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Blood metal concentrations and cardiac structure and function in total joint arthroplasty patients

World Journal of Orthopedics 2024年第8期15卷 773-782页

作者： Peter C Brennan Stephanie M Peterson Thomas J O'Byrne Mariana L Laporta Cody C Wyles Paul J Jannetto Garvan C Kane Maria Vassilaki Hilal Maradit Kremers department of Orthopedic Surgery Mayo ClinicRochesterMN 55905United States department of Quantitative Health Sciences Mayo ClinicRochesterMN 55905United States department of Anesthesiology and Perioperative Medicine Mayo ClinicRochesterMN 55905United States department of Laboratory Medicine and Pathology Mayo ClinicRochesterMN 55905United States department of Cardiovascular Diseases Mayo ClinicRochesterMN 55905United States

BACKGROUND There is concern regarding potential long-term cardiotoxicity with systemic distribution of metals in total joint arthroplasty(TJA)*** To determine the association of commonly used implant metals with echocardiographic measures in TJA *** The study comprised 110 TJA patients who had a recent history of high chromium,cobalt or titanium *** underwent two-dimensional,three-dimensional,Doppler and speckle-strain transthoracic echocardiography and a blood draw to measure metal *** and sex-adjusted linear and logistic regression models were used to examine the association of metal concentrations(exposure)with echocardiographic measures(outcome).RESULTS Higher cobalt concentrations were associated with increased left ventricular end-diastolic volume(estimate 5.09;95%CI:0.02-10.17)as well as left atrial and right ventricular dilation,particularly in men but no changes in cardiac *** titanium concentrations were associated with a reduction in left ventricle global longitudinal strain(estimate 0.38;95%CI:0.70 to 0.06)and cardiac index(estimate 0.08;95%CI,-0.15 to-0.01).CONCLUSION Elevated cobalt and titanium concentrations may be associated with structural and functional cardiac changes in some *** studies are warranted to better understand the systemic effects of metals in TJA patients.

关键词： Total joint arthroplasty Metal-on-metal Cardiotoxicity Heart failure Echocardiography Cobalt

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Impact of pre- and peri-operative risk factors on length of stay and hospital readmission following minimally-invasive partial nephrectomy

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Asian Journal of urology 2024年第1期11卷 72-79页

作者： Vanessa A.Lukas Rahul Dutta Ashok K.Hemal Matvey Tsivian Timothy E.Craven Nicholas A.Deebel David D.Thiel Ram Anil Pathak Brigham and Women's Hospital Division of UrologyDepartment of Surgery75 Francis StreetBostonMAUSA Atrium Health Wake Forest Baptist Medical Center Department of Urology1 Medical Center BlvdWinston-SalemNCUSA mayo clinic Florida Department of Urology4500 San Pablo RoadJacksonvilleFLUSA

Objective:We conducted an analysis of the American College of Surgeons National Surgical Quality Improvement Program database for minimally-invasive partial nephrectomy cases reported with the goal to identify pre-and peri-operative variables associated with length of stay(LOS)greater than 3 days and readmission within 30 ***:Records from 2008 to 2018 for“laparoscopy,surgical;partial nephrectomy”for prolonged LOS and readmission cohorts were *** analysis with Chi-square,t-tests,and multivariable logistic regression analysis with odds ratios(ORs),p-values,and 95%confidence intervals assessed statistical ***:Totally,20306 records for LOS greater than 3 days and 15854 for readmission within 30 days were *** and multivariable analysis exhibited similar *** LOS greater than 3 days,undergoing non-elective surgery(OR=5.247),transfusion of greater than four units within 72 h prior to surgery(OR=5.072),pre-operative renal failure or dialysis(OR=2.941),and poor pre-operative functional status(OR=2.540)exhibited the strongest statistically significant *** hospital readmission within 30 days,loss in body weight greater than 10%in 6 months prior to surgery(OR=2.227)and bleeding disorders(OR=2.081)exhibited strongest statistically significant ***:Multiple pre-and peri-operative risk factors are independently associated with prolonged LOS and hospital readmission within 30 days of surgery using the American College of Surgeons National Surgical Quality Improvement Program *** the risks factors that can potentially be improved prior to minimally-invasive partial nephrectomy is crucial to informing patient selection,optimization strategies,and patient education.

关键词： Minimally-invasive partial nephrectomy The American College of Surgeons National Surgical Quality Improvement Program Lengthof stay Hospital readmission

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Adenovirus F40/41 Gastroenteritis-Associated Emphysematous Gastritis:A Case Report

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Infectious Diseases & Immunity 2024年第2期4卷 93-95页

作者： Maulik K.Lathiya Abigail T.La Nou Maria E.Linnaus Susan M.Cullinan Emergency department Mayo Clinic Health SystemEau Claire 54703WIUSA Critical Care Medicine Mayo Clinic Health SystemEau Claire 54703WIUSA General Surgery department Mayo Clinic Health SystemEau Claire 54703WIUSA

Emphysematous gastritis(EG)is a rare form of gastritis characterized by gastric wall *** is associated with a high mortality *** case report describes a patient with a history of atrial fibrillation treated with apixaban,prior stroke,and schizoaffective disorder who showed epigastric tenderness on ***,no peritonitis signs were recorded,and laboratory values revealed high lactate levels and the presence of adenovirus F40/*** computed tomography scan showed extensive portal venous gas in the left hepatic lobe of the liver,as well as pneumatosis involving the entire stomach,indicating *** diagnosis was histologically confirmed and initially managed medically,which proved inefficacious,necessitating surgical intervention in the form of a laparotomy and esophagojejunostomy with Roux-en-Y *** case report suggests a potential association between EG and adenovirus F40/41–induced gastroenteritis,thereby emphasizing the challenging nature of *** underscores the need for comprehensive research to enhance our understanding of its underlying causes and effective treatment strategies.

关键词： Emphysema Gastritis Human adenovirus F40/41 Immunocompromised

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Multi-aspect analysis of ureteral access sheath usage in retrograde intrarenal surgery: A RIRSearch group study

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Asian Journal of urology 2024年第1期11卷 80-85页

作者： Oktay Özman Hacı M.Akgül Cem Başataç Önder Çınar Eyüp B.Sancak Cenk M.Yazıcı Bülent Önal Haluk Akpınar Gaziosmanpasa Training and Research Hospital Urology ClinicİstanbulTurkey TekirdağNamık Kemal University School of MedicineDepartment of UrologyTekirdağTurkey Group Florence Nightingale Hospitals Department of UrologyİstanbulTurkey Zonguldak Bulent Ecevit University School of MedicineDepartment of UrologyZonguldakTurkey Çanakkale Onsekiz Mart University School of MedicineDepartment of UrologyÇanakkaleTurkey İstanbul University-Cerrahpaşa Cerrahpaşa Medical FacultyDepartment of UrologyİstanbulTurkey

Objective:To evaluate the effect of ureteral access sheath(UAS)use and calibration change on stone-free rate and complications of retrograde intrarenal surgery(RIRS).Methods:Data from 568 patients undergoing RIRS for kidney or upper ureteral stones were retrospectively ***,patients were compared after 1:1 propensity score matching,according to UAS usage during RIRS(UAS used[+]87 and UAS non-used[−]87 patients).Then all UAS+patients(n=481)were subdivided according to UAS calibration:9.5-11.5 Fr,10-12 Fr,11-13 Fr,and 13-15 *** outcomes of the study were the success and complications of ***:Stone-free rate of UAS+patients(86.2%)was significantly higher than UAS−patients(70.1%)after propensity score matching(p=0.01).Stone-free rate increased with higher caliber UAS(9.5-11.5 Fr:66.7%;10-12 Fr:87.0%;11-13 Fr:90.6%;13-15 Fr:100%;p<0.001).Postoperative complications of UAS+patients(11.5%)were significantly lower than UAS−patients(27.6%)(p=0.01).Complications(8.7%)with 9.5-11.5 Fr UAS was lower than thicker UAS(17.2%)but was not statistically significant(p=0.09).UAS usage was an independent factor predicting stone-free status or peri-and post-operative complications(odds ratio[OR]3.654,95%confidence interval[CI]1.314-10.162;OR 4.443,95%CI 1.350-14.552;OR 4.107,95%CI 1.366-12.344,respectively).Conclusion:Use of UAS in RIRS may increase stone-free rates,which also increase with higher caliber *** usage may reduce complications;however,complications seemingly increase with higher UAS calibration.

关键词： Stone Retrograde intrarenal surgery Ureteral access sheath Urolithiasis Kidney

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Intraplaque injections of hyaluronic acid for the treatment of stable-phase Peyronie’s disease:a retrospective single-center experience

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Asian Journal of Andrology 2024年第3期26卷 268-271页

作者： Simone Cilio Roberto La Rocca Giuseppe Celentano Claudio Marino Massimiliano Creta Gianluigi Califano Celeste Manfredi Giorgio Ivan Russo Afonso Morgado Marco Falcone Marco Capece YAU Working Group Sexual and Reproductive Health department of Neurosciences Reproductive Sciences and OdontostomatologyUrology UnitUniversity of Naples“Federico II”Naples 80131Italy urology Unit Department of WomenChild and General and Specialized Surgery“Luigi Vanvitelli”UniversityNaples 80131Italy urology Section Department of SurgeryUniversityof CataniaCatania 95131Italy department of urology Centro Hospitalar Universitário São JoãoPorto 4200-319Portugal urology clinic-A.O.U.“Cittàdella Salute edella Scienza”-Molinette Hospital University of TurinTurin 10100Italy 不详

Peyronie’s disease(PD)is a condition of penile connective tissue affecting up to 10%of men *** the complexity ofits management,nonsurgical treatments,such as intraplaque injections,are gaining *** current literature shows dataon the efficacy of intraplaque injections of hyaluronic acid(HA)mainly in acute-phase ***,data on injections of HA instable-phase PD are *** for this retrospective study were derived from a prospectively maintained database of privatepatients presenting at a private medical practice affiliated to the University of Naples“Federico II”(Naples,Italy)with stable-phasePD between January 2020 and March *** underwent a standard protocol of three injections,each administered at atwo-week *** the intervals,patients performed vacuum device therapy,penile stretching,and modeling *** compiled the Peyronie’s Disease Questionnaire(PDQ)and Global Assessment of Peyronie’s Disease(GAPD)at baselineand 2 weeks after the third injection.A penile Doppler ultrasound was performed 2 weeks after the last injection to record thefinal ***,we recruited 62 patients with stable-phase PD and a mean(±standard deviation[s.d.])curvature of52.7°(±9.7°).After 6 weeks,eight(12.9%)patients did not experience any curvature *** remaining 54 patientshad a final mean(±s.d.)curvature of 40.3°(±9.1°)with P<0.001,compared to that before *** found improvement inall PDQ domains(all P≤0.01),and 50(80.6%)patients reported subjective improvement of the penile curvature according to *** conclusion,we demonstrated that after three injections of HA administered according to the adopted protocol,patientswith stable-phase PD could experience significant improvements in penile curvature,and physical and psychological consequencesof the disease without significantly relevant side effects.

关键词： hyaluronic acid intraplaque injection Peyronie’s disease stable-phase therapy

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M2 macrophage-related molecular subtypes and prognostic index for prostate cancer patients through integrating single-cell and bulk RNA sequencing analysis

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Genes & Diseases 2024年第4期11卷 131-133页

作者： Dechao Feng Xu Shi Dengxiong Li Ruicheng Wu Jie Wang Wuran Wei Ping Han department of urology Institute of UrologyWest China HospitalSichuan UniversityChengduSichuan 610041China

Prostate cancer(PCa)is considered as an age-related disease and accounts for the most prevalence of urinary malignancies in men.1 We previously analyzed the cellular landscape of tumor microenvironment in PCa patients,where we found that cancer-related fibroblasts might play an important role in tumorigenesis and the development of PCa and tumor-associated macrophage(TAM)could function synergistically with them.2 Thus,we further integrated single-cell and bulk RNA sequencing with meta-analysis to specify the prognostic effect of TAM on PCa and construct molecular subgroups and predictive index to guide clinical practice.

关键词： patients macrophage cancer

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Outcomes of a non-randomised audit of single pigtail suture stents in urolithiasis management of Asian patients in Singapore

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Asian Journal of urology 2024年第2期11卷 324-330页

作者： Ee Jean Lim Zhen Wei Choo Reshma Mangat Pradeep Durai Sarvajit Biligere Yiquan Tan Loh Hin Yeung Marcus Nicole Andrea Seet Li Ting Chin Tiong Heng Stefania Ferreti Vineet Gauhar urology department Singapore General HospitalSingapore urology department Tan Tock Seng HospitalSingapore urology department Ng Teng Fong HospitalSingapore urology department Azienda Ospedaliera-Uiversitaria(Hospital and University of Parma)ParmaItaly

Objective:Double-J(DJ)ureteric stents are commonly placed perioperatively for semirigid or flexible ureteroscopic renal *** is believed that lesser stent material within the bladder mitigates stent-related *** study aimed to evaluate the J-Fil ureteral stent,a single pigtail suture stent compared with conventional DJ stent in relation to stent symptoms in an Asian population undergoing ureterorenal ***:Based on internal audit committee recommendation approval,the records of 50 patients retrieved,available data of 41 patients who were prospectively enrolled into two groups(Group 1[J-Fil stent group],n=21 and Group 2[DJ stent group],n=20)between August 2020 to January 2021,were *** compared were nature of procedure,stone location and size,ease of deployment or removal,and complications.A modified universal stent symptom questionnaire was used to assess morbidity of stent symptoms within 48 h of insertion and at ***:Both groups had similar median age,distribution in male to female ratio,and stone *** overall median universal stent symptom questionnaire score at insertion was similar for bladder pain,flank or loin pain,and quality of life between Group 1 and 2;however,at removal Group 1 fared significantly better than Group 2,especially for flank or loin pain and pain at *** groups had similar ease in insertion with no hospital ***:Our audit favoured the single pigtail suture stent in Asian ureters in mitigating stent-related *** showed a good safety profile with easy deployment and *** promises a new standard in stenting.

关键词： Stent Ureteroscopy Pigtail suture stent Asianpatient Flexible ureteroscopic renal surgery

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The learning curve for transurethral enucleation with bipolar energy for benign prostate hyperplasia:a single-surgeon experience of 494 patients

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Asian Journal of Andrology 2024年第3期26卷 288-294页

作者： Byeongdo Song Sang Hun Song Seong Jin Jeong department of urology Seoul National University Bundang HospitalSeongnam 13620Korea department of urology Seoul National University College of MedicineSeoul 03080Korea

This study was performed to investigate the learning curve of transurethral enucleation with bipolar energy(TUEB)for benignprostatic *** study involved 494 consecutive patients who underwent TUEB for benign prostatic hyperplasia fromAugust 2018 to March 2022 by one surgeon(SJJ,Seoul National University Bundang Hospital,Seongnam,Korea).The patientswere followed up at 1 week,1 month,3 months,and 6 months *** evaluate the learning curve of TUEB,perioperativeparameters including the enucleation ratio(enucleated tissue weight/transitional zone volume),TUEB efficiency(enucleatedtissue weight/operation time),and enucleation efficiency(enucleated tissue weight/enucleation time)were *** and postoperative complications were also assessed,including the International Prostate Symptom Score(IPSS),IPSSquality-of-life(QoL)score,and uroflowmetry *** patients’median age was 72(interquartile range[IQR]:66–78)years,and the estimated prostate volume and transitional zone volume were 63.0(IQR:46.0–90.6)ml and 37.1(IQR:24.0–60.0)ml,*** enucleation ratio,TUEB efficiency,and enucleation efficiency were 0.60(IQR:0.46–0.54)g ml−1,0.33(IQR:0.22–0.46)g min−1,and 0.50(IQR:0.35–0.72)g min−1,respectively,plateauing after 70 *** functional outcomes,including total IPSS,IPSS QoL score,and uroflowmetry outcomes,significantly improved at 6 months after TUEB(all P<0.05),but without significant differences over the learning ***-five(13.2%)patients developed complications after TUEB,21.5%of whom experienced major complications(Clavien–Dindo grade≥3).The rate of major complications declined as the number ofTUEB cases increased(P=0.013).Our results suggest that the efficiency of TUEB stabilized within 70 procedures.

关键词： benign prostate hyperplasia learning curve perioperative efficiency prostate transurethral enucleation with bipolar energy

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Flexible ureteroscopic treatment of kidney stones: How do the new laser systems change our concepts?

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Asian Journal of urology 2024年第2期11卷 156-168页

作者： Simin Yu Linhu Liu Ya Li Liang Zhou Jixiang Chen Hong Li Kunjie Wang department of urology Institute of Urology(Laboratory of Reconstructive Urology)West China HospitalSichuan UniversityChengduSichuanChina

Objective: Flexible ureteroscopy (fURS) has become a widely accepted and effective technique for treating kidney stones. With the development of new laser systems, the fURS approach has evolved significantly. This literature review aims to examine the current state of knowledge on fURS treatment of kidney stones, with a particular focus on the impact of the latest laser technologies on clinical outcomes and patient ***: We conducted a search of the PubMed/PMC, Web of Science Core Collection, Scopus, Embase (Ovid), and Cochrane Databases for all randomized controlled trial articles on laser lithotripsy in September 2023 without time ***: We found a total of 22 relevant pieces of literature. Holmium laser has been used for intracavitary laser lithotripsy for nearly 30 years and has become the golden standard for the treatment of urinary stones. However, the existing holmium laser cannot completely powder the stone, and the retropulsion of the stone after the laser emission and the thermal damage to the tissue have caused many problems for clinicians. The introduction of thulium fiber laser and Moses technology brings highly efficient dusting lithotripsy effect through laser innovation, limiting pulse energy and broadening pulse ***: While the holmium:yttrium-aluminum-garnet laser remains the primary choice for endoscopic laser lithotripsy, recent technological advancements hint at a potential new gold standard. Parameter range, retropulsion effect, laser fiber adaptability, and overall system performance demand comprehensive attention. The ablation efficacy of high-pulse-frequency devices relies on precise targeting, which may pose practical challenges.

关键词： Laser lithotripsy Urolithiasis Thulium laser Holmium:yttrium-aluminum-garnet Moses effect

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Nano-Bacillus Calmette-Guérin immunotherapies for improved bladder cancer treatment

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2024年第7期25卷 557-567页

作者： Sheng ZENG Shaoqiang XING Yifei ZHANG Haifeng WANG Qian LIU department of urology Tianjin First Central HospitalTianjin 300192China department of urology First Central Clinical CollegeTianjin Medical UniversityTianjin 300192China

Cancer immunotherapy has rapidly become the fourth mainstream treatment alternative after surgery,radiotherapy,and chemotherapy,with some promising *** aims to kill tumor cells by mobilizing or stimulating cytotoxic immune ***,the clinical applications of tumor immunotherapies are limited owing to a lack of adequate delivery pathways and high ***,nanomaterials and genetic engineering have shown great potential in overcoming these limitations by protecting the delivery of antigens,activating targeted T cells,modulating the immunosuppressive tumor microenvironment,and improving the treatment *** Calmette-Gué;rin(BCG)is a live attenuated Mycobacterium bovis vaccine used to prevent tuberculosis,which was first reported to have antitumor activity in *** therapy can activate the immune system by inducing various cytokines and chemokines,and its specific immune and inflammatory responses exert antitumor *** was first used during the 1970s as an intravesical treatment agent for bladder cancer,which effectively improved immune antitumor activity and prevented tumor *** recently,nano-BCG and genetically engineered BCG have been proposed as treatment alternatives for bladder cancer due to their ability to induce stronger and more stable immune *** this study,we outline the development of nano-BCG and genetically engineered BCG for bladder cancer immunotherapy and review their potential and associated challenges.

关键词： Bladder cancer Bacillus Calmette-Gué rin vaccine Nanocarrier Genetic engineering Immunotherapy

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