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Stone management

S Al-Zahid, D Izadi, C J Day, A Wilson, C Stone, J Smith
We describe a rare case of cervical necrotising fasciitis caused by mastoiditis and Bezold's abscess. This case was complicated by a tracheostomy delaying wound healing. A novel strategy to repair the tracheotomy defect using Permacol™, an acellular porcine dermal substitute, and a local muscle flap not previously reported in the literature is described to allow the use of negative pressure wound therapy dressing. This technique may be employed in similar applications for non-healing tracheotomy wounds.
October 16, 2018: Annals of the Royal College of Surgeons of England
Diana K Bowen, Gregory E Tasian
Once considered rare, pediatric nephrolithiasis has become a critical field of study in the last decade due to the rapid increase in incidence. Understanding the changing epidemiology and lifelong implications of pediatric stone disease is critically important to effectively manage the individual patient as well as identify risk factors for childhood onset that could be modified. Determining the role of diagnostic imaging in children is a unique challenge as limiting radiation and imaging stewardship should be priorities...
November 2018: Urologic Clinics of North America
Andrea S Melani
Inhaled bronchodilators are the key-stone of chronic obstructive pulmonary disease (COPD) management. Olodaterol 5 µg, a long-acting β2-adrenoceptor agonist (LABA) is one such bronchodilator indicated as a once-daily maintenance therapy. Areas covered: This article reviews the several trials that have assessed olodaterol as a COPD therapy. It covers safety and tolerability data and provides the reader with an expert opinion on its use as a treatment for COPD. Expert opinion: Olodaterol improves lung function for 24 h and reduces rescue medication use...
October 12, 2018: Expert Opinion on Pharmacotherapy
Kemal Sarica
PURPOSE OF REVIEW: The incidence of urolithiasis has shown a prominent increase in the last two to three decades and evidence-based data have clearly indicated the certain role of obesity and overweight in both children and adults. As a certain component of metabolic syndrome, 'obesity' has been found to have a significant impact on the urinary metabolic risk factors which may be important in stone formation. In this present review article, we aimed to evaluate the possible association between obesity and urolithiasis and related risk factors...
October 10, 2018: Current Opinion in Urology
Nafeesah Fatimah, Abubaker Shafiq Ahmed, Muhammad Umar Warraich, Usman Ismat Butt, Qamar Ashfaq Ahmad, Mahmood Ayyaz
INTRODUCTION: Gallstone ileus is a rare presentation of cholelithiasis accounting for around 4% of cases of small bowel obstruction under 65 years of age but rises to 25% in those more than 65 years of age. Most gall stones, if impact in the bowel, are seen to lodge at the ileocecal valve as this is the most narrow part of the bowel. PRESENTATION OF CASE: We present a case of small intestinal obstruction because of a gallstone stuck in the distal jejunum. Patient was explored and one-stage surgery was done i...
October 4, 2018: International Journal of Surgery Case Reports
Ioanna Kosmidou, Gregg W Stone
PURPOSE OF REVIEW: To provide an up-to-date review of recent trials examining the incidence and prognostic impact of new-onset atrial fibrillation (NOAF) following percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD) and the impact of postprocedural NOAF compared to nonsurgical atrial fibrillation. RECENT FINDINGS: A recent analysis from the Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) trial demonstrated that NOAF is much more frequent following surgical compared with percutaneous revascularization for LMCAD, and is strongly associated with an increased 3-year risk of mortality and stroke...
November 2018: Current Opinion in Cardiology
Gerasimos Siasos, Vasiliki Tsigkou, Marina Zaromytidou, Jaskanwal D Sara, Anubodh Varshney, Ahmet Umit Coskun, Amir Lerman, Peter H Stone
PURPOSE OF REVIEW: The natural history of coronary atherosclerosis is complex and atherosclerotic plaques exhibit large morphologic and functional variability within the same individual as well as over time. The purpose of this article is to review the role of blood flow patterns and shear stress on the development of microvascular and epicardial endothelial dysfunction and atherosclerosis progression. RECENT FINDINGS: Recent breakthroughs in cardiovascular imaging have facilitated in-vivo characterization of the anatomic and functional characteristics of atherosclerotic plaques and have highlighted the role of endothelial shear stress and epicardial and microvascular endothelial dysfunction in the natural history of coronary atherosclerosis...
November 2018: Current Opinion in Cardiology
Michael W Sourial, Nathaly Francois, Geoffrey N Box, Bodo E Knudsen
INTRODUCTION AND OBJECTIVE: Supracostal access in percutaneous nephrolithotomy (PCNL) may be avoided due to concern for thoracic complications. The objective of the study is to report the safety and efficacy of supracostal access utilizing a tubeless (stent only) PCNL technique. PATIENTS AND METHODS: Retrospective review of perioperative outcomes of 70 patients (76 renal units) who underwent a supracostal tubeless PCNL. No nephrostomy tubes were left. All patients had a 7F ureteral stent and Foley catheter placed...
October 9, 2018: World Journal of Urology
Sheldon W Tobe, James A Stone, Todd Anderson, Simon Bacon, Alice Y Y Cheng, Stella S Daskalopoulou, Justin A Ezekowitz, Jean C Gregoire, Gord Gubitz, Rahul Jain, Karim Keshavjee, Patty Lindsay, Mary L'Abbe, David C W Lau, Lawrence A Leiter, Eileen O'Meara, Glen J Pearson, Doreen M Rabi, Diana Sherifali, Peter Selby, Jack V Tu, Sean Wharton, Kimberly M Walker, Diane Hua-Stewart, Peter P Liu
No abstract text is available yet for this article.
October 9, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Vincent Zimmer
No abstract text is available yet for this article.
October 5, 2018: Clinical Endoscopy
W X Yin, M Adnan, Y Shang, Y Lin, C X Luo
Botrytis cinerea, the causal agent of gray mold, can result in considerable preharvest and postharvest losses in many economically valuable plant species. Fungicides were widely used to minimize such losses, but fungicide resistances were detected frequently. In the present study, we collected 164 isolates from nectarine and cherry in China and tested the sensitivity to six fungicides. Among the tested isolates, 71 (43.3%) were resistant to azoxystrobin, 14 (8.5%) to cyprodinil, 7 (4.3%) to boscalid, 4 (2.4%) to carbendazim, 1 (0...
October 9, 2018: Plant Disease
L Fang, J Wang, W C Dai, B Liang, H M Chen, X W Fu, B B Zheng, J Lei, C W Huang, S B Zou
BACKGROUND: LTCBDE combined with or without modified techniques is safe and efficacious for the management of gallstones and concomitant, even large, common bile duct (CBD) stones. METHODS: To describe the surgical indications and procedure strategies of laparoscopic transcystic common bile duct exploration (LTCBDE), a retrospective analysis of 205 patients with concomitant gallstones and CBD stones treated using LTCBDE between June 2008 and June 2015 was performed...
October 8, 2018: Surgical Endoscopy
Ingrid Hoeritzauer, Savva Pronin, Alan Carson, Patrick Statham, Andreas K Demetriades, Jon Stone
BACKGROUND: The majority of patients presenting with suspected clinical cauda equina syndrome (CES) have no identifiable structural cause for their symptoms ('scan-negative' CES). Understanding these patients aids clinical differentiation and management in CES. METHODS: A retrospective electronic note review was undertaken of patients presenting with suspected CES, defined as ≥ 1 of acute bladder, bowel, sexual dysfunction or saddle numbness, to a regional neurosciences centre...
October 8, 2018: Journal of Neurology
I A Meka, U C Dilibe, M C Ugonabo, U U Ogbobe
Introduction: Urolithiasis is a global disease condition secondary to a variety of factors, and sometimes associated with serious complications. Determination of stone composition is important in delineating causative factors. Knowledge of causative and precipitating factors aids patient management and prevention of recurrence. Objective: The authors' aim was to evaluate the practice and perspective of doctors regarding chemical analysis of stones in management of urolithiasis...
October 2018: Nigerian Journal of Clinical Practice
Bassel Nazha, Bhavi Pandya, Alex C Spyropoulos, Craig M Kessler
Venous thromboembolism (VTE) is a leading cause of morbidity with potentially detrimental career consequences in elite athletes. Their unique predisposing factors entail a higher-than-expected VTE incidence. Anticoagulation treatment is challenging, especially among those athletes wishing to resume their competitive activities. The authors review the current VTE treatment guidelines from the perspective of treating elite athletes. They then provide an expert opinion individualized treatment approach based on the pharmacokinetic properties of direct oral anticoagulants that permits tailoring the drug's timing to the athlete's competitive endeavors...
October 8, 2018: Seminars in Thrombosis and Hemostasis
Juan A A Luna, Roland S Moore, Daniel J Calac, Joel W Grube, Richard P McGaffigan
OBJECTIVES: This exploratory study examined pain management practices among American Indians and Alaska Natives in the service area of a rural tribal clinic in Southern California. METHODS: Researchers invited 325 individuals to complete an anonymous survey in clinic waiting rooms and tribal gatherings. Analyses of the 295 eligible responses included calculating frequencies and conducting multiple logistic regressions and a Mantel-Haenszel analysis. RESULTS: Among respondents in this study, being male, younger, and having less education were strong predictors for riskier methods for managing pain...
October 4, 2018: Journal of Rural Health
S Keoghane, T Austin, J Coode-Bate, S Deverill, T Drake, J Sanpera-Iglesias, T Johnston
INTRODUCTION: The diagnostic and management pathways for patients presenting with acute flank pain are complex. Although computed tomography (CT) of the kidneys, ureters and bladder (KUB) is the gold standard investigation for urolithiasis, the multitude of differential diagnoses must also be considered in the context of long-term risk from ionising radiation. This study investigated the integrated role and diagnostic yield of non-contrast CT in cases of acute flank pain. METHODS: A retrospective cohort study was undertaken of 1,442 consecutive patients investigated with CT KUB between March 2013 and February 2015...
October 5, 2018: Annals of the Royal College of Surgeons of England
Tae Jin Kim, In Jae Lee, Jung Keun Lee, Hak Min Lee, Chang Wook Jeong, Sung Kyu Hong, Seok-Soo Byun, Jong Jin Oh
PURPOSE: To investigate the factors associated with hospital readmission (HR) after retrograde intrarenal surgery (RIRS) among renal stone patients. METHODS: The study included patients who underwent RIRS from June 2011 to December 2017. Patients who were readmitted due to surgery-related complications were evaluated retrospectively. Patient demographics including age, medical comorbidity, body mass indices, ASA score, perioperative parameters and stone factors were compared with total cohorts...
October 3, 2018: World Journal of Urology
Abhishek G Singh, Ankush Jairath, S B Sudharshan, Gopal Tak, Arvind P Ganpule, Mohankumar Vijayakumar, Ravindra B Sabnis, Mahesh R Desai
OBJECTIVES: To present single center experience of urolithiasis management in anomalous kidneys, highlighting the need for algorithm-based approach in deciding the modality to be used in treatment planning. PATIENTS AND METHODS: We retrospectively reviewed data of all the patients who presented to our anomalous renal unit with urolithiasis from January 1990 to July 2014. Perioperative features of all the patients along with management was studied. RESULTS: Percutaneous nephrolithotomy (PCNL) was the most common surgical modality used followed by flexible ureteroscopy...
October 3, 2018: BJU International
Olayinka R Ibrahim, Abubakar S Lugga, Nuraddeen Ibrahim, Lawal M Ibrahim, Bello M Suleiman
Background: Despite a high prevalence of iron-deficiency anemia (IDA) in developing countries such as Nigeria, intestinal obstruction secondary to lithobezoar (an accumulation of ingested stones within the gastrointestinal tract) is uncommon. Case presentation: Herein, we report a case of acute intestinal obstruction secondary to ingestion of large pebbles and IDA in a 5-year-old Nigerian boy. The patient was managed conservatively with the use of laxatives and a rectal wash-out, and the pebbles were excreted over 3 days...
2018: International Medical Case Reports Journal
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