Uric acid and acute kidney injury in high-risk patients for developing acute kidney injury undergoing cardiac surgery: A prospective multicenter study.

PURPOSE: It is unclear whether preoperative serum uric acid (SUA) elevation may play a role in the development of acute kidney injury (AKI) associated with cardiac surgery (CSA-AKI). We conducted a cohort study to evaluate the influence of preoperative hyperuricemia on AKI in patients at high risk for developing SC-AKI. DESIGN: Multicenter prospective international cohort study. SETTING: Fourteen university hospitals in Spain and the United Kingdom. PARTICIPANTS: We studied 261 consecutive patients at high risk of developing CSA-AKI, according to a Cleveland score ≥ 4 points, from July to December 2017. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: AKIN criteria were used for the definition of AKI. Multivariable logistic regression models and propensity score-matched pairwise analysis were used to determine the adjusted association between preoperative hyperuricemia (≥7 mg/dL) and AKI. Elevated preoperative AUS (≥7 mg/dL) was present in 190 patients (72.8%), whereas CSA-AKI occurred in 145 patients (55.5%). In multivariable logistic regression models, hyperuricemia was not associated with a significantly increased risk of AKI (adjusted Odds Ratio [OR]: 1.58; 95% confidence interval [CI]: 0.81-3; P = .17). In propensity score-matched analysis of 140 patients, the hyperuricemia group experienced similar adjusted odds of AKI (OR 1.05, 95%CI 0.93-1.19, P = .37). CONCLUSIONS: Hyperuricemia was not associated with an increased risk of AKI in this cohort of patients undergoing cardiac surgery at high risk of developing CSA-AKI.

Right renal vein elongation with the inferior vena cava for cadaveric kidney transplants: an old neglected surgical approach

INTRODUCTION: Short right renal vein is a frequent and well-known technical inconvenience that is commonly observed during transplantation of the right kidney. We present our experience with the elongation of short cadaveric right renal veins using the contiguous vena cava during cadaveric renal transplants. METHODS: We performed 34 kidney transplantations with a short right renal vein requiring elongation using the inferior vena cava, to make the venous anastomosis technically feasible. The elongated right renal vein was anastomosed end to side to the external iliac vein in 24 patients, to the common iliac vein in 8 patients and to the inferior vena cava in 2 patients. The right renal artery with an aortic patch was implanted end to side in 33 patients, and end to end without aortic patch to the internal iliac artery in one patient. RESULTS: In all cases, the vascular anastomoses were easily performed in the recipient and no thrombosis was observed. CONCLUSION: Elongation of a short right renal vein with the inferior vena cava is a feasible mean to overcome technical problems that may compromise the results of cadaveric renal transplantation.

Interes de la ecografía endocavitaria en el cáncer rectal / The interesting of the endocavitary echography in rectum neoplasm

Presentam los autores su experiencia con la ecografía endocavitaria en 18 pacientes portadores de câncer rectal a distintos niveles

Quistes hidatídicos primitivos de localización poco frecuente / Primary hydatid cysts of unfrequent localization

En nuestro trabajo revisamos los quistes hidatídicos únicos y primitivos, no asociados con localizaciones hepáticas o pulmonares, y que no competen a otras especialidades, como los que tienen asiento renal, óseo, encefálico o cardíaco, habiendo sido tratados todos ellos en el Departamento de Cirugía del Hospital Clínico Universitario de Salamanca

Coledocolitiasis residual / Residual choledocholithiasis

Se detalla un estudio de pacientes sometidos a cirugía biliar y referente a la litiasis residual, en cuanto a su incidencia, profilaxis y terapéutica compleja que motivó a revisar la experiencia de los autores en esa patología

Preservaçäo do ramo frontotemporal do nervo facial na craniotomia pterional: técnica de Speltzler e Lee: relato de 45 casos / Preservation of the frontotemporal branch of the facial nerve using Spetzler and Lee's technique for pterional craniotomy: report of 45 cases

No período entre dezembro de 1990 e novembro de 1994 (4 anos) 47 aneurismas cerebrais foram tratados através da craniotomia pterional. A técnica de Spetzler e Lee foi utilizada na abertura do músculo temporal, tendo sido observada a preservaçäo, do ramo frontotemporal do nervo facial, em todos os casos. É importante observar que houve boa exposiçäo da crista esfenoidal, reduçao do tempo cirúrgico e bom resultado cosmético com está técnica.