Current Issue : July - September Volume : 2018 Issue Number : 3 Articles : 6 Articles
Testicular cancer is the most common malignancy in young men, and the incidence is increasing in most countries worldwide.The\nvast majority of patients present with clinical stage I disease, and surveillance is being increasingly adopted as the preferred\nmanagement strategy. At the time of diagnosis, patients on surveillance are often counselled about their risk of relapse based on\nrisk factors present at diagnosis, but this risk estimate becomes less informative in patients that have survived a period of time\nwithout experiencing relapse. Conditional survival estimates, on the other hand, provide information on a patient�s evolving risk\nof relapse over time. In this review, we describe the concept of conditional survival and its applications for surveillance of clinical\nstage I seminoma and nonseminoma germ cell tumours. These estimates can be used to tailor surveillance protocols based on\nfuture risk of relapse within risk subgroups of seminoma and nonseminoma, which may reduce the burden of follow-up for some\npatients, physicians, and the health care system. Furthermore, conditional survival estimates provide patients with a meaningful,\nevolving risk estimate and may be helpful to reassure patients and reduce potential anxiety of being on surveillance....
Kidney stone disease is a crystal concretion formed usually within the kidneys. It is an increasing urological disorder of\nhuman health, affecting about 12% of the world population. It has been associated with an increased risk of end-stage renal\nfailure. The etiology of kidney stone is multifactorial. The most common type of kidney stone is calcium oxalate formed at\nRandall�s plaque on the renal papillary surfaces. The mechanism of stone formation is a complex process which results from\nseveral physicochemical events including supersaturation, nucleation, growth, aggregation, and retention of urinary stone\nconstituents within tubular cells. These steps are modulated by an imbalance between factors that promote or inhibit urinary\ncrystallization. It is also noted that cellular injury promotes retention of particles on renal papillary surfaces. The exposure of\nrenal epithelial cells to oxalate causes a signaling cascade which leads to apoptosis by p38 mitogen-activated protein kinase\npathways. Currently, there is no satisfactory drug to cure and/or prevent kidney stone recurrences. Thus, further understanding\nof the pathophysiology of kidney stone formation is a research area to manage urolithiasis using new drugs.\nTherefore, this review has intended to provide a compiled up-to-date information on kidney stone etiology, pathogenesis, and\nprevention approaches....
Anaemia is the common comorbidity in patients with chronic kidney disease (CKD). Clinical studies have shown that erythropoietin-stimulating agents decrease the need for transfusions and improve the quality of life. The objectives were to assess prevalence of anemia and its management. A prospective, hospital based study was conducted for a period of six months on 100 dialysis patients suffering from anaemia in chronic renal failure condition. A written informed consent was obtained from all the patients before inclusion in the study. Patient demographics, laboratory data and treatment chart were reviewed. The study results were analyzed by descriptive statistical analysis. Student t test was used to find significance of study parameters. Hemoglobin level was found to be significantly lower in CKD cases than in non-CKD cases. Anaemia was seen in all stages of CKD, severity of anaemia increased as kidney function detoriates. Anaemia in CKD is better treated with erythropoietin as well as iron sucrose. Prevalence of anaemia was strongly associated with declining glomerular filtration rate, which is more frequent at higher stages. It can be concluded that early detection and treatment of anemia has effective benefits in chronic kidney disease patients. Management includes erythropoietin stimulating agents as well as blood transfusion....
Background. At present, the percutaneous nephrolithotripsy (PCNL) is performed both in supine and in prone position. The aim\nof this paper is to describe an innovative position during PCNL. Methods. We describe a supine position. The patientââ?¬â?¢s legs are\nslightly abducted at the hips. The thorax is laterally tilted (inclination 30Ã?°ââ?¬â??35Ã?°) and kept in the right position by one or two gel pads\nplaced between the scapula and the vertebrae. External genitalia can be accessed at any time, so that it is always possible to use\nflexible instruments in the upper urinary tract. We used this position for a period of 12 months to treat with PCNL 45 patients with\nrenal lithiasis. Results. All the procedures were successfully completed without complications, using the position we are describing.\nThe following are some of its benefits: an easier positioning of the patient; a better exposure of the flank for an easier access to the\nposterior renal calyces of the kidney; a lower risk of pressure injuries compared to positions foreseeing the use of knee crutches; the\npossibility of combined procedures (ECIRS) through the use of flexible instruments; and a good fluoroscopic visualization of\nthe kidney not overlapped by the vertebrae. Conclusions. This position is effective, safe, easy, and quick to prepare and allows for\ncombined anterograde/retrograde operations....
Testicular cancer has become the paradigm of adult-onset cancer survivorship, due to the young age at diagnosis and 10-year\nrelative survival of 95%. This clinical review presents the current status of various treatment-related complications experienced by\nlong-term testicular cancer survivors (TCS) free of disease for 5 or more years after primary treatment. Cardiovascular disease and\nsecond malignant neoplasms represent the most common potentially life-threatening late effects. Other long-term adverse\noutcomes include neuro- and ototoxicity, pulmonary complications, nephrotoxicity, hypogonadism, infertility, and avascular\nnecrosis. Future research efforts should focus on delineation of the genetic underpinning of these long-term toxicities to understand\ntheir biologic basis and etiopathogenetic pathways, with the goal of developing targeted prevention and intervention\nstrategies to optimize risk-based care and minimize chronic morbidities. In the interim, health care providers should advise TCS\nto adhere to national guidelines for the management of cardiovascular disease risk factors, as well as to adopt behaviors consistent\nwith a healthy lifestyle, including smoking cessation, a balanced diet, and a moderate to vigorous intensity exercise program. TCS\nshould also follow national guidelines for cancer screening as currently applied to the general population....
We investigated gender differences in the histopathologic presentation of bladder cancer cases in Egypt, where both urothelial cell\ncarcinoma (UC) and squamous cell carcinoma (SCC) types are highly prevalent. We used logistic regression to estimate the\nunadjusted (OR) and adjusted odds ratio (AOR) and 95% confidence interval (CI) of the associations between gender and\ndifferent histopathologic and sociodemographic parameters of 2,186 confirmed cases of primary bladder cancer (1,775 males and\n411 females; 784 SCC and 1,402 UC). There were no statistically significant gender differences in tumor grade, stage, mucosal ulcer,\nor inflammatory cystitis, regardless of the cancer type, but men were less likely than women to have undergone cystectomy with\npelvic lymphadenectomy. Having Schistosoma haematobium (SH) ova in the bladder tissue was significantly associated with male\ngender in the fully adjusted model of either SCC (AOR (95% CI) 2.12 (1.15ââ?¬â??3.89)) or UC cases (3.78 (1.89ââ?¬â??7.55)). Compared to\nfemales, male cases were significantly older at time of diagnosis and smokers. In Egypt, regardless of the type of bladder cancer\n(SCC or UC), male more than female cases had evidence of SH infection, but not other histopathologic differences, in bladder\ntissue specimens....
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