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Stone management

Alexander Heinze, Ali S Gozen, Jens Rassweiler
PURPOSE OF REVIEW: To provide a summary of surgical outcomes in percutaneous nephrolithotomy (PCNL) according to various techniques and tract sizes. RECENT FINDINGS: Recent literature in this field concluded that standard PCNL (sPCNL) remains the optimal treatment for stones between 1 and 2.5 cm and can be managed with tracts 14-20 F, whereas small stones less than 1.5 cm can be treated with tracts under 14 F. According to new datasets, smaller tracts can be equally effective in the treatment and might offer the possibility to reduce bleeding, length of hospital stay, postoperative pain as well as overall complication rates when compared with sPCNL...
November 30, 2018: Current Opinion in Urology
Yong Zhou, Wen-Zhang Zha, Ren-Gen Fan, Guo-Qin Jiang, Xu-Dong Wu
BACKGROUND: there is an increasing incidence rate of cholecysto-choledocholithiasis associated with the increasing proportion of senile individuals. METHODS: a total of 100 elderly patients (over 80 years of age) suffering both from cholelithiasis and choledocholithiasis were retrospectively studied from January 2010 to December 2016. Patients were scheduled for either a single-stage or two-stage procedure. The LCBDE group (n = 54) included cases that underwent a single stage procedure of laparoscopic exploration of the common bile duct combined with cholecystectomy...
December 3, 2018: Revista Española de Enfermedades Digestivas
Kunj R Sheth, Jeffrey T White, Andre F Perez-Orozco, Natalie D Debolske, Christopher R Hyde, Christine Geistkemper, David R Roth, Paul F Austin, Edmond T Gonzales, Nicolette K Janzen, Duong D Tu, Angela G Mittal, Chester J Koh, Sheila L Ryan, Carolina Jorgez, Abhishek Seth
Objective: While small non-obstructive stones in the adult population are usually observed with minimal follow-up, the same guidelines for management in the pediatric population have not been well-studied. We evaluate the clinical outcomes of small non-obstructing kidney stones in the pediatric population to better define the natural history of the disease. Methods: In this IRB-approved retrospective study, patients with a diagnosis of kidney stones from January 2011 to March 2017 were identified using ICD9 and ICD10 codes...
2018: Frontiers in Pediatrics
Sheila Krishnan, Christopher M Kniese, Mark Mankins, Darel E Heitkamp, Francis D Sheski, Kenneth A Kesler
Broncholithiasis is a condition in which calcified material has entered the tracheobronchial tree, at times causing airway obstruction and inflammation. Broncholiths generally originate as calcified material in mediastinal lymph nodes that subsequently erode into adjacent airways, often as a result of prior granulomatous infection. Disease manifestations range from asymptomatic stones in the airway to life-threatening complications, including massive hemoptysis and post-obstructive pneumonia. Radiographic imaging, particularly computed tomography scanning of the chest, is integral in the evaluation of suspected broncholithiasis and can be helpful to assess involvement of adjacent structures, including vasculature, prior to any planned intervention...
October 2018: Journal of Thoracic Disease
Timothy Platt, Kristy Smith, Martha Nixon, Surajit Sinha, Gandrapu Srinivas, Stuart Andrews
Background: Laparoscopic common bile duct exploration (LCBDE) is gaining popularity over endoscopic retrograde cholangiopancreatography (ERCP) for the management of common bile duct stones. However, its application has been almost exclusively following preoperative stone confirmation via magnetic retrograde cholangiopancreatography (MRCP), endoscopic ultrasound (EUS) or ERCP. We present our series of LCBDE following detection of common bile duct stones with intraoperative imaging (IOI) alone, in consecutive elective and emergency patients with suspected choledocholithiasis...
December 2018: Annals of Medicine and Surgery
Bryce A Basques, Brian R Waterman, Gift Ukwuani, Edward C Beck, William H Neal, Nicole A Friel, Austin V Stone, Shane J Nho
BACKGROUND: Prolonged disease chronicity has been implicated as a cause of suboptimal clinical outcomes after hip arthroscopy for femoroacetabular impingement syndrome (FAIS), possibly due to disease progression, deconditioning, and the development of compensatory pathomechanics. PURPOSE: To evaluate the effect of increasing duration of preoperative symptoms on patient-reported outcomes, reoperation, and clinical failure of hip arthroscopy for FAIS. STUDY DESIGN: Cohort study; Level of evidence, 3...
November 28, 2018: American Journal of Sports Medicine
Mehrdad Mohammadi, Amin Shohani, Hatef Khorami, Kia Nouri Mahdavi, Mohammad Hossein IzadPanahi, Farshid Alizadeh, Mohammad Azizi
BACKGROUND: Cystinuria as an autosomal recessive sickness is a relatively rare disease. Formation of cystine stones indicates cystinuria. Few studies are considered the cysteine crystal volume in management of cystinuria. Selenium may inhibit organization of crystal stone, growth and stone aggregation. Since the role of selenium on inhibition of cystine crystal formation is not known, the aim of this study was to evaluate the effect of selenium supplementation on cystine crystals volume in patients with cystinuria...
December 2018: BioMedicine
Adeodatus Yuda Handaya, Nova Yuli Prasetyo Budi, Aditya Rifqi Fauzi
INTRODUCTION: Multiple and large pancreatic duct stones concomitant with primary choledochal stones is a rare case. Patients usually present with recurrent jaundice and signs of pancreatitis. Endoscopic retrograde cholangiopancreatography (ERCP) is the leading method to manage the patients. But ERCP has difficulties when facing the multiple and large stones PRESENTATION OF CASE: Our first case was a 51-years-old man who was admitted to our surgery unit with a diagnosis of chronic pancreatitis...
November 12, 2018: International Journal of Surgery Case Reports
Leah E Beland, Mark A Henry, Tania Solomon, Kenneth Ogan
Diaphragmatic herniations of the ureter are a rare occurrence overall, with fewer than 10 cases reported. Obstructing nephrolithiasis in the setting of diaphragmatic ureteral herniation has sparsely been documented. Management options to consider include ureteroscopy and laser lithotripsy to alleviate obstruction in herniated ureters. The abnormal path of the ureter and surrounding structures pose unique risks that require careful attention and a high level of operator skill. We present imaging of an 84-year-old woman incidentally found to have right ureteral herniation through the diaphragm with an obstructing 8 mm stone in the right proximal ureter with moderate hydronephrosis...
November 22, 2018: Urology
Erika J Espinosa-Ortiz, Brian H Eisner, Dirk Lange, Robin Gerlach
Infection stones are complex aggregates of crystals amalgamated in an organic matrix that are strictly associated with urinary tract infections. The management of patients who form infection stones is challenging owing to the complexity of the calculi and high recurrence rates. The formation of infection stones is a multifactorial process that can be driven by urine chemistry, the urine microenvironment, the presence of modulator substances in urine, associations with bacteria, and the development of biofilms...
November 23, 2018: Nature Reviews. Urology
Zheng Jin, Yaping Wei, Xiaowei Tang, Sisi Shen, Jing Yang, Hangbin Jin, Xiaofeng Zhang
OBJECTIVES: Current evidence supporting the utility of single-operator peroral cholangioscope (SOPOC) in the management of difficult bile duct stones is limited. We conducted the present systematic review and meta-analysis to evaluate the efficacy and safety of SOPOC in treating difficult bile duct stones. METHODS: We searched studies up to April 2018, using MEDLINE, EMBASE, the Cochrane Library, and Google Scholar. Quality assessment of the studies was completed with the Newcastle-Ottawa Scale...
November 23, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Phillip R Chisholm, Arpan H Patel, Ryan J Law, Allison R Schulman, Arti O Bedi, Richard S Kwon, Erik J Wamsteker, Michelle A Anderson, Grace H Elta, Shail M Govani, Anoop Prabhu
BACKGROUND AND AIMS: Markedly elevated liver chemistries in patients presenting with acute calculous cholecystitis (AC) often prompt an evaluation for concomitant choledocholithiasis (CDL). However, current guidelines directing the workup for CDL fail to address this unique population. The aims of this study are to define the range of presenting lab values and imaging findings in AC, develop a model to predict the presence of concurrent CDL, and develop a management algorithm that can be easily applied on presentation...
November 19, 2018: Gastrointestinal Endoscopy
Sidra Zafar, Syed Usman Bin Mahmood, Arsal Tharwani, Noreen Nasir
Extracorporeal shock wave lithotripsy (ESWL) is among the most widely used modalities for treatment of urolithiasis since its introduction in the 1980s. The non-invasive technique reduces the risk of post-procedure complications and produces excellent stone free rates. However, complications may still follow and albeit rare, there are reports in literature of abscess formation post ESWL. Herein, we report the case of a young, immunocompetent gentleman who developed bilateral psoas abscess after undergoing this procedure...
July 2018: Journal of Ayub Medical College, Abbottabad: JAMC
Laura Hope-Stone, Janice Ablett, Peter Salmon
We appraise the role of screening for distress as part of health psychology assessment of patients newly diagnosed with cancer. We reviewed records of consecutive patients who accepted a health psychologist's assessment over 4 years, examining convergence and divergence of the result of screening (whether patients reached threshold as 'cases') with the psychologist's clinical judgment of need for intervention. Of 261 patients, 88 (33.7%) were 'cases'. Of these, need for psychological intervention was identified in 70 (79...
November 21, 2018: Journal of Clinical Psychology in Medical Settings
Alberto A Perez, David F Schneider, Kristin L Long, Susan C Pitt, Rebecca S Sippel
BACKGROUND: Nephrolithiasis is a classic, treatable manifestation of primary hyperparathyroidism (PHPT). We examined predictors of kidney stone formation in PHPT patients and determined how efficiently the diagnosis of PHPT is made in patients whose initial presentation is with stones. MATERIALS AND METHODS: We performed a retrospective analysis of surgically treated PHPT patients, comparing 247 patients who were kidney stone formers and 1047 patients with no kidney stones...
December 2018: Journal of Surgical Research
Fay Hill, John A Sayer
Here we define precision medicine approaches and discuss how these may be applied to renal stone-formers to optimise diagnosis and a management. Using the gene discovery of monogenic stone disorders as examples, we discuss the benefits of personalising therapies for renal stone-formers to provide improved prevention and treatment of these disorders.
November 20, 2018: Urolithiasis
Scott Vincent Wiener, Marshall Stoller, John Boscardin, Anne Suskind
Purpose To explore regional adoption of URS over SWL in the state of California (CA) and to identify factors associated with this adoption over time. Materials and Methods We used the California Office of Statewide Health Planning and Development (OSHPD) public data to identify URS and SWL procedures performed for renal and ureteral stones from 2005-2016. The level of analysis was the region wherein each procedure was performed, defined by the 19 California labor market regions. OSHPD data were supplemented with the Area Health Resource File to provide information on regional characteristics...
November 20, 2018: Journal of Endourology
Udaya Man Singh Dongol, Sandeep Bohora
BACKGROUND: Urolithiasis is a worldwide problem  due to its high prevalence and  recurrence. Percutaneous nephrolithotomy is a minimally invasive surgical option for the treatment of large renal stone burden greater than 20mm, staghorn calculi and lower pole calyceal stone greater than 10 mm. The objective of this study was to evaluate the safety and  efficacy of percutaneous nephrolithotomy in the management of lower pole calyceal stones. METHODS: Seventy  patients who presented in between June 2013 and September 2017 with  lower pole calyceal stones and lower calyceal stones with pelvic extension  were included in the study...
October 30, 2018: Journal of Nepal Health Research Council
Melissa Hobbs, Nicola J Kalk, Paul D Morrison, James M Stone
Synthetic cannabinoid receptor agonists (SCRAs) are suggested to have increased potential to induce psychosis compared to natural cannabis (NC). In this review we synthesise current knowledge about the association of SCRA use with psychotic symptoms. Following a literature search we identified 2 toxicology reports, 4 case-control studies, 3 cross-sectional studies and 15 case reports. In each of the case reports, we identified the presence or absence of symptoms based on the items of the Postitive and Negative Syndrome Scele (PANSS)...
November 16, 2018: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
René Rizzoli
Osteoporosis increases the risk of fractures, which are associated with increased mortality and lower quality of life. Patients with prevalent fracture are at high risk to of sustaining another one. Optimal protein and calcium intakes, and vitamin D supplies, together with regular weight bearing physical exercise are the corner stones of fracture prevention. Evidence for anti-fracture efficacy of pharmacological interventions relies on results from randomised controlled trials in postmenopausal women with fractures as the primary outcome...
October 2018: Best Practice & Research. Clinical Endocrinology & Metabolism
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