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Renal surgery

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https://www.readbyqxmd.com/read/29474345/opioid-related-genetic-polymorphisms-do-not-influence-postoperative-opioid-requirement-a-prospective-observational-study
#1
Frédéric Aubrun, Noël Zahr, Olivier Langeron, Nicolas Boccheciampe, Nathalie Cozic, Lisa Belin, Jean-Sebastien Hulot, Frederic Khiami, Bruno Riou
BACKGROUND: Among the various factors that may influence the pharmacological response to opioids, genetic polymorphisms [single nucleotide polymorphisms (SNP)] have generated some interest. OBJECTIVES: To examine the influence on morphine dose requirements and adverse events in the postoperative period of four SNP [opioid receptor mu1 (OPRM1), ATP-binding cassette subfamily B, member 1 (ABCB1) ex-21 and ex-26, catechol-o-methyltransferase (COMT)] in candidate genes involved in morphine pharmacodynamics and pharmacokinetics...
February 22, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29474279/the-impact-of-the-affordable-care-act-on-urogynecologic-surgery-cancelation-rates
#2
Alexander A Berger, Lauren E Giugale, Jonathan P Shepherd
OBJECTIVES: We examined the impact of the implementation of the Affordable Care Act (ACA) on female pelvic medicine and reconstructive surgery (FPMRS) surgical cancelation rates. METHODS: A retrospective cohort study was performed on patients scheduling FPMRS procedures 1 year before and after ACA implementation at a regional academic medical center. We compared cancelation rates as well as sociodemographic, surgical, and medical history data. Analysis included χ test, t test, and univariable and multivariable logistic regression...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29473522/an-evidence-based-review-of-off-label-uses-of-polidocanol
#3
Hossein Babaei, Elgar Enamzadeh
BACKGROUND: Polidocanol is approved for its competence in treatment of varicose veins and spider veins; however, unfortunately, many of its off-label uses are still underappreciated. OBJECTIVE: Lack of an appropriate comprehensive review for off-label uses of this medication troubles physicians about making evidence-based decisions on prescribing it for its various outstanding off-label uses. This article attempts to provide physicians with the latest information concerning successful and unsuccessful use of polidocanol as an alternative treatment for esophageal and gastric varices, tendinopathy and epicondylitis, vascular malformations, varicocele, hydrocele and spermatocele, aneurysmal bone cysts, itching, management of gastrointestinal bleeding, simple renal cysts, reducing the incidence and severity of radio-induced dermatitis, and hemorrhoids...
February 23, 2018: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/29472806/neutrophil-gelatinase-associated-lipocalin-and-acute-kidney-injury-in-endovascular-aneurysm-repair-or-open-aortic-repair-a-pilot-study
#4
Benedetta Rampoldi, Serena Tessarolo, Paola Giubbilini, Paola Gaia, Samantha D Corino, Sarah Mazza, Roberta Rigolini, Marco Dei Poli, Elena Vianello, Massimiliano M Corsi Romanelli, Elena Costa
Introduction: Acute kidney injury (AKI) occurs frequently after abdominal aortic surgery and there is currently no effective marker able to detect early onset. The aim of this study is to evaluate the ability of neutrophil gelatinase-associated lipocalin (NGAL) to early identify the development of acute renal damage in patients undergoing endovascular aneurysm repair (EVAR) or open aortic repair (OAR). Materials and methods: Serial samples of blood and urine were obtained from 25 patients undergoing both EVAR and OAR...
February 15, 2018: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
https://www.readbyqxmd.com/read/29472757/trifecta-outcomes-to-assess-learning-curve-of-robotic-partial-nephrectomy
#5
Olamide O Omidele, Natan Davoudzadeh, Michael Palese
Background and Objectives: The learning curve for achieving desirable perioperative outcomes in robot-assisted partial nephrectomy (RAPN) has not been well studied. Information is available regarding "trifecta" outcomes of no complications, no positive margins, warm ischemia time (WIT) of ≤25 minutes, and a ≤15% decrease in postoperative glomerular filtration rate (GFR). This study was conducted to assess the impact of the learning curve on surgical outcomes in patients undergoing RAPN...
January 2018: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/29472379/diagnosis-of-endocrine-disease-the-role-of-the-desmopressin-test-in-the-diagnosis-and-follow-up-of-cushing-s-syndrome
#6
Dimitra Argyro Vassiliadi, Stylianos Tsagarakis
Desmopressin is a vasopressin analogue selective for type 2 vasopressin receptors that mediate renal water retention. In contrast to the native hormone arginine-vasopressin, a well-known ACTH secretagogue, desmopressin exerts minimal or no activity on ACTH excretion. However, in a substantial proportion of patients with ACTH-dependent Cushing's syndrome (CS), desmopressin elicits an ACTH and cortisol response, which contrasts with the minimal responses obtained in healthy subjects. The mechanism underlying this paradoxical response involves upregulation of vasopressin type 3 and/or the aberrant expression of type 2 receptors by neoplastic ACTH-producing cells...
February 22, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29468282/-standard-surgery-for-small-renal-masses-4-cm
#7
REVIEW
S K Frees, R Mager, H Borgmann, W Jäger, C Thomas, A Haferkamp
BACKGROUND: Several new treatment strategies have emerged in the treatment of small renal masses (<4 cm in diameter). Active surveillance and ablative techniques have been introduced but it remains unclear which patients will benefit the most from these new treatment options. A surgical approach remains standard of care. In recent decades, radical nephrectomy has been replaced by nephron-sparing surgery for the management of small renal masses. RESULTS: In addition to the open partial nephrectomy, which is considered the standard approach, the number of surgeries performed using minimally invasive techniques is increasing...
February 21, 2018: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29468090/the-role-of-bmi-in-hip-fracture-surgery
#8
Sheriff D Akinleye, Garret Garofolo, Maya Deza Culbertson, Peter Homel, Orry Erez
Introduction: Obesity is an oft-cited cause of surgical morbidity and many institutions require extensive supplementary screening for obese patients prior to surgical intervention. However, in the elderly patients, obesity has been described as a protective factor. This article set out to examine the effect of body mass index (BMI) on outcomes and morbidity after hip fracture surgery. Methods: The National Surgical Quality Improvement Program database was queried for all patients undergoing 1 of 4 surgical procedures to manage hip fracture between 2008 and 2012...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29467353/can-tolvaptan-protect-renal-function-in-the-early-postoperative-period-of-cardiac-surgery-results-of-a-single-center-randomized-controlled-study
#9
Yuichiro Kishimoto, Yoshinobu Nakamura, Shingo Harada, Takeshi Onohara, Satoru Kishimoto, Tomohiro Kurashiki, Yoshikazu Fujiwara, Motonobu Nishimura
BACKGROUND: Oral administration of tolvaptan, a vasopressin V2 receptor antagonist, significantly reduces deterioration of renal function, which has recently been highlighted as an exacerbating factor for adverse events in patients with acute heart failure. In the present study we tested the hypothesis that concomitant administration of tolvaptan with a conventional diuretic is beneficial for perioperative body fluid management in patients who have undergone cardiac surgery.Methods and Results:In all, 280 patients who underwent cardiac surgery were prospectively randomized to concomitant treatment with tolvaptan and a conventional diuretic (tolvaptan group; 147 patients) or treatment with a conventional diuretic alone (control group; 133 patients)...
February 21, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29466935/endovascular-approach-in-isolated-abdominal-aortic-dissections
#10
Kaptanıderya Tayfur, Mehmet Senel Bademci, Serkan Yazman, Murat Canyigit
Background Here, we report the mid-term results of endovascular treatment of isolated dissection of the abdominal aorta, which is a very rare pathology. Materials and methods A total of 11 patients (4 males (36.3%) and 7 females (63.6%)) aged 42-72 (mean, 60.3 ± 10.45) years with isolated dissection of the abdominal aorta underwent endovascular stent-graft treatment at our institution between August 2010 and September 2015. Eight patients were symptomatic, and the remaining three were asymptomatic. The asymptomatic patients had aortic aneurysms coexisting with dissection...
January 1, 2018: Vascular
https://www.readbyqxmd.com/read/29465550/clinical-significance-of-computed-tomography-detected-ascites-in-gastric-cancer-patients-with-peritoneal-metastases
#11
Su Hwan Kim, Young Ho Choi, Ji Won Kim, Sohee Oh, Seohui Lee, Byeong Gwan Kim, Kook Lae Lee
Patients with peritoneal metastases (PM) are generally considered incurable; therefore, the presence of PM is a critical factor in deciding between palliative surgery and curative resection as a therapeutic strategy. Previous studies have not determined the predictive value of ascites detected on computed tomography (CT) for the presence of PM. We aimed to analyze the factors that are associated with PM in patients with CT-detected ascites.A total of 2207 consecutive patients who were diagnosed with gastric cancer between 2004 and 2013 were identified...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29464756/impact-on-quality-of-life-and-sexual-satisfaction-of-continent-cystostomy-with-enterocystoplasty-in-an-adult-neurologic-population
#12
Ornella Lam Van Ba, Laurent Soustelle, Laurent Wagner, Nicolas Siegler, Michel Boukaram, Kamel Ben Naoum, Stéphane Droupy, Armand Chevrot, Pierre Costa
AIMS: To evaluate long-term general and urinary quality of life (QOL) and sexual satisfaction in adult neurologic patients undergoing continent cystostomy surgery associated with a bladder enlargement to treat neurogenic lower urinary tract dysfunction. METHODS: Monocentre, retrospective series of adult neurologic patients who underwent continent cystostomy with bladder enlargement and followed-up in the long-term. We assessed during follow-up, urinary and renal function and patients filled QOL questionnaires on general QOL, sexuality and urinary (short form Qualiveen) disability...
February 21, 2018: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29464581/urinary-neutrophil-gelatinase-associated-lipocalin-ngal-and-serum-cystatin-c-measurements-for-early-diagnosis-of-acute-kidney-injury-in-children-admitted-to-picu
#13
Jameela Abdulaziz Kari, Mohamed Ahmed Shalaby, Kholoud Sofyani, Ahmad Saleh Sanad, Albaraa Fuad Ossra, Rayan Smeer Halabi, Maha Hassan Aljuhani, Wael Mohammad Toffaha, Feras Aymen Moria, Samar Sabry, Hanan AbdelAziz Ahmed, Khalid Abdulaziz Alhasan, Sara Sharief, Osama Safdar
BACKGROUND: Acute kidney injury (AKI) is common in critically ill children with significant mortality and morbidity. Serum creatinine is an insensitive and late biomarker compared to newly proposed AKI biomarkers. METHODS: Prospective study in pediatric intensive care unit (PICU) over three months to compare between serum cystatin-C (s-Cys-C) and urinary neutrophil gelatinase-associated lipocalin (uNGAL) as AKI biomarkers at multiple time points with pediatric risk, injury, failure, loss, end-stage renal disease (pRIFLE) classification in diagnosing AKI...
February 20, 2018: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/29464030/under-expression-of-ck2%C3%AE-subunit-in-ccrcc-represents-a-complementary-biomarker-of-p-stat3-ser727-that-correlates-with-patient-survival
#14
Jordi Vilardell, Estefania Alcaraz, Eduard Sarró, Enric Trilla, Thaïs Cuadros, Inés de Torres, Maria Plana, Santiago Ramón Y Cajal, Lorenzo A Pinna, Maria Ruzzene, Juan Morote, Anna Meseguer, Emilio Itarte
Clear cell renal cell carcinoma (ccRCC) is the most common and aggressive subtype of renal cancer. STAT3 pathway is altered in these tumors and p-STAT3 Ser727 is an independent prognostic factor for ccRCC. Protein kinase CK2 is altered in different types of tumors and overexpression of CK2α is considered predictive of bad prognosis and metastatic risk. CK2 subunits analyses in ccRCC samples showed increased CK2α/α' nuclear content in all cases, but decreased cytosolic CK2β (CK2βcyt) levels in the more advanced tumors...
January 19, 2018: Oncotarget
https://www.readbyqxmd.com/read/29463251/kidney-autotransplantation-after-nephrectomy-and-work-bench-surgery-as-an-ultimate-approach-to-nephron-sparing-surgery
#15
Martin W W Janssen, Johannes Linxweiler, Ines Philipps, Zentia Bütow, Stefan Siemer, Michael Stöckle, Carsten-Henning Ohlmann
BACKGROUND: Kidney autotransplantation (KAT) is the ultimate approach for nephron-sparing surgery. It is a rarely used method in renal tumor surgery today as minimal invasive and open techniques for nephron-sparing surgery improve constantly. In this publication, the complication rate and the long-term functional and oncological outcome at a single center are analyzed. METHODS: A prospectively constructed database of patients with renal tumors who underwent renal surgery was retrospectively analyzed to identify patients with KAT and describe surgical and oncological outcomes and to obtain long-term follow-up...
February 20, 2018: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29462089/evaluation-of-the-management-of-severe-trauma-kidney-injury-and-long-term-renal-function-in-children
#16
Camille Overs, Youssef Teklali, Bernard Boillot, Delphine Poncet, Pierre-Yves Rabattu, Yohan Robert, Christian Piolat
BACKGROUND: To evaluate the management and long term renal function with DMSA scintigraphy in pediatric severe traumatic kidney injury (STKI) grade IV (STKI IV) and V (STKI V) at the trauma center of Grenoble Teaching Hospital. METHODS: This is a single-center observational retrospective study between 2004 and 2014. All children under the age of 15 managed at the Grenoble teaching Hospital for a STKI IV or V were included. The trauma grade was radiologically diagnosed on arrival at hospital, using the classification of the American Association for Surgery of Trauma...
February 17, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29459947/association-of-vegetation-size-with-embolic-risk-in-patients-with-infective-endocarditis-a-systematic-review-and-meta-analysis
#17
Divyanshu Mohananey, Ashley Mohadjer, Gosta Pettersson, Jose Navia, Steven Gordon, Nabin Shrestha, Richard A Grimm, L Leonardo Rodriguez, Brian P Griffin, Milind Y Desai
Importance: Infective endocarditis is a life-threating condition with annual mortality of as much as 40% and is associated with embolic events in as many as 80% of cases. These embolic events have notable prognostic implications and have been linked to increased length of stay in intensive care units and mortality. A vegetation size greater than 10 mm has often been suggested as an optimal cutoff to estimate the risk of embolism, but the evidence is based largely on small observational studies...
February 19, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29459617/ngal-neutrophil-gelatinase-associated-lipocalin-is-an-early-predictor-of-acute-kidney-injury-after-cardiac-surgery-and-variation-of-ngal-values-in-homogenous-study-subject
#18
O F Miah, F A Dowel, A Latif, A N Hai, M A Mahmud, M A Razzak, T Ahammod
Isolated CABG (coronary artery bypass grafting) has the lowest incidence of AKI (Acute Kidney Injury), followed by valvular surgery and then, combined CABG with valvular surgery. Due to the difference in baseline characteristics and in surgery type, the range of incidence is between 8.9 and 39% based on RIFLE (Risk Injury failure loss end stage kidney disease) or AKIN (Acute Kidney Injury Network) criteria. The advent of novel biomarkers of kidney injury has opened a new era of early detection and prognosis prediction for AKI...
January 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29459134/upper-pole-access-is-safe-and-effective-for-pediatric-percutaneous-nephrolithotomy
#19
Sedat Oner, Ahsen Karagozlu Akgul, Murat Demirbas, Efe Onen, Murat Aydos, Abdullah Erdogan
INTRODUCTION: Upper pole access in percutaneous nephrolithotomy (PCNL) provides a straight tract to the ureter, resulting in easier placement of a guidewire to the ureter, good exposure of the pelvis, calices, and upper ureter, and comfortable manipulations. However, despite these benefits, upper pole access is usually avoided because of the risk of chest complications in both pediatric and adult patients. OBJECTIVE: We aimed to evaluate the safety and morbidity of single upper pole access in pediatric patients undergoing PCNL...
February 2, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29459111/a-trial-of-two-anesthetic-regimes-for-minimally-invasive-mitral-valve-repair
#20
Marco Moscarelli, Nora Terrasini, Anna Nunziata, Prakash Punjabi, Gianni Angelini, Marco Solinas, Alba Buselli, Paolo Del Sarto, Dorela Haxhiademi
OBJECTIVE: Minimally invasive mitral valve repair may be associated with prolonged cardioplegic arrest times and ischemic reperfusion injury. Intravenous (propofol) and volatile (sevoflurane) anesthesia are used routinely during cardiac surgery and are thought to provide cardioprotection; however, the individual contribution of each regimen to cardioprotection is unknown. Therefore, the authors sought to compare the cardioprotective effects of propofol and sevoflurane anesthesia in patients undergoing minimally invasive mitral valve repair...
January 31, 2018: Journal of Cardiothoracic and Vascular Anesthesia
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