Pub Date : 2023-10-20DOI: 10.2174/011874303x257072231002120604
Muhammad Moazzam, Aibak Khwaja
Purpose: This study evaluated the early postoperative complications in Circumplast ® and Plastibell ® techniques for infant male circumcision in two community clinics. Materials and Methods: We retrospectively reviewed the outcome of infant male circumcision (n=649) over 1 year (Jan 2021 to Feb 2022) performed under local anaesthesia by a single urologist. The technique was non-randomly selected. Data were collected retrospectively, and early postoperative complications were compared between Circumplast ® and Plastibell ® circumcisions. Both parents consented to the procedure. The 24-telephone support and follow-up were provided if required. Results: All records of infants were reviewed with Circumplast ® circumcision (CC) n=302 and Plastibell ® circumcision (PC) n=347 during this period. The mean age was 52.33 +/- 44.16 days in CC and 38.64 ± SD 30.39 days in PC. Three infants were excluded. There was no major complication and minor complications were lower in CC (0.99% n=3/302) versus PC (2.9% n=10/347). Delayed ring separation happened in PC (2.3% n=8/347), which was separated by a bone cutter in the clinic and no ring impaction occurred in CC. One infant in CC had bleeding after 24 hours, which was managed by removal of the ring and revision of circumcision. Two infants required separation of coronal adhesions in CC and two required revisions of circumcision in PC. Discussion: This is the first study to report the results of early experience involving the use of Circumplast ® ring to perform pediatric circumcision. Our findings reflect the use of this device as a safe alternative to Plastibell ® . A randomised controlled trial (RCT) would be required to document the relative superiority of either device. The reduced number of ring impactions among CC may be attributed to its unique design. Conclusion: Infant male circumcision by the Circumplast ® device has a lower risk of early postoperative minor complications especially migration/impaction and may offer a safe alternative.
{"title":"Does Circumplast Ring Offer Safe Alternative to Standard Plastibell Ring for Infant Male Circumcision?","authors":"Muhammad Moazzam, Aibak Khwaja","doi":"10.2174/011874303x257072231002120604","DOIUrl":"https://doi.org/10.2174/011874303x257072231002120604","url":null,"abstract":"Purpose: This study evaluated the early postoperative complications in Circumplast ® and Plastibell ® techniques for infant male circumcision in two community clinics. Materials and Methods: We retrospectively reviewed the outcome of infant male circumcision (n=649) over 1 year (Jan 2021 to Feb 2022) performed under local anaesthesia by a single urologist. The technique was non-randomly selected. Data were collected retrospectively, and early postoperative complications were compared between Circumplast ® and Plastibell ® circumcisions. Both parents consented to the procedure. The 24-telephone support and follow-up were provided if required. Results: All records of infants were reviewed with Circumplast ® circumcision (CC) n=302 and Plastibell ® circumcision (PC) n=347 during this period. The mean age was 52.33 +/- 44.16 days in CC and 38.64 ± SD 30.39 days in PC. Three infants were excluded. There was no major complication and minor complications were lower in CC (0.99% n=3/302) versus PC (2.9% n=10/347). Delayed ring separation happened in PC (2.3% n=8/347), which was separated by a bone cutter in the clinic and no ring impaction occurred in CC. One infant in CC had bleeding after 24 hours, which was managed by removal of the ring and revision of circumcision. Two infants required separation of coronal adhesions in CC and two required revisions of circumcision in PC. Discussion: This is the first study to report the results of early experience involving the use of Circumplast ® ring to perform pediatric circumcision. Our findings reflect the use of this device as a safe alternative to Plastibell ® . A randomised controlled trial (RCT) would be required to document the relative superiority of either device. The reduced number of ring impactions among CC may be attributed to its unique design. Conclusion: Infant male circumcision by the Circumplast ® device has a lower risk of early postoperative minor complications especially migration/impaction and may offer a safe alternative.","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135666956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-13DOI: 10.2174/1874303x-v15-e221227-2022-9
Ravi Kumar P, V Vinayagmoorthy, Amol Dongre, Pradeep Deshmukh
Background: Despite the advent of dialysis technology, the survival of patients on hemodialysis (HD) is not encouraging. There is little information available regarding the prognostic factors of HD, its population characteristics, or outcomes in India. Objectives: We attempted to describe the profile of patients on HD, estimate the mean days of their survival and to determine the various factors associated with their survival. Materials and Methods: It was a retrospective cohort study conducted on patients who were on maintenance HD, registered during the five-year period between 1 st January 2014 and 31 st December 2018 in a tertiary care teaching hospital in Rural Puducherry, South India. Demographic, hematological, biochemical, electrocardiographic, echocardiographic parameters and death during follow-up were extracted from the dialysis database after de-identification. The survival rate was calculated using Kaplan- Meir Curves and Cox Regression analysis was done to estimate the adjusted hazard ratio. Results: The median survival of the 229 eligible patients on HD was 819 days. Cardiac pathology accounted for 25.7% of those deaths and 33.9% was sudden death. Adjusted Cox proportional model showed the presence of Left Ventricular Hypertrophy (LVH) (HR: 78.1), increase in phosphorus (HR: 1.26), decrease in haemoglobin (HR: 0.78), and decrease in serum albumin (HR: 0.52) were significant bad prognostic factors. Conclusion: Screening for LVH, anemia, hypoaluminemia and hyperphosphatemia amongst HD patients and managing them to prevent these bad prognostic factors has the potential to improve their survival.
{"title":"Survival and Analysis of Predictors of Mortality in Patients Undergoing Hemodialysis in a Rural Hospital in Puducherry, India: A Retrospective Cohort Study","authors":"Ravi Kumar P, V Vinayagmoorthy, Amol Dongre, Pradeep Deshmukh","doi":"10.2174/1874303x-v15-e221227-2022-9","DOIUrl":"https://doi.org/10.2174/1874303x-v15-e221227-2022-9","url":null,"abstract":"Background: Despite the advent of dialysis technology, the survival of patients on hemodialysis (HD) is not encouraging. There is little information available regarding the prognostic factors of HD, its population characteristics, or outcomes in India. Objectives: We attempted to describe the profile of patients on HD, estimate the mean days of their survival and to determine the various factors associated with their survival. Materials and Methods: It was a retrospective cohort study conducted on patients who were on maintenance HD, registered during the five-year period between 1 st January 2014 and 31 st December 2018 in a tertiary care teaching hospital in Rural Puducherry, South India. Demographic, hematological, biochemical, electrocardiographic, echocardiographic parameters and death during follow-up were extracted from the dialysis database after de-identification. The survival rate was calculated using Kaplan- Meir Curves and Cox Regression analysis was done to estimate the adjusted hazard ratio. Results: The median survival of the 229 eligible patients on HD was 819 days. Cardiac pathology accounted for 25.7% of those deaths and 33.9% was sudden death. Adjusted Cox proportional model showed the presence of Left Ventricular Hypertrophy (LVH) (HR: 78.1), increase in phosphorus (HR: 1.26), decrease in haemoglobin (HR: 0.78), and decrease in serum albumin (HR: 0.52) were significant bad prognostic factors. Conclusion: Screening for LVH, anemia, hypoaluminemia and hyperphosphatemia amongst HD patients and managing them to prevent these bad prognostic factors has the potential to improve their survival.","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135902698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. C. John, G. Gipson, C. King, T. Bunchman, O. Karam
Aim Fluid overload is a major contributor to mortality in critically ill patients but is difficult to estimate clinically. Bioimpedance has been used to estimate fluid volumes with three different methods of analysis:1. single-frequency; 2. multi-frequency; 3. bioimpedance spectroscopy. The aim of this study is to assess the accuracy of different types of bioimpedance analysis in detecting changes in fluid volumes. Methods Prospective observational study, in end-stage renal disease patients requiring dialysis, in a tertiary care center. During hemodialysis, we assessed the correlation between change in estimated total body water volumes, as measured by all three methods of bioimpedance, and fluid volumes removed, as measured by changes in body weight. Results Twenty-four pediatric and adult patients were included in the study (median age 42.4 years) with a total of 30 study assessments performed. There was a weak correlation between change in body weight and change in estimated total body water volumes (R=0.15, 0.41, and 0.38, respectively). In the Bland-Altman analysis, the mean biases along with their associated 95% confidence limits of agreement were -0.23 L (-4.1 to 3.5 L) for single-frequency; -1.1 L (-4.1 to 1.9 L) for multi-frequency; and -0.6 L (-6.1 to 4.8 L) for bioimpedance spectroscopy. Conclusion In this study of end-stage renal disease patients requiring dialysis, the accuracy of bioimpedance measurement to evaluate fluid changes was poor, regardless of bioimpedance modality.
{"title":"Accuracy of Bioimpedance Modalities for Fluid Assessment in Hemodialysis Patients: A Randomized Observational Study","authors":"J. C. John, G. Gipson, C. King, T. Bunchman, O. Karam","doi":"10.17140/npoj-6-124","DOIUrl":"https://doi.org/10.17140/npoj-6-124","url":null,"abstract":"Aim Fluid overload is a major contributor to mortality in critically ill patients but is difficult to estimate clinically. Bioimpedance has been used to estimate fluid volumes with three different methods of analysis:1. single-frequency; 2. multi-frequency; 3. bioimpedance spectroscopy. The aim of this study is to assess the accuracy of different types of bioimpedance analysis in detecting changes in fluid volumes. Methods Prospective observational study, in end-stage renal disease patients requiring dialysis, in a tertiary care center. During hemodialysis, we assessed the correlation between change in estimated total body water volumes, as measured by all three methods of bioimpedance, and fluid volumes removed, as measured by changes in body weight. Results Twenty-four pediatric and adult patients were included in the study (median age 42.4 years) with a total of 30 study assessments performed. There was a weak correlation between change in body weight and change in estimated total body water volumes (R=0.15, 0.41, and 0.38, respectively). In the Bland-Altman analysis, the mean biases along with their associated 95% confidence limits of agreement were -0.23 L (-4.1 to 3.5 L) for single-frequency; -1.1 L (-4.1 to 1.9 L) for multi-frequency; and -0.6 L (-6.1 to 4.8 L) for bioimpedance spectroscopy. Conclusion In this study of end-stage renal disease patients requiring dialysis, the accuracy of bioimpedance measurement to evaluate fluid changes was poor, regardless of bioimpedance modality.","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76418715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-31DOI: 10.2174/1874303x02114010026
Anusua Trivedi, W. Liles, N. Becker, Catherine Egan, J. Ferres, Aaron Y. Lee, P. Bhatraju
University of Washington, School of Medicine, Seattle, United States AI for Good Research, Microsoft, United States Department of Medicine and Sepsis Center of Research Excellence, University of Washington (SCORE-UW), Seattle, United States University of Washington, Computer Science and Engineering, United States Moorfields Eye Hospital NHS Foundation Trust, United Kingdom University of Washington Division of Pulmonary, Critical Care and Sleep Medicine, Seattle, United States
{"title":"Parameters of Chronic Kidney Disease to Identify Outpatients at Increased Risk for COVID-19 Mortality: A Cohort Study of UK Biobank Participants","authors":"Anusua Trivedi, W. Liles, N. Becker, Catherine Egan, J. Ferres, Aaron Y. Lee, P. Bhatraju","doi":"10.2174/1874303x02114010026","DOIUrl":"https://doi.org/10.2174/1874303x02114010026","url":null,"abstract":"University of Washington, School of Medicine, Seattle, United States AI for Good Research, Microsoft, United States Department of Medicine and Sepsis Center of Research Excellence, University of Washington (SCORE-UW), Seattle, United States University of Washington, Computer Science and Engineering, United States Moorfields Eye Hospital NHS Foundation Trust, United Kingdom University of Washington Division of Pulmonary, Critical Care and Sleep Medicine, Seattle, United States","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49295608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Issa Alhamoud, Ei Khin, Rong Huang, Lesli McConnell, M. Seikaly
Introduction Acute antibody-mediated rejection (aAMR) can negatively impact renal allografts outcomes. To date, there has not been a consistent therapeutic approach to manage aAMR. The aim of the study is to evaluate the tolerance and efficacy of an institutional protocol of methylprednisolone, intravenous gamma globulin (IVIG), rituximab, and bortezomib used to treat aAMR in pediatric renal transplant recipients (pRTRs). Methods A retrospective chart review was performed on 10 pediatric renal transplant recipients (pRTRs) who were diagnosed with aAMR on a renal biopsy performed between January 2014 and November 2015. Results Over the study period, 9.5% of pRTRs had aAMR. Sixty percent of whom had concurrent acute cellular rejection (ACR). Renal allografts survival was 100% during the the first post-aAMR. At the time of diagnosis of aAMR, estimated glomerular filtration rate (eGFR) had decreased by 42% (mean at baseline eGFR=67.2±19.5 mL/min/1.73 m2 vs mean at aAMR eGFR=38.9±14.2 mL/min/1.73 m2; p=0.002). At 1-year post rejection, eGFR had increased by 26% as compared eGFR at the time of rejection (mean eGFR=49.0±13.2 mL/min/1.73 m2; p=0.006). Immuno-dominant donor-specific anti-HLA antibody titers (iDSAs) class I and class II decreased by 69% and 15% at 6-month follow-up visit. No serious opportunistic infections nor malignancy were reported in our subjects. Conclusion Our study suggests that our protocol improved kidney function with 100% graft survival at 1-year post aAMR episode. The percentage decline in iDSAs class I titers was more significant than class II. Furthermore, our treatment protocol was well-tolerated with no life threatening complications.
{"title":"Treatment of Acute Antibody-Mediated Rejection in Children Post-Kidney Transplantation: A Single Center’s Experience","authors":"Issa Alhamoud, Ei Khin, Rong Huang, Lesli McConnell, M. Seikaly","doi":"10.17140/npoj-6-125","DOIUrl":"https://doi.org/10.17140/npoj-6-125","url":null,"abstract":"Introduction Acute antibody-mediated rejection (aAMR) can negatively impact renal allografts outcomes. To date, there has not been a consistent therapeutic approach to manage aAMR. The aim of the study is to evaluate the tolerance and efficacy of an institutional protocol of methylprednisolone, intravenous gamma globulin (IVIG), rituximab, and bortezomib used to treat aAMR in pediatric renal transplant recipients (pRTRs). Methods A retrospective chart review was performed on 10 pediatric renal transplant recipients (pRTRs) who were diagnosed with aAMR on a renal biopsy performed between January 2014 and November 2015. Results Over the study period, 9.5% of pRTRs had aAMR. Sixty percent of whom had concurrent acute cellular rejection (ACR). Renal allografts survival was 100% during the the first post-aAMR. At the time of diagnosis of aAMR, estimated glomerular filtration rate (eGFR) had decreased by 42% (mean at baseline eGFR=67.2±19.5 mL/min/1.73 m2 vs mean at aAMR eGFR=38.9±14.2 mL/min/1.73 m2; p=0.002). At 1-year post rejection, eGFR had increased by 26% as compared eGFR at the time of rejection (mean eGFR=49.0±13.2 mL/min/1.73 m2; p=0.006). Immuno-dominant donor-specific anti-HLA antibody titers (iDSAs) class I and class II decreased by 69% and 15% at 6-month follow-up visit. No serious opportunistic infections nor malignancy were reported in our subjects. Conclusion Our study suggests that our protocol improved kidney function with 100% graft survival at 1-year post aAMR episode. The percentage decline in iDSAs class I titers was more significant than class II. Furthermore, our treatment protocol was well-tolerated with no life threatening complications.","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81876865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-23DOI: 10.2174/1874303x02114010013
Pringgodigdo Nugroho, M. Marbun, Bella Yunita, Cindy Astrella, C. A. Noor, A. Lydia
Patients with early and moderate stages of chronic kidney disease (CKD) have normal serum phosphate levels. Increased fibroblast growth factor-23 (FGF23) levels in these patients are responsible for maintaining normophosphatemia status by increasing the excretion of phosphate through urine. However, an increased serum FGF23 level is related to cardiomegaly, vascular calcification, CKD progression, and mortality. This study aimed to examine the effectiveness and safety of calcium carbonate use in stage 3 or 4 CKD patients with normophosphatemia. This double-blind randomized controlled trial (ClinicalTrials.gov identifier NCT03550534) included stage 3 or 4 CKD patients with normophosphatemia who visited the nephrology or endocrinology clinic at Dr. Cipto Mangunkusumo Hospital. Forty-six subjects were randomized to receive either calcium carbonate or placebo over a 12-weeks period. Urine phosphate, serum phosphate, serum calcium, and serum intact FGF23 levels were measured before and after the intervention. The baseline characteristics of the two groups were similar, except for the higher prevalence of dyslipidemia in the placebo group. The CaCO3 group had shown reduced levels of FGF23 compared to the placebo group, -8.03 vs. 0.15 pg/ml respectively (p = 0.019). The median level of FGF23 showed a significant decrease only in the CaCO3 group. An increase in eGFR and a slightly decrease in urine phosphate were observed in the CaCO3 group; however, the data was found to be statistically not significant. No significant changes were noted in the serum calcium levels in both groups. The administration of calcium carbonate has been shown to be effective and safe for moderate CKD patients with normophosphatemia due to its effect in lowering FGF23 levels without escalating the serum calcium level.
{"title":"The Effectiveness and Safety of Calcium Carbonate Use in Chronic Kidney Disease Patients with Normophosphatemia","authors":"Pringgodigdo Nugroho, M. Marbun, Bella Yunita, Cindy Astrella, C. A. Noor, A. Lydia","doi":"10.2174/1874303x02114010013","DOIUrl":"https://doi.org/10.2174/1874303x02114010013","url":null,"abstract":"\u0000 \u0000 Patients with early and moderate stages of chronic kidney disease (CKD) have normal serum phosphate levels. Increased fibroblast growth factor-23 (FGF23) levels in these patients are responsible for maintaining normophosphatemia status by increasing the excretion of phosphate through urine. However, an increased serum FGF23 level is related to cardiomegaly, vascular calcification, CKD progression, and mortality. This study aimed to examine the effectiveness and safety of calcium carbonate use in stage 3 or 4 CKD patients with normophosphatemia.\u0000 \u0000 \u0000 \u0000 This double-blind randomized controlled trial (ClinicalTrials.gov identifier NCT03550534) included stage 3 or 4 CKD patients with normophosphatemia who visited the nephrology or endocrinology clinic at Dr. Cipto Mangunkusumo Hospital. Forty-six subjects were randomized to receive either calcium carbonate or placebo over a 12-weeks period. Urine phosphate, serum phosphate, serum calcium, and serum intact FGF23 levels were measured before and after the intervention.\u0000 \u0000 \u0000 \u0000 The baseline characteristics of the two groups were similar, except for the higher prevalence of dyslipidemia in the placebo group. The CaCO3 group had shown reduced levels of FGF23 compared to the placebo group, -8.03 vs. 0.15 pg/ml respectively (p = 0.019). The median level of FGF23 showed a significant decrease only in the CaCO3 group. An increase in eGFR and a slightly decrease in urine phosphate were observed in the CaCO3 group; however, the data was found to be statistically not significant. No significant changes were noted in the serum calcium levels in both groups.\u0000 \u0000 \u0000 \u0000 The administration of calcium carbonate has been shown to be effective and safe for moderate CKD patients with normophosphatemia due to its effect in lowering FGF23 levels without escalating the serum calcium level.\u0000","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49325306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-30DOI: 10.2174/1874303x02114010004
A. C. D. Scoralick, A. D. C. V. Júnior, André L. Cavalcanti, A. P. C. Dos Santos, D. Neves, M. H. Melo
Erectile Dysfunction (ED) has affected people suffering from Obstructive Sleep Apnea Syndrome (OSAS) and multiple studies have confirmed this correlation. The objective of the is to identify the association between ED and Obstructive Sleep Apnea (OSA) in nonobese, nondiabetic men based on the International Index of Erectile Function (IIEF). This retrospective cross-sectional study included 143 nonobese, nondiabetic men with OSA (age, ≥20 years) who visited the Sleep Outpatient Clinic of the Otorhinolaryngology Department at Hospital Naval Marcílio Dias from May 2017 to August 2018. Patient age, body mass index (BMI), drinking, smoking, laboratory diagnosis of hypogonadism based on total testosterone levels, and sleep parameters (e.g., apnea–hypopnea index, rapid eye movement density, and minimum Oxygen Saturation [SatO2]) were considered. Analysis of variance was used to evaluate means. The chi-squared test and Fisher’s exact test were used to compare variables and Person’s correlation coefficient was used to analyze numerical variables. The mean minimum SatO2 was 78.89%, and 46% of patients exhibited minimum SatO2 <80%. Moreover, minimum SatO2 of <80% and increasing age were associated with ED complaints based on IIEF scores,. A laboratory diagnosis of hypogonadism was associated with increased BMI, and aging was associated with SatO2. The results of the study revealed that oxygen desaturation of <80% was related to complaints of ED from the IIEF. Moreover, a relationship between laboratory hypogonadism and increased BMI values, aging, and oxygen desaturation has been demonstrated. Therefore, we recommend polysomnography in patients with ED complaints.
{"title":"Evaluation of Erectile Dysfunction in Nonobese, Nondiabetic Men with Obstructive Sleep Apnea","authors":"A. C. D. Scoralick, A. D. C. V. Júnior, André L. Cavalcanti, A. P. C. Dos Santos, D. Neves, M. H. Melo","doi":"10.2174/1874303x02114010004","DOIUrl":"https://doi.org/10.2174/1874303x02114010004","url":null,"abstract":"\u0000 \u0000 Erectile Dysfunction (ED) has affected people suffering from Obstructive Sleep Apnea Syndrome (OSAS) and multiple studies have confirmed this correlation.\u0000 \u0000 \u0000 \u0000 The objective of the is to identify the association between ED and Obstructive Sleep Apnea (OSA) in nonobese, nondiabetic men based on the International Index of Erectile Function (IIEF).\u0000 \u0000 \u0000 \u0000 This retrospective cross-sectional study included 143 nonobese, nondiabetic men with OSA (age, ≥20 years) who visited the Sleep Outpatient Clinic of the Otorhinolaryngology Department at Hospital Naval Marcílio Dias from May 2017 to August 2018. Patient age, body mass index (BMI), drinking, smoking, laboratory diagnosis of hypogonadism based on total testosterone levels, and sleep parameters (e.g., apnea–hypopnea index, rapid eye movement density, and minimum Oxygen Saturation [SatO2]) were considered. Analysis of variance was used to evaluate means. The chi-squared test and Fisher’s exact test were used to compare variables and Person’s correlation coefficient was used to analyze numerical variables.\u0000 \u0000 \u0000 \u0000 The mean minimum SatO2 was 78.89%, and 46% of patients exhibited minimum SatO2 <80%. Moreover, minimum SatO2 of <80% and increasing age were associated with ED complaints based on IIEF scores,. A laboratory diagnosis of hypogonadism was associated with increased BMI, and aging was associated with SatO2.\u0000 \u0000 \u0000 \u0000 The results of the study revealed that oxygen desaturation of <80% was related to complaints of ED from the IIEF. Moreover, a relationship between laboratory hypogonadism and increased BMI values, aging, and oxygen desaturation has been demonstrated. Therefore, we recommend polysomnography in patients with ED complaints.\u0000","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49053388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-22DOI: 10.2174/1874303x02114010001
T. Umemoto, K. Oda, T. Kano, Hakushi Kim, Hidenori Zakoji, A. Miyajima
Bacillus Calmette-Guérin instillation is an established therapy for the treatment of carcinoma in situ of the upper urinary tract. A 72-year-old woman underwent radical cystectomy with cutaneous ureterostomy for invasive bladder cancer with carcinoma in situ of both ureters. For the treatment of upper urinary tract carcinoma in situ, an infusion of 40 mg bacillus Calmette-Guérin through each ureterostomy was performed once weekly for 5 times. Urine cytology of the left upper urinary tract became negative, with a recurrence-free survival of 4 months. On the other hand, the right upper urinary tract became temporarily negative but turned positive after 3 months. Bacillus Calmette-Guérin perfusion therapy via cutaneous ureterostomy is considered as one of the useful therapies for carcinoma in situ of the upper urinary tract. Furthermore, there are several factors to be discussed, including the treatment duration, dosage and secondary therapeutic options.
{"title":"Bacillus Calmette-Guérin Perfusion Treatment via Cutaneous Ureterostomy for Carcinoma in Situ of the Upper Urinary Tract","authors":"T. Umemoto, K. Oda, T. Kano, Hakushi Kim, Hidenori Zakoji, A. Miyajima","doi":"10.2174/1874303x02114010001","DOIUrl":"https://doi.org/10.2174/1874303x02114010001","url":null,"abstract":"\u0000 \u0000 Bacillus Calmette-Guérin instillation is an established therapy for the treatment of carcinoma in situ of the upper urinary tract.\u0000 \u0000 \u0000 \u0000 A 72-year-old woman underwent radical cystectomy with cutaneous ureterostomy for invasive bladder cancer with carcinoma in situ of both ureters. For the treatment of upper urinary tract carcinoma in situ, an infusion of 40 mg bacillus Calmette-Guérin through each ureterostomy was performed once weekly for 5 times. Urine cytology of the left upper urinary tract became negative, with a recurrence-free survival of 4 months. On the other hand, the right upper urinary tract became temporarily negative but turned positive after 3 months.\u0000 \u0000 \u0000 \u0000 Bacillus Calmette-Guérin perfusion therapy via cutaneous ureterostomy is considered as one of the useful therapies for carcinoma in situ of the upper urinary tract. Furthermore, there are several factors to be discussed, including the treatment duration, dosage and secondary therapeutic options.\u0000","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43295387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-12DOI: 10.1101/2021.03.11.21253269
A. Das, D. K. Mishra, S. Gopalan
Background: The average age of diagnosis for bladder cancer is 73 and about 75 percent of all bladder cancers are non-muscle invasive at initial diagnosis. It is recommended that non-muscle invasive bladder cancers (NMIBC) should be treated with transurethral resection of the bladder tumor (TURBT) followed by chemotherapy. However, there is no large-scale study from real-world databases to show the effectiveness of chemotherapy on the survival of older adults with NMIBC that have undergone TURBT. This study aimed to investigate the effects of chemotherapy on survival among older NMIBC patients with TURBT. Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database (2010-2015), we performed analyses of cancer-specific mortality and overall mortality comparing chemotherapy versus no chemotherapy after TURBT. Coarsened exact matching was performed to balance the baseline patient characteristics. Cox proportional hazards and Kaplan-Meir analyses were used to evaluate survival outcomes. Results: A total of 3,222 matched patients with 1,611 in each arm (chemotherapy and no chemotherapy) were included in our study. After adjusting for covariates, multivariable Cox regression analyses show chemotherapy was associated with lower cancer-specific mortality (HR 0.63; 95% CI 0.42-0.94; p value 0.024). However, chemotherapy did not have any effect on overall mortality (HR 0.84; 95% CI 0.65-1.07; p value 0.159). The Kaplan-Meier curves show the protective effects of chemotherapy on cancer specific survival (p=0.032), but not on overall survival (p=0.34). Conclusion: Chemotherapy improved cancer specific survival among older patients with non-muscle invasive bladder cancer undergoing TURBT surgery, but it had no effect on overall survival. There is a need for more granular level real-world data on chemotherapy regimens and dosage to effectively investigate the effects of chemotherapy on survival of older patients with NMIBC that have undergone TURBT.
背景:膀胱癌的平均诊断年龄为73岁，大约75%的膀胱癌在最初诊断时是非肌肉侵入性的。建议非肌肉浸润性膀胱癌(NMIBC)应经尿道膀胱肿瘤切除术(TURBT)后化疗治疗。然而，目前还没有来自真实世界数据库的大规模研究显示化疗对接受TURBT的老年NMIBC患者生存的有效性。本研究旨在探讨化疗对老年NMIBC合并TURBT患者生存的影响。方法:利用监测、流行病学和最终结果(SEER)数据库(2010-2015)，我们对TURBT术后化疗与不化疗的癌症特异性死亡率和总死亡率进行了分析。进行粗化精确匹配以平衡基线患者特征。Cox比例风险和Kaplan-Meir分析用于评估生存结果。结果:我们的研究共纳入3222例匹配患者，每组1611例(化疗和不化疗)。调整协变量后，多变量Cox回归分析显示化疗与较低的癌症特异性死亡率相关(HR 0.63;95% ci 0.42-0.94;P值0.024)。然而，化疗对总死亡率没有任何影响(HR 0.84;95% ci 0.65-1.07;P值0.159)。Kaplan-Meier曲线显示化疗对癌症特异性生存的保护作用(p=0.032)，但对总生存没有保护作用(p=0.34)。结论:化疗可提高老年非肌性浸润性膀胱癌TURBT手术患者的肿瘤特异性生存，但对总生存无影响。为了有效地研究化疗对行TURBT的老年NMIBC患者生存的影响，需要更细粒度的化疗方案和剂量的真实数据。
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Pub Date : 2020-12-31DOI: 10.2174/1874303X02013010039
Y. J. Lee, B. Park, Jin Han Park, K. Park, I. Kim, Junghae Ko, Sihyung Park, Y. Kim
The purpose of this study is to broaden the understanding of peritoneal dialysis by presenting the most-cited articles pertaining to this subject. We searched articles on the Web of Science and selected 100 articles according to the frequency of citations. Next, we reviewed the contents of the articles and identified the characteristics of these articles. There are 21 journals in which the top-100 cited articles were published. The names of the journals, in the order in which the articles are cited, are as follows: Kidney International (25 articles), Nephrology Dialysis Transplantation (13 articles), and Journal of the American Society of Nephrology (12 articles). The top 100-cited articles were published in 15 countries. The country with the greatest number of publications was the United States of America (19 articles). The institution with the greatest number of articles (7 articles) was the University Health Network of Toronto. The author who wrote the most number of articles (5 articles) was Davies SJ. This study is the first in the field of nephrology to provide a list of the top-100 cited articles dedicated to peritoneal dialysis. Through this study, the research trends and major academic interests pertaining to peritoneal dialysis would be identified.
{"title":"Top 100 Cited Articles on Peritoneal Dialysis: A Bibliometric Analysis","authors":"Y. J. Lee, B. Park, Jin Han Park, K. Park, I. Kim, Junghae Ko, Sihyung Park, Y. Kim","doi":"10.2174/1874303X02013010039","DOIUrl":"https://doi.org/10.2174/1874303X02013010039","url":null,"abstract":"\u0000 \u0000 The purpose of this study is to broaden the understanding of peritoneal dialysis by presenting the most-cited articles pertaining to this subject.\u0000 \u0000 \u0000 \u0000 We searched articles on the Web of Science and selected 100 articles according to the frequency of citations. Next, we reviewed the contents of the articles and identified the characteristics of these articles.\u0000 \u0000 \u0000 \u0000 There are 21 journals in which the top-100 cited articles were published. The names of the journals, in the order in which the articles are cited, are as follows: Kidney International (25 articles), Nephrology Dialysis Transplantation (13 articles), and Journal of the American Society of Nephrology (12 articles). The top 100-cited articles were published in 15 countries. The country with the greatest number of publications was the United States of America (19 articles). The institution with the greatest number of articles (7 articles) was the University Health Network of Toronto. The author who wrote the most number of articles (5 articles) was Davies SJ.\u0000 \u0000 \u0000 \u0000 This study is the first in the field of nephrology to provide a list of the top-100 cited articles dedicated to peritoneal dialysis. Through this study, the research trends and major academic interests pertaining to peritoneal dialysis would be identified.\u0000","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42845782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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