Current Issue : January - March Volume : 2019 Issue Number : 1 Articles : 8 Articles
Background: There were 800 individual case reports of urogenital foreign\nbodies in the English literature from 1755 to 1999. The use of urogenital\nforeign bodies for sexual pleasure is a common occurrence in todayâ??s population.\nThe aim of this discussion is the management of scrotal injury\ncaused by magnetic urogenital foreign bodies. Case Presentation:\n56-year-old male with scrotal tissue entrapped between two opposed magnet\nrings. Self-reported attempts at removal were unsuccessful and caused\nfor presentation to the emergency department. Additional attempts at removal\nby medical staff unsuccessful in emergency department and therefore\nthe patient proceeded to the operating room. Intraoperatively the use of two\ncardiac magnets allowed for removal without a need for invasive surgical\nprocedure. Conclusion: Cardiac magnets are preferred means of removal for\nentrapped skin between magnetic foreign bodies that could be utilized at the\nbedside....
Prostate cancer is the leading male cancer worldwide. There remains a controversy\nas to which patients have indolent disease and which patients present\nan aggressive disease needing treatment with intent to cure. Because of quality\nof life impairment associated with treatment by radiation or surgery, active\nsurveillance (AS) is a valid management option to avoid or differ aggressive\ntreatment. Traditionally, AS was reserved for men with low risk prostate cancer,\nhowever intermediate risk patients are more and more found in AS cohorts.\nThe aim of this review is to describe the place of AS in intermediate\nrisk patients and the perspectives offered by such a treatment modality....
Purpose.This trial aimed to compare mortality and recovery of renal function in acute kidney injury (AKI) patients treated with\ndifferent durations of prolonged hemodialysis (PHD) sessions (6 h versus 10 h). Methodology. We included patients with sepsisassociated\nAKI, >18 years, who are in use of a norepinephrine (lower than 0.7 ucg/kg/min). Results. One hundred and ninety-four\npatients were treated with 531 sessions of PHD (G1=104 and G2=90 patients).The two groups were similar in age and SOFA.There\nwas no significant difference in hypotension, hypokalemia, and anticoagulation during PHD sessions. The two groups showed\ndifferences in filter clotting, hypophosphatemia, and treatment discontinuation (12.3 versus 23.1%, p=0.002; 15.5 versus 25.8%,\np=0.005; and 7.9 versus 15.6%, p=0.008, respectively). There was no difference in fluid balance (FB) before and after PHD sessions.\nDeath and complete recovery of renal function were similar (81.3 versus 82.2%, p=0.87 and 21 versus 31.2%, p=0.7, respectively). At\nlogistic regression, the positive FB before and after dialysis was identified as risk factor for death, while volume overload after three\nPHD sessions and predialysis creatinine were negatively associated with recovery of renal function in 28 days. Conclusion. There\nwas no difference in the mortality and recovery of renal function of AKI patients submitted to different durations of PHD and\nsessions lasting 10 h presented higher filter clotting, hypophosphatemia, and treatment discontinuation. ISRCTN Registry number\nis ISRCTN33774458....
Background. To describe the extent of renal disease in Ugandan children surviving at least ten years after spina bifida repair and\nto investigate risk factors for renal deterioration in this cohort. Patients and Methods. Children who had undergone spina bifida\nrepair at CURE Childrenâ??s Hospital of Uganda between 2000 and 2004 were invited to attend interview, physical examination,\nrenal tract ultrasound, and a blood test (creatinine).Medical records were retrospectively reviewed. The following were considered\nevidence of renal damage: elevated creatinine, hypertension, and ultrasound findings of hydronephrosis, scarring, and discrepancy\nin renal size >1cm. Female sex, previous UTI, neurological level, mobility, detrusor leak point pressure, and adherence with clean\nintermittent catheterisation (CIC) were investigated for association with evidence of renal damage. Results. 65 of 68 children aged\n10â??14 completed the assessment.Themajority (83%) reported incontinence. 17 children (26%) were performing CIC. One child had\nelevated creatinine. 25 children (38%) were hypertensive. There was a high prevalence of ultrasound abnormalities: hydronephrosis\nin 10 children (15%), scarring in 42 (64%), and >1cm size discrepancy in 28 (43%). No children with lesions at S1 or below had\nhydronephrosis (p = 0.025), but this group had comparable prevalence of renal size discrepancy, scarring, and hypertension to\nthose children with higher lesions. Conclusions. Incontinence, ultrasound abnormalities, and hypertension are highly prevalent in\na cohort of Ugandan children with spina bifida, including those with low neurological lesions.These findings support the early and\nuniversal initiation of CIC with anticholinergic therapy in a low-income setting....
Utilization of kidneys from extended criteria donors leads to an increase in average warm ischemia time (WIT), which is associated\nwith larger degrees of ischemia-reperfusion injury (IRI). Kidney resuscitation by extra corporeal perfusion in situ allows up to 60\nminutes of asystole after the circulatory death.Molecular studies of kidney grafts from human donors with critically expanded WIT\nare warranted. Transcriptomes of two human kidneys from two different donors were profiled after 35-45minutes of WIT and after\n120 minutes of normothermic perfusion and compared. Baseline gene expression patterns in ischemic grafts display substantial\nintrinsic differences. IRI does not lead to substantial change in overall transcription landscape but activates a highly connected\nprotein network with hubs centered on Jun/Fos/ATF transcription factors and HSP1A/HSPA5 heat shock proteins. This response\nis regulated by positive feedback. IRI networks are enriched in soluble proteins and bio fluids assayable substances, thus, indicating\nfeasibility of the longitudinal, minimally invasive assessment in vivo. Mapping of IRI related molecules in ischemic and re per fused\nkidneys provides a rationale for possible organ conditioning during machine assisted ex vivo normothermic perfusion. A study of\nnatural diversity of the transcriptional landscapes in presumably normal, transplantation-suitable human organs is warranted....
Objective: To observe the clinical effect and safety of circumcision stapler in\nchildren with phimosis and redundant prepuce. Methods: From July 2013 to\nJuly 2017, 40 children were prospectively randomized and assigned to experiment\ngroup (circumcision stapler n = 20) or control group (conventional\ncircumcision, n = 20). Outcomes were operation time, intraoperative blood\nloss and postoperative complications. Results: There was significant difference\nbetween the two groups for operation time (5.35 min vs 30.30 min, P <\n0.05) and intraoperative blood loss (2.56 ml vs 10.40 ml, P < 0.05) respectively.\nConclusion: Circumcision staplers are superior to conventional circumcision\nfor the advantages of shorter operation time and fewer blood losses....
Background: More and more chronic kidney disease (CKD) patients are accompanied\nwith hyperuricaemia. As is known, hyperuricaemia is an independent\nhazard of both cardiovascular diseases (CVD) and chronic kidney\ndiseases. We aim at identifying Single Nucleotide Polymorphism (SNP) difference\nof hURAT1 (rs7932775) and ABCG2 (rs3825016) on CKD patient\nwith hyperuricemia and/or gout. Methods: All forty-two CKD patients were\ndivided into two groups: hyperuricemia, and control group. 24 hours urine\nsample and serum were prepared for testing biochemistry parameters. The\npolymerase chain reaction-restriction fragment length polymorphism\n(PCR-RFLP) method is used to analyze hURAT1 and ABCG2 single nucleotide\npolymorphisms in different groups. Results: 17 patients have CT SNP of\nhURAT1 (rs7932775) and 13 patients have CT SNP of ABCG2 (rs3825016) in\nhyperuricemia group, while only 5 persons and 6 persons have the same mutations\nin control group respectively. 7 patients have CT SNP of both hURAT1\n(rs7932775) and ABCG2 (rs3825016) in hyperuricemia group, while\nonly 2 persons have the same mutations in control group. CT mutation rates\nof hURAT1 (rs7932775) and ABCG2 (rs3825016) in hyperuricemia group\nwere 60.7% (17/28) and 50% (13/28) respectively, higher than that of control\ngroup (35.7% (5/14) and 42.8% (6/14)). What is more, Double SNP mutations\nin both hURAT1 (rs7932775) and ABCG2 (rs3825016) in hyperuricemia\ngroup were 25% (7/28), higher than that of control group (14.2%, 2/14).\nConclusion: There are higher mutation rates of CT SNP in hURAT1\n(rs7932775) and/or ABCG2 (rs3825016) in hyperuricemia group. We can\nconclude that hyperuricemia is a high risk factor in progress of CKD, which is necessary to take measures of decreasing serum uric acid to delay CKD\nprogress....
Cardiovascular complications are extremely frequent in patients with chronic kidney disease (CKD) and death from cardiac\ncauses is the most common cause of death in this particular population. Cardiovascular disease is approximately 3 times more\nfrequent in patients with CKD than in other known cardiovascular risk groups and cardiovascular mortality is approximately 10-\nfold more frequent in patients on dialysis compared to the age- and sex-matched segments of the nonrenal population. Among\nother structural and functional factors advanced calcification of atherosclerotic plaques as well as of the arterial and venous\nmedia has been described as potentially relevant for this high cardiovascular morbidity and mortality. One potential explanation\nfor this exceedingly high vascular calcification in animal models as well as in patients with CKD increased systemic and most\nimportantly local (micro)inflammation that has been shown to favor the development of calcifying particles by multiple ways. Of\nnote, local vascular up regulation of pro in flammatory and proosteogenic molecules is already present at early stages of CKD and\nmay thus be operative for vascular calcification. In addition, increased expression of costimulatory molecules and mast cells has\nalso been documented in patients with CKD pointing to a more inflammatory and potentially less stable phenotype of coronary\natherosclerotic plaques in CKD....
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