Nonocclusive mesenteric ischemia after renal transplantation: A case report and literature review.

Nonocclusive mesenteric ischemia (NOMI) is a very rare occurrence after renal transplantation. This disorder is difficult to diagnose and can even be fatal. We describe a 51- year-old man with end-stage renal disease who developed intestinal ischemia and infarction due to NOMI three days after deceased donor kidney transplantation, which was managed success- fully and his renal graft function was saved. To the best of our knowledge, this is one of the few cases of NOMI occurring after renal transplantation reported in the literature.

Platelet volume indices in patients with varicocele.

OBJECTIVE: This study sought to evaluate platelet volume indices (mean platelet volume [MPV], platelet distribution width [PDW], and platelet large cell ratio [P-LCR]) in varicocele patients, and compare it with platelet volume parameters in healthy controls. METHODS: This cross-sectional study involved 2 groups: group 1 included 51 varicocele subjects and group 2 consisted of 50 healthy control subjects of similar ages. Peripheral venous blood samples were collected with ethylenediaminetetraacetic acid-K2 anticoagulant between 8:30 AM and 10 AM following an overnight fast. Platelet volume parameters (MPV, PDW, and P-LCR) were measured in both groups within 2 hours of sampling. RESULTS: The mean PDW, MPV, and P-LCR were 13.9±2.5%, 10.1±1.3 fL, and 27.3±7.8% in varicocele patients, respectively, and were 12.6±2.4%, 9.3±1.1 fL, and 21.9±6.4% in the control group, respectively. The mean PDW, MPV, and P-LCR were significantly higher in the varicocele group than the control group. CONCLUSION: The results of the present study suggest that vascular components may play an important role in the pathophysiology of varicocele; therefore, there is a great need for prospective studies to confirm this relationship.

Treatment of monosymptomatic nocturnal enuresis: sertraline for non-responders to desmopressin.

One of the challenges in the management of primary monosymptomatic enuresis (PME), especially in adolescents, is response failure to medical regimens such as desmopressin. This prospective study aimed at addressing the efficacy of sertraline in the treatment of 25 adolescents (13-18 year old) with PME having experienced failure to previous desmopressin therapy. Patients were recommended to take one oral tablet of sertraline (50 mg) every morning after meal for 3 months. The patients were followedup every 6 weeks, the final visit being 6 months after treatment termination. Comparing the number of wet nights in the pretreatment nocturnal records with the follow-up visits revealed a significant reduction (P=0.01). The primary efficacy outcome was achieved in 18 (72%) of the 25 patients; 12 patients had full response, whereas six patients showed partial response. Four (16%) of the 25 children presented with a relapse after 6 months of follow-up. Drug-related adverse events were rare. Sertraline effectively reduced the number of wet episodes in adolescents with PME who had experienced failure to desmopressin therapy. With respect to the favorable efficacy outcome of this medication and the scarce drug-related adverse effects, sertraline can be proposed as a novel treatment for PME.

Testis-sparing surgery in testicular mass: Testicular epidermoid cysts.

We present 3 patients with testicular epidermoid cysts who experienced testis-sparing surgery. These patients had a palpable painless testicular mass and underwent inguinal testicular exploration. Intraoperative frozen section revealed no evidence of malignancy and therefore enucleation of the tumour was performed. We demonstrate that careful intraoperative frozen-section examination helps to avoid unnecessary orchidectomy in testicular epidermoid cysts.

Transplanting pediatric deceased-donor kidneys into adult recipients: an Iranian experience.

OBJECTIVES: This study sought to evaluate graft outcome of kidneys from deceased-donor pediatric donors in adult recipients, and compare it with outcomes of kidney transplants from adult donors. MATERIALS AND METHODS: This historical cohort study involved 2 groups. Group 1 included 23 first kidney adult recipients who received their first renal transplant from pediatric deceased-donor donors. Group 2 consisted of 33 first renal transplant adult recipients with kidneys coming from adult deceased donors. The Kaplan-Meier method was used to generate graft survival and patient survival curves. The log-rank test was done to compare differences between survival outcomes. RESULTS: Graft survival rates at 1 and 5 years were 96% and 85% in group 1, and 91% and 85% in group 2. No significant difference existed in graft survival rates between the groups. Patient survival rates at 1 and 5 years in group 1 were 94% and 94% compared with 91% and 91% for group 2. No significant difference existed in graft survival rates between the groups. CONCLUSIONS: This study demonstrates that with our experience, improvement in surgical technique and immunosuppressive therapy, pediatric deceased-donor kidneys may be considered as an alternate option for adult recipients. Renal transplants from pediatric donors into adult recipients is associated with good graft and patient survival outcomes.