Current Issue : July - September Volume : 2021 Issue Number : 3 Articles : 7 Articles
Objective: To evaluate the efficacy and safety of Combined detrusor and external urethral sphincter BTX-A injections for detrusor overactivity (DO) and detrusor external sphincter dyssynergia (DESD) secondary to spinal cord injury. Study Design: Prospective study. Methods: The study was carried out in 18 SCI patients with detrusor overactivity (DO) and detrusor external sphincter dyssynergia (DESD) receiving Combined detrusor and external urethral sphincter BTX-A injections treatment. Contain 200 U botulinum toxin intradetrusor and 100 U external urethral sphincter injections. The effective outcomes included maximum detrusor pressure at first DO and DESD (PdetmaxDO- DESD), volume at first DO and DESD (VDO-DESD), maximum urethral closure pressure (MUCP), and Incontinence-Specific Quality-of-Life Instrument (I-QoL). Adverse events were recorded. Results: All patients experienced a significant mean reduction...............
Background: Chronic kidney disease as well as acute kidney injury are associated with adverse outcomes after transcatheter aortic valve replacement (TAVR). However, little is known about the prognostic implications of an improvement in renal function after TAVR. Methods: Renal improvement (RI) was defined as a decrease in postprocedural creatinine in μmol/l of ≥1% compared to its preprocedural baseline value. A propensity score representing the likelihood of RI was calculated to define patient groups which were comparable regarding potential confounders (age, sex, BMI, NYHA classification, STS score, log. EuroSCORE, history of atrial fibrillation/atrial flutter, pulmonary disease, previous stroke, CRP, creatinine, hsTNT and NT-proBNP). The cohort was stratified into 5 quintiles according to this propensity score and the survival time after TAVR was compared within each subgroup. Results: Patients in quintile 5 (n = 93) had the highest likelihood for RI. They were characterized by higher creatinine, lower eGFR, higher NYHA class, higher..............
Background: Associations between microvascular variation and chronic kidney disease (CKD) have been reported previously. Non-invasive retinal fundus imaging enables evaluation of the microvascular network and may offer insight to systemic risk associated with CKD. Methods: Retinal microvascular parameters (fractal dimension [FD] – a measure of the complexity of the vascular network, tortuosity, and retinal arteriolar and venular calibre) were quantified from macula-centred fundus images using the Vessel Assessment and Measurement Platform for Images of the REtina (VAMPIRE) version 3.1 (VAMPIRE group, Universities of Dundee and Edinburgh, Scotland) and assessed for associations with renal damage in a casecontrol study nested within the multi-centre UK Biobank cohort study. Participants were designated cases or controls based on urinary albumin to creatinine ratio (ACR) thresholds. Participants with ACR ≥ 3 mg/mmol (ACR stages A2-A3) were characterised as cases, and those with an ACR < 3 mg/mmol (ACR stage A1) were categorised as controls. Participants were matched on age, sex and ethnic background. Results: Lower FD (less extensive microvascular branching) was associated with a small increase in odds of albuminuria independent of blood pressure, diabetes and other potential confounding variables (odds ratio [OR] 1.18, 95% confidence interval [CI] 1.03–1.34 for arterioles and OR 1.24, CI 1.05–1.47 for venules). Measures of tortuosity or retinal arteriolar and venular calibre were not significantly associated with ACR. Conclusions: This study supports previously reported associations between retinal microvascular FD and other metabolic disturbances affecting the systemic vasculature. The association between retinal.................
Introduction: Tubular and interstitial nephropathy syndrome with uveitis or TINU syndrome is a rare association. Patients and methods: We have listed cases in which the clinical-biological picture and histology were consistent with this syndrome. Results: Two cases were retained: These were two female patients whose mean age at diagnosis was 16 years. The inaugural symptoms were bilateral anterior uveitis in two cases. The time to onset of renal signs: was 4 to 2 weeks months. Acute kidney failure was reported in both cases with a mean creatinine of 36.4 mg/l. An average proteinuria of 1.1 g/24 h associated with aseptic leukocyturia in one case/2 and glycosuria normoglycemic in 1 case/2. Non inflammatory syndrome specific with inflammatory anemia is reported in both cases. Kidney puncture biopsy confirmed the diagnosis with nephropathy diffuse polymorphic tubulointerstitial and immunofluorescence negative in both cases. Oral corticosteroid therapy (1 mg/kg per day) was started for 4 to 6 months. Both patients received initial local corticosteroid therapy for uveitis. The outcome was favorable..............
Background: A growing body of evidence supports the potential role of social determinants of health on health outcomes. However, few studies have examined the cumulative effect of social determinants of health on health outcomes in adults with chronic kidney disease (CKD) with or without diabetes. This study examined the cumulative impact of social determinants of health on mortality in U.S. adults with CKD and diabetes. Methods: We analyzed data from National Health and Nutrition Examination Surveys (2005–2014) for 1376 adults age 20 and older (representing 7,579,967 U.S. adults) with CKD and diabetes. The primary outcome was all-cause mortality. CKD was based on estimated glomerular filtration rate and albuminuria. Diabetes was based on self-report or Hemoglobin A1c of ≥6.5%. Social determinants of health measures included family income to poverty ratio level, depression based on PHQ-9 score and food insecurity based on Food Security Survey Module. A dichotomous social determinant measure (absence vs presence of ≥1 adverse social determinants) and a cumulative social determinant score ranging from 0 to 3 was constructed based on all three measures. Cox proportional models were used to estimate the association between social determinants of health factors and mortality while controlling for covariates. Results: Cumulative and dichotomous social determinants of health score were significantly associated with mortality after adjusting for demographics, lifestyle variables, glycemic control and comorbidities (HR = 1.41, 95%CI 1.18–1.68 and HR = 1.41, 95%CI 1.08–1.84, respectively). When investigating social determinants of health variables separately, after adjusting for covariates, depression (HR = 1.52, 95%CI 1.10–1.83) was significantly and independently associated with mortality, however, poverty and food insecurity were not statistically significant.............
Introduction: Hypertension, often associated with hypervolemia, is common in chronic hemodialysis patients. However, the relationship between interdialytic weight gain (IDWG) and blood pressure (BP) is incompletely characterized. Our study seeks to appreciate the relationship between IDWG and BP in a cohort of chronic hemodialysis patients. Patients and Methods: It is a prospective study involving 52 chronic hemodialysis patients and 528 dialysis sessions following a hemodialysis program of 3 times a week, where BP and IDWG were measured before the session. The dialysis sessions occurred over a period of 30 days from January 02 to 30, 2019 in the Hemodialysis unit of Mohammed V Military Training Hospital. Demographic data and dialytic parameters were collected over a 30-day period then analyzed using the following statistical tools: correlation coefficient r, simple linear regression (univariate analysis) and multiple linear regression...............
Introduction: Trauma of the external male genital organs (TEMGO) is multifaceted and rare. The objective of this work was to provide an overview of these lesions by describing the epidemiology, the diagnostic approach, their therapeutic and prognostic aspects. Materials and Methods: It was a retrospective study carried out over a ten-year period, from January 1, 2009 to December 31, 2018. It included male patients, admitted and treated in surgical emergencies and in the urology department of the Sylvanus Olympio Teaching Hospital in Lomé for trauma of male external genital organs. Results: Thirty-five cases had been collected. They had represented 1.5% of urological emergencies. The subjects were young with a mean age of 29.6 ± 3.1 years, with extremes of 18 and 60 years. Trauma to the penis was more frequent and found in 60% of cases, with the mechanism of coitus misstep in 54.3%, leading to a fracture of the penis. Testicular contusions were found in 22.9% of the cases. The ultrasound was performed................
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