scholarly journals Feasibility of a single session retrograde endoscopic laser lithotripsy of two large stones located in a bifid urinary tract. Presentation of a rare case

2020 ◽  
Vol 92 (2) ◽  
Author(s):  
Diomidis Kozyrakis ◽  
Anastasios Zarkadas ◽  
Ilias Katsaros ◽  
Vasileios Mourkas ◽  
Zisis Kratiras
Keyword(s):  
Rare Case ◽  
Laser Lithotripsy ◽  
Acute Renal Injury ◽  
Single Session ◽  
Left Ureter ◽  
Stone Clearance ◽  
The Past ◽  
Endoscopic Laser ◽  
The Common ◽  
Bifid Ureter

A 76 year-old male presented with urosepsis and acute renal injury secondary to obstruction by a 13 mm stone located in the common segment of a bifid left ureter. A second 10 mm stone was detected in the mid calyx of the lower moiety of the kidney. Drainage of both moieties with two double-J stents was initially performed. Following recovery from urosepsis a retrograde endoscopic semirigid and flexible laser lithotripsy of the distal and proximal stone respectively was performed resulting in stone clearance. Although retrograde ureterolithotripsy has been presented in the past, to the best of the authors’ knowledge, this is the first description of flexible retrograde intrarenal lithotripsy performed through a bifid ureter.

Cholangioscopy-guided lithotripsy for difficult bile duct stone clearance in a single session of ERCP: results from a large multinational registry demonstrate high success rates

Endoscopy ◽  
2019 ◽  
Vol 51 (10) ◽  
pp. 922-929 ◽  
Author(s):  
Amit P. Maydeo ◽  
Rungsun Rerknimitr ◽  
James Y. Lau ◽  
Abdulrahman Aljebreen ◽  
Saad K. Niaz ◽  
...  
Keyword(s):  
Bile Duct ◽  
Bile Duct Stone ◽  
Hepatic Duct ◽  
Laser Lithotripsy ◽  
Bile Duct Stones ◽  
Success Rates ◽  
Single Session ◽  
Serious Adverse Events ◽  
Stone Clearance ◽  
First Line Therapy

Abstract Background Peroral cholangioscopy (POCS) can be useful for difficult bile duct stone clearance. Large prospective multinational data on POCS-guided lithotripsy for clearing difficult bile duct stones in a single session of endoscopic retrograde cholangiopancreatography (ERCP) are missing. Methods Patients with difficult bile duct stones (defined as one or more of: largest stone diameter ≥ 15 mm, failed prior attempt at stone clearance, impacted, multiple, hepatic duct location, or located above a stricture) were enrolled at 17 centers in 10 countries. The principal endpoint was stone clearance in a single ERCP procedure using POCS. Results 156 patients underwent 174 sessions of POCS-guided electrohydraulic or laser lithotripsy. Stone clearance had failed in a previous ERCP using traditional techniques in 124/156 patients (80 %), while 32 /156 patients (21 %) were referred directly to POCS-guided therapy based on preprocedural assessment of the difficulty of stone clearance. In 101/156 patients (65 %), there were impacted stones. POCS-guided stone clearance was achieved in a single POCS procedure in 125 /156 patients (80 %, 95 % confidence interval [CI] 73 % – 86 %), and was significantly more likely for stones ≤ 30 mm compared with > 30 mm (odds ratio 7.9, 95 %CI 2.4 – 26.2; P = 0.002). Serious adverse events occurred in 3/156 patients (1.9 %, 95 %CI 0.4 % – 5.5 %), and included pancreatitis, perforation due to laser lithotripsy, and cholangitis (n = 1 each), all resolved within 1 week. Conclusion POCS-guided lithotripsy is highly effective for clearance of difficult bile duct stones in a single procedure and successfully salvages most prior treatment failures. It may also be considered first-line therapy for patients with difficult choledocholithiasis to avoid serial procedures.

Beyond Promoter: The Role of Macrophage in Invasion and Progression of Renal Cell Carcinoma

2020 ◽  
Vol 15 (7) ◽  
pp. 588-596
Author(s):  
Haibao Zhang ◽  
Guodong Zhu
Keyword(s):  
Renal Cell Carcinoma ◽  
Tumor Microenvironment ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Cell Formation ◽  
Biological Behavior ◽  
Tumor Stem Cell ◽  
The Past ◽  
The Common

Renal cell carcinoma (RCC) is one of the common urologic neoplasms, and its incidence has been increasing over the past several decades; however, its pathogenesis is still unknown up to now. Recent studies have found that in addition to tumor cells, other cells in the tumor microenvironment also affect the biological behavior of the tumor. Among them, macrophages exist in a large amount in tumor microenvironment, and they are generally considered to play a key role in promoting tumorigenesis. Therefore, we summarized the recent researches on macrophage in the invasiveness and progression of RCC in latest years, and we also introduced and discussed many studies about macrophage in RCC to promote angiogenesis by changing tumor microenvironment and inhibit immune response in order to activate tumor progression. Moreover, macrophage interactes with various cytokines to promote tumor proliferation, invasion and metastasis, and it also promotes tumor stem cell formation and induces drug resistance in the progression of RCC. The highlight of this review is to make a summary of the roles of macrophage in the invasion and progression of RCC; at the same time to raise some potential and possible targets for future RCC therapy.

Searching for Political Parties in the Past

2017 ◽  
Author(s):  
Piero Ignazi
Keyword(s):  
Eighteenth Century ◽  
Political Parties ◽  
Political Party ◽  
Ancient Greece ◽  
Political Community ◽  
Democratic Politics ◽  
The Political ◽  
The Past ◽  
The Common

Chapter 1 introduces the long and difficult process of the theoretical legitimation of the political party as such. The analysis of the meaning and acceptance of ‘parties’ as tools of expressing contrasting visions moves forward from ancient Greece and Rome where (democratic) politics had first become a matter of speculation and practice, and ends up with the first cautious acceptance of parties by eighteenth-century British thinkers. The chapter explores how parties or factions have been constantly considered tools of division of the ‘common wealth’ and the ‘good society’. The holist and monist vision of a harmonious and compounded society, stigmatized parties and factions as an ultimate danger for the political community. Only when a new way of thinking, that is liberalism, emerged, was room for the acceptance of parties set.

Can Groups Assert That P?

2019 ◽  
pp. 326-344
Author(s):  
Deborah Tollefsen
Keyword(s):  
Common Ground ◽  
Speech Act ◽  
Single Individual ◽  
Constitutive Rule ◽  
The Past ◽  
Group Members ◽  
The Common ◽  
Declarative Statement ◽  
John Macfarlane

When a group or institution issues a declarative statement, what sort of speech act is this? Is it the assertion of a single individual (perhaps the group’s spokesperson or leader) or the assertion of all or most of the group members? Or is there a sense in which the group itself asserts that p? If assertion is a speech act, then who is the actor in the case of group assertion? These are the questions this chapter aims to address. Whether groups themselves can make assertions or whether a group of individuals can jointly assert that p depends, in part, on what sort of speech act assertion is. The literature on assertion has burgeoned over the past few years, and there is a great deal of debate regarding the nature of assertion. John MacFarlane has helpfully identified four theories of assertion. Following Sandy Goldberg, we can call these the attitudinal account, the constitutive rule account, the common-ground account, and the commitment account. I shall consider what group assertion might look like under each of these accounts and doing so will help us to examine some of the accounts of group assertion (often presented as theories of group testimony) on offer. I shall argue that, of the four accounts, the commitment account can best be extended to make sense of group assertion in all its various forms.

Penile Lymphoepithelioma-Like Carcinoma: A Rare Case With PD-L1 Expression

2021 ◽  
pp. 106689692098834
Author(s):  
Raquel Machado-Neves ◽  
Bernardo Teixeira ◽  
Elsa Fonseca ◽  
Pedro Valente ◽  
Joaquim Lindoro ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Tumor Cells ◽  
Rare Case ◽  
Malignant Tumors ◽  
Squamous Cell Carcinomas ◽  
The Third ◽  
The Past ◽  
First Case ◽  
Lymphoplasmacytic Infiltrate

Most malignant tumors of the penis are squamous cell carcinomas (SCC), being divided in 2 groups, one human papillomavirus (HPV)-related and another non-HPV-related, with lymphoepithelioma-like carcinoma (LELC) being one of the rarest HPV-related SCC. In this article, we report a case of a 50-year-old man who presented testicular swelling and pain for the past 3 months. A penile mass was identified, and the patient was submitted to a total penectomy. The penectomy specimen showed an ulcerated lesion at the glans reaching the cavernous bodies. Microscopic examination showed undifferentiated epithelial cells with syncytial growth pattern mix with a dense lymphoplasmacytic infiltrate, consistent with LELC. The tumor cells expressed p16 and all 3 different clones of PDL1 (22C3, SP263, and SP142). The patient is alive and well with a follow-up of 3 months. To our knowledge, this is the third LELC of the penis reported in literature and the first case reported with PDL1 expression.

scholarly journals A Theoretical Framework on the Determinants of Food Purchasing Behavior of the Elderly: A Bibliometric Review with Scientific Mapping in Web of Science

Foods ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 688
Author(s):  
Khaled Alhammadi ◽  
Luna Santos-Roldán ◽  
Luis Javier Cabeza-Ramírez
Keyword(s):  
Elderly Population ◽  
Web Of Science ◽  
The Elderly ◽  
Purchasing Behavior ◽  
Food Purchasing ◽  
The Past ◽  
Bibliometric Review ◽  
Food Market ◽  
The Common ◽  
Elderly Consumers

The past few years have seen significant demographic changes in most regions, including an increased elderly population. Subsequently, elderly citizens comprise an important market segment of consumers, with the food industry one of the most affected areas in this context. However, food market managers previously believed that elderly consumers’ needs were stereotyped in nature. The lack of focus on this sector, therefore, left elderly consumers as an untapped market, without realizing the financial independence of this segment regarding their nutrition. This research will attempt to provide the key determinant factors on elderly consumers’ behavior related to food. For that purpose, a complete literature review of more than 123 papers regarding these concepts has been carried out. Once analyzed, we highlight the common insights to give clear guidance for supermarket managers and food manufacturers to have a better knowledge of the reasons behind elderly people’s food acquisitions.

scholarly journals Mixed Cutaneous Infection Caused byMycobacterium szulgaiandMycobacterium intermediumin a Healthy Adult Female: A Rare Case Report

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Amresh Kumar Singh ◽  
Rungmei S. K. Marak ◽  
Anand Kumar Maurya ◽  
Manaswini Das ◽  
Vijaya Lakshmi Nag ◽  
...  
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Healthy Adult ◽  
Nontuberculous Mycobacteria ◽  
Anterior Abdominal Wall ◽  
Cutaneous Infection ◽  
Once Daily ◽  
The Past ◽  
Rare Case Report

Nontuberculous mycobacteria (NTMs) are ubiquitous and are being increasingly reported as human opportunistic infection. Cutaneous infection caused by mixed NTM is extremely rare. We encountered the case of a 46-year-old female, who presented with multiple discharging sinuses over the lower anterior abdominal wall (over a previous appendectomy scar) for the past 2 years. Microscopy and culture of the pus discharge were done to isolate and identify the etiological agent. Finally, GenoType Mycobacterium CM/AS assay proved it to be a mixed infection caused byMycobacterium szulgaiandM. intermedium. The patient was advised a combination of rifampicin 600 mg once daily, ethambutol 600 mg once daily, and clarithromycin 500 mg twice daily to be taken along with periodic follow-up based upon clinical response as well as microbiological response. We emphasize that infections by NTM must be considered in the etiology of nonhealing wounds or sinuses, especially at postsurgical sites.

scholarly journals B.05 Hemi-laryngopharyngeal spasm (HELPS) syndrome: The discovery, cure, and characterization of a new neurological condition

2017 ◽  
Vol 44 (S2) ◽  
pp. S11-S11
Author(s):  
C Honey ◽  
M Morrison
Keyword(s):  
Surgical Care ◽  
Review Of The Literature ◽  
The Past ◽  
First Case ◽  
Patient Reported ◽  
Operative Outcome ◽  
Small Cohort ◽  
The Common ◽  
Similar Motor

Background: We published the world’s first case of hemi-laryngpharyngeal spasm (HELPS) syndrome cured by microvascular decompression (MVD) of the Xth cranial nerve in 2016. We now present a small cohort of patients (n=3) successfully treated with surgery in order to better delineate the common characteristics of this syndrome, diagnostic tests of choice, nuances of their surgical care and outcomes of their treatment. Methods: The history and physical examination of three patients with HELPS syndrome are presented. Pre-operative laryngoscopy, neuroimaging, response to botox and intra-operative videos are detailed. Post-operative outcome and complications are presented. Results: Each patient reported similar motor (choking) and sensory (coughing) features in their history. Episodic choking relentlessly progressed over the years until it occurred while sleeping and with frightening severity prompting tracheostomy in one patient and intubation in another. A “tickling” sensation deep in the throat triggered episodic coughing that worsened over the years until it occurred while sleeping and with frightening severity (syncope and incontinence). Conclusions: A review of the literature suggests that patients with similar symptoms, often called episodic laryngospasm in the past, have been treated with psychotherapy or antacids. With the recognition that a clearly defined subset of these patients have HELPS syndrome, we can offer them the potential of a neurosurgical cure.

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