scholarly journals Novel method to decrease the exposure time of the extraction string of the ureteral stent and its efficiency and safety verification in the clinic

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
WenGang Hu ◽  
YaJun Song ◽  
Yang Li ◽  
YueHua Li ◽  
Jiao Mu ◽  
...  
Keyword(s):  
Exposure Time ◽  
Medical Costs ◽  
Demographic Characteristics ◽  
Ureteral Stent ◽  
Continuous Exposure ◽  
The Novel ◽  
Ureteral Stents ◽  
Stent Removal ◽  
Significant Difference ◽  
Novel Method

AbstractUreteral stent removal by an extraction string is advantageous. However, the increased risk of complications attributed to the continuous exposure of the string outside the urethra must be managed. This paper introduces a method to decrease the exposure time, and conducts a retrospective study to verify its efficiency and safety. A total of 231 male patients undergoing routine ureteroscopy (URS) were included, and all of them accepted indwelling ureteral stents with strings. Among them, 123 patients (Normal-S group) underwent the normal method to determine the length of string (Lstring), which was shortened to 4 cm (cm) past the urethral meatus; 108 patients (Novel-S group) underwent the novel method (Lstring = Lurethra + 2 cm), the length of urethra (Lurethra) was measured during ureteroscopy by ureteroscope body. The demographic characteristics, stent indwelling and removal-related variables, complications, and medical costs in each group were recorded. There was no significant difference in demographic characteristics, the rate of UTI, the operative duration of URS, or the VAS pain scores for stent removal between the 2 groups. For the Novel-S group, the stent dwelling time was longer, the self-rated discomfort and symptom, the stent dislodgement rate, the numbers of clinic or emergency visits and the overall medical cost post operation was lower in comparison with the Normal-S group, while the rate of removal of stents by hand was lower, the time for removing ureteral stents was longer. This novel method improved stenting comfort, avoided ureteral stent dislodgement, decreased complications, and lowered medical costs, it was safe and reliable and merits widespread application.

scholarly journals A novel PS4 criterion approach based on symptoms of rare diseases and in-house frequency data in a Bayesian framework

2020 ◽  
Author(s):  
You Kyung Cho ◽  
Dhong-gun Won ◽  
Changwon Keum ◽  
Beom Hee Lee ◽  
Go Hun Seo ◽  
...  
Keyword(s):  
Rare Diseases ◽  
Odds Ratio ◽  
Case Control Study ◽  
Rare Variants ◽  
Bayesian Framework ◽  
The Novel ◽  
Significant Difference ◽  
Novel Method ◽  
Control Study ◽  
Criterion Approach

AbstractThe American College of Medical Genetics (ACMG) and Genomics/Association for Molecular Pathology (AMP) previously reported standardized guidance for the assessment of genetic variants. One of the criteria regarding the prevalence in a case-control study, PS4, is important due to its evidence of pathogenicity. Despite recent studies approaching gene- and disease-specific probands, interpretation of a variant to PS4 still has certain limitations for rare variants. Here, we suggest a generalized method, Bayesian odds ratio (BayesianOR), applicable to PS4 via decomposing a disease to its symptoms and applying a Bayesian framework. Using this approach, we demonstrate reproducibility of the calculation of the original odds ratio from well-studied epilepsy data and verify the applicability to in-house frequencies for various rare diseases. In addition, BayesianOR showed a significant difference in tendency with different ClinVar pathogenicity, using in-house data. Thus, the novel method described here should provide an improved interpretation of sequence variants. Furthermore, we anticipate that it will enhance the diagnosis of patients with rare diseases.

scholarly journals Outcomes of Ureteral Stent Placement for Hydronephrosis in Patients with Gynecological Malignancies

2016 ◽  
Vol 10 (3) ◽  
pp. 126-131 ◽  
Author(s):  
Saya Kurata ◽  
Shohei Tobu ◽  
Kazuma Udo ◽  
Mitsuru Noguchi
Keyword(s):  
Radiation Therapy ◽  
Stent Placement ◽  
Poor Prognosis ◽  
Ureteral Stent ◽  
Ureteral Stents ◽  
Ureteral Stenosis ◽  
Stent Removal ◽  
Gynecological Malignancies ◽  
Lymph Node Swelling ◽  
Observation Period

Objective: We examined the outcomes of patients undergoing ureteral stent placement for hydronephrosis that occurred during treatment for gynecological malignancies. Materials and Methods: From January 2004 to December 2009, we enrolled 33 patients with 45 ureters undergoing ureteral stent placement for hydronephrosis which occurred during treatment for gynecological malignancies. We examined the outcomes of the patients after stent placement. Results: The causes of hydronephrosis were obstruction of the urinary tract by a tumor (n = 22), obstruction due to lymph node swelling (n = 6), ureteral stenosis after radiation therapy (n = 4), and others (n = 1). The ureteral stent was inserted into both ureters in 12 cases, and into one ureter in 21 cases. Ureteral stents were replaced 1-26 times during the observation period (median 3 times). Eighteen (40%) ureteral stents were removed. The reasons for ureteral stent removal were hydronephrosis improvement (11 ureters, 24.4%), a change to nephrostomy (cystectomy: 1 ureter, progression of ureteral stenosis: 2 ureters), renal atrophy (3 ureters), and ureteral dilatation (1 ureter). All of the cases in which ureteral stent withdrawal due to hydronephrosis improvement were cases in which the ureter was compressed by a tumor and were lower ureteral obstructions. Twenty-one patients (64%) died due to cancer after stent placement. The periods from the first stent placement to death ranged from 1 to 58 months (median 18 months). Conclusion: Ureteral stent placement was associated with a poor prognosis in patients with gynecological malignancies. There were a few cases in which stent withdrawal became possible due to the improvement of hydronephrosis. In such cases, the withdrawal rate varied according to the cause and obstructive level.

scholarly journals Ratios of CD64 expressed on neutrophils, monocytes, and lymphocytes may be a novel method for diagnosis of neonatal sepsis

2015 ◽  
Vol 9 (02) ◽  
pp. 175-181 ◽  
Author(s):  
Dai-Hua Fang ◽  
Cong-Hai Fan ◽  
Juan Li ◽  
Qi An ◽  
Hong Yao ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Evaluation Method ◽  
High Sensitivity ◽  
Receiver Operating Curve ◽  
The Novel ◽  
Cd64 Expression ◽  
Neutrophil Cd64 ◽  
Significant Difference ◽  
Novel Method ◽  
And Control

Introduction: Neutrophil CD64 expression has been demonstrated as an improved diagnostic marker of infection and sepsis. The purpose of this study was to develop a new method to evaluate neutrophil CD64 expression for diagnosis of neonatal sepsis. Methodology: Eighty neonates with neonatal sepsis (21 culture positive, 59 negative) were enrolled in this prospective study along with 19 neonates with no symptoms or signs of infection as controls. Expressions of CD64 on monocytes, lymphocytes, and neutrophils were evaluated with flow cytometry (FCM). Ratios were calculated with these levels of CD64 expression. Blood culture and other laboratory exams were done at the same time for the diagnosis of neonatal sepsis. Results were compared between the neonatal sepsis and control groups. Results: CD64 ratios showed significant difference between the groups (p < 0.01). Receiver operating curve (ROC) analysis showed that the CD64 ratios possessed high sensitivity (90%) and specificity (89.5%) in neonatal sepsis identification. Conclusions: The novel CD64 evaluation method, CD64 ratio, can be used as a supplementary method for diagnosis of neonatal sepsis.

scholarly journals EFFECT OF TAMSULOSIN ON STENTRELATED SYMPTOMS

2016 ◽  
Vol 23 (01) ◽  
pp. 114-118
Author(s):  
Rana Ata ur Rehman ◽  
Muhammad Muzammil Tahir ◽  
Muhammad Seerwan
Keyword(s):  
Placebo Group ◽  
Ureteral Obstruction ◽  
Controlled Trial ◽  
Ureteral Stent ◽  
Control Group ◽  
P Value ◽  
Routine Practice ◽  
Ureteral Stents ◽  
Significant Difference ◽  
Group 2

Introduction: Cystoscopic intraluminal placement of ureteral stents has become a routine practice in urology. Ureteral stents preserve urine flow from the kidney to the bladder in cases of ureteral obstruction (intrinsic or extrincis). In patients with obvious ureteral obstruction, the placement of a ureteral stent will restart urine transport and protect the kidney from possible risks. Ureteral stents are troublesome in some patients and causes LUTS. Study Design: Prospective randomized controlled trial. Setting: Urology Department, Sheikh Zayed Hospital Lahore. Period: Six month started from August 2015 to December 2015. Material and Methods: 100 patients who were randomly divided into two equal groups. The patients were between 18 to 50 years of age of both gender undergo retrograde double-J ureteral stent placement. Before the double-J stent will be applied, all patients completed an International Prostate Symptom Score (IPSS) questionnaire for evaluation of lower urinary tract symptoms.Patients were divided in two groups on the basis of lottery method tamsolusin group (1) and placebo group (2). Tamsulosin group patients was given tamsulosin post operatively and placebo group was given a placebo postoperatively. Results: There were total 100 patients who were enrolled in this study with a mean age of 42.63±6.24. There were 75(75%) were male while 25(25%) were female. The mean IPSS sore at presentation was 2.47±1.43 and post treatment was 5.20±1.65. There was significant difference in IPSS score in control group with mean 5.28±1.69 versus study as mean 2.22±1.05 group, p-value= 0.010. Conclusion: There is difference in lowering of IPSS score in the patients who are given tamsolusin versus those who were retained on placebo.

scholarly journals Innovation and new technology in ureteral stents

2021 ◽  
Vol 42 (2) ◽  
pp. 160-168
Author(s):  
Tongtra Watcharawittayakul ◽  
◽  
Manint Usawachintachit ◽  
Keyword(s):  
Clinical Trials ◽  
New Technology ◽  
Material Design ◽  
Ureteral Stent ◽  
Biodegradable Materials ◽  
Stent Insertion ◽  
Ureteral Stents ◽  
Stent Removal ◽  
Silicone Polymers ◽  
Removal Technique

Ureteral stent insertion is a procedure performed extensively by all urologists. Nevertheless, stent-related symptoms and stent encrustation are still common complications pushing the innovation and development of novel ureteral stents. Developments are focussing on three significant aspects: material, design, and removal technique. Various materials including silicone, polymers, and metals are frequently utilized, with or without an additional coating. The use of biodegradable materials is looking promising but these is a lack of proven clinical trials in association with this in humans. The new designs focus on the reduction of stent-related symptoms through the modification of the bladder end. The new stent removal techniques with extraction strings or novel magnetic end may exclude subsequent cystoscopic procedures. Finally, utilization of a ureteral stent tracker application helps in reminding both physicians and patients to remove the stent at the appropriate time.

scholarly journals Efficacy of Tamsulosin in Relieving Double-J Stentrelated Symptoms: a Randomized Controlled Study

2016 ◽  
Vol 19 (2) ◽  
pp. 3-6
Author(s):  
Deepak K Thakur ◽  
Suman Chapagain ◽  
Bhojraj Luitel ◽  
Pawan Raj Chalise ◽  
Uttam Kumar Sharma ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stent Placement ◽  
Ureteral Stent ◽  
Controlled Study ◽  
Control Group ◽  
Stent Removal ◽  
Significant Difference ◽  
Dj Stent ◽  
And Control

Introduction: Ureteral stent placement is an increasingly common procedure in urological practice. They are used for both prevention and treatment of ureteral obstruction. Despite improved design and materials, many patients still develop stent-related symptoms which commonly affect quality of life and sometimes necessitate early removal. Tamsulosin improves stent-related symptoms and quality of life. But such study has not been conducted in Nepalese context. In the present study, the effect of Tamsulosin in improving double-J stent-related symptoms and quality of life following ureteral stent placement was studied. Methods: This study was carried out in the Department of Urology and Kidney Transplant Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal from February 2015 to January 2016. Forty six patients were included in the study and randomized into Tamsulosin (T) group and Control (C) group each having 23 patients. In addition to standard postoperative care, Tamsulosin group received 0.4 mg Tamsulosin daily for 2 weeks and Paracetamol on demand and control group received only Paracetamol (1gram/dose). Stent related symptoms and quality of life was assessed by International prostate symptom score (IPSS) at discharge (day2) and at the time of DJ stent removal (2 weeks). Pain was evaluated by visual analog scale (VAS) and analgesic requirement was documented. Data were analysed using Statistical Package for the Social Sciences (SPSS) 20, chisquare test and Student’s t- test was used. A p-value of <0.05 was considered significant. Results: Mean age in Tamsulosin group was 37.96±12.98 years and Control group 36.43± 10.99 years (p=0.67).There was no significant difference in IPSS (p=0.141), QoL index (p=0.089) and VAS (p=0.59) in the two groups at the time of discharge. At the time of DJ stent removal, IPSS (p<0.001), QoL index(p<0.001), VAS(p=0.004) and analgesic needed(p<0.001) was significantly lower in T group than in C group. Conclusion: Tamsulosin lowers stent related symptoms, pain and improves quality of life in patients with indwelling DJ stent though the effect is not immediate.  

scholarly journals Stent encrustation or fragmentation? A case report of post stent removal encrustation in postpartum woman and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhaohua Ye ◽  
Qiwu Mi ◽  
Renzhao Huang
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Literature Review ◽  
Medical Malpractice ◽  
Ureteral Stent ◽  
Postpartum Woman ◽  
Ureteral Stents ◽  
Case Presentation ◽  
Stent Removal ◽  
Indwelling Time

Abstract Background Ureteral stents are commonly used in the field of urology to relieve ureteral obstruction. However, complications relating to ureteral stent use, such as encrustation continue to occur, especially with prolonged indwell time. Case presentation Here we present a 37-year-old postpartum woman with a foreign body in her bladder after removing a ureteral stent 1 month before. She insisted that the foreign body was the fragment of stent and asked for medical malpractice indemnity payments while the surgeon of her insisted that the stent was intact during the procedure. Finally, the foreign body was confirmed as an encrustation by cystoscopy and the patient received 10,000 yuan ($ 1500) as indemnity payments after encrustation removal. Conclusion In the absence of guidelines, stent indwelling time vary with centers’ habits, stent materials and patient’s education. Early detection of stent encrustation and timely removal of the encrusted stent are still the best way to avoid stent retention. Violent stent removal is of danger and not recommended in any case.

scholarly journals Socio-demographic characteristics influencing knowledge, attitude and preventive practices of COVID-19 among Ghanaians: A cross-sectional study

2021 ◽  
pp. 019-027
Author(s):  
Tawiah Philip Apraku ◽  
Arhin-Wiredu Kingsley ◽  
Oppong Kwabena ◽  
Torgbor Bernard Nii ◽  
Konadu Phenehance Effah ◽  
...  
Keyword(s):  
Ethnic Group ◽  
Health Worker ◽  
Demographic Characteristics ◽  
Male Gender ◽  
P Value ◽  
The Novel ◽  
Cross Sectional ◽  
Preventive Practices ◽  
Significant Difference ◽  
Novel Coronavirus

Background: In recent times, the novel coronavirus disease is one of the most challenging public health burdens. Low-and-middle-income countries including Ghana have not been spared by the infection. Several measures are being undertaken by countries to control and prevent the future waves of the disease. Previous studies have established the importance of knowledge, attitude and practices towards an infection as a remedy for controlling the spread of such infection. However, further studies are required to ascertain the socio-demographic characteristics influencing the knowledge, attitude and preventive measures of COVID-19. Methods: This study investigated the socio-demographic characteristics influencing knowledge, attitude and preventive practices towards COVID-19 among the Ghanaian population. A cross-sectional design was adopted to recruit 369 participants for the study utilizing convenience and snowball sampling methods. With the use of an electronic semi-structured questionnaire and social media platforms, an online survey was conducted from March 26 to May 1, 2020. Descriptive statistics, independent t-test, chi-square test, one-way analysis of variance (ANOVA) and linear regression were used to analyze data. Results: The average mean percentage of good knowledge, positive attitudes and good preventive practices regarding the novel coronavirus disease was 83.2%, 88.2% and 69.2%, respectively. In relation to occupation, there was significant difference (t = -2.984, p-value = 0.0030) in COVID-19 knowledge. Income level was significantly associated with attitudes towards COVID-19. Male gender (vs female, β = -1.276, p-value = <0.00001), less than ¢500 income earners (vs above ¢1000, β = -0.845, p-value = 0.017) were associated with lower COVID-19 preventive practice score while being the 42-64 age category (vs 18–25-year group, β = 1.128, p-value = 0.028), health worker (vs non-health worker, β = 0.816, p-value = 0.001) and belonging to Ga ethnic group (vs Akan ethnic group, β = 0.89, p-value = 0.027) were associated with higher scores. Conclusion: Although this study found higher knowledge and attitudes toward the novel coronavirus disease, it did not reflect in higher preventive practices towards the infection. In our fight against this infection in Ghana, COVID-19 preventive measure educational campaigns targeting the male gender and low-income earners should be considered and implemented.

scholarly journals Silicone or polyurethane ureteral stent: assessment of the intensity of stent-related symptoms

2020 ◽  
Vol 20 (5-6) ◽  
pp. 125-131
Author(s):  
Nariman K. Gadzhiev ◽  
Sergey B. Petrov ◽  
Andrey O. Ivanov ◽  
Vladimir M. Obidnyak ◽  
Vladislav E. Grigoriev ◽  
...  
Keyword(s):  
Ureteral Stent ◽  
Control Group ◽  
Ureteral Stents ◽  
Stent Removal ◽  
Pain Visual Analog Scale ◽  
Group A ◽  
Bladder Symptoms ◽  
Cook Medical ◽  
Group B ◽  
Experimental Group

Introduction. About 80% of patients with ureteral stents experience symptoms associated with them. We believe that the intensity of stent-assosiated symptoms (SAS) can be reduced by the replacement of the stent material with a less solid one. The aim of our research was to compare the intensity of the symptoms and signs as well as the safety of silicone and poly urethane ureteral stent. Materials and methods. The study included 70 patients who were divided into two groups. Group A included patients who were placed with polyurethane stents (Rsch, Teleflex). The experimental group B included patients who were placed with silicone stents (Cook Medical). Specialized questionnaires like pain Visual Analog Scale (VAS) and Overactive Bladder Symptoms (OAB) questionnaires were used to study the patients for SAS severity 1 hour after the stent was placed, in the middle of the observation period and before the stent was removed or ureteroscopy was performed. In addition, each group was assessed for the effectiveness of the stent placement, the presence of hematuria, the number of unscheduled visits to the doctor and the degree of stent incrustation. Results. A total of 70 patients participated in the study, while the control group A included of 30 patients and experimental group B included 40 patients. Group B participants having silicone ureteral stents showed significantly lower average VAS values 2 weeks before stent removal and shortly before stent removal (p = 0.023 and p = 0.014 respectively). No other comparisons between the two groups were statistically significant. Conclusions. The obtained findings demonstrate that silicone ureter stents, unlike polyurethane ureter stents, cause less pain according to VAS two weeks before and during the stent removal procedure.

scholarly journals Change of Renal Parenchymal Width in Patients with Unilateral Ureteral Stent: A Bicenter Retrospective Study

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Hee Youn Kim ◽  
Seung-Ju Lee ◽  
Jin Bong Choi ◽  
Je Mo Yoo ◽  
Joon Ho Lee ◽  
...  
Keyword(s):  
Compensatory Growth ◽  
Ureteral Stent ◽  
Ureteral Stents ◽  
Kidney Size ◽  
Contralateral Kidney ◽  
Significant Difference ◽  
Glomerular Filtrate ◽  
The Mean ◽  
Spearman’S Correlation ◽  
Coronal View

Purpose. To determine whether kidney sizes were changed after ureteral stents were instilled, and if so, what parameters were significant. Methods. Parenchymal width (PW) of 98 patients with unilateral ureteral stents was measured from the coronal view of CT scans for both stented and unstented contralateral kidney. The mean PW and % change of mean PW were calculated before stenting and at the time of last stent change. Estimated glomerular filtrate rate (eGFR) was recorded as well. Results. The mean duration of ureteral stent indwelled was 15.6±10.2 (mean ± SD) months. The change of mean PW of stented kidneys and unstented contralateral kidneys was −16.9±16.4 (mean ± SD)% and 3.6±10.7%, respectively. eGFR before and at the time of the last stent change did not show significant difference (p=0.294). Duration of ureteral stent indwelled was found to be inversely related to the % change of mean PW (Spearman’s correlation coefficient = −0.291, p<0.001). Conclusions. For unilateral ureteral obstruction, kidney size was decreased over time in spite of indwelling ureteral stent. This finding can be overlooked by clinicians due to compensatory growth of contralateral kidney and resultant normal eGFR.

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