with complete urinary obstruction secondary to nonopaque uric acid stones. They were treated with percutaneous nephrostomy for urinary diversion and urinary alkalinization by local irrigation and oral sodium bicarbonate therapy with complete dissolution of the stone after 16 and 21 days of therapy. Percutaneous nephrostomy with urinary alkalinization is a reasonable, relatively safe alternative to surgical stone removal for patients with obstructing uric acid stones.

Aged↗
PubMed1978

Tissue adhesive in surgical and crush renal trauma. An experimental angiographic investigation in the rabbit.

Angiography and nephroangiography has been performed 3 and 6--10 weeks after induced trauma to 18 rabbit kidneys. The lesions, mimicking crush trauma or surgical ectomy, were repaired using a cyano-acrylate. Perinephric tissue was adhered to the wound and made repair easier in crush trauma. In the resected kidneys it constituted a new pelvic wall. The angiographies demonstrated that in essence only the directly traumatized arteries were abnormal, that the cortical lesions were very small and the venous drainage unimpaired. The function, assessed on urograms, was good. No ureteric obstruction was present.

Animals↗
PubMed1978

Intraoperative ureteral trauma: a radiologic approach.

Thirty-two patients with inadvertent intraoperative ureteral trauma or ligation are presented. One-third of the injuries were due to general surgical procedures such as lumbar sympathectomy, aortoiliac bypass and colectomy. Because of postoperative pain, discomfort and sedation, these injuries are frequently unrecognized for long periods. This delay in diagnosis results in significant morbidity and mortality. The usual radiologic approach is an excretory urogram supplemented if necessary by a retrograde pyelogram. Temporary percutaneous or operative nephropyelostomies have been employed in seven of these patients.

Adult↗