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[PMID]: 29376597
[Au] Autor:Pirogov AV; Sizonov VV; Kogan MI
[Ad] Address:N.N. Silishcheva Regional Childrens Clinical Hospital, Astrakhan, Russia.
[Ti] Title:[Experience of 157 vesikoscopic operations in children].
[So] Source:Urologiia;(6):59-64, 2017 Dec.
[Is] ISSN:1728-2985
[Cp] Country of publication:Russia (Federation)
[La] Language:rus
[Ab] Abstract:AIM: Recent advances in the field of minimally invasive surgical technologies in children and adolescents have led to the development of vesicoscopic (transvesical, pneumoscopic) access (VA). Current limitations in using VA emphasize the need for further studies investigating surgical options for the management of various pathological conditions of the bladder and ureterovesical junction, the features of surgical techniques and the course of the early postoperative period when used in pediatric urological practice. MATERIALS AND METHODS: From 2013 to 2017, 157 patients (79 girls and 78 boys) aged between 2 months and 18 years (mean age 4.9-8.7 years) underwent surgery using VD. Unilateral and bilateral vesicoscopic ureterocystoneoimplantation was performed in 110 (70%) and 44 (28%) patients, respectively. A total of 198 ureters was implanted. Three (1.9%) children underwent vesicoscopic excision of the bladder diverticulum. Transvesicoscopic Cohen ureteric reimplantation, pneumovesical Glenn-Anderson procedure, and Chumakov ureterocystoneoimplantation were performed in 151 (96.1%), 2 (1.3%) and 1 (0.6%) patients, respectively. RESULTS: The mean operative time when using VA was 126.8+/-46.7 min. In patients younger than one year, 1-3 years, 4-17 years, it was 136.0+/-43.8 min, 130.1+/-43.5 min and 122.4+/-65.8 min, respectively. The mean length of postoperative hospital stay was 6.2+/-2.3 days. In 3 (1.9%) cases we had to convert to open surgery. Gas migration into the abdominal cavity occurred in 6 (3.8%) patients. Fourteen (9%) patients had early postoperative complications. Transient obstruction of ureterovesical junction occurred in 6 (3.8%) patients. Acute complete obstruction of the distal ureter developed in 3 (1.9%) patients aged three months who did not undergo drainage of the upper urinary tract intraoperatively. A paravesical urine leak occurred in 1 (0.6%) patient. In one (0.6%) of the boys, the distal end of the urinary drainage inserted through the trocar into the ureter migrated in the bladder. The urine leakage from the trocar puncture occurred once (0.6%) and was stopped by indwelling urethral catheterization for seven days. In 2 (1.3%) patients, exacerbation of pyelonephritis required a modification in antibacterial therapy. DISCUSSION: Despite the accumulated experience, vesicoscopic surgery remains a laborious and complicated surgical intervention, requiring long learning curves even for surgeons who have good manual skills in laparoscopic surgery. CONCLUSION: In our opinion, vesicoscopic access allows the entire range of surgical interventions on the vesicoureteral junction and bladder in children to be performed. It is effective, significantly less traumatic than traditional open cystotomy access, and associated with an excellent cosmetic result.
[Mh] MeSH terms primary: Cystostomy/methods
Minimally Invasive Surgical Procedures/methods
Ureter/surgery
Urinary Bladder Diseases/surgery
Urinary Bladder/surgery
[Mh] MeSH terms secundary: Adolescent
Child
Child, Preschool
Female
Humans
Infant
Male
Ureter/pathology
Urinary Bladder/physiology
Urinary Bladder Diseases/pathology
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:180130
[St] Status:MEDLINE

  2 / 18035 MEDLINE  
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[PMID]: 29522292
[Au] Autor:Ando SM; Moreno RA; Viana PCC; Yamauchi FI
[Ad] Address:Departamento de Radiologia, Hospital das Clínicas da Universidade de São Paulo HC-FMUSP, São Paulo, Brasil.
[Ti] Title:Extensive renal sinus lipomatosis in xanthogranulomatous pyelonephritis simulating liposarcoma.
[So] Source:Int Braz J Urol;44, 2018 Mar 09.
[Is] ISSN:1677-6119
[Cp] Country of publication:Brazil
[La] Language:eng
[Ab] Abstract:Renal replacement lipomatosis is a condition characterized by varying degrees of renal parenchymal atrophy and perirenal fibrofatty proliferation secondary to chronic inflammation such as xanthogranulomatous pyelonephritis. In severe cases, imaging findings can be misdiagnosed as retroperitoneal liposarcoma.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1590/S1677-5538.IBJU.2017.0509

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[PMID]: 29515214
[Au] Autor:Guillot-Tantay C; Chartier-Kastler E; Perrouin-Verbe MA; Denys P; Léon P; Phé V
[Ad] Address:Department of Urology, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Sorbonne Universités, Paris 6 University, Paris, France. c.guillot.tantay@gmail.com.
[Ti] Title:Complications of non-continent cutaneous urinary diversion in adults with spinal cord injury: a retrospective study.
[So] Source:Spinal Cord;, 2018 Mar 07.
[Is] ISSN:1476-5624
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To report the long-term complications of non-continent cutaneous urinary diversion (NCCUD) in adult patients with spinal cord injury (SCI). SETTING: Hospital in Paris, France. METHODS: A retrospective single center study included all adult patients with SCI who underwent an ileal conduit between 1997 and 2014. Early complications were reported according to Clavien-Dindo classification. Long-term complications and reoperation rates were recorded, as well as stoma management and autonomy improvement related to urinary function. RESULTS: One hundred and two patients were included. The surgical indications included failure of intermittent catheterization (n = 43), urethral fistulae due to skin ulcers (n = 50), renal failure (n = 8), recurrent urinary tract infections (n = 9), lithiasis (n = 3), and bladder tumors (n = 2). There were 67 early postoperative complications for 44 patients (43%) leading to an additional surgery in 15 cases: 30 grade I-II, 30 grade III, 6 grade IV, and 1 grade V. A total of 37 late complications were reported for 36 patients (35%): 17 ureteral anastomosis stenosis, 3 stoma hernia, 3 pyocystis (3/15 patients), 7 pyelonephritis, 2 renal failures, 2 ureteral lithiasis, 1 uterine prolapse, 1 incisional hernia, and 1 tumor recurrence. Renal function remained unchanged (p = 0.53). Autonomy related to urinary function was improved in 88% of patients. The correct fitting of the stoma was possible for 81% of the patients. CONCLUSIONS: Despite a perioperative morbidity rate of 43% and a late complication rate of 35%, as a last resort procedure, NCCUD is an end-stage solution in patients with SCI to preserve renal function and achieve autonomy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1038/s41393-018-0083-1

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[PMID]: 29514462
[Au] Autor:Cho JC; Zmarlicka MT; Shaeer KM; Pardo J
[Ad] Address:1 The University of Texas at Tyler, Tyler, TX, USA.
[Ti] Title:Meropenem/Vaborbactam, the First Carbapenem/ß-Lactamase Inhibitor Combination.
[So] Source:Ann Pharmacother;:1060028018763288, 2018 Mar 01.
[Is] ISSN:1542-6270
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To review the pharmacology, spectrum of activity, pharmacokinetics, pharmacodynamics, safety, efficacy, administration, and considerations for clinical use of meropenem/vaborbactam (M/V). DATA SOURCES: A literature search using PubMed and clinicaltrials.gov (June 2013 to December 2017) was conducted using the search terms meropenem, vaborbactam, RPX7009, biapenem, RPX2003, and carbavance. References from relevant articles and conference abstracts were also reviewed. STUDY SELECTION AND DATA EXTRACTION: Preclinical, phase I studies, and phase III studies written in the English language were evaluated. DATA SYNTHESIS: M/V is a novel carbapenem/ß-lactamase inhibitor antimicrobial with in vitro activity against nearly 99% of Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae. M/V is approved for the treatment of adults with complicated urinary tract infections (cUTIs), including pyelonephritis. In a phase III cUTI trial (TANGO I), 98.4% of patients treated with M/V experienced overall clinical success compared with 94% of patients treated with piperacillin/tazobactam (95% CI = 0.7 to 9.1). When compared with best available therapy for carbapenem-resistant Enterobacteriaceae (CRE) infections in TANGO II, patients receiving M/V were more likely to achieve clinical cure at both the end of therapy (64.3% vs 33.3%, P = 0.04) as well as at the test of cure (57.1% vs 26.7%, P = 0.04). The most common adverse effects associated with M/V were headache, infusion-site reactions, and diarrhea. CONCLUSION: M/V has a valuable role in the treatment of CRE and should be used judiciously to preserve its use for resistant infections.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1177/1060028018763288

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[PMID]: 29514028
[Au] Autor:Marinacci LX; Rosales I
[Ad] Address:Massachusetts General Hospital, Boston, MA lmarinacci@partners.org.
[Ti] Title:Xanthogranulomatous Pyelonephritis.
[So] Source:N Engl J Med;378(10):940, 2018 Mar 08.
[Is] ISSN:1533-4406
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Process
[do] DOI:10.1056/NEJMicm1710400

  6 / 18035 MEDLINE  
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[PMID]: 29513702
[Au] Autor:Wijkström J; Jayasumana C; Dassanayake R; Priyawardane N; Godakanda N; Siribaddana S; Ring A; Hultenby K; Söderberg M; Elinder CG; Wernerson A
[Ad] Address:Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
[Ti] Title:Morphological and clinical findings in Sri Lankan patients with chronic kidney disease of unknown cause (CKDu): Similarities and differences with Mesoamerican Nephropathy.
[So] Source:PLoS One;13(3):e0193056, 2018.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:In Sri Lanka, an endemic of chronic kidney disease of unknown origin (CKDu) is affecting rural communities. The endemic has similarities with Mesoamerican Nephropathy (MeN) in Central America, however it has not yet been clarified if the endemics are related diagnostic entities. We designed this study of kidney biopsies from patients with CKDu in Sri Lanka to compare with MeN morphology. Eleven patients with CKDu were recruited at the General Hospital, Polonnaruwa, using similar inclusion and exclusion criteria as our previous MeN studies. Inclusion criteria were 20-65 years of age and plasma creatinine 100-220 µmol/L. Exclusion criteria were diabetes mellitus, uncontrolled hypertension and albuminuria >1g/24h. Kidney biopsies, blood and urine samples were collected, and participants answered a questionnaire. Included participants were between 27-61 years of age and had a mean eGFR of 38±14 ml/min/1.73m2. Main findings in the biopsies were chronic glomerular and tubulointerstitial damage with glomerulosclerosis (8-75%), glomerular hypertrophy and mild to moderate tubulointerstitial changes. The morphology was more heterogeneous and interstitial inflammation and vascular changes were more common compared to our previous studies of MeN. In two patients the biopsies showed morphological signs of acute pyelonephritis but urine cultures were negative. Electrolyte disturbances with low levels of serum sodium, potassium, and/or magnesium were common. In the urine, only four patients displayed albuminuria, but many patients exhibited elevated α-1-microglobulin and magnesium levels. This is the first study reporting detailed biochemical and clinical data together with renal morphology, including electron microscopy, from Sri Lankan patients with CKDu. Our data show that there are many similarities in the biochemical and morphological profile of the CKDu endemics in Central America and Sri Lanka, supporting a common etiology. However, there are differences, such as a more mixed morphology, more interstitial inflammation and vascular changes in Sri Lankan patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Data-Review
[do] DOI:10.1371/journal.pone.0193056

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[PMID]: 29508659
[Au] Autor:Karakonstantis S; Kalemaki D
[Ad] Address:a 2nd Department of Internal Medicine , General Hospital of Heraklion 'Venizeleio-Pananeio' , Heraklion , Greece.
[Ti] Title:Blood culture useful only in selected patients with urinary tract infections - a literature review.
[So] Source:Infect Dis (Lond);:1-9, 2018 Mar 06.
[Is] ISSN:2374-4243
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:PURPOSE: The practice of obtaining blood culture in febrile urinary tract infections is controversial, considering that blood cultures rarely provide additional useful information compared to urine cultures alone. Furthermore, whether a longer treatment duration is necessary in bacteremic patients is also controversial. Here, we aim to review to relevant studies. MATERIALS AND METHODS: We searched PubMed and Scopus for studies providing information regarding the discordance between urine and blood cultures. We also searched for clinical trials regarding the treatment duration in bacteremic patients with urinary tract infections. RESULTS: It seems that a higher likelihood of a negative urine culture (e.g. in patients with antibiotic pre-treatment) combined with a higher likelihood of a positive blood culture (e.g. patients with high fever, or patients with complicated urinary tract infections) increases the chance that a blood culture might provide additional useful information. Furthermore, when polymicrobial infection or contamination of the urine specimen is likely (e.g. in patients with indwelling urinary tract catheters or bedridden patients with frequent hospitalizations and catheterizations), blood cultures may help identify the clinically significant pathogen and guide the choice of the antimicrobial regimen. Finally, because bacteremia has been associated with more severe disease and worse outcomes, some authors suggest a longer treatment duration for bacteremic patients. However, whether the presence of bacteremia should alter the duration of treatment remains unclear. CONCLUSIONS: Obtaining blood cultures may be useful in selected patients. Randomized controlled trials are needed to clarify the value of bacteremia in guiding the duration of antimicrobial therapy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher
[do] DOI:10.1080/23744235.2018.1447682

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[PMID]: 29480882
[Au] Autor:Yang JH; Shin JY; Roh SG; Chang SC; Lee NH
[Ad] Address:Department of Plastic and Reconstructive Surgery, Medical School of Chonbuk National University.
[Ti] Title:Delayed diagnosis of xanthogranulomatous pyelonephritis in a quadriplegic patient with uncontrolled cutaneous fistula: A case report.
[So] Source:Medicine (Baltimore);97(2):e9659, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Xanthogranulomatous pyelonephritis (XGP) is a chronic destructive granulomatous inflammation that is characterized by urinary tract obstruction and invasion of the renal parenchyma. Although rare, XGP can lead to fatal complications, including perinephric inflammation, psoas abscess, and cutaneous fistula. PATIENT CONCERNS: A quadriplegic patient initially presented to the hospital with a chronic open wound and cutaneous fistula. DIAGNOSES: Abdominal computed tomography revealed a renal obstructing stone and enlarged right kidney with a perinephric fluid collection that communicated with the cutaneous fistula. INTERVENTIONS: The patient underwent a right nephrectomy at the department of urology. OUTCOMES: Two months after surgery, the patient was clinically well with no discharging fistula. LESSONS: The XGP accompanied by complications requires an immediate evaluation and early diagnosis. In this case, the diagnosis was delayed because the state of quadriplegia rendered no symptoms of XGP.
[Mh] MeSH terms primary: Cutaneous Fistula/complications
Pyelonephritis, Xanthogranulomatous/complications
Pyelonephritis, Xanthogranulomatous/diagnosis
Quadriplegia/complications
[Mh] MeSH terms secundary: Cutaneous Fistula/diagnosis
Delayed Diagnosis
Humans
Kidney/diagnostic imaging
Kidney/surgery
Male
Middle Aged
Nephrectomy
Pyelonephritis, Xanthogranulomatous/surgery
Quadriplegia/diagnosis
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180227
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009659

  9 / 18035 MEDLINE  
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[PMID]: 29331197
[Au] Autor:Clavagnier I
[Ad] Address:Lycée des métiers de la santé et du social François Rabelais, Ifsi, 9, rue Francis-de-Croisset, 75018 Paris, France. Electronic address: isabelle.clavagnier@laposte.net.
[Ti] Title:Talking about the Impact of Screen-viewing on Health.
[So] Source:Rev Infirm;67(237):49-50, 2018 Jan.
[Is] ISSN:1293-8505
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:Emilia is a young woman admitted to the hospital for pyelonephritis. Sophie finds out, from the morning reports about her, that she stays awake very late every night watching television or chatting on her mobile phone.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:In-Process

  10 / 18035 MEDLINE  
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[PMID]: 29504860
[Au] Autor:Jones B; Berent AC; Weisse CW; Hart R; Alvarez L; Fischetti A; Horn BD; Canning D
[Ti] Title:Surgical and endoscopic treatment of bladder exstrophy-epispadias complex in a female dog.
[So] Source:J Am Vet Med Assoc;252(6):732-743, 2018 Mar 15.
[Is] ISSN:1943-569X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:CASE DESCRIPTION A 14-week-old 7.7-kg (16.9-lb) sexually intact female Golden Retriever was evaluated because of urine dripping from the caudoventral aspect of the abdomen. CLINICAL FINDINGS Ultrasonography, radiography, excretory CT urography, and vaginocystourethroscopy were performed. Results indicated eversion of the bladder through the ventral abdominal wall with exposure of the ureterovesicular junctions, pubic diastasis, and an open vulva and clitoral fossa. Clinical findings were suggestive of bladder exstrophy, a rare congenital anomaly. TREATMENT AND OUTCOME The dog was anesthetized and bilateral ileal osteotomies were performed. Two ureteral catheters were passed retrograde into the renal pelves under fluoroscopic guidance. The lateral margins of the bladder, bladder neck, and urethra were surgically separated from the abdominal wall, and the bladder was closed, forming a hollow viscus. The symphysis pubis was closed on midline with horizontal mattress sutures. The defects in the vestibule and clitoral fossa were closed. Lastly, the iliac osteotomies were stabilized. The dog was initially incontinent with right hind limb sciatic neuropraxia and developed pyelonephritis. Over time, the dog became continent with full return to orthopedic and neurologic function, but had recurrent urinary tract infections, developed renal azotemia likely associated with chronic pyelonephritis, and ultimately was euthanized 3.5 years after surgery because of end-stage kidney disease. CLINICAL RELEVANCE Bladder exstrophy and epispadias is a treatable but rare congenital abnormality. The procedure described could be considered for treatment of this condition, but care should be taken to monitor for urinary tract infections and ascending pyelonephritis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Data-Review
[do] DOI:10.2460/javma.252.6.732


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