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Background: Firearm injuries increased significantly during the coronavirus disease 2019 (COVID-19) pandemic. We aimed to describe our experience with patients admitted to a level 1 trauma center with gunshot-related trauma to the genitourinary (GU) tract before and during COVID-19 pandemic. Methods: Patients sustaining gunshot-related trauma to the adrenals, kidneys, ureters, bladder, scrotum, testicles, penis, and urethra between January 1, 2018 and December 31, 2021 were identified from our institutional trauma database. Patient charts were queried to extract demographic information, management, and follow-up. Results: A total of 117 patients met inclusion criteria with 39 (33%) of GU injuries occurring pre-COVID, and 78 (67%) occurring during or post-COVID. Seventy-two (62%) presented with kidney injury. Patients injured in the pre-COVID period were more likely to participate in a follow-up visit by 2.17 times at 60 days (P=0.017), 1.98 times at 90 days (P=0.030), and 2.04 times at 1-year (P=0.014) than during COVID. Pre-COVID, 46% of patients were injured in the city's northwestern region and 54% from other areas, during COVID 24% of patients came from the northwestern region compared to 76% from other areas (P=0.029). Conclusions: Gunshot wounds (GSW) involving the GU tract increased during the COVID-19 pandemic, with renal injury most frequent. Follow-up visits declined by around half during the pandemic, primarily at 60 days, 90 days, and 1 year post-injury. The number of patients admitted with urologic injuries pre-COVID versus during COVID was significantly different depending on the patient's area of residence. More work is needed to evaluate the outcomes of traumatic GU injuries due to GSW pre- and post-pandemic.
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Introduction: Ureteral hernias are a rare urologic occurrence and can complicate otherwise straightforward management of commonly encountered urologic emergencies. Methods: We review the incidence and identification of ureteroinguinal hernias and present a novel and easily reproducible technique using a modified bander stent to decompress the upper tracts. Results: The technique allowed for decompression of the upper tract secondary to an obstructing stone in a ureteral hernia. No complications were documented. Conclusion: We propose a novel and easily reproducible technique to allow for emergent upper tract decompression in patients with ureteral hernias who are not candidates for percutaneous access.
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Myopia (short-sightedness) is a visual problem associated with excessive eye growth and vitreous chamber expansion. Within the eye serotonin (5-hydroxytryptamine, 5-HT) appears to have a variety of effects, it alters retinal amacrine cell processing, increases intraocular pressure, constricts ocular blood vessels, and is also mitogenic. This study sought to determine the role of the retinal serotonin system in eye growth regulation. Myopia was produced in 7-day-old chicks using -15 D spectacle lenses (LIM) and form deprivation (FDM). The effect on LIM and FDM of daily intravitreal injections of a combination of 5-HT receptor antagonists (1, 10, 50 microM), 5-HT(2) selective antagonist (Mianserin 0.5, 20 microM) or 5-HT (1, 10, 50 microM) were assessed. Counts were performed of serotonin and tyrosine hydroxylase positive neurons and the relative density used to account for areal changes due to eye growth. The effect of LIM and lens-induced hyperopia (LIH) on the numbers of 5-HT-containing amacrine cells in the retina were then determined. The combination of 5-HT receptor antagonists inhibited LIM by approximately half (1 microM RE: -7.12+/-1.0 D, AL: 0.38+/-0.06 mm vs. saline RE: -13.19+/-0.65 D, AL: 0.64+/-0.03 mm. RE: p<0.01, AL: p<0.01), whereas FDM was not affected (1 microM RE: -8.88+/-1.10 D vs. saline RE: -9.28+/-1.38 D). The selective antagonist was slightly less effective at inhibiting LIM (0.5 microM RE: -9.02+/-1.01 D). These data suggest that serotonin has a stimulatory role in LIM, although high doses of serotonin were inhibitory (1 microM RE: -9.30+/-1.34 D). 5-HT immunoreactivity was localised to a subset of amacrine cell bodies in the inner nuclear layer of the retina, and to two synaptic strata in the inner plexiform layer. LIM eyes had increased numbers of 5-HT-containing amacrine cells in the central retina (12.5%). Collectively, these results suggest that manipulations to the serotonin system can alter the eye growth process but the role of this transmitter system within this process remains unclear.
