Pub Date : 2018-08-31DOI: 10.2174/1874303X01811010046
G. Duarsa, Anak Agung Gde Oka, S. Maliawan, D. Soebadi, P. Astawa, I. Bakta, D. Sukrama, I. B. P. Manuaba, N. Astawa
Lower Urinary Tract Symptoms (LUTS) after Transurethral Resection of the Prostate (TURP) occur in one-third of Benign Prostatic Hyperplasia (BPH) patients, may be caused by persistent prostatic inflammation and fibrosis. This study aims to evaluate the role of inflammation and fibrosis in pathological mechanism of LUTS among patients with BPH who underwent TURP by assessing their PSA, TNF-α, and TGF-β level. Data in this study were analyzed with the 2-way hypothesis. The study used odds ratio to define the risk factors of LUTS after TURP. The samples of the study are BPH patients after TURP aged 50-80 years old. No intervention(s). The data analyzed using SPSS version 21.0 for Windows. There were 34 cases of LUTS and 42 controls without LUTS. We found that there were an increased levels of TNF-α (> 46.95 pg/ml) (OR 55.6, 95% Confidence Interval [CI] 11.1-278.4, p=0.00) and TGF-β (> 207.63 pg/ml) (OR 16.7, 95%CI 5.3-52.8, p=0.00). The result of multiple linear logistic regression analysis obtained equation Y= 0.033 x TNF-α + 0.031 x TGF-β. Population Attributable Risk (PAR) % TNF-α is 60%, PAR % TGF-β is 53%. Combination of elevated levels of TNF-α (>46.95 pg/ml) and TGF-β (>207.63) in prostate tissue is the risk factors for the occurrence of LUTS after TURP. In this study, we enrolled 76 patients who were diagnosed with BPH and urinary retention. After TURP, there were 34 cases of LUTS and 42 controls without LUTS. We found that the levels of TNF-α and TGF-β between cases and controls were significantly different. We conclude that the combination of elevated levels of TNF-α and TGF-β in prostate tissue is the risk factors for the occurrence of LUTS after TURP.
{"title":"Elevated Tumor Necrosis Factor-α and Transforming Growth Factor-β in Prostatic Tissue are Risk Factors for Lower Urinary Tract Symptoms after Transurethral Resection of the Prostate in Benign Prostatic Hyperplasia Patients with Urinary Retention","authors":"G. Duarsa, Anak Agung Gde Oka, S. Maliawan, D. Soebadi, P. Astawa, I. Bakta, D. Sukrama, I. B. P. Manuaba, N. Astawa","doi":"10.2174/1874303X01811010046","DOIUrl":"https://doi.org/10.2174/1874303X01811010046","url":null,"abstract":"\u0000 \u0000 Lower Urinary Tract Symptoms (LUTS) after Transurethral Resection of the Prostate (TURP) occur in one-third of Benign Prostatic Hyperplasia (BPH) patients, may be caused by persistent prostatic inflammation and fibrosis.\u0000 \u0000 \u0000 \u0000 This study aims to evaluate the role of inflammation and fibrosis in pathological mechanism of LUTS among patients with BPH who underwent TURP by assessing their PSA, TNF-α, and TGF-β level.\u0000 \u0000 \u0000 \u0000 Data in this study were analyzed with the 2-way hypothesis. The study used odds ratio to define the risk factors of LUTS after TURP. The samples of the study are BPH patients after TURP aged 50-80 years old.\u0000 \u0000 \u0000 \u0000 No intervention(s).\u0000 \u0000 \u0000 \u0000 The data analyzed using SPSS version 21.0 for Windows.\u0000 \u0000 \u0000 \u0000 There were 34 cases of LUTS and 42 controls without LUTS. We found that there were an increased levels of TNF-α (> 46.95 pg/ml) (OR 55.6, 95% Confidence Interval [CI] 11.1-278.4, p=0.00) and TGF-β (> 207.63 pg/ml) (OR 16.7, 95%CI 5.3-52.8, p=0.00). The result of multiple linear logistic regression analysis obtained equation Y= 0.033 x TNF-α + 0.031 x TGF-β. Population Attributable Risk (PAR) % TNF-α is 60%, PAR % TGF-β is 53%.\u0000 \u0000 \u0000 \u0000 Combination of elevated levels of TNF-α (>46.95 pg/ml) and TGF-β (>207.63) in prostate tissue is the risk factors for the occurrence of LUTS after TURP.\u0000 \u0000 \u0000 \u0000 In this study, we enrolled 76 patients who were diagnosed with BPH and urinary retention. After TURP, there were 34 cases of LUTS and 42 controls without LUTS. We found that the levels of TNF-α and TGF-β between cases and controls were significantly different. We conclude that the combination of elevated levels of TNF-α and TGF-β in prostate tissue is the risk factors for the occurrence of LUTS after TURP.\u0000","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47255500","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 : 2018-08-31DOI: 10.2174/1874303X01811010054
F. Ehsanipour, Z. Movahedi, Leila Taherinia, S. Noorbakhsh
The sacral bone anomalies have an important effect on urinary and gastrointestinal tract and sacral ratio was defined as an indicator for estimating the anorectal abnormalities in children. This study was carried out for determining the association between sacral ratio and Urinary Tract Infections (UTI) among children.In a cross sectional study, 100 children under 15 years with proven febrile UTI were referred to a referral children center considering the presence and grading of VUR according to VCUG enrolled in this study.Sacral ratio was measured for all cases and the data were compared by student T test, Chi 2 and Mann Whitney tests. SPSS 16.0 software was used for data analysis. P values less than 0.05 were considered significant.41 boys and 59 girls with mean age 4.8 years were enrolled in this study. The average range of sacral ratio was 0.82. There was no staistical difference between two different genders and ages (p> 0.05).The values of SR in patients with VUR were lower than patients without VUR(P˂0.05) but there was no statistically significant difference between both bilateral and unilateral VUR and SR (p> 0.05).The risk of sacral bone abnormality in patients with VUR is more than patients without VUR. Therefore, in patients with UTI and low SR simultaneously, tighter evaluation for VUR and treatment should be considered.
{"title":"Correlation of Sacral Ratio and Urinary Tract Infection in Children","authors":"F. Ehsanipour, Z. Movahedi, Leila Taherinia, S. Noorbakhsh","doi":"10.2174/1874303X01811010054","DOIUrl":"https://doi.org/10.2174/1874303X01811010054","url":null,"abstract":"The sacral bone anomalies have an important effect on urinary and gastrointestinal tract and sacral ratio was defined as an indicator for estimating the anorectal abnormalities in children. This study was carried out for determining the association between sacral ratio and Urinary Tract Infections (UTI) among children.In a cross sectional study, 100 children under 15 years with proven febrile UTI were referred to a referral children center considering the presence and grading of VUR according to VCUG enrolled in this study.Sacral ratio was measured for all cases and the data were compared by student T test, Chi 2 and Mann Whitney tests. SPSS 16.0 software was used for data analysis. P values less than 0.05 were considered significant.41 boys and 59 girls with mean age 4.8 years were enrolled in this study. The average range of sacral ratio was 0.82. There was no staistical difference between two different genders and ages (p> 0.05).The values of SR in patients with VUR were lower than patients without VUR(P˂0.05) but there was no statistically significant difference between both bilateral and unilateral VUR and SR (p> 0.05).The risk of sacral bone abnormality in patients with VUR is more than patients without VUR. Therefore, in patients with UTI and low SR simultaneously, tighter evaluation for VUR and treatment should be considered.","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44034786","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 : 2018-08-31DOI: 10.2174/1874303X01811010060
Y. Kandarini, K. Suwitra, R. Widiana
Intradialytic hypertension is one of many complications during Hemodialysis (HD). The mechanism of intradialytic hypertension is currently unclear. This research aims to understand the association between excessive Ultrafiltration (UF) and intradialytic hypertension episode and its relationship with changes in endothelin-1 level (ET-1), Asymmetric Dimethylarginine (ADMA) level and Nitric Oxide (NO) level during HD. This study utilized a case-control design. A sample of one hundred and eleven patients who were already undergoing maintenance HD for more than three months was included. Serum levels of NO, ET-1, and ADMA were examined before and after HD; samples were followed by as much as six times consecutive HD session, in which ultrafiltration and blood pressure during HD were noted. From 112 samples obtained, 32.1% (36/112) had intradialytic hypertension. Using regression analysis, we found a significant association between changes in NO levels and intradialytic hypertension. We found a significant association between excessive UF and intradialytic hypertension (p=0.001), adjusted OR=5.17. Path analysis showed the existence of a significant relationship between UF volume during HD and intradialytic hypertension (CR 5.74; p<0.01), as well as a significant relationship between UF volume during HD and NO levels (CR -3.70: p<0.01). There was a direct relationship between NO serum levels with intradialytic hypertension (CR -7.08: p<0.01). Excessive UF during HD plays a role in intradialytic hypertension episode through decreased NO serum levels. There was no clear role of ADMA and ET-1 serum levels on intradialytic hypertension episode.
{"title":"Excessive Ultrafiltration During Hemodialysis Plays a Role in Intradialytic Hypertension Through Decreased Serum Nitric Oxide (NO) Level","authors":"Y. Kandarini, K. Suwitra, R. Widiana","doi":"10.2174/1874303X01811010060","DOIUrl":"https://doi.org/10.2174/1874303X01811010060","url":null,"abstract":"\u0000 \u0000 Intradialytic hypertension is one of many complications during Hemodialysis (HD). The mechanism of intradialytic hypertension is currently unclear.\u0000 \u0000 \u0000 \u0000 This research aims to understand the association between excessive Ultrafiltration (UF) and intradialytic hypertension episode and its relationship with changes in endothelin-1 level (ET-1), Asymmetric Dimethylarginine (ADMA) level and Nitric Oxide (NO) level during HD.\u0000 \u0000 \u0000 \u0000 This study utilized a case-control design. A sample of one hundred and eleven patients who were already undergoing maintenance HD for more than three months was included. Serum levels of NO, ET-1, and ADMA were examined before and after HD; samples were followed by as much as six times consecutive HD session, in which ultrafiltration and blood pressure during HD were noted.\u0000 \u0000 \u0000 \u0000 From 112 samples obtained, 32.1% (36/112) had intradialytic hypertension. Using regression analysis, we found a significant association between changes in NO levels and intradialytic hypertension. We found a significant association between excessive UF and intradialytic hypertension (p=0.001), adjusted OR=5.17. Path analysis showed the existence of a significant relationship between UF volume during HD and intradialytic hypertension (CR 5.74; p<0.01), as well as a significant relationship between UF volume during HD and NO levels (CR -3.70: p<0.01). There was a direct relationship between NO serum levels with intradialytic hypertension (CR -7.08: p<0.01).\u0000 \u0000 \u0000 \u0000 Excessive UF during HD plays a role in intradialytic hypertension episode through decreased NO serum levels. There was no clear role of ADMA and ET-1 serum levels on intradialytic hypertension episode.\u0000","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42328363","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 : 2018-08-31DOI: 10.2174/1874303X01811010039
K. Lee, K. Han, S. Han
Both the quality of water and biocompatibility of dialyzers are responsible for systemic inflammation in hemodialysis patients. As the biocompatibility of dialyzers has improved, focus for procedural improvements has shifted to water quality. Although ultrapure water reduces the inflammatory response, it is not clear whether different qualities of ultrapure water can further decrease the inflammatory response. This study aims to evaluate the relationship between water quality and the inflammatory response in hemodialysis patients. We enrolled five patients (two men and three women, mean age 44.6 ± 7.36 years) in maintenance hemodialysis (HD) for three sessions a week. Three quality grades of water were applied in successive weeks: Standard water (N0), single-filter ultrapure water (N1), and double-filter ultrapure water (N2). N2 water was created by mixing N1 water with N1 dialysate and passing the mixture through a second filter. Each patient was exposed to different water quality (N0, N1, N2) for a period of 1 week. Monocyte chemoattractant peptide-1 (MCP-1) mRNA expression in peripheral blood mononuclear cells (PBMCs) was determined by real-time PCR. MCP-1 protein in plasma was measured by ELISA. The expression of MCP-1 mRNA in isolated PBMCs after HD was invariant between the N1 and N2 water. The expression of MCP-1 mRNA decreased by 16.1% compared to pre-HD in the N0 system. The expression of MCP-1 mRNA increased by 10.5% in N1 system, and decreased by 12.2% in the N2 system. The water quality did not have a significant impact on MCP-1 protein expression. MCP-1 protein expressions pre- and post-HD were 160.9 ± 13.9 and 153.6 ± 51.6 pg/mL, respectively, when no filter was used (N0). In the case of single-filtered water (N1), the expression levels were 166.6 ± 41.9 and 190.7 ± 88.2 pg/mL pre- and post-HD, respectively. For double-filtered water (N2), the expression levels were 147.8 ± 40.0 and 169.1 ± 52.5 pg/mL pre- and post-HD, respectively. There was no difference in MCP-1 response with respect to the number of water filtration steps in HD patients. Further study with especially ultrapure and sterile water is needed to examine the long-term consequence of water purity on inflammatory reactions, and will require more participants in a longer examination window.
{"title":"Inflammatory Response Variance Based on Quality of Ultrapure Water in Hemodialysis Patients","authors":"K. Lee, K. Han, S. Han","doi":"10.2174/1874303X01811010039","DOIUrl":"https://doi.org/10.2174/1874303X01811010039","url":null,"abstract":"\u0000 \u0000 Both the quality of water and biocompatibility of dialyzers are responsible for systemic inflammation in hemodialysis patients. As the biocompatibility of dialyzers has improved, focus for procedural improvements has shifted to water quality. Although ultrapure water reduces the inflammatory response, it is not clear whether different qualities of ultrapure water can further decrease the inflammatory response. This study aims to evaluate the relationship between water quality and the inflammatory response in hemodialysis patients.\u0000 \u0000 \u0000 \u0000 We enrolled five patients (two men and three women, mean age 44.6 ± 7.36 years) in maintenance hemodialysis (HD) for three sessions a week. Three quality grades of water were applied in successive weeks: Standard water (N0), single-filter ultrapure water (N1), and double-filter ultrapure water (N2). N2 water was created by mixing N1 water with N1 dialysate and passing the mixture through a second filter. Each patient was exposed to different water quality (N0, N1, N2) for a period of 1 week. Monocyte chemoattractant peptide-1 (MCP-1) mRNA expression in peripheral blood mononuclear cells (PBMCs) was determined by real-time PCR. MCP-1 protein in plasma was measured by ELISA.\u0000 \u0000 \u0000 \u0000 The expression of MCP-1 mRNA in isolated PBMCs after HD was invariant between the N1 and N2 water. The expression of MCP-1 mRNA decreased by 16.1% compared to pre-HD in the N0 system. The expression of MCP-1 mRNA increased by 10.5% in N1 system, and decreased by 12.2% in the N2 system. The water quality did not have a significant impact on MCP-1 protein expression. MCP-1 protein expressions pre- and post-HD were 160.9 ± 13.9 and 153.6 ± 51.6 pg/mL, respectively, when no filter was used (N0). In the case of single-filtered water (N1), the expression levels were 166.6 ± 41.9 and 190.7 ± 88.2 pg/mL pre- and post-HD, respectively. For double-filtered water (N2), the expression levels were 147.8 ± 40.0 and 169.1 ± 52.5 pg/mL pre- and post-HD, respectively.\u0000 \u0000 \u0000 \u0000 There was no difference in MCP-1 response with respect to the number of water filtration steps in HD patients. Further study with especially ultrapure and sterile water is needed to examine the long-term consequence of water purity on inflammatory reactions, and will require more participants in a longer examination window.\u0000","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41933228","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 : 2018-07-31DOI: 10.2174/1874303X01811010028
M. Bonomini, L. Pieroni, M. Ronci, V. Sirolli, A. Urbani
The uremic syndrome mimes a systemic poisoning with the retention of numerous compounds which are normally removed by the kidney. The study of proteins and peptides, or proteomics, represents an important field of research for the investigation of blood and blood diseases. We focused our review on the results of proteomic investigations on blood cells of uremic patients with particular regard to the study of red blood cells, platelets, and monocytes. In literature there are few, preliminary studies on platelets and monocytes while the knowledge on uremic erythrocytes is much wider. Proteomic investigations showed that erythrocyte membrane proteome of uremic patients, differs significantly from the proteome of healthy subjects, being characterized by an extensive remodeling which may influence visco-elastic properties of RBC such as deformability and involve diverse molecular pathways driving red blood cell signaling and removal. Proteomic technologies emerged as a useful tool in defining and characterizing both physiological and disease processes being able, among others, to give important insights into uremic anemia.
{"title":"Blood Cell Proteomics in Chronic Kidney Disease","authors":"M. Bonomini, L. Pieroni, M. Ronci, V. Sirolli, A. Urbani","doi":"10.2174/1874303X01811010028","DOIUrl":"https://doi.org/10.2174/1874303X01811010028","url":null,"abstract":"\u0000 \u0000 The uremic syndrome mimes a systemic poisoning with the retention of numerous compounds which are normally removed by the kidney. The study of proteins and peptides, or proteomics, represents an important field of research for the investigation of blood and blood diseases.\u0000 \u0000 \u0000 \u0000 We focused our review on the results of proteomic investigations on blood cells of uremic patients with particular regard to the study of red blood cells, platelets, and monocytes.\u0000 \u0000 \u0000 \u0000 In literature there are few, preliminary studies on platelets and monocytes while the knowledge on uremic erythrocytes is much wider. Proteomic investigations showed that erythrocyte membrane proteome of uremic patients, differs significantly from the proteome of healthy subjects, being characterized by an extensive remodeling which may influence visco-elastic properties of RBC such as deformability and involve diverse molecular pathways driving red blood cell signaling and removal.\u0000 \u0000 \u0000 \u0000 Proteomic technologies emerged as a useful tool in defining and characterizing both physiological and disease processes being able, among others, to give important insights into uremic anemia.\u0000","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42823672","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 : 2018-06-29DOI: 10.2174/1874303X01811010022
R. Bajwa, Ami Amin, Bhavika Gandhi, Sarmed Mansur, A. Amirpour, Tejas Karawadia, P. Patel, E. Costanzo, Mohammad A. Hossain, Jennifer Cheng, Mayurkumar B. Patel, T. Vachharajani, A. Asif
While patients with hypercalcemia can be treated with various treatment options including volume expansion, loop diuretics, calcitonin, bisphosphonate, sensipar; hypercalcemia can be resistant to these measures. In this report, we present two elderly patients with hypercalcemia resistant to traditional therapy. Both had parathyroid tumor. Early diagnosis could not be established. Both patients required hemodialysis. Hypercalcemia was controlled in the 74-year old who successfully underwent surgery with normalization of calcium level. The 79-year old was not considered a surgical candidate and was transitioned to hospice. Primary hyperparathyroidism is an important cause of hypercalcemia. In order to reduce morbidity and mortality, its diagnosis must be established earlier on. These case reports prepared with residents/junior faculty will benefit other trainees with the diagnosis and management of refractory hypercalcemia and highlight a teaching point that prompt diagnosis of primary hyperparathyroidism can have a major positive impact on the overall management of hypercalcemia.
{"title":"A Simplified Approach to the Management of Hypercalcemia","authors":"R. Bajwa, Ami Amin, Bhavika Gandhi, Sarmed Mansur, A. Amirpour, Tejas Karawadia, P. Patel, E. Costanzo, Mohammad A. Hossain, Jennifer Cheng, Mayurkumar B. Patel, T. Vachharajani, A. Asif","doi":"10.2174/1874303X01811010022","DOIUrl":"https://doi.org/10.2174/1874303X01811010022","url":null,"abstract":"\u0000 \u0000 While patients with hypercalcemia can be treated with various treatment options including volume expansion, loop diuretics, calcitonin, bisphosphonate, sensipar; hypercalcemia can be resistant to these measures.\u0000 \u0000 \u0000 \u0000 In this report, we present two elderly patients with hypercalcemia resistant to traditional therapy. Both had parathyroid tumor. Early diagnosis could not be established. Both patients required hemodialysis. Hypercalcemia was controlled in the 74-year old who successfully underwent surgery with normalization of calcium level. The 79-year old was not considered a surgical candidate and was transitioned to hospice. \u0000 \u0000 \u0000 \u0000 Primary hyperparathyroidism is an important cause of hypercalcemia. In order to reduce morbidity and mortality, its diagnosis must be established earlier on. These case reports prepared with residents/junior faculty will benefit other trainees with the diagnosis and management of refractory hypercalcemia and highlight a teaching point that prompt diagnosis of primary hyperparathyroidism can have a major positive impact on the overall management of hypercalcemia.\u0000","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48009487","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 : 2018-03-30DOI: 10.2174/1874303X01811010014
B. Hameed, A. Chawla, P. Hegde, A. Odugoudar, T. Vasa
Background:Percutaneous Nephrolithotomy (PCNL) is the gold standard for endoscopic management of large renal stones. Various modifications have been done to bring down the morbidity of this procedure. Ambulatory PCNL (APCNL) defines PCNL as day-care procedure,avoiding overnight hospital stay which is less than 24 hours. Totally tubeless makes faster recovery without the need for double J stent or nephrostomy tubes. This study aimed at exploring the feasibility and safety of APCNL in selective patients. It also aimed at improvising the procedure to facilitate early recovery and discharge of patients within 24 hrs.Materials ands Methods:In this study, 12 patients underwent APCNL under general anaesthesia with endotracheal intubation from April 2016 to March 2017.All the procedures were done by a single surgeon. The inclusion criteria were stone size of less than 2cm, without any comorbidities,Computed Tomography (CT)/Retrograde Pyelogram(RGP) evidence of normal pyelocalyceal anatomy, patient staying within the radius of 15km, well informed patient. All patients underwent totally tubeless PCNL i.e. without nephrostomy, DJ stent and catheter. Skin infiltration was given with 0.25% Bupivacaine. Post operatively analgesia was given on demand (intramuscular Aceclofenac / oral Acetaminophen plus Tramadol). All patients were followed up after 2 weeks.Results:Twelve patients underwent prone PCNL. All patients had single puncture (10 lower calyx, 2 middle calyx), Amplatz size was less than 30F, size of the stone (1.3cm to 2cm) with a mean size- 1.7cm, saline used around 300ml. But, two patients were discharged after 36hrs and 48hrs due to pain. None of them returned to hospital with haematuria, pain or urinary tract infection.Conclusion: APCNL is a safe procedure in well informed selective patients. These are the patients with small burden of stone and staying close to the hospital. APCNL reduces the hospital stay, expenses and results in early return to work.
{"title":"Safety and viability of totally tubeless ambulatory percutaneous nephrolithotomy (APCNL) in the fast paced world","authors":"B. Hameed, A. Chawla, P. Hegde, A. Odugoudar, T. Vasa","doi":"10.2174/1874303X01811010014","DOIUrl":"https://doi.org/10.2174/1874303X01811010014","url":null,"abstract":"Background:Percutaneous Nephrolithotomy (PCNL) is the gold standard for endoscopic management of large renal stones. Various modifications have been done to bring down the morbidity of this procedure. Ambulatory PCNL (APCNL) defines PCNL as day-care procedure,avoiding overnight hospital stay which is less than 24 hours. Totally tubeless makes faster recovery without the need for double J stent or nephrostomy tubes. This study aimed at exploring the feasibility and safety of APCNL in selective patients. It also aimed at improvising the procedure to facilitate early recovery and discharge of patients within 24 hrs.Materials ands Methods:In this study, 12 patients underwent APCNL under general anaesthesia with endotracheal intubation from April 2016 to March 2017.All the procedures were done by a single surgeon. The inclusion criteria were stone size of less than 2cm, without any comorbidities,Computed Tomography (CT)/Retrograde Pyelogram(RGP) evidence of normal pyelocalyceal anatomy, patient staying within the radius of 15km, well informed patient. All patients underwent totally tubeless PCNL i.e. without nephrostomy, DJ stent and catheter. Skin infiltration was given with 0.25% Bupivacaine. Post operatively analgesia was given on demand (intramuscular Aceclofenac / oral Acetaminophen plus Tramadol). All patients were followed up after 2 weeks.Results:Twelve patients underwent prone PCNL. All patients had single puncture (10 lower calyx, 2 middle calyx), Amplatz size was less than 30F, size of the stone (1.3cm to 2cm) with a mean size- 1.7cm, saline used around 300ml. But, two patients were discharged after 36hrs and 48hrs due to pain. None of them returned to hospital with haematuria, pain or urinary tract infection.Conclusion: APCNL is a safe procedure in well informed selective patients. These are the patients with small burden of stone and staying close to the hospital. APCNL reduces the hospital stay, expenses and results in early return to work.","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"11 1","pages":"14-21"},"PeriodicalIF":0.0,"publicationDate":"2018-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43431674","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 : 2018-03-30DOI: 10.2174/1874303X01811010001
B. Hameed, A. Chawla, P. Hegde, T. Vasa
Background:Crossed renal ectopia with fusion is the abnormal migration of the kidney to the opposite side of the insertion of the ureter to the bladder. It is the second most common congenital anomaly of the kidney and urinary tract preceded by horseshoe kidney. The following article serves to highlight the anomaly in a conglomeration of 17 unique cases, managed in our tertiary care centre over a period of 5 years.Materials and Methods:This is a descriptive study analysing the demographic features and the management of seventeen patients diagnosed with crossed renal ectopia with fusion during the period January 2012 to January 2017. Radiological modalities of investigation were modified as per the anomaly. The management plan was devised keeping in mind, the essence of preserving the functional unit.Results:Of the seventeen cases, nine patients were symptomatic and eight were asymptomatic. The most recurring crossed renal ectopia with fusion was L- shaped (n=6), disc shaped (n=6) sigmoid shaped (n=2), inferior (n=1), cake shaped (n=1) and superior ectopia (n=1). Left to right ectopia (n=9) was more common than right to left (n=8). Three patients had a solitary crossed ectopia. Out of nine symptomatic patients, six patients underwent surgical procedures, the remaining three were treated conservatively and advised regular biannual follow-up with imaging.Conclusion:The management of crossed renal ectopia with fusion is individualised according to the underlying urological anomaly and its sequelae. Importance is given to preserve the renal function whenever possible. Reconstructive surgeries like pyeloplasty, ureteric reimplantation, boari flap can salvage some function in these units.
{"title":"Crossed Fused Ectopia of Kidney – An Account of Tertiary Healthcare Center Experience","authors":"B. Hameed, A. Chawla, P. Hegde, T. Vasa","doi":"10.2174/1874303X01811010001","DOIUrl":"https://doi.org/10.2174/1874303X01811010001","url":null,"abstract":"Background:Crossed renal ectopia with fusion is the abnormal migration of the kidney to the opposite side of the insertion of the ureter to the bladder. It is the second most common congenital anomaly of the kidney and urinary tract preceded by horseshoe kidney. The following article serves to highlight the anomaly in a conglomeration of 17 unique cases, managed in our tertiary care centre over a period of 5 years.Materials and Methods:This is a descriptive study analysing the demographic features and the management of seventeen patients diagnosed with crossed renal ectopia with fusion during the period January 2012 to January 2017. Radiological modalities of investigation were modified as per the anomaly. The management plan was devised keeping in mind, the essence of preserving the functional unit.Results:Of the seventeen cases, nine patients were symptomatic and eight were asymptomatic. The most recurring crossed renal ectopia with fusion was L- shaped (n=6), disc shaped (n=6) sigmoid shaped (n=2), inferior (n=1), cake shaped (n=1) and superior ectopia (n=1). Left to right ectopia (n=9) was more common than right to left (n=8). Three patients had a solitary crossed ectopia. Out of nine symptomatic patients, six patients underwent surgical procedures, the remaining three were treated conservatively and advised regular biannual follow-up with imaging.Conclusion:The management of crossed renal ectopia with fusion is individualised according to the underlying urological anomaly and its sequelae. Importance is given to preserve the renal function whenever possible. Reconstructive surgeries like pyeloplasty, ureteric reimplantation, boari flap can salvage some function in these units.","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"11 1","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2018-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46633846","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 : 2017-12-29DOI: 10.2174/1874303X01710010059
A. Hamzah, Faris Mohamad, T. Mallhi, Mohamad Nor Gohar Rahman, Y. Khan, A. Khan, A. Adnan, O. H. Khan
Testicular fracture is a urological emergency that requires early diagnosis and timely surgical exploration in order to maximize testicular salvage. We presented a case of 17 year old male with left testicular fracture after roadside accident. The patient was surgically explorated and repaired with salvage of the injured testicle.
{"title":"Salvaging Left Testicular Fracture After a Motorcycle Accident: A Case Report","authors":"A. Hamzah, Faris Mohamad, T. Mallhi, Mohamad Nor Gohar Rahman, Y. Khan, A. Khan, A. Adnan, O. H. Khan","doi":"10.2174/1874303X01710010059","DOIUrl":"https://doi.org/10.2174/1874303X01710010059","url":null,"abstract":"Testicular fracture is a urological emergency that requires early diagnosis and timely surgical exploration in order to maximize testicular salvage. We presented a case of 17 year old male with left testicular fracture after roadside accident. The patient was surgically explorated and repaired with salvage of the injured testicle.","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"10 1","pages":"59-64"},"PeriodicalIF":0.0,"publicationDate":"2017-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43836549","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 : 2017-12-18DOI: 10.2174/1874303X01710010052
Lukas Barwitz, A. Berger, Stefanie Zschaebitz, M. Jenzer, C. Nientiedt, S. Duensing, D. Jäger, D. Teber, M. Hohenfellner, C. Grüllich
Results: Median overall survival (OS) from first line therapy over all lines was 28,0 months. Median OS from second line was 14,7 months (95% CI, 11,4-18,0). No significant differences between regimens could be detected. OS of patients with lymphonodal only involvement (n=16, 22,5%) was 35.5 months (95% CI 0.0-73.9), OS with visceral metastases excluding liver was 14.7 months (95% CI 9.8-19.6) .and OS with any liver involvement was 9.4 months (95% CI 0.0-20.9).
结果:一线治疗的中位总生存期(OS)为280个月。二线的中位OS为14.7个月(95% CI, 11,4-18,0)。两种治疗方案之间未发现显著差异。仅淋巴结受累(n=16、22、5%)患者的生存期为35.5个月(95% CI 0-73.9)，不包括肝脏的内脏转移的生存期为14.7个月(95% CI 9.8-19.6)，任何肝脏受累的生存期为9.4个月(95% CI 0-20.9)。
{"title":"Efficacy of Different Second-line Therapy Regimens in Metastatic Urothelial Carcinoma","authors":"Lukas Barwitz, A. Berger, Stefanie Zschaebitz, M. Jenzer, C. Nientiedt, S. Duensing, D. Jäger, D. Teber, M. Hohenfellner, C. Grüllich","doi":"10.2174/1874303X01710010052","DOIUrl":"https://doi.org/10.2174/1874303X01710010052","url":null,"abstract":"Results: Median overall survival (OS) from first line therapy over all lines was 28,0 months. Median OS from second line was 14,7 months (95% CI, 11,4-18,0). No significant differences between regimens could be detected. OS of patients with lymphonodal only involvement (n=16, 22,5%) was 35.5 months (95% CI 0.0-73.9), OS with visceral metastases excluding liver was 14.7 months (95% CI 9.8-19.6) .and OS with any liver involvement was 9.4 months (95% CI 0.0-20.9).","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"10 1","pages":"52-58"},"PeriodicalIF":0.0,"publicationDate":"2017-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43855775","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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