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[PMID]: 24630841
[Au] Autor:Pérez-Fentes D; Blanco-Gómez B; García-Freire C
[Ad] Address:Servicio de Urología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España. Electronic address: danielfentes@gmail.com.
[Ti] Title:Micropercutaneous nephrolithotomy. A new therapeutic option for pediatric renal lithiasis.
[So] Source:Actas Urol Esp;38(7):483-7, 2014 Sep.
[Is] ISSN:1699-7980
[Cp] Country of publication:Spain
[La] Language:eng; spa
[Ab] Abstract:INTRODUCTION: Micropercutaneous nephrolithotomy is an evolution from the conventional percutaneous surgery in which pyelocaliceal access is obtained through minimum bore holes. Its objective is the complete removal of the calculi, lowering the morbidity associated with larger bore percutaneous tracts. MATERIAL AND METHODS: We present the case of a micropercutaneous nephrolithotomy performed in a 14-year-old female patient with a 35 mm diameter kidney stone located in the renal pelvis. Surgery was performed in the Galdakao-modified supine Valdivia position. Puncture was done under ultrasound and fluoroscopic guidance. The 4.85 Ch needle of the Microperc(®) set was used, completing the procedure through the 8 Ch working shaft. Lasertripsy was done with the Ho:YAG laser. An indwelling double J stent was placed at the end of the procedure. RESULTS: Operating time was 170 minutes. Hospital stay was one day. She suffered renal colic after 72 hours, which was resolved with oral analgesic treatment at home (Clavien I). She returned to school on the fifth postoperative day. The double J was removed at 2 weeks. At one month of the surgery, the patient is asymptomatic, a 4mm lower calyx residual stone being observed in the abdominal ultrasound. CONCLUSION: Micropercutaneous nephrolithotomy is a step forward towards the search for a less invasive kidney stone treatment. It is a safe and effective technique in the pediatric population, and it can be performed in the supine position, even in orthotropic kidneys. Future studies and collaborative works will help to better define its indications, to optimize its technique and to analyze its cost-effectiveness compared with other treatment options.
[Mh] MeSH terms primary: Kidney Calculi/therapy
Lithiasis/therapy
Nephrostomy, Percutaneous/methods
[Mh] MeSH terms secundary: Adolescent
Female
Humans
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1607
[Js] Journal subset:IM
[Da] Date of entry for processing:140826
[St] Status:MEDLINE

  2 / 6162 MEDLINE  
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[PMID]: 27358103
[Au] Autor:Dagang DJ; Gutierrez JB; Sandoval MA; Lantion-Ang FL
[Ad] Address:Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines....
[Ti] Title:Multiple brown tumours from parathyroid carcinoma.
[So] Source:BMJ Case Rep;2016, 2016.
[Is] ISSN:1757-790X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:We report a case of a 29-year-old woman who suffered from severe bilateral inguinal pain and left mandibular mass. CT scan showed innumerable expansile osteolytic bone masses on the iliac wings, femur, ribs and vertebral bodies, diffuse skeletal osteopaenia, calyceal lithiasis on the right kidney and a left thyroid mass. Ionised calcium and intact parathyroid hormone (PTH) were elevated. Parathyroid sestamibi scan showed a hyperfunctioning left inferior parathyroid gland. Biopsy of the left mandibular mass was consistent with brown tumour. The patient underwent parathyroidectomy of the enlarged parathyroid gland. Final histopathology, however, revealed parathyroid carcinoma, 4.7 cm in widest dimension, with capsular and vascular space invasion. The patient underwent repeat surgery, specifically, left thyroid lobectomy, isthmectomy and central node dissection. Intact PTH decreased from 681.3 to 74 pg/mL (normal range: 10-65) 24 hours postoperatively. Follow-up at 6 months showed normal serum calcium levels, size reduction of bone lesions and improvement of quality of life.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1606
[Js] Journal subset:IM
[St] Status:In-Data-Review

  3 / 6162 MEDLINE  
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[PMID]: 26859276
[Au] Autor:Silva MA; Key S; Han E; Malloy MJ
[Ad] Address:From the Department of Pharmacy Practice, MCPHS University, Worcester, MA.
[Ti] Title:Acute Pancreatitis Associated With Antipsychotic Medication: Evaluation of Clinical Features, Treatment, and Polypharmacy in a Series of Cases.
[So] Source:J Clin Psychopharmacol;36(2):169-72, 2016 Apr.
[Is] ISSN:1533-712X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Antipsychotic-associated acute pancreatitis presents like pancreatitis from other causes, requiring clinical judgment, tests, and decision support to establish the diagnosis. Many new cases of atypical antipsychotic pancreatitis have been established, and current decision supports are out of date as antipsychotic polypharmacy is being recognized. Given the population frequency of psychosis and frequency of antipsychotic prescribing, we reviewed published cases summarizing common clinical findings and antipsychotics associated with acute pancreatitis to updating earlier decision support. METHODS: Case reports of antipsychotic pancreatitis from 1990 to 2015 were reviewed and abstracted by independent reviewers. Demographic, clinical features, management, and Naranjo and probability scores were abstracted and reviewed for associations. Appropriate statistical tests were selected for normally and non-normally distributed data. RESULTS: We summarized 41 cases of acute pancreatitis associated with antipsychotics, and cases were younger men (59%) (mean age, 39 years). Alcohol, diabetes, and previous lithiasis appeared in 27%; polypharmacy was associated with 53% of cases, and 80% had concomitant use of other medication linked to pancreatitis.The median lipase, amylase, and alkaline phosphate during acute presentation were 1210 IU/L (range, 243-5482 IU/L), 492 IU/L (range, 3-2916 IU/L), and 152 IU/L (range, 119-367 IU/L), respectively. Median exposure to antipsychotics were 49 days (range, 5-3,650 days); most were mild (63%, n = 26), several severe (27%, n = 11), and few fatal (10%, n = 4). DISCUSSION: We identified 41 reports of antipsychotic-related acute pancreatitis, many associated with antipsychotic polypharmacy. Olanzapine, risperidone, quetiapine, aripiprazole, and ziprasidone are associated with acute pancreatitis and often in combination with mood stabilizers.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1603
[Js] Journal subset:IM
[St] Status:In-Process
[do] DOI:10.1097/JCP.0000000000000459

  4 / 6162 MEDLINE  
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[PMID]: 26230750
[Au] Autor:Soria F; Morcillo E; Serrano A; Cansino R; Rioja J; Fernandez I; de la Cruz J; Van Cleynenbreugel B; Sanchez-Margallo FM
[Ad] Address:1 Department of Endourology-Endoscopy, Minimally Invasive Surgery Centre Jesús Usón , Cáceres, Spain ....
[Ti] Title:Development and Validation of a Novel Skills Training Model for Retrograde Intrarenal Surgery.
[So] Source:J Endourol;29(11):1276-81, 2015 Nov.
[Is] ISSN:1557-900X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: The aim of this study is to validate a training model that combines the use of nonbiologic and biologic simulators as well as live porcine animal model in endoscopic retrograde intrarenal surgery (RIRS). MATERIALS AND METHODS: A total of 60 urologists took part in this study, and the activity lasted for 2 days. The training model was divided into three modules: Module-I, related to the acquisition of basic theoretical knowledge; Module-II, consisting of an internship with bench models; and Module III, in which animal models were used. First, trainees practiced with animals without using a lesion model (placement of an ureteral access sheath under fluoroscopic guidance and flexible ureterorenoscopy). Afterward, they practiced on a porcine animal model of bilateral renal lithiasis. Performance was measured using a validated global rating score and RIRS checklist score. Face and content validation as well as constructive validation provided by trainees in front of 15 experts were performed during the practice. RESULTS: Face and content validations were satisfactory. "Individual" constructive validity showed statistical significance between the first and the last time that trainees practiced on an animal model. Statistical significance was also found between trainees and expert scores. There were 73.4% of trainees who increased their skills by more than 40%. CONCLUSION: This RIRS training model allows for the acquisition of technical knowledge and skills as face, content, and constructive validation show. A structured use of nonbiologic, biologic, and animal model simulators allows the increase of RIRS skills.
[Mh] MeSH terms primary: Clinical Competence
Kidney Calculi/surgery
Models, Anatomic
Simulation Training/methods
Ureteroscopy/education
Urology/education
[Mh] MeSH terms secundary: Animals
Internship and Residency
Swine
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; VALIDATION STUDIES
[Em] Entry month:1606
[Js] Journal subset:IM
[Da] Date of entry for processing:151106
[St] Status:MEDLINE
[do] DOI:10.1089/end.2015.0421

  5 / 6162 MEDLINE  
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[PMID]: 26242825
[Au] Autor:Padrón-Arredondo G; de Atocha Rosado-Montero M
[Ad] Address:Departamento de Cirugía, Hospital General de Playa del Carmen, Solidaridad, Quintana Roo, México. Electronic address: gpadronarredondo@hotmail.com.
[Ti] Title:Colecistitis litiásica crónica agudizada y apendicitis aguda perforada sincrónicas. Reporte de caso. [Synchronous acute cholecystolithiasis and perforated acute appendicitis. Case report].
[So] Source:Cir Cir;84(1):50-3, 2016 Jan-Feb.
[Is] ISSN:0009-7411
[Cp] Country of publication:Spain
[La] Language:spa
[Ab] Abstract:BACKGROUND: Acute appendicitis and acute cholecystitis are among the most common diagnoses that general surgeons operate on. However, it is rarely described in its synchronous form. CLINICAL CASE: A 43 year-old woman attending the clinic for right upper quadrant pain of 11 days duration. The patient refers to intermittent radiating pain in the right side, with positive Murphy, tachycardia, and fever. The laboratory results showed white cells 16,200/mm(3), glucose 345 mg/dl, abnormal liver function tests. Acute cholecystitis was reported with ultrasound. A Masson-type incision was made, noting an enlarged pyogenic gallbladder with thickened walls, sub-hepatic abscess of approximately 300 ml, greenish-yellow colour, and foetid. An anterograde subtotal cholecystectomy is performed due to difficulty in identifying elements of Calot triangle due to the inflammatory process, opening it and extracting stones. The right iliac fossa is reviewed, finding a plastron and a sub-serous retrocaecal appendix perforated in its middle third with free fecalith and an abscess in the pelvic cavity. An anterograde appendectomy was performed and the patient progressed satisfactorily, later being discharged due to improvement. DISCUSSION: In this patient, with a history of recurrent episodes of gallbladder pain and disseminated acute abdominal pain without peritoneal irritation, clinical suspicion was exacerbated cholecystitis with probable empyema of the gallbladder. Open surgery approach for this patient allowed access to both the appendix and gallbladder in order to perform a complete exploration of the abdominal cavity. CONCLUSION: The synchronous presentation of cholecystolithiasis and complicated appendicitis has not been reported in the literature.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1602
[Js] Journal subset:IM
[St] Status:In-Process

  6 / 6162 MEDLINE  
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[PMID]: 25582924
[Au] Autor:Budía Alba A; López Acón JD; Polo-Rodrigo A; Bahílo-Mateu P; Trassierra-Villa M; Boronat-Tormo F
[Ad] Address:Hospital Virgen del Consuelo-Grupo NISA de Valencia, Valencia, España; Hospital Universitario y Politécnico La Fe, Valencia, España....
[Ti] Title:Analysis of the safety profile of treatment with a large number of shock waves per session in extracorporeal lithotripsy.
[So] Source:Actas Urol Esp;39(5):291-5, 2015 Jun.
[Is] ISSN:1699-7980
[Cp] Country of publication:Spain
[La] Language:eng; spa
[Ab] Abstract:OBJECTIVE: To assess the safety of increasing the number of waves per session in the treatment of urolithiasis using extracorporeal lithotripsy. MATERIAL AND METHODS: Prospective, comparative, nonrandomized parallel study of patients with renoureteral lithiasis and an indication for extracorporeal lithotripsy who were consecutively enrolled between 2009 and 2010. We compared group I (160 patients) treated on schedule with a standard number of waves/session (mean 2858,3±302,8) using a Dornier lithotripter U/15/50 against group II (172 patients) treated with an expanded number of waves/session (mean, 6728,9±889,6) using a Siemens Modularis lithotripter. The study variables were age, sex, location, stone size, number of waves/session and total number of waves to resolution, stone-free rate (SFR) and rate of complications (Clavien-Dindo classification). Student's t-test and the chi-squared test were employed for the statistical analysis. RESULTS: The total rate of complications was 11.9% and 10.46% for groups I and II, respectively (P=.39). All complications were minor (Clavien-Dindo grade I). The most common complications were colic pain and hematuria in groups I and II, respectively, with a similar treatment intolerance rate (P>.05). The total number of waves necessary was lower in group II than in group I (P=.001), with SFRs of 96.5% and 71.5%, respectively (P=.001). CONCLUSION: Treatment with an expanded number of waves per session in extracorporeal lithotripsy does not increase the rate of complications or their severity. However, it could increase the overall effectiveness of the treatment.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[St] Status:In-Process

  7 / 6162 MEDLINE  
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[PMID]: 27335796
[Au] Autor:Saljoghi R; Lipsker A; Caillet K; Malaterre J; Le Roux F; Pignot G; Saint F
[Ad] Address:Urology & Transplantation Department, Amiens University Hospital, University of Picardie Jules Verne, CHU d'Amiens, Avenue R.-Laennec, 80054 Amiens cedex 1, France....
[Ti] Title:Encrusted Uretero-pyelitis: Case Report.
[So] Source:Urol Case Rep;7:58-60, 2016 Jul.
[Is] ISSN:2214-4420
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Encrusted uretero-pyelitis is a rare and serious disease, related to the presence of calcifications in the pelvicalyceal system and ureter, associated with chronic urinary tract infection. In most cases, the causal agent of this infection lithiasis is corynebacterium urealyticum. The specific aspect of calcifications on CT scan can help to suggest diagnosis. To avoid a delay in diagnosis (which is frequent), an accurate exploration by the bacteriologist is crucial. The combination of a glycopeptides antibiotherapy and urine acidification has proved its effectiveness, as described in the medical literature. We report the case of a 77-year-old male patient, successfully treated for a bilateral encrusted uretero-pyelitis by local acidification (Thomas's solution) followed by oral acidification (ammonium chloride).
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1606
[Cu] Class update date: 160626
[Lr] Last revision date:160626
[Da] Date of entry for processing:160623
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1016/j.eucr.2016.04.014

  8 / 6162 MEDLINE  
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[PMID]: 26223953
[Au] Autor:Schnabel MJ; Brummeisl W; Burger M; Rassweiler JJ; Knoll T; Neisius A; Chaussy CG; Fritsche HM
[Ad] Address:Klinik für Urologie, Caritas-Krankenhaus St. Josef, Universität Regensburg, Landshuter Straße 65, 93053, Regensburg, Deutschland.
[Ti] Title:Stoßwellenlithotripsie in Deutschland: Ergebnisse einer deutschlandweiten Umfrage. [Shock wave lithotripsy in Germany: Results of a nationwide survey].
[So] Source:Urologe A;54(9):1277-82, 2015 Sep.
[Is] ISSN:1433-0563
[Cp] Country of publication:Germany
[La] Language:ger
[Ab] Abstract:BACKGROUND: Following its introduction in the 1980s extracorporeal shock wave lithotripsy (SWL) became the gold standard for therapy of ureteral and renal calculi. The research data published during the last decade suggest a paradigm shift to endourological techniques. OBJECTIVES: The purpose of this study was to compare whether the suggested loss of status for SWL corresponds with actual real-life treatment in Germany. A further aim was to assess the quality of SWL therapy in German hospitals. MATERIALS AND METHODS: The board of the German Society for Shock Wave Lithotripsy (DGSWL) sent a questionnaire to 306 urological departments in Germany, which encompassed medical, technical and organizational topics in the therapy of ureteral and renal calculi. A total of 99 (33%) questionnaires were returned. CONCLUSION: With the exception of a few departments, non-invasive SWL still plays a major role in the treatment of urolithiasis and a loss of the gold standard status is not in sight. The performance of SWL in German hospitals is carried out at a high level of quality. To maintain and optimize this status a structured SWL training and adherence to clinical practice guidelines are needed.
[Mh] MeSH terms primary: Health Care Surveys
Lithotripsy/standards
Lithotripsy/utilization
Practice Patterns, Physicians´/statistics & numerical data
Urolithiasis/epidemiology
Urolithiasis/therapy
[Mh] MeSH terms secundary: Germany/epidemiology
Guideline Adherence/utilization
Humans
Practice Patterns, Physicians'/standards
Practice Patterns, Physicians'/trends
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1606
[Js] Journal subset:IM
[Da] Date of entry for processing:150905
[St] Status:MEDLINE
[do] DOI:10.1007/s00120-015-3920-2

  9 / 6162 MEDLINE  
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[PMID]: 27157204
[Au] Autor:Araújo MR; Marques C; Freitas S; Santa-Bárbara R; Alves J; Xavier C
[Ad] Address:Departamento de Anestesiologia, Hospital Santa Maria, Lisboa, Portugal. Electronic address: m.rita.araujo@gmail.com....
[Ti] Title:Síndrome de Marfan: novos critérios diagnósticos, mesma abordagem anestésica? Relato de caso e revisão. [Marfan Syndrome: new diagnostic criteria, same anesthesia care? Case report and review].
[So] Source:Rev Bras Anestesiol;66(4):408-13, 2016 Jul-Aug.
[Is] ISSN:1806-907X
[Cp] Country of publication:Brazil
[La] Language:por
[Ab] Abstract:BACKGROUND: Marfan's Syndrome (MFS) is a disorder of connective tissue, mainly involving the cardiovascular, musculoskeletal, and ocular systems. The most severe problems include aortic root dilatation and dissection. Anesthetic management is vital for the improvement on perioperative morbidity. CASE REPORT: 61-year-old male with MFS, presenting mainly with pectus carinatum, scoliosis, ectopia lens, previous spontaneous pneumothorax and aortal aneurysm and dissection submitted to thoracoabdominal aortic prosthesis placement. Underwent routine laparoscopic cholecystectomy due to lithiasis. Important findings on preoperative examination were thoracolumbar kyphoscoliosis, metallic murmur on cardiac exam. Chest radiograph revealed Cobb angle of 70°. Echocardiogram showed evidence of aortic mechanical prosthesis with no deficits. DISCUSSION: Preoperative evaluation should focus on cardiopulmonary abnormalities. The anesthesiologist should be prepared for a potentially difficult intubation. Proper positioning and limb support prior to induction is crucial in order to avoid joint injuries. Consider antibiotic prophylaxis for subacute bacterial endocarditis. The patient should be carefully positioned to avoid joint injuries. Intraoperatively cardiovascular monitoring is mandatory: avoid maneuvers that can lead to tachycardia or hypertension, control airway pressure to prevent pneumothorax and maintain an adequate volemia to decrease chances of prolapse, especially if considering laparoscopic surgery. No single intraoperative anesthetic agent or technique has demonstrated superiority. Adequate postoperative pain management is vitally important to avoid the detrimental effects of hypertension and tachycardia.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1606
[Da] Date of entry for processing:160626
[St] Status:PubMed-not-MEDLINE

  10 / 6162 MEDLINE  
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[PMID]: 27343792
[Au] Autor:Araújo MR; Marques C; Freitas S; Santa-Bárbara R; Alves J; Xavier C
[Ad] Address:Anesthesiology Department, Hospital Santa Maria, Lisbon, Portugal. Electronic address: m.rita.araujo@gmail.com....
[Ti] Title:Marfan Syndrome: new diagnostic criteria, same anesthesia care? Case report and review.
[So] Source:Braz J Anesthesiol;66(4):408-13, 2016 Jul-Aug.
[Is] ISSN:0104-0014
[Cp] Country of publication:Brazil
[La] Language:eng
[Ab] Abstract:BACKGROUND: Marfan's Syndrome (MFS) is a disorder of connective tissue, mainly involving the cardiovascular, musculoskeletal, and ocular systems. The most severe problems include aortic root dilatation and dissection. Anesthetic management is vital for the improvement on perioperative morbidity. CASE REPORT: 61-year-old male with MFS, presenting mainly with pectus carinatum, scoliosis, ectopia lens, previous spontaneous pneumothorax and aortal aneurysm and dissection submitted to thoracoabdominal aortic prosthesis placement. Underwent routine laparoscopic cholecystectomy due to lithiasis. Important findings on preoperative examination were thoracolumbar kyphoscoliosis, metallic murmur on cardiac exam. Chest radiograph revealed Cobb angle of 70°. Echocardiogram showed evidence of aortic mechanical prosthesis with no deficits. DISCUSSION: Preoperative evaluation should focus on cardiopulmonary abnormalities. The anesthesiologist should be prepared for a potentially difficult intubation. Proper positioning and limb support prior to induction is crucial in order to avoid joint injuries. Consider antibiotic prophylaxis for subacute bacterial endocarditis. The patient should be carefully positioned to avoid joint injuries. Intraoperatively cardiovascular monitoring is mandatory: avoid maneuvers that can lead to tachycardia or hypertension, control airway pressure to prevent pneumothorax and maintain an adequate volemia to decrease chances of prolapse, especially if considering laparoscopic surgery. No single intraoperative anesthetic agent or technique has demonstrated superiority. Adequate postoperative pain management is vitally important to avoid the detrimental effects of hypertension and tachycardia.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1606
[Js] Journal subset:IM
[St] Status:In-Data-Review


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