Prophylactic Peritoneal Fenestration during Kidney Transplantation Can Reduce the Type C Lymphocele Formation

Lymphocele is a common complication following kidney transplantation (KTx). We aimed to evaluate the preventive effect of peritoneal fenestration during KTx in reducing lymphocele. From January 2001, the data of all KTx were prospectively gathered in our digital data bank. From 2008, preventive peritoneal fenestration was performed as a routine procedure for all patients with KTx. Between 2001 and 2008, 579 KTx were performed without preventive peritoneal fenestration. To compare the results between with and without peritoneal fenestration, the same number of patients after 2008 (579 patients) was included in this study. The pre-, intra-, and postoperative data of the patients in these two groups were analyzed and compared, especially regarding the postoperative different types of lymphocele formation. The mean recipient age was 52.6 ± 13.8, and 33.7% of the patients were female. Type C lymphocele was significantly lower in the group with preventive fenestration (5.3% vs. 8.8%, p = 0.014 for 31/579 vs. 51/579). Peritoneal dialysis and implantation of the kidney in the left fossa were independently associated with a higher rate of type C lymphocele (OR 2.842, 95% CI 1.354–5.967, p = 0.006 and OR 3.614, 95% CI 1.215–10.747, p = 0.021, respectively). The results of this study showed that intraoperative preventive peritoneal fenestration could significantly reduce type C lymphocele.

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The Die Punch Fragment: Analysis of Fragment Geometry and Need for Fixation

Journal of Hand and Microsurgery ◽

10.1055/s-0040-1712328 ◽

2020 ◽

Author(s):

Sezai Özkan ◽

Svenna H. W. L. Verhiel ◽

Samantha A. Jayasinghe ◽

Chaitanya S. Mudgal

Keyword(s):

Fragment Size ◽

Distal Radioulnar Joint ◽

Dorsal Approach ◽

Level Of Evidence ◽

Locked Plating ◽

Fragment Analysis ◽

Number Of Patients ◽

Preoperative Ct ◽

Type C ◽

The Mean

Abstract Introduction Die punch (DP) fragments are among the most common fracture fragments to lose reduction after volar locked plating of articular distal radius fractures (DRFs). We aimed to report the number of patients in our institution who had a computed tomography (CT)-confirmed DP fragment and who had open reduction and internal fixation (ORIF) through a dorsal approach; to report the length of the radioulnar portion of the DP fragment relative to the total distal radioulnar joint (DRUJ) length; and to identify if an association exists between this length and the choice for a volar versus a dorsal operative approach to the DP fragment. Materials and Methods We performed measurements on the preoperative CT scans of 94 skeletally mature patients with a DP fragment. We also collected data related to their demographics, injury, and treatment. Of the 94 patients in this study, 84 (89%) had AO type C fractures. Results Thirteen out of 94 patients (14%) who had ORIF of their DRF with a DP fragment had a separate dorsal incision. The mean proportion of the DP fragment length relative to the total DRUJ length was 0.51 ± 0.19. There was no association between the length of the DP fragment and volar versus dorsal approach. Conclusion DP fragment size is not an indicator of the need for or use of a dorsal approach in DRF fixation. Level of Evidence This is a Level IV,—retrospective study.

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PENINGKATAN KUALITAS HIDUP MELALUI LOGOTERAPI PADA KLIEN YANG MENJALANI HEMODIALISIS

Jurnal Keperawatan ◽

10.32583/keperawatan.v11i1.425 ◽

2019 ◽

Vol 11 (1) ◽

pp. 9-18

Author(s):

Abdul Wakhid ◽

Ana Puji Astuti ◽

Maya Kurnia Dewi

Keyword(s):

Quality Of Life ◽

Renal Failure ◽

Test Group ◽

Sampling Technique ◽

T Test ◽

P Value ◽

Number Of Patients ◽

Post Test ◽

The Mean

Logoterapi merupakan terapi untuk menemukan makna positif dibalik sebuah kejadian yang tidak diharapkan. Logoterapi dilaksanakan secara individu maupun berkelompok dalam bentuk konseling dan berorientasi pada pencarian makna hidup individu. Tujuan logoterapi meningkatkan makna pengalaman hidup individu yang diarahkan kepada pengambilan keputusan yang bertanggung jawab. Penelitian ini dilakukan dengan menggunakan rancangan pre-experiment dengan metode pre and post test group, artinya pengumpulan data dilakukan terhadap responden untuk membandingkan kualitas hidup sebelum dan sesudah dilakukan intervensi. Teknik pengambilan sampel dilakukan dengan metode total sampling yaitu pengambilan seluruh sampel dengan tetap memperhatikan kriteria yang telah ditetapkan. Jumlah pasien yang menjalani hemodialisis di RSUD Ungaran sebanyak 21 orang dan di RSUD Ambarawa sebanyak 25 pasien. Analisis data dilakukan dengan menggunakan uji t test dependent. Hasil penelitian didapatkan bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 60.22 dengan skor terrendah 55 dan skor tertinggi 69. Bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 88.72 dengan skor terrendah 79 dan skor tertinggi 103. Hasil uji statistik dengan uji t test dependent diketahui ada pengaruh logoterapi terhadap kemampuan memaknai hidup pada klien yang menjalani hemodialisis di RSUD Kabupaten Semarang (p value: 0,0001). Saran perlunya peningkatan kemampuan perawat dalam memberikan layanan kesehatan termasuk pemberian atau pemanduan penemuan makna hidup bagi pasien hemodialysis, agar selain dengan hemodialysis, ada faktor internal dari pasien yang dapat dijadikan sebagai motivasi untuk sembuh dari penyakit. Kata Kunci: Logoterapi, kualitas hidup IMPROVE THE QUALITY OF LIFE OF PATIENTS WITH RENAL FAILURE WHO UNDERWENT HEMODIALYSIS ABSTRACT Logotherapy is a therapy to discover the positive meaning behind an unexpected event. Logotherapy is carried out individually or in groups in the form of counseling and oriented to the search for the meaning of individual life. This study aims to improve the quality of life of patients with renal failure who underwent hemodialysis. This research was conducted by using pre-experiment with pre-post test study. The sampling technique was done by the convenience sampling. The number of patients undergoing hemodialysis as many as 46 respondents. Data analysis was done by using test t test dependent. The result showed that from 46 respondents got the mean of quality of life of patients who had hemodialysis 60.22 with lowest score 55 and highest score 69. Whereas from 46 respondents got the mean score of life quality of patients who had hemodialysis 88.72 with score the lowest score 79 and the highest score 103. The result of statistical test with t test dependent is known there is influence of logoterapi to the ability of meaningful life on client who undergo hemodialysis at Semarang Regency hospitals (p value: 0.0001). Advice on the need to improve the nurse's ability to provide health services, including the provision or guidance of the discovery of the meaning of life for hemodialysis patients, in addition to hemodialysis, there are internal factors of the patient that can be used as a motivation to recover from illness. Keywords: Logotherapy, quality of life, kidney failure.

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COVID-19—Importance for Patients on the Waiting List and after Kidney Transplantation—A Single Center Evaluation in 2020–2021

Pathogens ◽

10.3390/pathogens10040429 ◽

2021 ◽

Vol 10 (4) ◽

pp. 429

Author(s):

Simone C. Boedecker ◽

Pascal Klimpke ◽

Daniel Kraus ◽

Stefan Runkel ◽

Peter R. Galle ◽

...

Keyword(s):

Kidney Transplantation ◽

Waiting List ◽

Smoking History ◽

Immunocompromised Patients ◽

Dialysis Patients ◽

Vaccination Programs ◽

Mild Disease ◽

Probability Of Survival ◽

Number Of Patients ◽

Immunosuppressed Patients

(1) Background: Dialysis patients and recipients of a kidney allograft are at high risk for infection with SARS-CoV-2. It has been shown that the development of potent neutralizing humoral immunity against SARS CoV-2 leads to an increased probability of survival. However, the question of whether immunocompromised patients develop antibodies has not yet been sufficiently investigated; (2) Methods: SARS-CoV-2 antibodies were examined in hemodialysis patients on the waiting list for kidney transplantation as well as patients after kidney transplantation. Patients were interviewed about symptoms and comorbidities, BMI, and smoking history; (3) Results: SARS-CoV-2 antibodies were found in 16 out of 259 patients (6%). The trend of infections here reflects the general course of infection in Germany with a peak in November/December of 2020. Remarkably, patients on the waiting list experienced only mild disease. In contrast, transplanted patients had to be hospitalized but recovered rapidly from COVID-19. Most interesting is that all immunosuppressed patients developed antibodies against SARS-CoV-2 after infection; (4) Conclusions: Even with extensive hygiene concepts, an above-average number of patients were infected with SARS-CoV-2 during the second wave of infections in Germany. Because SARS-CoV-2 infection triggered the formation of antibodies even in these immunocompromised patients, we expect vaccination to be effective in this group of patients. Thus, dialysis patients and patients after kidney transplantation should be given high priority in vaccination programs.

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Management of optic disc pit-associated maculopathy: A case series from a tertiary referral center

European Journal of Ophthalmology ◽

10.1177/11206721211023727 ◽

2021 ◽

pp. 112067212110237

Author(s):

Ilkay Kilic Muftuoglu ◽

Ecem Onder Tokuc ◽

V Levent Karabas

Keyword(s):

Optic Disc ◽

Case Series ◽

Internal Limiting Membrane ◽

Maximum Height ◽

Optic Disc Pit ◽

Tertiary Referral Center ◽

Number Of Patients ◽

The Mean ◽

Foveal Center

Purpose: To report outcomes of pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) stuffing technique in patients with optic disc pit associated maculopathy (ODP-M). Methods: Data including best-corrected visual acuity (BCVA), central macular thickness (CMT), foveal center point thickness (FCP), and maximum height of fluid (max_fluid) (intraretinal or subretinal) were collected from the medical records of the patients. Results: Six eyes of six patients with a mean age of 28.0 ± 17.68 years (range: 9–53 year) underwent PPV + ILM plug surgery. The mean follow-up duration was 25.62 ± 26.11 months (range: 11.80–78.00 month) duration. The mean BCVA increased from 1.25 ± 1.04 logMAR (20/355, Snellen equivalent) to 0.86 ± 1.09 logMAR (20/144, Snellen equivalent) at last follow-up ( p = 0.043). Compared to baseline, CMT, FCP, and max_fluid significantly decreased at all visits after the surgery ( p < 0.05 for all visits). At last follow-up, 66.6% of the eyes (four eyes) showed complete resolution of fluid at a mean of 5.25 ± 4.99 months (range: 1–12 months) after the surgery. Conclusion: PPV with ILM plug seemed to be an effective surgical technique in ODP-M. Studies with longer follow-up and higher number of patients are needed to confirm our results.

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Incidence and Characteristics of Retinoblastoma in Poland: The First Nationwide Study 2010–2017

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126539 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6539

Author(s):

Michał S. Nowak ◽

Bożena Romanowska-Dixon ◽

Iwona Grabska-Liberek ◽

Michał Żurek

Keyword(s):

Western Europe ◽

External Beam Radiotherapy ◽

Cohort Analysis ◽

Developed Countries ◽

Live Births ◽

Focal Treatment ◽

Different Types ◽

The Mean ◽

Birth Cohort Analysis

Background: The present study aimed to investigate the incidence and characteristics of retinoblastoma in the overall population of Poland. Methods: The retrospective survey of both National Health Fund (NHF) and National Cancer Registry (NCR) databases were performed to identify all retinoblastoma cases in Poland in the years 2010–2017. Results: During 2010–2017, the mean age-standardised incidence of retinoblastoma (the unit of incidence is per 1,000,000 person-years) was 10.15 (95% CI 7.23–13.08) among children aged 0 to 4 years and 5.39 (95% CI 4.18–6.60) in those aged 0 to 9 years. During 2010–2014 (to allow 5 years of follow-up), the mean incidence of retinoblastoma by birth cohort analysis in Poland was 4.89 (95% CI 4.04–5.74) per 100,000 live births, corresponding to an incidence of 1 per 20,561 (95% CI 15,855–25,267) live births. In Poland, 14.6% of children with retinoblastoma had enucleation of the eye globe, 76.8% received different types of chemotherapy combined with focal treatment, 5.9% were treated with external beam radiotherapy, and 2.7% were treated with focal treatments only. Conclusions: The incidence of retinoblastoma and the pattern of medical management of retinoblastoma in Poland was similar to that reported in developed countries in Western Europe, Asia, and North America.

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Combined Heart-Liver and Domino Liver Transplantation in Familial Amyloidosis

The American Surgeon ◽

10.1177/00031348211023427 ◽

2021 ◽

pp. 000313482110234

Author(s):

Angela Sickels ◽

Keyur B. Shah ◽

Brianna Ruch ◽

Adrian Cotterell ◽

Inna Tchoukina ◽

...

Keyword(s):

Liver Transplantation ◽

Total Artificial Heart ◽

Donor Pool ◽

Cardiac Rejection ◽

Recipient Age ◽

Hospital Stays ◽

The Mean ◽

Domino Liver Transplantation ◽

End Stage

Background Combined heart-liver transplantation (CHLT) is the only curative option for patients with concomitant pathology affecting the heart and liver. In some cases, the native livers of familial amyloidosis (FA) patients may be suitable for domino transplantation into other recipients. Methods Retrospective analysis (2013 to 2019) of all CHLT at our center was performed. Continuous data were presented as mean with standard deviation and discrete variables as percentages. Results Familial amyloidosis was the indication for CHLT in 5 out of 6 patients. The mean recipient age was 55 ± 5.62 years. Two patients were bridged with total artificial heart. The mean model for end-stage liver disease score at transplant was 17.17 ± 3.7. Two explanted livers were used for transplantation in a domino fashion. The median intensive care and hospital stays were 5.5 and 19 days, respectively. Complications included renal failure (1), groin abscess (1), pulmonary embolism (1), and cardiac rejection (1). Patient and graft survival for both organs was 100% at a median follow-up of 59 (range 20-76) months. Discussion Combined heart-liver transplantation for FA achieves excellent outcomes. The possible use of livers explanted from patients with FA for domino liver transplantation can contribute to the liver donor pool.

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Does Every Calculation Formula Fit for All Types of Intraocular Lenses? Optimization of Constants for Tecnis ZA9003 and ZCB00 Is Necessary

Medicina ◽

10.3390/medicina57040319 ◽

2021 ◽

Vol 57 (4) ◽

pp. 319

Author(s):

Ivajlo Popov ◽

Veronika Popova ◽

Juraj Sekac ◽

Vladimir Krasnik

Keyword(s):

Prediction Error ◽

Poor Performance ◽

Intraocular Lenses ◽

Power Calculation ◽

Universal Formula ◽

Aspheric Iol ◽

Different Types ◽

The Mean ◽

Clinically Significant ◽

Mean Prediction Error

Background and Objectives: To evaluate the performance of intraocular lenses (IOLs) using power calculation formulas on different types of IOL. Materials and Methods: 120 eyes and four IOL types (BioLine Yellow Accurate Aspheric IOL (i-Medical), TECNIS ZCB00, TECNIS ZA9003 (Johnson & Johnson) (3-piece IOL) and Softec HD (Lenstec)) were analyzed. The performance of Haigis, Barret Universal II and SKR-II formulas were compared between IOL types. The mean prediction error (ME) and mean absolute prediction error (MAE) were analyzed. Results: The overall percentage of eyes predicted within ±0.25 diopters (D) was 40.8% for Barret; 39.2% Haigis and 31.7% for SRK-II. Barret and Haigis had a significantly lower MAE than SRK-II (p < 0.05). The results differed among IOL types. The largest portion of eyes predicted within ±0.25 D was with the Barret formula in ZCB00 (33.3%) and ZA9003 (43.3%). Haigis was the most accurate in Softec HD (50%) and SRK-II in Biolline Yellow IOL (50%). ZCB00 showed a clinically significant hypermetropic ME compared to other IOLs. Conclusions: In general, Barret formulas had the best performance as a universal formula. However, the formula should be chosen according to the type of IOL in order to obtain the best results. Constant optimizations are necessary for the Tecnis IOL ZCB00 and ZA9003, as all of the analyzed formulas achieved a clinically significant poor performance in this type of IOL. ZCB00 also showed a hypermetropic shift in ME in all the formulas.

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Outcomes of Ureteroscopy and Laser Stone Fragmentation (URSL) for Kidney Stone Disease (KSD): Comparative Cohort Study Using MOSES Technology 60 W Laser System versus Regular Holmium 20 W Laser

Journal of Clinical Medicine ◽

10.3390/jcm10132742 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2742

Author(s):

Amelia Pietropaolo ◽

Thomas Hughes ◽

Mriganka Mani ◽

Bhaskar Somani

Keyword(s):

Operative Time ◽

Laser System ◽

Stone Fragmentation ◽

System Versus ◽

Number Of Patients ◽

Higher Power ◽

Group A ◽

The Mean ◽

Laser Group ◽

Second Procedure

Background: For ureteroscopy and laser stone fragmentation (URSL), the use of laser technology has shifted from low power to higher power lasers and the addition of Moses technology, that allows for ‘fragmentation, dusting and pop-dusting’ of stones. We wanted to compare the outcomes of URSL for Moses technology 60 W laser system versus matched regular Holmium 20 W laser cases. Methods: Prospective data were collected for patients who underwent URSL using a Moses 60 W laser (Group A) and matched to historical control data using a regular Holmium 20 W laser (Group B), performed by a single surgeon. Data were collected for patient demographics, stone location, size, pre- and post-operative stent, operative time, length of stay, complications and stone free rate (SFR). Results: A total of 38 patients in each group underwent the URSL procedure. The stones were matched for their location (17 renal and 11 ureteric stones). The mean single and cumulative stone sizes (mm) were 10.9 ± 4.4 and 15.5 ± 9.9, and 11.8 ± 4.0 and 16.5 ± 11.3 for groups A and B, respectively. The mean operative time (min) was 51.6 ± 17.1 and 82.1 ± 27.0 (p ≤ 0.0001) for groups A and B. The initial SFR was 97.3% and 81.6% for groups A and B, respectively (p = 0.05), with 1 and 7 patients in each group needing a second procedure (p = 0.05), for a final SFR of 100% and 97.3%. While there were 2 and 5 Clavien I/II complications for groups A and B, none of the patients in group A had any infection related complication. Conclusions: Use of Moses technology with higher power was significantly faster for stone lithotripsy and reduced operative time and the number of patients who needed a second procedure to achieve a stone free status. It seems that the use of Moses technology with a mid-power laser is likely to set a new benchmark for treating complex stones, without the need for secondary procedures in most patients.

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Kidney transplantation in the extremely elderly from extremely aged deceased donors: a kidney for each age

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfz293 ◽

2020 ◽

Vol 35 (4) ◽

pp. 687-696

Author(s):

Jimena Cabrera ◽

Mario Fernández-Ruiz ◽

Hernando Trujillo ◽

Esther González ◽

María Molina ◽

...

Keyword(s):

Kidney Transplantation ◽

Graft Survival ◽

Cox Regression ◽

Patient Survival ◽

Incidence Rates ◽

Allocation Policy ◽

Recipient Age ◽

Deceased Donors ◽

Stage Renal Disease ◽

End Stage

Abstract Background Advances in life expectancy have led to an increase in the number of elderly people with end-stage renal disease (ESRD). Scarce information is available on the outcomes of kidney transplantation (KT) in extremely elderly patients based on an allocation policy prioritizing donor–recipient age matching. Methods We included recipients ≥75 years that underwent KT from similarly aged deceased donors at our institution between 2002 and 2015. Determinants of death-censored graft and patient survival were assessed by Cox regression. Results We included 138 recipients with a median follow-up of 38.8 months. Median (interquartile range) age of recipients and donors was 77.5 (76.3–79.7) and 77.0 years (74.7–79.0), with 22.5% of donors ≥80 years. Primary graft non-function occurred in 8.0% (11/138) of patients. Cumulative incidence rates for post-transplant infection and biopsy-proven acute rejection (BPAR) were 70.3% (97/138) and 15.2% (21/138), respectively. One- and 5-year patient survival were 82.1 and 60.1%, respectively, whereas the corresponding rates for death-censored graft survival were 95.6 and 93.1%. Infection was the leading cause of death (46.0% of fatal cases). The occurrence of BPAR was associated with lower 1-year patient survival [hazard ratio (HR) = 4.21, 95% confidence interval (CI) 1.64–10.82; P = 0.003]. Diabetic nephropathy was the only factor predicting 5-year death-censored graft survival (HR = 4.82, 95% CI 1.08–21.56; P = 0.040). Conclusions ESRD patients ≥75 years can access KT and remain dialysis free for their remaining lifespan by using grafts from extremely aged deceased donors, yielding encouraging results in terms of recipient and graft survival.

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Disability in Schizophrenic Disorders

European Psychiatry ◽

10.1016/s0924-9338(09)70442-0 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

J. Wancata ◽

M. Freidl ◽

F. Friedrich ◽

T. Matschnig ◽

A. Unger ◽

...

Keyword(s):

Hospital Admissions ◽

Social Consequences ◽

Subjective Burden ◽

Social Contacts ◽

Mothers And Fathers ◽

Duration Of Illness ◽

The Family ◽

Different Types ◽

Icd 10 ◽

The Mean

Aims:The purpose of this study was to investigate disability among patients suffering from schizophrenia and to identify predictors of disability.Methods:101 patients from different types of psychiatric services in Vienna and diagnosed with schizophrenia according to ICD-10 were included. They were investigates by means of 36-Item self-administered version of the WHO Disability Assessment Schedule II (WHO-DAS-II) and the PANSS-scale. Patients’ mothers and fathers were asked to fill in the Family Problem Questionnaire.Results:The mean total score of the WHO-DAS-II was 74.1 (SD 21.9). When using weighted sub-scores the highest disability scores were found for social contacts, participation in society and household (means 2.58, 2.57 and 2.51 respectively). Using logistic regression, overall disability was positively associated with patient's age, overall severity of symptoms (PANSS) and number of previous hospital admissions. Overall disability was not associated with duration of illness and or patient's gender. The subjective burden experienced by patients’ fathers and mothers were increased by reduced social contacts and impaired participation in society, while we could not find an association with other domains of patient's disability (understanding, mobility, self-care, household).Conclusions:This study shows that schizophrenia results in disability in several domains. Family caregivers’ burden was predominantly increased by social consequences of schizophrenia.

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