Kidney structure and function in dilating vesicoureteral reflux patients with anorectal malformation

BackgroundWe assessed the impact of anorectal malformation (ARM) on the kidneys of children with dilating vesicoureteral reflux (D-VUR) ≥grade III using a simple dimercaptosuccinic acid (DMSA) scintigraphy scan based renal dysfunction score (RDS).MethodsThe medical records of 121 patients with D-VUR treated between 2000 and 2014 were reviewed retrospectively. After excluding patients with secondary D-VUR (n=18), presence of ARM was used to create two groups: ARM+ (n=12 cases; 15 ureters) and ARM– (n=91 cases; 131 ureters). Types of ARM, grades of D-VUR, bladder and bowel dysfunction (BBD) and RDS were compared.ResultsPatient demographics, mean follow-up, grades of D-VUR and history of urinary tract infections were not significantly different. BBD was significantly higher in ARM+ (41.7% versus 7.7%, p=0.0006). RDS was significantly higher in ARM+ (p=0.036). Grades of D-VUR were significantly lower in ARM– with low RDS (p=0.008). During follow-up, changes in DMSA uptake over time were not observed in ARM+.ConclusionsWhile renal cortical lesions were correlated with grade of D-VUR in ARM– and RDS was significantly higher in ARM+, BBD did not appear to contribute to progressive renal dysfunction as is commonly believed. In fact, no progression in renal cortical lesions was observed in ARM+ based on RDS data. Renal cortical lesions may possibly be a feature of ARM, a topic that warrants further study.

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Does routine ultrasound change management in the follow-up of patients with vesicoureteral reflux?

Canadian Urological Association Journal ◽

10.5489/cuaj.202 ◽

2013 ◽

Vol 7 (7-8) ◽

pp. 467 ◽

Cited By ~ 1

Author(s):

Jan K. Rudzinski ◽

Bryce Weber ◽

Petra Wildgoose ◽

Armando Lorenzo ◽

Darius Bagli ◽

...

Keyword(s):

Vesicoureteral Reflux ◽

Demographic Data ◽

Multivariable Analysis ◽

Renal Ultrasound ◽

Dysfunctional Voiding ◽

Voiding Symptoms ◽

Previous Diagnosis ◽

History Of ◽

The Impact

Introduction: Children with vesicoureteral reflux (VUR) usually need a renal ultrasound (RUS). There is little data on the role of follow-up RUS in VUR. We evaluated the impact of follow-up RUS on the change in clinical management in patients with VUR.Methods: We prospectively analyzed children with a previous diagnosis of VUR seen in the outpatient clinic with a routine follow-up RUS within 4 months. Variables collected included: demographic data, VUR history, dysfunctional voiding symptoms and concurrent ultrasound findings. Change in management was defined as addition of new medication, nurse counselling, surgery or further investigations.Results: The study included 114 consecutive patients. The mean patient age was 4.5 years old, mean age of VUR diagnosis was 1.7 years, with average follow-up of 2.8 years. A change in management with stable RUS occurred in 14 patients, in which the change included ordering a DMSA in 9, nurse counselling for dysfunctional voiding in 3, and booking surgery in 2 patients. Change on RUS was seen in 4 patients. Multivariable analysis showed that history of urinary tract infection (UTI) since the last follow-up visit was more significant than RUS findings.Conclusions: The RUS findings in most patients followed for VUR remain stable or with minimal changes. The variable showing a significant effect on change in management in our study was history of UTI since the last follow-up visit rather than RUS findings. The value of follow-up RUS for children with VUR may need to be revisited.

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S19 The impact of clotting abnormalities on the natural history of idiopathic pulmonary fibrosis: an extended follow up of a population based cohort

Thorax ◽

10.1136/thoraxjnl-2016-209333.25 ◽

2016 ◽

Vol 71 (Suppl 3) ◽

pp. A13.1-A13

Author(s):

V Navaratnam ◽

AW Fogarty ◽

T McKeever ◽

N Thompson ◽

G Jenkins ◽

...

Keyword(s):

Natural History ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Population Based ◽

History Of ◽

The Impact

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Urinothorax Caused by Xanthogranulomatous Pyelonephritis

Case Reports in Pulmonology ◽

10.1155/2018/7976839 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

Waiel Abusnina ◽

Hazim Bukamur ◽

Zeynep Koc ◽

Fauzi Najar ◽

Nancy Munn ◽

...

Keyword(s):

Urinary Tract ◽

Obstructive Uropathy ◽

Xanthogranulomatous Pyelonephritis ◽

Robot Assisted ◽

Rare Form ◽

X Ray ◽

History Of ◽

Chest X Ray ◽

Tract Infections

Xanthogranulomatous pyelonephritis is a rare form of chronic pyelonephritis that generally afflicts middle-aged women with a history of recurrent urinary tract infections. Its pathogenesis generally involves calculus obstructive uropathy and its histopathology is characterized by replacement of the renal parenchyma with lipid filled macrophages. This often manifests as an enlarged, nonfunctioning kidney that may be complicated by abscess or fistula. This case details the first reported case of xanthogranulomatous pyelonephritis complicated by urinothorax, which resolved on follow-up chest X-ray after robot-assisted nephrectomy.

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The Impact of Arthroscopic Capsular Release in Patients with Primary Frozen Shoulder on Shoulder Muscular Strength

BioMed Research International ◽

10.1155/2014/834283 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Michał Waszczykowski ◽

Michał Polguj ◽

Jarosław Fabiś

Keyword(s):

Muscular Strength ◽

Frozen Shoulder ◽

Active Motion ◽

Capsular Release ◽

Arthroscopic Capsular Release ◽

Limited Function ◽

And Function ◽

The Impact

The aim of this study was to evaluate the impact of arthroscopic capsular release in patients with primary frozen shoulder on muscular strength of nonaffected and treated shoulder after at least two-year follow-up after the surgery. The assessment included twenty-seven patients, who underwent arthroscopic capsular release due to persistent limitation of range of passive and active motion, shoulder pain, and limited function of upper limb despite 6-month conservative treatment. All the patients underwent arthroscopic superior, anteroinferior, and posterior capsular release. After at least two-year follow-up, measurement of muscular strength of abductors, flexors, and external and internal rotators of the operated and nonaffected shoulder, as well as determination of range of motion (ROM) and function (ASES) in the operated and nonaffected shoulder, was performed. Measurement of muscular strength in the patient group did not reveal statistically significant differences between operated and nonaffected shoulder. The arthroscopic capsular release does not have significant impact on the decrease in the muscular strength of the operated shoulder.

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Exploring the scope of homoeopathy in combating the unfortunate consequences of post-COVID-19 survivors based on non-COVID conditions: a narrative review

Journal of Complementary and Integrative Medicine ◽

10.1515/jcim-2021-0200 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Ashish Kumar Dixit ◽

Nibha Giri ◽

Shishir Singh

Keyword(s):

Chronic Fatigue ◽

Cardiac Insufficiency ◽

Medical Database ◽

Fatigue Syndrome ◽

Tract Infections ◽

The Impact

Abstract Objectives The long-term consequences of COVID-19 survivors care and post-coronavirus infection are not yet well understood. The review aims to see whether homoeopathy can help COVID-19 survivors recover from its consequences and improve their quality of life. Content A systematic search of published articles for post-COVID sequelae and the impact of Homoeopathy were conducted. For the literature search, the major electronic bio-medical database PubMed/MEDLINE was used. In addition, supplementary searches were conducted through the references of those published articles. Summary A total of 113 records were identified of which 61 studies included for this review. Homoeopathy is effective in the treatment of mental disorders including anxiety and depressive disorder (ADD), some research studies have found, although systematic reviews disagree. Likewise, some medical societies denounce homoeopathy for pain management; other literature shows that it can be used to treat pain effectively. Homoeopathy can aid in the treatment of cardiovascular diseases, as Crataegus, a homoeopathic medication, was found to be just as effective as a standard angiotensin-converting enzyme (ACE) inhibitor and diuretic treatment for minor cardiac insufficiency. The outcomes for Chronic Fatigue Syndrome (CFS), Influenza, and Acute Respiratory Tract Infections (ARTIs) are also promising. Outlook Based on the results of homoeopathy in non-COVID conditions, it can be thought of in the management of post-COVID-19 outcomes. Consequently, we propose that while investigating post-COVID-19 patient rehabilitation, homoeopathic management may be included as part of the follow-up route and as much data as possible in the context of homoeopathy should be collected, so that in future, the role of homoeopathy in dealing with it can be better demonstrated.

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Abstract 14134: The Impact of Ablation for Atrial Fibrillation on Dementia Incidence in Patients With and Without Depression

Circulation ◽

10.1161/circ.142.suppl_3.14134 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Heidi T May ◽

Tami L Bair ◽

Stacey Knight ◽

Jeffrey L Anderson ◽

Joseph B Muhlestein ◽

...

Keyword(s):

Atrial Fibrillation ◽

Treatment Strategies ◽

Brain Perfusion ◽

Cardiovascular Comorbidities ◽

Incident Dementia ◽

History Of ◽

The Impact ◽

Mean Time ◽

History Of Depression

Introduction: Studies have previously shown that atrial fibrillation (AF) is associated with dementia. The mechanisms are likely multifactorial, but may involve treatment strategies that include anticoagulation use and rhythm management, particularly when used early. Patients that have earlier-life depression are at risk of dementia. However, depression diagnosis in AF patients may indicate a patient at higher risk of developing dementia and whether treatments ameliorate that risk is unknown. Methods: A total of 132,703 AF patients without a history of dementia were studied. History of depression was determined at the time of AF diagnosis. Patients were deemed as having a follow-up ablation if it occurred prior to a dementia diagnosis. Patients were stratified into 4 groups based on depression history and follow-up ablation status: no depression, ablation (n=5,960); no depression, no ablation (n=106,986); depression, ablation (n=923); and depression, no ablation (n=18,834). Patients were followed for 5-year incidence of dementia. Results: A total of 14.9% (n=19,757) pts had a history of depression at the time of AF diagnosis. The mean time between depression and AF diagnoses was 4.9±4.8 years. Patients with depression were younger (68±15 vs. 71±14 years), more likely to be female (62% vs. 44%), and had more cardiovascular comorbidities. Mean time to ablation was 1.3±1.4 days (median: 7.7 months) from AF diagnosis. Frequencies of 5-year dementia were: no depression, ablation=1.6%; no depression, no ablation=5.2%; depression, ablation=4.7%; and depression, no ablation=9.7%, p<0.0001. Multivariable comparisons between the groups are shown in the Figure. Conclusion: In AF patients with and without depression, ablation was associated with a lower risk of incident dementia. Rhythm control approaches that improve long-term brain perfusion may represent a means to impact cognitive declines in patients at higher risk because of earlier-life depression.

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Impact of obesity on male urethral sling outcomes

Therapeutic Advances in Urology ◽

10.1177/1756287220927997 ◽

2020 ◽

Vol 12 ◽

pp. 175628722092799

Author(s):

M. Francesca Monn ◽

Hannah V. Jarvis ◽

Thomas A. Gardner ◽

Matthew J. Mellon

Keyword(s):

Operative Time ◽

Cohort Analysis ◽

Obese Patients ◽

Retrospective Cohort Analysis ◽

Surgical Complexity ◽

History Of ◽

Sling Placement ◽

The Impact ◽

Male Urethral Sling

Background: The impact of obesity on AdVance male urethral sling outcomes has been poorly evaluated. Anecdotally, male urethral sling placement can be more challenging due to body habitus in obese patients. The objective of this study was to evaluate the impact of obesity on surgical complexity using operative time as a surrogate and secondarily to evaluate the impact on postoperative pad use. Methods: A retrospective cohort analysis was performed using all men who underwent AdVance male urethral sling placement at a single institution between 2013 and 2019. Descriptive statistics comparing obese and non-obese patients were performed. Results: A total of 62 patients were identified with median (IQR) follow up of 14 (4–33) months. Of these, 40 were non-obese and 22 (35.5%) were obese. When excluding patients who underwent concurrent surgery, the mean operative times for the non-obese versus obese cohorts were 61.8 min versus 73.7 min ( p = 0.020). No Clavien 3–5 grade complications were noted. At follow up, 47.5% of the non-obese cohort and 63.6% of the obese cohort reported using one or more pads daily ( p = 0.290). Four of the five patients with a history of radiation were among the patients wearing pads following male urethral sling placement. Conclusion: Obese men undergoing AdVance male urethral sling placement required increased operative time, potentially related to operative complexity, and a higher proportion of obese compared with non-obese patients required postoperative pads for continued urinary incontinence. Further research is required to better delineate the full impact of obesity on male urethral sling outcomes.

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Long-term prognosis of patients withJ-wave syndrome

Heart ◽

10.1136/heartjnl-2019-315007 ◽

2019 ◽

Vol 106 (4) ◽

pp. 299-306

Author(s):

Tsukasa Kamakura ◽

Tetsuji Shinohara ◽

Kenji Yodogawa ◽

Nobuyuki Murakoshi ◽

Hiroshi Morita ◽

...

Keyword(s):

High Amplitude ◽

Long Term Study ◽

St Segment ◽

History Of ◽

Provocation Testing ◽

Long Term Prognosis ◽

Electrocardiographic Parameters ◽

The Impact

ObjectiveLimited data are currently available regarding the long-term prognosis of patients with J-wave syndrome (JWS). The aim of this study was to investigate the long-term prognosis of patients with JWS and identify predictors of the recurrence of ventricular fibrillation (VF).MethodsThis was a multicentre retrospective study (seven Japanese hospitals) involving 134 patients with JWS (Brugada syndrome (BrS): 85; early repolarisation syndrome (ERS): 49) treated with an implantable cardioverter defibrillator. All patients had a history of VF. All patients with ERS underwent drug provocation testing with standard and high intercostal ECG recordings to rule out BrS. The impact of global J waves (type 1 ECG or anterior J waves and inferolateral J waves in two or more leads) on the prognosis was evaluated.ResultsDuring the 91±66 months of the follow-up period, 52 (39%) patients (BrS: 37; ERS: 15) experienced recurrence of VF. Patients with BrS and ERS with global J waves showed a significantly higher incidence of VF recurrence than those without (BrS: log-rank, p=0.014; ERS: log-rank, p=0.0009). The presence of global J waves was a predictor of VF recurrence in patients with JWS (HR: 2.16, 95% CI 1.21 to 3.91, p=0.0095), while previously reported high-risk electrocardiographic parameters (high-amplitude J waves ≥0.2 mV and J waves associated with a horizontal or descending ST segment) were not predictive of VF recurrence.ConclusionsThis multicentre long-term study showed that the presence of global J waves was associated with a higher incidence of VF recurrence in patients with JWS.

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Is baseline routine renal ultrasound indicated for all MS patients?

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2019-136838 ◽

2019 ◽

Vol 96 (1134) ◽

pp. 194-196

Author(s):

Igor B Títoff ◽

Victoria Titoff ◽

Thomas F Scott

Keyword(s):

Urinary Tract ◽

Upper Urinary Tract ◽

Renal Ultrasound ◽

Red Flags ◽

Inclusion Criteria ◽

Detrusor Sphincter Dyssynergia ◽

History Of ◽

Bladder Symptoms ◽

Tract Infections

BackgroundMost patients with multiple sclerosis (MS) develop multiple urological complaints due to hyperactive or hypoactive bladder, and may have detrusor-sphincter dyssynergia. Routine renal ultrasound (RUS) screening has been recommended for both symptomatic and asymptomatic MS patients; however, there is little data to support this practice.MethodsProspectively screened consecutive MS clinic patients in 2016–2017 with functional systems scores (FSS) indicating moderate to severe neurogenic bladder symptoms (FSS bladder ≥2) were sent for RUS. We also screened for history of urinary tract infections.Results872 patients were screened between 3 September 2016 and 13 April 2017. 58 patients met inclusion criteria for RUS. 6 were excluded due to non-compliance with testing or unavailability of results; 52 patients were imaged. Only 3/52 patients were found to have renal pathology requiring follow-up. Of those three, one had known symptomatic nephrolithiasis, and one had subsequently normal findings, leaving one patient newly found to have valid abnormal upper urinary tract (UUT) findings. Multiple incidental findings were also discovered.ConclusionThe minimal yield for significant UUT pathology found in this enriched group of symptomatic MS patients indicates that RUS screening for asymptomatic MS patients without clear risk factors is not indicated. Red flags for high risk of UUT complications should be used as triggers for baseline RUS screening in MS patients.

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Adherence and Effects Derived from FODMAP Diet on Irritable Bowel Syndrome: A Real Life Evaluation of a Large Follow-Up Observation

Nutrients ◽

10.3390/nu12040928 ◽

2020 ◽

Vol 12 (4) ◽

pp. 928 ◽

Cited By ~ 6

Author(s):

Antonietta Gerarda Gravina ◽

Marcello Dallio ◽

Mario Romeo ◽

Antonietta Di Somma ◽

Gaetano Cotticelli ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Symptom Control ◽

Bowel Dysfunction ◽

Positive Effects ◽

Diet Regimen ◽

Irritable Bowel ◽

Fodmap Diet ◽

The Impact

Introduction: Irritable bowel syndrome represents one of the most difficult gastroenterological diseases to treat, that usually induces the patients to follow different drug therapies, often not useful in symptom control. In this scenario low FODMAP diet could have positive effects in patients with irritable bowel syndrome, even because this type of diet regimen is characterized by a low gluten amount due to the exclusion of cereals. Methods: We enrolled 120 patients with irritable bowel syndrome, according to the Rome IV criteria, who were referred to Hepatogastroenterology Division of the University of Campania L. Vanvitelli from June to December 2018. They underwent a low FODMAP diet for six weeks, followed by a gradual weekly reintroduction of every category of food for three months. The patients had a follow-up evaluation for six months after the end of food reintroduction period. We measured abdominal pain with subjective numerical scale from 0 to 10. We evaluated other gastrointestinal symptoms with a questionnaire about symptoms of lower digestive tract, evaluating their frequency and intensity. We also evaluated the impact of irritable bowel syndrome on daily life with neurological bowel dysfunction score. Results: We obtained a good patient-adherence to diet and a statistically significant decrease of abdominal pain, bloating, flatulence, diarrhea, constipation, and neurological bowel dysfunction score (p < 0.001) at the end of the diet. These results remained constant in the follow-up period. Conclusions: We recommend the use of a low FODMAP diet regimen in patients with irritable bowel syndrome in order to control the symptoms and improve the quality of life.

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