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Stone management

Thomas A A Skinner, Luke Witherspoon, Ali Dergham, Jeffery E Warren, James Watterson, Brian Blew
INTRODUCTION: Ureteropelvic junction obstruction (UPJO) is a condition characterized by partial or complete obstruction of urine transport from the renal pelvis to the ureter and can present with intermittent flank pain, recurrent urinary tract infections, renal stones, or renal dysfunction. While historically, open pyeloplasty was the gold standard for surgical management, laparoscopic methods to repair UPJO have largely taken over as the preferred approach for adolescent and adult patients...
January 21, 2019: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
T V Filippova, M M Litvinova, V I Rudenko, Z K Gadzhieva, L M Rapoport, Yu B Kazilov, A Yu Asanov, T I Subbotina, K F Khafizov
The article presents pooled results of domestic and international studies investigating genetic aspects of urolithiasis associated with impaired calcium metabolism. The review highlights the importance of early and accurate diagnosis of hereditary diseases associated with kidney stone formation. Of more than 80 currently known monogenic forms of urolithiasis, the authors provide the list of the most significant forms. Using such molecular genetic methods as NGS (next generation sequencing) allows accurate detection of the genetic cause of the disease, develop an individual approach the patients management and timely prevention of the disease among the relatives of the proband...
October 2018: Urologii︠a︡
V A Malkhasyan, I V Semenyakin, V Yu Ivanov, S O Sukhikh, N K Gadzhiev
To date, percutaneous nephrolithotomy (PNL) is the standard treatment modality for large-volume renal stones and staghorn stones in patients with urolithiasis. Despite low invasiveness, this method is not without complications. This review discusses the most common complications and suggests methods for their prevention and appropriate management. To unify the study of complications they were categorized based on the modified Clavien classification. According to the available data, about 80% of the PNL complications belong to grade I-II complications and does not require any additional treatment...
October 2018: Urologii︠a︡
O V Teodorovich, M N Shatokhin, M I Abdullaev, A V Krasnov, M R Khommyatov
This article presents a case of a 59-year-old patient with a primary tumor of the right kidney with bladder and liver metastases. The patient was treated in three-stages. In the first stage, he underwent ureteral stone extraction, laser resection of the tumor with subsequent vaporization. In the second stage, a repeat laser resection and vaporization of the tumor was performed. During the third stage, the patient underwent TUR of the bladder wall with the tumor, followed by laser vaporization of the tumor bed...
October 2018: Urologii︠a︡
D S Merinov, A V Artemov, V A Epishov, L D Arustamov, Sh Sh Gurbanov, A M Polikarpova
AIM: To compare the results of a single tract versus multi-tract percutaneous nephrolithotomy (PNL) MATERIALS AND METHODS: Over a period of 6 years, a total of 2,264 PNLs was performed at the N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology, of which 875 PNLs were done for stage K3-K4 staghorn calculi. Among them, 244 (27.7%) patients underwent multi-tract PNL. We included 873 patients in our study. The median stone size was 59 (46; 88) mm. Two, three and four percutaneous tracts were used in 165 (67...
October 2018: Urologii︠a︡
James A McKinnell, Raveena D Singh, Loren G Miller, Ken Kleinman, Gabrielle Gussin, Jiayi He, Raheeb Saavedra, Tabitha D Dutciuc, Marlene Estevez, Justin Chang, Lauren Heim, Stacey Yamaguchi, Harold Custodio, Shruti K Gohil, Steven Park, Steven Tam, Philip A Robinson, Thomas Tjoa, Jenny Nguyen, Kaye D Evans, Cassiana E Bittencourt, Bruce Y Lee, Leslie E Mueller, Sarah M Bartsch, John A Jernigan, Rachel B Slayton, Nimalie D Stone, Matthew Zahn, Vincent Mor, Kevin McConeghy, Rosa R Baier, Lynn Janssen, Kathleen O'Donnell, Robert A Weinstein, Mary K Hayden, Micaela H Coady, Megha Bhattarai, Ellena M Peterson, Susan S Huang
Background: Multidrug-resistant organisms (MDROs) spread between hospitals, nursing homes (NH), and long-term acute care facilities (LTACs) via patient transfers. SHIELD OC is a regional public health collaborative involving decolonization at 38 healthcare facilities selected based upon their high degree of patient sharing. We report baseline MDRO prevalence in 21 NH/LTACs. Methods: A random sample of 50 adults for 21 NH/LTACs (18 NHs, 3 LTACs) were screened for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus spp...
February 11, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Bella Vivat, Lucy Bemand-Qureshi, Jane Harrington, Sarah Davis, Patrick Stone
BACKGROUND: Little research has explored the detail of practice when using sedative medications at the end of life. One work package of the I-CAN-CARE research programme investigates this in UK palliative care. AIMS: To investigate current practices when using sedative medication at the end of life in London, UK, by (1) qualitatively exploring the understandings of palliative care clinicians, (2) examining documented sedative use in patient records and (3) comparing findings from both investigations...
February 12, 2019: Palliative Medicine
Amy Gerrish, Edward Stone, Samuel Clokie, John R Ainsworth, Helen Jenkinson, Maureen McCalla, Carol Hitchcott, Isabel Colmenero, Stephanie Allen, Manoj Parulekar, Trevor Cole
Retinoblastoma is the most common eye malignancy in childhood caused by mutations in the RB1 gene. Both alleles of the RB1 gene must be mutated for tumour development. The initial RB1 mutation may be constitutional germline or somatic (originating in one retinal cell only). Distinguishing between these alternative mechanisms is crucial, with wider implications for management of the patient and family members. Bilateral retinoblastoma is nearly always due to a constitutional mutation; however, approximately 15% of unilateral cases also carry a germline mutation, and identifying these cases is important...
February 11, 2019: British Journal of Ophthalmology
Jesús Rodrigo-Comino, Manuel Seeger, Thomas Iserloh, José María Senciales González, José Damián Ruiz-Sinoga, Johannes B Ries
In the context of the Sustainable Development Goals (SDG), understanding landscape evolution is essential to design long-term management plans. In agricultural fields, such as the vineyards on steep slopes, the terraces offer one of the most important morphological changes. However, it is not clear if the poorly managed agricultural terraces are optimal to reduce soil erosion and overland flow, although the trafficability is improved. Therefore, the main aim of this research is to compare the differences between initial soil erosion processes on poorly managed terraced vineyards and sloping vineyards at the pedon scale, considering the key role of the SSC (Soil Surface Components)...
April 10, 2019: Science of the Total Environment
Alberta Cappelli, Cristina Mosconi, Alessandro Cucchetti, Irene Pettinari, Andrea Andreone, Sara Zanardi, Francesco Modestino, Caterina De Benedittis, Matteo Serenari, Rita Golfieri
BACKGROUND: The percutaneous approach (PA) for management of biliary stones (BS) with or without an underlying biliary stenosis is an option for patients in whom an endoscopic approach (EA) is not possible. The aim of this study was to evaluate the efficacy of a PA in patients with BS unsuitable for an EA. METHODS: A retrospective review of a database was performed. Inclusion criteria included patients with benign disease, BS who had undergone a PA. The outcomes were technical success rate, short (≤90 days) and long-term (>90 days) efficacy and safety...
February 6, 2019: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Melissa Milligan, Allyson C Berent
Nephroliths are often clinically silent. When non-obstructive and of an amenable stone type, dissolution should be attempted. When problematic, nephrolithotomy can be considered. Depending on stone type, size, and species, extracorporeal shockwave lithotripsy or endoscopic nephrolithotomy are preferred techniques. Obstructive ureterolithiasis should be addressed immediately to preserve kidney function. Because of decreased morbidity and mortality and versatility for all causes, interventional techniques for kidney decompression are preferred by the authors...
March 2019: Veterinary Clinics of North America. Small Animal Practice
Edward Assaf, Rawad Abou Zahr, Elie Ghabi, Imad Ghantous
Subcapsular hematoma is an exceedingly rare complication of extracorporeal shockwave lithotripsy (ESWL) for renal stones with cases demonstrating evidence of active arterial bleeding even more so. A 49-year-old male presented with acute onset right flank pain two hours following ESWL. CT scan with contrast revealed active contrast extravasation consistent with arterial bleeding. The patient was managed with arterial embolization and recovered uneventfully following a 4-day hospitalization.
2019: Case Reports in Urology
Chao Cai, Yang Liu, Wen Zhong, Wei Zhu, Zhijian Zhao, Wenqi Wu, Yongda Liu, Guohua Zeng
PURPOSE: To evaluate the safety and efficacy of new generation super-mini percutaneous nephrolithotomy (New-SMP) in the treatment of ≥20 mm renal stone. METHODS: We retrospectively analyzed the New-SMP procedures (14F) performed in the cases with ≥20 mm renal stone between 1st April, 2016 to 1st July, 2018. The cases with ipsilateral DJ stent and/or nephrostomy tube preoperatively, ipsilateral ureteric stone, uncorrected coagulopathy, active urinary tract infection, congenital abnormalities, urinary diversion were excluded...
February 6, 2019: Journal of Endourology
En-Liang Li, Rong-Fa Yuan, Wen-Jun Liao, Qian Feng, Jun Lei, Xiang-Bao Yin, Lin-Quan Wu, Jiang-Hua Shao
BACKGROUND: To evaluate the perioperative and long-term results of intrahepatic bile duct exploration lithotomy (IHBDIL) combined with hepatectomy for patients with complicated bilateral primary hepatolithiasis. METHODS: A study was conducted involving 56 patients with complicated bilateral primary hepatolithiasis who underwent IHBDIL combined with hepatectomy at our hospital from January 2006 to December 2014. The perioperative and long-term outcomes that were retrospectively analysed included the stone clearance rate, operative morbidity and mortality, and stone recurrence rate...
February 4, 2019: BMC Surgery
Jae Hwi Choi, Sol Yoon, Sin Woo Lee, Seong Uk Jeh, Jeong Seok Hwa, Jae Seog Hyun, Ky Hyun Chung, Deok Ha Seo, Chunwoo Lee, Sung Chul Kam, See Min Choi
OBJECTIVES: The aim of this study was to investigate the risk factors for postoperative urinary retention (POUR) among female patients by evaluating its occurrence in women who underwent laparoscopic cholecystectomy in Gyeongsang National University Hospital. METHODS: The medical records of female patients who had undergone laparoscopic cholecystectomy for gallbladder stones between March 2014 and February 2018 were reviewed. Information was collected regarding patient age, body mass index (BMI), creatinine, absolute neutrophil count, duration of the operation and anesthesia, the amount of fluid infused, American Society of Anesthesiologists (ASA) classification, and medical comorbidities, such as hypertension, diabetes, and lung, liver, heart, renal, and neurologic disease...
February 3, 2019: Lower Urinary Tract Symptoms
James Papworth, L Osborne, M A Shimmings, C C S Roberts
INTRODUCTION: In April 2017, 22% of Army Full-time Trade Trained Strength was downgraded, reducing fully deployable strength to 60 546, against a target of 82 000. In June 2017, Commander 20 Armoured Infantry Brigade (20 AI Bde) initiated a study to look at the principal conditions causing medical downgrading, as a stepping stone to finding ways of reducing injury, enhancing rehabilitation and improving deployability. METHOD: The Defence Medical Information Capability Programme medical records for every downgraded soldier in 20 AI Bde and supporting units were scrutinised to identify their Medical Deployment Standard and the primary condition causing downgrading...
February 2, 2019: Journal of the Royal Army Medical Corps
Cason Pierce, Angela Keniston, Richard K Albert
OBJECTIVES: To determine the frequency, timing, and types of imaging obtained in patients with a discharge diagnosis of acute pyelonephritis, and how often imaging findings affect therapy. METHODS: This was a retrospective chart review of 1062 adults with a diagnosis of acute pyelonephritis discharged from an urban, safety-net hospital between January 1, 2008 and December 31, 2012. From the 739 patients selected after exclusions, we determined the number and proportion of patients imaged within the first 24 hours of admission, stratified by risk factors for pyelonephritis complications, and the frequency of positive findings leading to invasive interventions...
February 2019: Southern Medical Journal
Robert Memba, Sergio González, Daniel Coronado, Verónica González, Fernando Mata, José Antonio Rodríguez, Carlos Mühlenberg, Joan Sala, Ruth Ribas, Eva Pueyo, Alfredo Mata, Donal B O'Connor, Kevin C Conlon, Rosa Jorba
BACKGROUND: Current evidence shows that single-stage treatment of concomitant choledocholithiasis and cholelithiasis is as effective and safe as two-stage treatment. However, several studies suggest that single-stage approach requires shorter hospitalization time and is more cost-effective than the two-stage approach, even though it requires considerable training. This study aimed to evaluate the implementation of a protocol for managing concomitant choledocholithiasis and cholelithiasis using single-stage treatment...
January 28, 2019: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Xiao-Dong Zhou, Qiao-Feng Chen, Yuan-Yuan Zhang, Ming-Ju Yu, Chang Zhong, Zhi-Jian Liu, Guo-Hua Li, Xiao-Jiang Zhou, Jun-Bo Hong, You-Xiang Chen
BACKGROUND: Endoscopic sphincterotomy (EST) for the management of common bile duct stones (CBDS) is used increasingly widely because it is a minimally invasive procedure. However, some clinical practitioners argued that EST may be complicated by post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and accompanied by a higher recurrence of CBDS than open choledochotomy (OCT). Whether any differences in outcomes exist between these two approaches for treating CBDS has not been thoroughly elucidated to date...
January 28, 2019: World Journal of Gastroenterology: WJG
Eric D Crandall, Robert J Toonen, Kimberly A Selkoe
Assessing the geographic structure of populations has relied heavily on Sewell Wright's F -statistics and their numerous analogues for many decades. However, it is well appreciated that, due to their nonlinear relationship with gene flow, F -statistics frequently fail to reject the null model of panmixia in species with relatively high levels of gene flow and large population sizes. Coalescent genealogy samplers instead allow a model-selection approach to the characterization of population structure, thereby providing the opportunity for stronger inference...
February 2019: Evolutionary Applications
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