Current Issue : October - December Volume : 2018 Issue Number : 4 Articles : 7 Articles
Vascular calcification isamain causeof increased cardiovascularmorbidity andmortality in chronic kidney disease (CKD) patients.\nThis study aimed to investigate the role of the bone morphogenetic protein (BMP) signaling pathway in the early development\nof vascular calcification in CKD. A CKD vascular calcification rat model was established by providing rats with a 1.8% highphosphorus\ndiet and an intragastric administration of 2.5% adenine suspension.The kidney and aortic pathologies were analyzed.\nBlood biochemical indicators, serum BMP-2 and BMP-4 levels, and aortic calcium content were determined.The expression levels\nof BMP-2, BMP-4, bonemorphogenetic protein receptor-IA (BMPR-IA), andmatrix Gla protein (MGP) in aorta were examined by\nquantitative real-time polymerase chain reaction and immunohistochemistry. Compared with the normal control (Nor) rats, the\nCKD rats exhibited a significantly decreased body weight and an increased kidney weight as well as abnormal renal function and\ncalcium-phosphorus metabolism. Aortic von Kossa and Alizarin red staining showed massive granular deposition and formation\nof calcified nodules in aorta at 8 weeks. The aortic calcium content was significantly increased, which was positively correlated with\nthe serum BMP-2 (...
This study aimed to compare the oncological and renal outcomes of partial ureterectomy (PU) versus radical nephroureterectomy\n(RNU) for upper tract urothelial carcinoma (UTUC). UTUC patientsââ?¬â?¢ clinical information was reviewed, and progression-free\nsurvival (PFS), overall survival (OS), and kidney function were collected.Themean follow-up period was 59 (6ââ?¬â??135) months in the\nRNU group and 34.5 (5ââ?¬â??135) months in the PU group. The mean operation time in the PU group was 141 (64ââ?¬â??340) min, which is\nsignificantly shorter than the RNU group (...
Aim: To describe the epidemiological, clinical, etiologic and therapeutic aspects\nof patients with acute obstructive renal failure at the Medical Surgical\nCenter of Urology (MSCU). Materials and methods: this was a descriptive retrospective\nstudy of 106 patient records treated for acute renal failure from\nJanuary 2012 to December 2016. Patients came for spontaneous consultation\nor were referred. They had benefited from a clinical and paraclinical assessment\nat the end of which the diagnosis of acute renal failure was retained and\nthen an effective management at the MSCU. The variables studies were clinical,\nparaclinical, therapeutic and progressive. The treatment included: hemodialysis,\nurinary diversion (suprapubic, urethrovesical and ureteral), trans-urethral\nresection of the prostate, trans-urethral resection of the bladder, nephrostomy,\nendoscopic incision of catheter valves, posterior urethra or laparoscopic\nnephroureterectomy as indicated. The emergency treatments consisted of removing\nthe obstacle and the etiological treatment was done later. External\nfollow-up consultation varied by etiology. Results: In 4 years we had treated\n106 patients, a frequency of 26.5%. The average age was 47.83 years with extreme\nof 2 and 80 years old. The sex ratio was 68 men for 38 women. The\nmean serum creatinine level was 37.8 mg/l (335 �¼mol/l). The etiologies were:\nprostatic pathologies (n = 38), lithiasic pathologies (n = 20) and gynecological\npathologies (n = 18). The treatments were: endoscopic resection of prostate (n\n= 24), bladder (n = 6), posterior urethral valves (n = 4), JJ probe (n = 27) and\nnephrostomy (n = 23). The result was good (normalization of creatinine serum)\nin 79 patients, the persistence of elevated serum creatinine was observed\nin 4 patients and 18 patients died. Conclusion: Acute obstructive renal failure\nis a common diagnosis in our exercise setting at MSCU where it can be managed\nwith respect to our technical platform....
Acute haemodynamic instability is a natural consequence of disordered cardiovascular physiology during haemodialysis (HD).\nPrevalence of intradialytic hypotension (IDH) can be as high as 20ââ?¬â??30%, contributing to subclinical, transientmyocardial ischemia.\nIn the long term, this results in progressive, maladaptive cardiac remodeling and impairment of left ventricular function. This is\nthought to be a major contributor to increased cardiovascular mortality in end stage renal disease (ESRD). Medical strategies\nto acutely attenuate haemodynamic instability during HD are suboptimal. Whilst a programme of intradialytic exercise training\nappears to facilitate numerous chronic adaptations, little is known of the acute physiological response to this type of exercise. In particular,\nthe potential for intradialytic exercise to acutely stabilise cardiovascular hemodynamics, thus preventing IDH and myocardial\nischemia, has not been explored. This narrative reviewaims to summarise the characteristics and causes of acute haemodynamic\ninstability during HD, with an overview of current medical therapies to treat IDH. Moreover, we discuss the acute physiological\nresponse to intradialytic exercise with a view to determining the potential for this nonmedical intervention to stabilise cardiovascular\nhaemodynamics during HD, improve coronary perfusion, and reduce cardiovascular morbidity and mortality in ESRD....
Introduction: High Grade Prostatic Intraepithelial Neoplasia (HGPIN) was\noriginally thought to be a cancer precursor, but subsequent data has questioned\nits prognostic significance. We analyzed a large cohort of men diagnosed\nwith HGPIN for subsequent occurrence of prostate cancer. Methods:\nFrom 2001 to 2011, we identified 567 men with isolated HGPIN and followed\nthem for subsequent diagnosis of prostate cancer. Results: Two hundred and\nfive patients were followed (median 5.9 years) without biopsy and remained\nclinically free of prostate cancer. The remaining 362 men underwent repeat\nbiopsies and 133 (37%) were diagnosed with prostate cancer. The number of\ncores of HGPIN and whether they were unilateral or bilateral was not predictive\nfor subsequent diagnosis of cancer. Prostate specific antigen was the only\nstatistically significant predictor for prostate cancer. Conclusions: We found\nthe incidence of cancer after a diagnosis of HGPIN to be 37%, which is consistent\nwith other published series. This is only marginally higher than in patients\nre-biopsied after a prior benign biopsy. It appears that isolated HGPIN\nhas only a small predictive value for subsequent diagnosis of prostate cancer.\nTherefore the finding of HGPIN should be used only in conjunction with\nother risk factors and patient considerations in deciding whether to proceed\nwith further prostate biopsies....
Objective.The presence of testicular appendices was prospectively evaluated in 89 boys with 96 undescended testes who underwent\norchidopexy over the period of 4 years. Results. The patients were divided into two groups. Group A included 42 boys with 49\nundescended testes positioned close to the internal inguinal ring, and Group B included 47 boys with 47 undescended testes close\nto the external inguinal ring.The incidence of appendix testis (AT) inGroup A was 57.1% (28 in 49) and 78.7% (37 in 47) inGroup B.\nThe results of our study showed significantly decreased incidence of testicular appendices in undescended testes positioned close to\nthe internal inguinal ring compared with undescended testes positioned close to the external inguinal ring (...
Introduction. Trefoil factor family (TFF) peptides are increased in serum and urine in patients with chronic kidney disease (CKD).\nHowever,whether the levels of TFF predict the progression ofCKDremains to be elucidated. Methods.We determined the TFF levels\nusing peptide-specific ELISA in spot urine samples and performed a prospective cohort study.The association between the levels\nof urine TFFs and other urine biomarkers as well as the renal prognosis was analyzed in 216 CKD patients (mean age: 53.7 years,\n47.7% female, 56.9% with chronic glomerulonephritis, and mean eGFR: 58.5 ml/min/1.73m2). Results. The urine TFF1 and TFF3\nlevels significantly increased with the progression of CKD stages, but not the urine TFF2 levels. The TFF1 and TFF3 peptide levels\npredicted the progression of CKD ââ?°Â¥ stage 3b by ROC analysis (AUC 0.750 and 0.879, resp.); however, TFF3 alone predicted CKD\nprogression in a multivariate logistic regression analysis (odds ratio 3.854, 95% confidence interval 1.316ââ?¬â??11.55). The Kaplan-Meier\nsurvival curves demonstrated that patients with a higher TFF1 and TFF3 alone, or in combination with macroalbuminuria, had a\nsignificantly worse renal prognosis. Conclusion.The data suggested that urine TFF peptides are associated with renal progression\nand the outcomes in patients with CKD....
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