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Bertram Richter, Jeff Bergman, James Pierre, Nestor D Tomycz
Loin Pain Hematuria Syndrome (LPHS) is a rare condition characterized by cryptogenic debilitating flank pain and microscopic or macroscopic hematuria. The pathophysiology of LPHS remains poorly understood and diagnosis is made largely by exclusion of alternate pathology. Management strategies can vary widely and include chronic opioid medication and a variety of invasive procedures including regional nerve blocks, transcutaneous electrical nerve stimulation, local capsaicin infusion, and surgical renal denervation...
December 16, 2018: Pain Practice: the Official Journal of World Institute of Pain
Hans W Sollinger, Talal Al-Qaoud, Natalie Bath, Robert R Redfield
OBJECTIVES: The objectives of this pilot study were twofold. First, we aimed to elicit whether the "UW-LPHS test" definitively localizes pain from patients' loin pain hematuria syndrome to the ureter and thus proves our hypothesis. Second, we aimed to understand whether a positive UW-LPHS test predicts a successful outcome after renal autotransplant. MATERIALS AND METHODS: The UW-LPHS test is described in detail in this manuscript. Briefly, 0.5% bupivacaine is injected into the ureter of the affected side and kept there using a balloon catheter for 5 minutes...
September 25, 2018: Experimental and Clinical Transplantation
Tao Ma, Xueli Bai, Wen Chen, Guogang Li, Mengyi Lao, Tingbo Liang
PURPOSE: Optimal surgical strategy for grade-C postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) is not justified. External wirsungostomy is feasible. However, the subsequent repeat pancreaticojejunostomy (PJ) is challenging. This study aims to introduce our experience of external wirsungostomy for grade-C POPF and a novel technique to do the repeat PJ (re-PJ). MATERIALS AND METHODS: From January 1, 2012 to December 31, 2016, all consecutive patients who underwent pancreaticoduodenectomy (PD) with PJ were identified...
April 2018: International Journal of Surgery
Shanshan Gao, Xing Liu, Juanjuan Liu, Wenfeng Xiong, Xiaowen Song, Wei Wu, Luting Wei, Bin Li
Latrophilins (LPHs) are adhesion G-protein-coupled receptors comprising three paralogous forms (LPH-1, LPH-2, and LPH-3) and known receptors for α-latrotoxin, which are involved in growth, development, adaptability, and schizophrenia and other diseases in vertebrates. However, the functions of LPH are poorly understood in most insects. Here, phylogenetic and synteny analysis indicated that LPH-1 and LPH-3 evolved separately from a common ancestor LPH-2. Then, latrophilin (Tclph) was cloned in Tribolium castaneum, and three alternatively spliced transcripts (Tclpha, Tclphb and Tclphc) were identified...
December 2017: Genesis: the Journal of Genetics and Development
Jarlath E Nally, Simone Schuller
Lungs perform an essential physiological function, mediated by a complex series of events that involve the coordination of multiple cell types to support not only gaseous exchange, but homeostasis and protection from infection. Guinea pigs are an important animal disease model for a number of infectious and noninfectious pulmonary conditions and the availability of a complete genome facilitates comprehensive analysis of tissues using the tools of proteomics. Here, we describe the application of 2-D Difference Gel Electrophoresis (DIGE) to compare, quantify, and identify differential protein expression of proteins in lung tissue from guinea pigs with leptospiral pulmonary hemorrhage syndrome (LPHS) compared to noninfected controls...
2018: Methods in Molecular Biology
Rosa L de Jager, Niek F Casteleijn, Esther de Beus, Michiel L Bots, Evert-Jan E Vonken, Ron T Gansevoort, Peter J Blankestijn
Background: Loin pain haematuria syndrome (LPHS) and autosomal dominant polycystic kidney disease (ADPKD) are the most important non-urological conditions to cause chronic severe kidney-related pain. Multidisciplinary programmes and surgical methods have shown inconsistent results with respect to pain reduction. Percutaneous catheter-based renal denervation (RDN) could be a less invasive treatment option for these patients. Methods: Our aim was to explore the change in perceived pain and use of analgesic medication from baseline to 3, 6 and 12 months after RDN...
June 22, 2017: Nephrology, Dialysis, Transplantation
Bhanu Prasad, Shelley Giebel, Francisco Garcia, Kunal Goyal, Jennifer Rose St Onge
Loin pain hematuria syndrome (LPHS) is a painful and incapacitating condition that typically affects young women. Treatment options, including opiates and/or surgical denervation of the renal nerves by autotransplantation, have variable success. In this report, we describe the successful use of endovascular renal nerve ablation in this population. Four women with LPHS and intractable pain unresponsive to conservative measures underwent endovascular ablation of the renal nerves between July and November 2015 using the Vessix renal denervation system...
January 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Mohd Basri Mat Nor, Azrina Md Ralib, Noor Airini Ibrahim, Mohd Rasydan Abdul-Ghani
Hypoxemia in severe leptospirosis-associated pulmonary hemorrhage syndrome (LPHS) is a challenging clinical scenario not usually responsive to maximal support on mechanical ventilation. We described the efficacy and safety of high frequency oscillatory ventilation (HFOV) as rescue therapy in acute respiratory failure secondary to LPHS. This is a retrospective case study of five patients with diagnosis of severe LPHS, who were admitted to Intensive Care Unit from October 2014 to January 2015. They developed refractory hypoxemia on conventional mechanical ventilation and rescue therapy was indicated...
June 2016: Indian Journal of Critical Care Medicine
Adeel S Zubair, Wisit Cheungpasitporn, Stephen B Erickson, Mikel Prieto
OBJECTIVE: The objective of this study is to assess clinical and safety outcomes after laparoscopic nephrectomy with autotransplantation for loin pain-hematuria syndrome (LPHS). METHODS: We conducted telephone interviews using structured questionnaires and retrospectively reviewed data on all patients who underwent laparoscopic nephrectomy with autotransplantation for LPHS between January 2000 and May 2014. RESULTS: A total of 24 laparoscopic nephrectomies with renal autotransplantation of 21 patients with LPHS refractory to conservative medical treatment were reviewed...
May 17, 2016: Journal of Evidence-based Medicine
Andrew Kristian Grech
Loin pain haematuria syndrome (LPHS) is an uncommon clinical entity that has divided renal physicians, pain practitioners, and even psychiatrists since its initial description. A relative paucity of data exists regarding the condition, with best practice guidelines lacking amid the existing threads of anecdotal experiences and variable follow-up observations. The aim of this article was to review the cumulative published experience of pain relief strategies for LPHS.
April 2016: Korean Journal of Pain
Adeel S Zubair, Hassan Salameh, Stephen B Erickson, Mikel Prieto
Loin pain hematuria syndrome (LPHS), first described in 1967, is a rare pain syndrome, which is not well understood. The syndrome is characterized by severe intermittent or persistent flank pain, either unilateral or bilateral, associated with gross or microscopic hematuria. LPHS is a diagnosis of exclusion as there still is not a consensus of validated diagnostic criteria, though several criteria have been proposed. The wide differential diagnosis would suggest a meticulous yet specific diagnostic work-up depending on the individual clinical features and natural history...
February 2016: Clinical Kidney Journal
Félix Rohrer, Sebastien Déglise, Vincent Bettschart, Jan Schmidtko
Loin pain haematuria (LPHS) is a rare and difficult-to-diagnose syndrome. Different therapeutic approaches have been used historically with little or no success. We report a case of LPHS in which bilateral renal autotransplantation led to pain relief, cessation of all medication and no recurrence beyond two years of follow-up.
2017: Urologia Internationalis
Donald M Steinwachs
INTRODUCTION: This paper examines the organization, services, and priorities of public health agencies and their capacity to be learning public health systems (LPHS). An LPHS uses data to measure population health and health risks and to evaluate its services and programs, and then integrates its own research with advances in scientific knowledge to innovate and improve its efficiency and effectiveness. PUBLIC HEALTH AGENCIES AND IMPACT FOR LPHS: Public health agencies' (PHA) organizational characteristics vary across states, as does their funding per capita...
2014: EGEMS
Simone Schuller, John J Callanan, Sheila Worrall, Thierry Francey, Ariane Schweighauser, Barbara Kohn, Robert Klopfleisch, Horst Posthaus, Jarlath E Nally
Leptospiral pulmonary haemorrhage syndrome (LPHS) is a severe form of leptospirosis. Pathogenic mechanisms are poorly understood. Lung tissues from 26 dogs with LPHS, 5 dogs with pulmonary haemorrhage due to other causes and 6 healthy lungs were labelled for IgG (n=26), IgM (n=25) and leptospiral antigens (n=26). Three general staining patterns for IgG/IgM were observed in lungs of dogs with LPHS with most tissues showing more than one staining pattern: (1) alveolar septal wall staining, (2) staining favouring alveolar surfaces and (3) staining of intra-alveolar fluid...
June 2015: Comparative Immunology, Microbiology and Infectious Diseases
Alan Russell, Suman Chatterjee, Michael Seed
A patient with loin pain haematuria syndrome suffering chronic throbbing pulsing pain overlaid with prolonged periods of incapacitating colic and overnight vomiting was presented 10 months following diagnosis. Ultrasound was normal. No renal or ureteral stones, or filling defects were seen on CT. At cytoscopy, bladder and urethra were normal, and bloody urine effluxed from the left ureteric orifice. The ureters were normal at diagnosis, and developed new abutting non-penetrating calcifications by 8 months...
April 26, 2015: BMJ Case Reports
Simone Schuller, Kjell Sergeant, Jenny Renaut, John J Callanan, Caitriona Scaife, Jarlath E Nally
UNLABELLED: Leptospiral pulmonary haemorrhage syndrome (LPHS) is a particularly severe form of leptospirosis. LPHS is increasingly recognized in both humans and animals and is characterized by rapidly progressive intra-alveolar haemorrhage leading to high mortality. The pathogenic mechanisms of LPHS are poorly understood which hampers the application of effective treatment regimes. In this study a 2-D guinea pig proteome lung map was created and used to investigate the pathogenic mechanisms of LPHS...
June 3, 2015: Journal of Proteomics
Zhenlong Li, Alemayehu A Gorfe
Lipid-polymer hybrid (LPH) nanoparticles represent a novel class of targeted drug delivery platforms that combine the advantages of liposomes and biodegradable polymeric nanoparticles. However, the molecular details of the interaction between LPHs and their target cell membranes remain poorly understood. We have investigated the receptor-mediated membrane adhesion process of a ligand-tethered LPH nanoparticle using extensive dissipative particle dynamics (DPD) simulations. We found that the spontaneous adhesion process follows a first-order kinetics characterized by two distinct stages: a rapid nanoparticle-membrane engagement, followed by a slow growth in the number of ligand-receptor pairs coupled with structural re-organization of both the nanoparticle and the membrane...
January 14, 2015: Nanoscale
María del Carmen Millán-Linares, María del Mar Yust, Juan María Alcaide-Hidalgo, Francisco Millán, Justo Pedroche
Lupine protein hydrolysates (LPHs) were obtained from a lupine protein isolate (LPI) by enzymatic hydrolysis using two proteases, Izyme AL and Alcalase 2.4 L, and their potential anti-inflammatory capacities were studied by determining their in vitro inhibition of the following enzymes that are involved in the inflammatory process: phospholipase A2 (PLA2), cyclooxygenase 2 (COX-2), thrombin, and transglutaminase (TG). The strongest inhibitory activities toward PLA2 and TG were found in the hydrolysates obtained by hydrolysis with Izyme and subsequently with Alcalase, with more than 70% inhibition obtained in some cases...
May 15, 2014: Food Chemistry
K Gendron, A Christe, S Walter, A Schweighauser, T Francey, M G Doherr, J Lang
Leptospirosis pulmonary haemorrhage syndrome (LPHS) is a frequent manifestation of Leptospira infection in dogs and is associated with a high morbidity and mortality. Three helical 16-slice thoracic CT scans were performed in 10 dogs naturally infected with Leptospira, within 24 hours of admission, and three and seven days later. Patients were sedated and scanned without breathhold, with a protocol adapted for rapid scanning. One dog died of respiratory failure on the morning following the first scan. On the initial scan, imaging features of LPHS included ground-glass nodules (10/10), peribronchovascular interstitial thickening (10/10), diffuse or patchy ground-glass opacity (9/10), solid nodules (8/10) and consolidation (7/10)...
February 15, 2014: Veterinary Record
Susan M Moeschler, Bryan C Hoelzer, Jason S Eldrige
INTRODUCTION: Chronic abdominal and flank pain can be multifactorial and difficult to treat. Loin pain hematuria syndrome (LPHS) is a rare clinical cause of chronic abdominal and flank pain and is a diagnosis of exclusion with limited treatment options, ranging from medications to renal autotransplantation or even nephrectomy in resistant cases. CASE DESCRIPTION: A 50-year-old man with a history of recurrent nephrolithiasis secondary to hypercalcemia presented to the pain clinic with bilateral flank pain...
November 2013: Clinical Journal of Pain
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