Obstructive uropathy in the context of ureteroinguinal hernia: experience of challenges in surgical management of an unwell patient

2020 ◽  
Vol 13 (8) ◽  
pp. e235060
Author(s):  
Mitchell Egerton Barns ◽  
Arvind Vasudevan ◽  
Emma Lucy Marsdin
Keyword(s):  
Obstructive Uropathy ◽  
Anatomical Variation ◽  
Surgical Patients ◽  
Definitive Treatment ◽  
Ureteric Stent ◽  
Common Presentation ◽  
Iatrogenic Damage ◽  
Vesicoureteric Junction ◽  
Collecting System

This case exemplifies an unusual anatomical variation of a common presentation and highlights the importance of perioperative diagnosis and planning in complex surgical patients. A 72-year-old comorbid man presented to the emergency department with an infected obstructed right kidney secondary to an obstructing 12 mm vesicoureteric junction calculi. However, imaging also showed concurrent ureteroinguinal hernia associated with a 130 cm-long ureter, too long for conventional treatment with a ureteric stent. Acutely, the patient’s collecting system was decompressed via nephrostomy, but due to the rarity of this anatomical variation, definitive treatment had to be rethought to help reduce the risk of iatrogenic damage and the associated long-term complications.

1903: Long-Term Recurrence Rate After ESWL of Isolated Lower Calyx Stones in Relation to the Collecting System Anatomy

2004 ◽  
Vol 171 (4S) ◽  
pp. 503-503
Author(s):  
Roger M. Mueller ◽  
Bernard Descoeudres ◽  
Werner W. Hochreiter ◽  
Urs E. Studer ◽  
Hansjoerg Danuser
Keyword(s):  
Recurrence Rate ◽  
Collecting System ◽  
Long Term Recurrence Rate

scholarly journals Study of factors influencing the encrustation of indwelling catheters: prospective case series

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Sanket Kalpande ◽  
P. R. Saravanan ◽  
K. Saravanan
Keyword(s):  
Case Series ◽  
Definitive Treatment ◽  
Physically Active ◽  
Indwelling Catheters ◽  
Factors Influencing ◽  
Culture Sensitivity ◽  
Calcium Phosphorus ◽  
Prospective Case Series ◽  
Active Patients

Abstract Background Long-term catheterisation is frequently necessary for patients with retention of urine or intractable incontinence who are unfit for definitive treatment or being evaluated for definitive treatment. In this study, the important factors influencing the encrustation of indwelling catheters are analysed. Methods A total of 52 patients on catheter drainage for a period ranging from 1 month to 1 year were taken in the study. Patients reported either for problems like catheter block or routine changing of catheter. The catheters were removed, and encrustation was subjected to chemical analysis. Urine was examined for pH, specific gravity, culture sensitivity and appearance. Blood samples were taken for estimation of calcium, phosphorus and uric acid. Results Out of 52 patients, 28 with urea splitting and 15 with non-urea splitting had positive urine culture (43 out of 52). Amongst 28, 27 (96%) had encrustation compared to 10 (50%) out of 15 with non-urea splitting bacteria (p value < .05). Amongst 24 patients having pH > 6, 22 (92%) had encrustation (p value < .05). The encrustation was found to be more common in bedridden patients (91%) when compared to physically active patients (54%) (p value < .05). The encrustation was more common in patients having single catheter for more than 15 days (86%) when compared to patients having catheter for shorter period (43%) (p value < .05). Conclusion This study showed definitive influence of the following factors in encrustation formation: infection with urea splitting organism, alkaline pH, physical activity of patient and duration of keeping a particular catheter.

Management of breast infections in primary care

2021 ◽  
pp. 175573802199282
Author(s):  
Serena Rose Strickland ◽  
Rishabha Deva Sharma
Keyword(s):  
Primary Care ◽  
Abscess Formation ◽  
Tissue Destruction ◽  
Inflammatory Mass ◽  
Skin Changes ◽  
Lactating Women ◽  
Common Presentation ◽  
Systemic Sepsis ◽  
Inappropriate Treatment

Breast infections are a common presentation globally. Symptoms can range from mild discomfort and erythema of the skin to systemic sepsis and abscess formation with associated long-term physical and psychological morbidity. Although more common in the puerperium, non-lactating women, in particular, those between the ages of 18 and 50 years can be affected by the condition. Prompt recognition and treatment in primary care can reduce the incidence of abscess formation. Delayed or inappropriate treatment can lead to chronic infection with associated tissue destruction. In a minority of cases an inflammatory mass and skin changes can be a presenting feature of breast cancer.

Long-term follow-up of renal function in patients after surgery for obstructive uropathy

2008 ◽  
Vol 23 (6) ◽  
pp. 937-945 ◽  
Author(s):  
Daniela Miklovicova ◽  
Olga Cervenova ◽  
Andrea Cernianska ◽  
Zuzana Jancovicova ◽  
Ladislav Dedik ◽  
...  
Keyword(s):  
Renal Function ◽  
Obstructive Uropathy ◽  
Long Term Follow Up

312 Retrospective Analysis of Long-Term Scarring Outcomes in Paediatric Burns Patients

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Mistry
Keyword(s):  
Outcome Measure ◽  
Patient Reported Outcome ◽  
Burn Patients ◽  
Burn Scar ◽  
Common Presentation ◽  
Paediatric Burns ◽  
Significant Difference ◽  
Patient Reported

Abstract Introduction Paediatric burns are a common presentation to a plastic surgery unit. The long-term scar outcomes in paediatric burns patients are relatively unknown as most are discharged after 6 weeks follow up. We aimed to determine whether the long-term scarring outcomes are significantly different in those who had surgical treatment with Versajetâ debridement and Biobraneâ, versus those treated conservatively with non-adherent dressings, in a cohort of paediatric burns patients. Method The parents of all paediatric burns patients admitted to Stoke Mandeville Hospital from October 2014 to September 2017 were contacted by telephone to fill in the Brisbane Burn Scar Impact Profile (BBSIP), a patient reported outcome measure specifically aimed at children. The results from the questionnaires underwent statistical analysis to see if there was a significant difference in questionnaire scores between children treated surgically versus those treated conservatively. Results A total of 107 children were admitted in the timeframe, responses were received from 34 patients with 13 having been treated surgically and 21 having been treated conservatively. In all 58 questions that make up the BBSIP, there was no statistically significant difference observed in the scores of those treated surgically versus those treated conservatively. For 31 questions on the BBSIP, the lowest score indicating the best outcome was observed in all patients in both groups. Conclusions We found no statistically significant difference in the long-term scar outcomes as assessed by the BBSIP in paediatric burn patients treated with Versajetâ debridement and Biobraneâ, versus those treated conservatively with non-adherent dressings.

Updated picture of SARS-CoV-2 variants and mutations

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Giuseppe Lippi ◽  
Camilla Mattiuzzi ◽  
Brandon M. Henry
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Preventive Measures ◽  
Definitive Treatment ◽  
Social Distancing ◽  
Viral Spread ◽  
Limited Efficacy ◽  
Highly Virulent ◽  
New Mutations

Abstract The worldwide burden of coronavirus disease 2019 (COVID-19) is still unremittingly prosecuting, with nearly 300 million infections and over 5.3 million deaths recorded so far since the origin of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic at the end of the year 2019. The fight against this new highly virulent beta coronavirus appears one of the most strenuous and long challenges that humanity has ever faced, since a definitive treatment has not been identified so far. The adoption of potentially useful physical preventive measures such as lockdowns, social distancing and face masking seems only partially effective for mitigating viral spread, though efficacy and continuation of such measures on the long term is questionable, due to many social and economic reasons. Many COVID-19 vaccines have been developed and are now widely used, though their effectiveness is challenged by several aspects such as low uptake and limited efficacy in some specific populations, as well as by continuous emergence of new mutations in the SARS-CoV-2 genome, accompanying the origin and spread of new variants, which in turn may contribute to further decrease the effectiveness of current vaccines and treatments. This article is hence aimed to provide an updated picture of SARS-CoV-2 variants and mutations that have emerged from November 2019 to present time (i.e., early December 2021).

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