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urology and Transplantation

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https://www.readbyqxmd.com/read/28444291/pasteurella-aerogenes-as-an-asymptomatic-bacteriuria-agent
#1
Demet Alaygut, Aynur Engin
'Asymptomatic bacteriuria' (ASB) is isolation of a specified quantitative count of bacteria in an appropriately collected urine specimen obtained from a person without symptoms or signs referable to urinary infection. Catheterized specimens are less likely to be contaminated compared with voided specimens; therefore, positive cultures of catheterized specimens are more likely to reflect true bladder bacteriuria even with low colony counts. The common pathogens for ASB are Escherichia coli, Klebsiella and Streptococcus spp...
April 21, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28366942/renal-and-cardiac-assessment-of-living-kidney-donor-candidates
#2
REVIEW
Ngan N Lam, Krista L Lentine, Amit X Garg
Living kidney donation provides the best therapeutic outcomes for eligible patients with end-stage renal disease. To ensure suitability for living kidney donation, donor candidates undergo a thorough medical, surgical, and psychosocial evaluation by a multidisciplinary transplant assessment team. Numerous guidelines are available to assist clinicians in the process of donor evaluation and selection. These guidelines outline the minimum recommended requirements for donor screening and additional tests that are indicated when abnormalities arise; however, evidence suggests that some of these additional tests might not be required in certain donor candidates...
April 3, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28340826/optimal-timing-for-removal-of-the-double-j-stent-after-kidney-transplantation
#3
Y Yuksel, S Tekin, D Yuksel, I Duman, M Sarier, L Yucetin, K Kiraz, M Demirbas, A Kaya Furkan, M Aslan Sezer, A Demirbas, Y H Asuman
BACKGROUND: Urologic complications (UC) have gradually decreased in recent years after advanced surgical experience. The incidence of urologic complications varies between 0.22% and 30% in different medical studies. There is no routine usage of double-J stenting (DJS) during renal transplantation (RT) in the literature. It is a necessity, and optimal timing for stent removal is an important question for many transplantation centers. METHODS: This study includes 818 renal transplant patients whose ureteroneocystostomy anastomoses were completed by use of the Lich-Gregorie procedure during a 2-year period at a transplantation center...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340825/should-interventional-radiology-or-open-surgery-be-the-first-choice-for-the-management-of-ureteric-stenosis-after-transplantation-dual-center-study
#4
C Simsek, S M Dogan, T Piskin, G Okut, K Cayhan, A Aykas, E Tatar, A Uslu
BACKGROUND: Ureteric stenosis (US) is the most common urologic complication after kidney transplantation. In this dual-center retrospective study we compared the efficacy and safety of open surgery versus interventional radiology for the management of US. METHODS: From 2009 to January 2016, US was treated by surgical revision in 22 (7.8%) out of 281 recipients at one center (group 1) and managed by percutaneous nephrostomy with antegrade nephroureteral stenting (PNAS) in 22 (14...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28337568/hospital-microbial-surface-colonization-revealed-during-monitoring-of-klebsiella-spp-pseudomonas-aeruginosa-and-non-tuberculous-mycobacteria
#5
Pedro Geadas Farias, Fernando Gama, Diogo Reis, Susana Alarico, Nuno Empadinhas, José Carlos Martins, Ana Figueiredo de Almeida, Paula Vasconcelos Morais
Hospital environmental conditions, human occupancy, and the characteristics of the equipment influence the survival of microbial communities and raise a concern with regard to nosocomial infections. The objective of the present work was to use the monitoring of Pseudomonas aeruginosa, Klebsiella spp. and non-tuberculous mycobacteria as a strategy to improve knowledge on microbial colonization of non-critical equipment and surfaces, in a tertiary hospital from Central Portugal. A 3-month microbiological survey was performed in a district teaching hospital...
March 23, 2017: Antonie Van Leeuwenhoek
https://www.readbyqxmd.com/read/28302440/kidney-allograft-pyelonephritis-caused-by-salmonella-enterica-serovar-schwarzengrund
#6
Kenta Ito, Haruomi Nishio, Yuji Iwatani, Ryo Yamada, Takao Okawa, Takumi Yamamoto, Masaaki Murakami, Yoko Matsuo, Ken Matsuo, Satoshi Tanaka, Kiyoshi Mori, Noriko Mori
Kidney transplant recipients (KTRs) taking immunosuppressive drugs have a 20-fold greater risk of nontyphoidal Salmonella (NTS) infection than the healthy adult population. Among KTRs, the urinary tract is the most common site of infection. However, few cases of urinary tract infection caused by NTS have been documented in KTRs, and only one in Japan. Furthermore, it frequently induces acute allograft rejection with high mortality. Salmonella enterica subsp. enterica serovar Schwarzengrund (S. Schwarzengrund) is now among the more common Salmonella serovars isolated in Japan and is likely to be invasive...
March 13, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28292360/acute-on-chronic-liver-failure-causes-clinical-characteristics-and-predictors-of-mortality
#7
Abbas Ali Tasneem, Nasir Hassan Luck
OBJECTIVE: To determine the causes, characteristics and predictors of mortality in patients with acute-on-chronic liver failure (ACLF). STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, from July 2014 to June 2016. METHODOLOGY: All patients with acute-on-chronic liver disease (ACLD) with ages > 12 were included...
January 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28284738/procedure-specific-risks-of-thrombosis-and-bleeding-in-urological-non-cancer-surgery-systematic-review-and-meta-analysis
#8
REVIEW
Kari A O Tikkinen, Samantha Craigie, Arnav Agarwal, Reed A C Siemieniuk, Rufus Cartwright, Philippe D Violette, Giacomo Novara, Richard Naspro, Chika Agbassi, Bassel Ali, Maha Imam, Nofisat Ismaila, Denise Kam, Michael K Gould, Per Morten Sandset, Gordon H Guyatt
CONTEXT: Pharmacological thromboprophylaxis involves a trade-off between a reduction in venous thromboembolism (VTE) and increased bleeding. No guidance specific for procedure and patient factors exists in urology. OBJECTIVE: To inform estimates of absolute risk of symptomatic VTE and bleeding requiring reoperation in urological non-cancer surgery. EVIDENCE ACQUISITION: We searched for contemporary observational studies and estimated the risk of symptomatic VTE or bleeding requiring reoperation in the 4 wk after urological surgery...
March 8, 2017: European Urology
https://www.readbyqxmd.com/read/28260480/living-donor-liver-transplant-follow-up-a-singlecenter-experience
#9
Syed Mudassir Laeeq, Farina M Hanif, Nasir Hassan Luck, Rajesh Kumar Mandhwani, Jawed Iqbal, Syed Haider Mehdi
OBJECTIVES: Liver transplant is a definite treatment of decompensated liver disease. Because of the shortage of livers from deceased donors, living-donor liver transplant is becoming more common. Here, we analyzed our clinical experience in the follow-up care of these patients. MATERIALS AND METHODS: Liver transplant recipients seen at the Sindh Institute of Urology and Transplantation (Karachi, Pakistan) were included in this analysis. Baseline characteristics and follow-up events were recorded...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260444/pediatric-kidney-transplant-experience-at-an-algerian-nephrology-department
#10
Ali Benziane, Saliha Boutennoune
OBJECTIVES: To evaluate the outcomes, complications, causes of graft loss, and patient and graft survival in pediatric renal transplant. MATERIALS AND METHODS: We conducted a retrospective study using the records of 32 children who had a renal transplant between February 2007 and October 2014. RESULTS: All donations were intrafamily, and all patients had a living donor: the patient's mother in 56.3%, the father in 40.6%, and a brother in 3...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260439/kidney-swap-in-pakistan-experience-at-the-sindh-institute-of-urology-and-transplantation
#11
Naveeda Nizam, Farida Mazhar, Khawar Abbas, Tahir Aziz, Mirza Naqir Zafar, Rehan Mohsin, Bux Ali, Asad Shahzad, Mohammed Imran, Syed Adibul Hasan Rizvi
Kidney paired exchange is an established method of overcoming incompatibility in donor-recipient pairs and expanding the living-donor pool. It is infrequently performed in developing countries. We report the first kidney paired exchange in Pakistan, successfully performed at our center. One donor-recipient pair consisted of a 38-year-old female recipient (blood type, B positive) and her 40-year-old husband (A positive) as the potential donor. The second pair consisted of a 30-year-old male recipient (A positive) and his 30-year-old wife (B positive) as the potential donor...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260431/problems-associated-with-access-to-renal-replacement-therapy-experience-of-the-sindh-institute-of-urology-and-transplantation
#12
Farida Mazhar, Naveeda Nizam, Nazia Fatima, Sana Siraj, Syed Adibul Hasan Rizvi
OBJECTIVES: The prevalence of end-stage renal disease is increasing worldwide. It is also one of the main health problems in Pakistan. Currently, hemodialysis represents the main mode of treatment for patients with end-stage renal disease in this country. Despite 24-hour free dialysis at the Sindh Institute of Urology and Transplantation (Karachi, Pakistan), a significant number of patients do not turn up for regular dialysis or miss regular sessions of dialysis. We conducted this study to identify and highlight the factors leading to poor compliance with regular hemodialysis treatment despite free dialysis treatment offered at our center...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260430/anesthetic-and-perioperative-management-of-nontransplant-surgery-in-patients-after-liver-transplant
#13
Zeynep Ersoy, Asude Ayhan, Aycan Ozdemirkan, Gulsi Gulsah Polat, Pinar Zeyneloglu, Gulnaz Arslan, Mehmet Haberal
OBJECTIVES: We aimed to document the anesthetic management and metabolic, hemodynamic, and clinical outcomes of liver-graft recipients who subsequently undergo nontransplant surgical procedures. MATERIALS AND METHODS: We retrospectively analyzed the data of 96 liver-graft recipients who underwent 144 nontransplant surgeries between October 1998 and April 2016 at Başkent University Hospital. RESULTS: The median patient age at the time of nontransplant surgery was 32 years, and 35% were female (n = 33)...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260426/borderline-changes-on-dysfunctional-renal-allograft-biopsies-clinical-relevance-in-a-living-related-renal-transplant-setting
#14
Muhammed Mubarak, Shaheera Shakeel, Khawar Abbas, Tahir Aziz, Mirza Naqi Zafar, Syed Anwer Naqvi, Syed Adibul Hasan Rizvi
OBJECTIVES: Our aim was to determine the clinical significance of borderline lymphocytic infiltrates on indicated renal allograft biopsies in a living related renal transplant setting. MATERIALS AND METHODS: The study was conducted at the histopathology department of Sindh Institute of Urology and Transplantation. A retrospective review of 421 renal transplant patients was conducted from October 2007 to September 2008 to identify patients in whom a histologic diagnosis of borderline changes was made on dysfunctional renal allograft biopsies...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28254584/outcomes-and-risk-factors-for-graft-loss-lessons-learned-from-1-056-pediatric-kidney-transplants-at-the-university-of-minnesota
#15
Srinath Chinnakotla, Priya Verghese, Blanche Chavers, Michelle N Rheault, Varvara Kirchner, Ty Dunn, Clifford Kashtan, Thomas Nevins, Michael Mauer, Timothy Pruett
BACKGROUND: Advances in immunosuppression, surgical techniques, and management of infections in children receiving kidney transplants have impacted outcomes. STUDY DESIGN: We analyzed a prospectively maintained database of pediatric kidney transplants. RESULTS: From June 1963 through October 2016, we performed 1,056 pediatric kidney transplants. Of these 129 were < 2 years old. The most common indications for transplant were congenital anomalies (dysplastic kidneys), obstructive uropathy and congenital nephrotic syndrome...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28237495/prostate-cancer-before-renal-transplantation-a-multicentre-study
#16
C Chahwan, A Doerfler, N Brichart, S Bouyé, T Culty, C Iselin, C Pfister, F Sallusto, L Salomon, G Verhoest, L Viart, X Tillou
INTRODUCTION: The surgical issues of renal transplantation (RT) after localized prostate cancer (PC) treatment and oncological outcomes after transplantation in patients on the waiting list with a history of PC were unknown. We conducted a retrospective multicentre study including all patients with PC diagnosed before the kidney transplantation. METHODS: Fifty-two patients were included from December 1993 to December 2015. The median age at diagnosis of PC was 59...
March 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28229802/renal-transplant-in-patients-with-abnormal-bladder-impact-of-causes-on-graft-function-and-survival
#17
Baher M Salman, Ahmed I Hassan, Sultan M Sultan, Paul R Tophill, Ahmed M Halawa
OBJECTIVES: Successful kidney transplant depends partly on the normal physiologic functioning of the bladder, which involves effective urine storage and emptying. The bladder may become abnormal owing to various urologic and neuropathic disorders. Patients with abnormal bladders need careful management before and after transplant. In this study, we aimed to determine the outcomes of renal transplants in relation to various causes of abnormal bladder. MATERIALS AND METHODS: We conducted a retrospective review of 25 patients with abnormal bladder who received 30 renal transplants between 1990 and 2014...
February 23, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28219588/early-removal-of-double-j-stents-decreases-urinary-tract-infections-in-living-donor-renal-transplantation-a-prospective-randomized-clinical-trial
#18
S Liu, G Luo, B Sun, J Lu, Q Zu, S Yang, X Zhang, J Dong
BACKGROUND: The optimal timing for stent removal after renal transplantation remains controversial. This article describes an interim analysis of a randomized, prospective, double-blind trial aimed at detecting differences in urological complications between early ureteral stent removal at 1 week and routine ureteral stent removal at 4 weeks. METHODS: Between October 2010 and March 2015, 103 patients who underwent living donor renal transplantation at a single center were pre-operatively randomly assigned to the early ureteral stent removal (at 1 week) group or the routine ureteral stent removal (at 4 weeks) group...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28216945/ex-vivo-partial-nephrectomy-after-living-donor-nephrectomy-surgical-technique-for-expanding-kidney-donor-pool
#19
Yaw A Nyame, Paurush Babbar, Ahmed A Aboumohamed, Ryan L Mori, Stuart M Flechner, Charles S Modlin
Renal transplantation has profound improvements in mortality, morbidity, and overall quality of life compared to renal replacement therapy. This report aims to illustrate the use of ex-vivo partial nephrectomy in a patient with a renal angiomyolipoma prior to living donor transplantation. The surgical outcomes of the donor nephrectomy and recipient transplantation are reported with 2 years of follow-up. Both the donor and recipient are healthy and without any significant comorbidities. In conclusion, urologic techniques such as partial nephrectomy can be used to expand the living donor pool in carefully selected and well informed transplant recipients...
January 2017: Urology Annals
https://www.readbyqxmd.com/read/28188678/prophylactic-ureteric-stents-in-renal-transplant-recipients-a-multicentre-randomised-controlled-trial-of-early-versus-late-removal
#20
Pareeta Patel, Irene Rebollo-Mesa, Elizabeth Ryan, Manish D Sinha, Stephen D Marks, Neal Banga, Iain C Macdougall, Michelle C Webb, Geoff Koffman, Jonathon Olsburgh
Prophylactic ureteric stenting in renal transplantation reduces major urological complications (MUCs). There is however morbidity related to the indwelling duration of a stent, we aimed to determine the optimal duration for stents in this clinical setting. Patients (aged 2-75 years) from 6 UK hospitals undergoing renal transplantation were recruited and randomly assigned, to either early stent removal at 5 days (without cystoscopy) or late at 6 weeks post-transplantation (with cystoscopy). The primary outcome was a composite of stent-related complications defined as pain, visible haematuria, migration, fragmentation, and urinary tract infections (UTIs) within 3 months of transplantation...
February 11, 2017: American Journal of Transplantation
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