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1.
Exp Clin Transplant ; 18(Suppl 1): 10-15, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32008485

RESUMO

Kidney transplant has been the standard-of-care treatment for patients with end-stage renal disease for many years. To expand the acceptance and care of complicated situations in patients with end-stage renal disease, transplant teams should be ready to find innovative solutions to prevent and manage pretransplant, intraoperative, and posttransplant problems. In this report, we present our approach for the following scenarios: transplant in patients with urinary diversion and augmentation, polycystic disease in recipients, tumors in transplanted kidney and native kidneys, and the roles of laparoscopy and mini-laparoscopy in kidney transplant.

2.
Urol J ; 17(2): 173-179, 2020 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-31953832

RESUMO

PURPOSE:   The ureteric stent can be attached to the Foley catheter in kidney transplantation to exclude cystoscopy for its removal. It is rarely practiced in renal transplantation. There has been no randomized trial to evaluate the outcome of this procedure on major urologic complications. MATERIALS AND METHODS: One hundred sixty-three kidney transplant patients were randomized into an intervention group in which the stent was attached to the Foley catheter and removed together and a control group in which stent was removed by cystoscopy. In both groups, stents were removed around the 8th post-operative day. RESULTS: From March 2016 to June 2017, out of 234 kidney transplants performed in our center, one hundred Sixty-three (69.6%) patients met the study inclusion criteria.  91patients (55.8%) were allocated to the intervention group. Mean days before JJ removal for intervention and control groups ("per-protocol" group) were 8.08 ± 1.52 and 8.57 ± 1.58, respectively (P = .09). There was no difference between groups regarding major urologic complications (P = .679). Visual analog scale pain scores were significantly higher in the control group (p = .001). The procedure reduced 63-120 USD from the cost of operation in the intervention group. CONCLUSION: In selected kidney transplant patients, attaching stent to the Foley catheter and removing both of them early may be a safe maneuver regarding major urological complications, reduces pain, and eliminates the cost of cystoscopy.

3.
BJU Int ; 125(1): 133-143, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31145528

RESUMO

OBJECTIVES: To investigate potential oxalate-degrading bacteria, including Oxalobacter formigenes, Lactobacillus (Lac) and Bifidobacterium (Bif) genera, and Oxalyl-CoA decarboxylase (oxc) encoding Lac (LX) and Bif (BX) species in participants with recurrent calcium kidney stones, and their correlation with 24-h urine oxalate. PARTICIPANTS AND METHODS: Stool and 24-h urine samples were collected from 58 patients with urolithiasis (29 cases with and 29 without hyperoxaluria) and 29 healthy controls. Absolute quantitation and relative abundance of the bacteria were measured by real-time PCR. The relationship between the investigated bacteria and 24-h urine oxalate were assessed statistically. RESULTS: The count per gram of stool and relative abundance of O. formigenes, Lac, Bif, LX and BX and the number of participants carrying O. formigenes, LX and BX bacteria were not significantly different between the groups; however, the relative abundance of O. formigenes in the kidney stone group was lower than in healthy controls (P = 0.035). More healthy controls were O. formigenes-positive compared with participants in the kidney stone group (P = 0.052). The results of the linear regression model, including all study participants, showed that the presence of O. formigenes could decrease 24-h urine oxalate (ß = -8.4, P = 0.047). Neither Lac and Bif genera nor LX and BX species were correlated with calcium stones or urine oxalate. CONCLUSION: These results emphasize the role of O. formigenes in kidney stone formation and its role in hyperoxaluria, which may be independent of kidney stone disease. Moreover, our results suggest that, although some Lac and Bif strains have oxalate-degrading potential, they may not be among the major oxalate-degrading bacteria of the gut microbiome.

4.
Urologia ; : 391560319890993, 2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31868562

RESUMO

OBJECTIVES: To evaluate the safety and efficacy of transperitoneal laparoscopic pyelolithotomy in renal stone cases with previous renal surgeries. PATIENTS AND METHODS: In this prospective study, 190 consecutive patients with renal stones, who were candidates for transperitoneal laparoscopic pyelolithotomy, were enrolled. The patients were divided into two groups. In group A, 163 patients without a history of renal surgery underwent standard laparoscopic pyelolithotomy, whereas in group B laparoscopic pyelolithotomy was performed in 27 patients with a history of kidney stone surgery including percutaneous nephrolithotomy or open stone surgery. All intraoperative data including the operating time and complications such as bleeding requiring transfusion were recorded. Postoperative data such as length of hospitalization, hemoglobin level alteration, and other complications were also recorded. RESULTS: There was no significant difference in the preoperative data such as stone size, stone site, age, sex, and stone side between the two groups. There was no significant difference in the stone-free rate between the two groups (p = 0.4). There was no significant difference between the two study groups regarding the operating time, hospital stay, stone-free rate, complications, and transfusion rate. CONCLUSION: Laparoscopic pyelolithotomy can be used as a safe and feasible treatment modality in the setting of previous renal surgery. The complications and stone-free rate of laparoscopic pyelolithotomy in patients with history of renal surgery are acceptable.

5.
Investig Clin Urol ; 60(6): 472-479, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31692870

RESUMO

Purpose: A few experimental and observational studies have reported that atorvastatin prevents calcium oxalate stone formation. Our study is the first to investigate the effect of atorvastatin on 24-hour urinary metabolites, urinary malondialdehyde (U-MDA) (an oxidative stress marker) and urinary neutrophil gelatinase-associated lipocalin (U-NGAL) (a renal tubular injury marker) in patients with calcium stones and hyperoxaluria. Materials and Methods: This randomized, double-blind, placebo-controlled, parallel-group clinical trial included 32 adults with recurrent calcium stone formation and hyperoxaluria. All participants received a 3-month course of either atorvastatin (20 mg/d) or placebo of an identical shape. Both groups received the usual nutritional care based on the European Association of Urology guidelines. Results: Twenty-eight participants completed the study. Serum levels of total and low-density lipoprotein cholesterol decreased in the atorvastatin group, and these changes were significantly different between groups (p<0.001). No statistically significant differences were observed between intergroup changes of the 24-hour urinary metabolite analysis, the U-MDA to creatinine ratio and the U-NGAL to creatinine ratio. Conclusions: Atorvastatin administration at a dose of 20 mg/d for 3 months did not affect 24-hour urinary metabolite, U-MDA and U-NGAL levels in recurrent calcium stone formers. However, this study could not disprove the preventive role of atorvastatin in kidney stone formation. Future studies should consider a larger sample size, longer follow-up, different drug doses, and measurements of multiple biomarkers of oxidative stress and tubular injury.

6.
Curr Mol Pharmacol ; 2019 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-31622214

RESUMO

BACKGROUND: Bladder cancer accounts for almost 54% of urinary system cancer and is the second most frequent cause of death in genitourinary malignancies after prostate cancer. About 70% of bladder tumors are non-muscle-invasive, and the rest are muscle-invasive. Recurrence of the tumor is the common feature of bladder cancer. Chemotherapy is a conventional treatment for MIBC, but it cannot improve the survival rate of these patients sufficiently. Therefore, researchers must develop new therapies. Antibody-based therapy is one of the most important strategies for the treatment of solid tumors. Selecting a suitable target is the most critical step for this strategy. OBJECTIVE: The aim of this study is to detect therapeutic cell surface antigen targets in bladder cancer using data obtained by proteomic studies METHODS: Isobaric tag for relative and absolute quantitation (iTRAQ) analysis had identified 131 overexpressed proteins in baldder cancer tissue and reverse-phase proteomic array (RPPA) analysis had been done for 343 tumor tissues and 208 antibodies. All identified proteins from two studies (131+208 proteins) were collected and duplicates were removed (331 unique proteins). Gene ontology study was performed using gene ontology (GO) and protein analysis through evolutionary relationships (PANTHER) databases. The Human Protein Atlas database was used to search the protein class and subcellular location of membrane proteins obtained from the PANTHER analysis. RESULTS: Membrane proteins that could be suitable therapeutic targets for bladder cancer were selected. These included: Epidermal growth factor receptor (EGFR), Her2, Kinase insert domain receptor (KDR), Heat shock protein 60 (HSP60), HSP90, Transferrin receptor (TFRC), Activin A Receptor Like Type 1 (ACVRL1), and cadherin 2 (CDH2). Monoclonal antibodies against these proteins or their inhibitors were used for the treatment of different cancers in preclinical and clinical trials. CONCLUSION: These monoclonal antibodies and inhibitor molecules and also their combination can be used for the treatment of bladder cancer.

7.
Urol J ; 2019 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-31535360

RESUMO

PURPOSE: To evaluate the safety and efficacy of discharging patients on the first postoperative day after an uncomplicated percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: after an uncomplicated successful PCNL without significant residual stone (>5mm) or any complication up to the first postoperative day, we randomly assigned patients into two groups-Group 1: overnight surgery, and Group 2: routine discharge after three days. Patients with significant residual stone on control fluoroscopy were excluded. Ninety eight and 102 patients were assigned to groups 1 and 2, respectively. Serum Hemoglobin and Cr were evaluated before the operation as well as the first postoperative day. Stone free status was evaluated using ultrasound and KUB radiography at the first postoperative day. RESULTS: The stone and patient characteristics were not different in two groups. The preoperative and change in the hemoglobin and creatinine levels were not significantly different between the two groups. Nine patients (9.2%) in Group 1 and five (4.9%) in Group 2 were readmitted because of complications (mainly hematuria) (p=.23). Of the readmitted patients, five in Group 1 (55%), and three in Group 2 (60%) received blood transfusion (p=.87). in these patients, group 1 received 1.6±0.51 units of blood compared with 1.93±0.25 in group 2 (p=.07). All the readmitted patients did well with conservative therapy with no need for angioembolization. CONCLUSION: In uncomplicated PCNL with no significant residual stone, discharging the patient on the first postoperative day is safe. The outcome is comparable to a routine three-day hospital stay.

8.
Exp Ther Med ; 18(2): 1345-1349, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31384335

RESUMO

Autosomal dominant polycystic kidney disease (ADPKD) is the fourth most common cause of end-stage renal disease, occurring at a frequency of 1 in 400 to 1 in 800 individuals among different populations. The disease affects all ethnic groups worldwide, and there is a requirement for population-based studies to be conducted in order to improve diagnosis, genetic counseling and treatment. A large Iranian family with ADPKD was recruited for the current study. Clinical evaluation was performed to diagnose and assess disease progression in 11 members of this family, including 7 affected members and 4 unaffected members. PKD1 and PKD2 genes were genotyped in subjects by next-generation sequencing (NGS). Mutational analysis of PKD1 and PKD2 genes in this family revealed three intronic variations and three synonymous exonic variants in the PKD2 gene, and two non-synonymous exonic variants and eight intronic variants in PKD1, resulting in a total of 16 heterozygous variations among these two genes. Among the 16 variations, all except three intronic variants in the PKD1 gene have already reported in the Iranian population. The three novel mutations were predicted to be deleterious polymorphisms using in silico methods. Among the reported intronic variations, rs201204878 was identified as a splice region variant, leading to truncation of the polycystin-1 protein. In conclusion, genotyping of PKD1 and PKD2 in this family with ADPKD revealed no mutational hot spots. However, genetic screening identified three novel variants in the Iranian population. The data generated in the present study will contribute to improving the diagnosis, genetic counseling and treatment of patients with ADPKD.

9.
Urologia ; 86(4): 211-215, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31268823

RESUMO

INTRODUCTION: In this study, we aimed to evaluate the safety and efficacy of the percutaneous nephrolithotomy procedure performed with adult-sized instruments in pediatric cases with staghorn kidney stone. METHODS: We retrospectively evaluated the efficacy and safety of 94 percutaneous nephrolithotomy procedures performed during 15 years in a single center for 82 pediatric patients with staghorn calculi using adult-sized instruments (24-Fr nephroscope). Stone free status was defined as complete clearance of the stones or the presence of insignificant residual stones of <3 mm in diameter. RESULTS: The mean age was 108 ± 53 months (range, 14-180 months). There were 39 patients (48%) with complete staghorn stones and 43 cases (52%) with partial staghorn. We fulfilled 91.4% of operations through a single access. The stone free rate was 86.6% after one percutaneous nephrolithotomy session. In total, seven patients referred for shock wave lithotripsy and four cases were scheduled for the second percutaneous nephrolithotomy session. Fever occurred in 18 patients (21%) and bleeding requiring transfusion in four children (5%). Prolonged leakage from nephrostomy site requiring anesthesia for double J stent placement occurred in one patient. No grade IV or V Clavien complication occurred. CONCLUSION: The success rate and complications of percutaneous nephrolithotomy with adult-size instruments in pediatric patients are acceptable.


Assuntos
Nefrolitotomia Percutânea/instrumentação , Cálculos Coraliformes/cirurgia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Desenho de Equipamento , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos
10.
Urol J ; 2019 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-31004341

RESUMO

Today, there are several methods to repair colon and rectal injury such as primary repair, stoma, resection with anastomosis and damage control only. To our best knowledge, there is no definite method published in literature about iatrogenic rectal injury during perineal urethroplasty in children.  Here we explain two 10 and 12-year old boys with iatrogenic rectal injury during perineal urethroplasty that underwent primary repair. Due to our experience, primary repair of rectum in such condition is feasible, successful and it can be a good choice to avoid placing colostomy and secondary repair.

11.
Int J Urol ; 26(7): 688-709, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31016804

RESUMO

The Urological Association of Asia, consisting of 25 member associations and one affiliated member since its foundation in 1990, has planned to develop Asian guidelines for all urological fields. The field of stone diseases is the third of its guideline projects. Because of the different climates, and social, economic and ethnic environments, the clinical practice for urinary stone diseases widely varies among the Asian countries. The committee members of the Urological Association of Asia on the clinical guidelines for urinary stone disease carried out a surveillance study to better understand the diversity of the treatment strategy among different regions and subsequent systematic literature review through PubMed and MEDLINE database between 1966 and 2017. Levels of evidence and grades of recommendation for each management were decided according to the relevant strategy. Each clinical question and answer were thoroughly reviewed and discussed by all committee members and their colleagues, with suggestions from expert representatives of the American Urological Association and European Association of Urology. However, we focused on the pragmatic care of patients and our own evidence throughout Asia, which included recent surgical trends, such as miniaturized percutaneous nephrolithotomy and endoscopic combined intrarenal surgery. This guideline covers all fields of stone diseases, from etiology to recurrence prevention. Here, we present a short summary of the first version of the guideline - consisting 43 clinical questions - and overview its key practical issues.

12.
Int. braz. j. urol ; 45(2): 340-346, Mar.-Apr. 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1002204

RESUMO

ABSTRACT Purpose: Hypercalciuria is one of the risk factors for calcium kidney stone formation (the most common type of urinary stones). Although vitamin D deficiency is prevalent among urolithiasis patients, the effect of vitamin D supplementation on urine calcium in these patients is still unclear. Materials and Methods: In this retrospective study, medical and laboratory tests records of 26 patients with recurrent calcium kidney stones and vitamin D deficiency treated with 50000IU vitamin D per week for 8-12 weeks were analyzed. The changes in 24-hour urine calcium (24-h Ca), serum 25-hydroxyvitamin D (25 (OH) D), serum parathormone (PTH), other 24-hour urine metabolites and calculated relative supersaturations of calcium oxalate (CaOxSS), calcium phosphate (CaPSS) and uric acid (UASS) were assessed. Moreover, correlations between changes in 24-h Ca and other aforementioned variables were assessed. Results: Serum 25 (OH) D and 24-h Ca increased after vitamin D supplementation, while serum PTH decreased (p < 0.001, for all analyses). The levels of 24-hour urine sodium and urea increased significantly (p = 0.005 and p = 0.031, respectively). The levels of CaOxSS and CaPSS increased, but the changes were not significant (p = 0.177, and p = 0.218, respectively). There were no correlations between the changes in 24-h Ca and serum 25 (OH) D or PTH. Conclusions: The result of current study suggests that although urine Ca increased in vitamin D supplemented patients, this increase was not associated with the increase in serum vitamin D and may be due to other factors such as dietary factors. Further randomized clinical trials considering other factors associated with urine Ca are warranted.

13.
Int. braz. j. urol ; 45(2): 408-409, Mar.-Apr. 2019.
Artigo em Inglês | LILACS-Express | ID: biblio-1040053

RESUMO

ABSTRACT A healthy 37 - year - old woman referred to our clinic with one - year history of recurrent urinary tract infection, dysuria and frequency. Her past medical history informed us that an IUD (Copper TCu380A) had been inserted 11 years ago. Eleven months after the IUD insertion she had become pregnant, unexpectedly. At that time, she had undergone gynecological examination and abdominal ultrasound study. However, the IUD had not been found, and the gynecologist had made the diagnosis of spontaneous fall out of the IUD. She had experienced normal pregnancy and caesarian section with no complications. On physical examination, pelvic examination was normal and no other abnormalities were noted. Urinalysis revealed microhematuria and pyuria. Urine culture was positive for Escherichia coli. Ultrasound study revealed a calculus of about 10 mm in the bladder with a hyperdense lesion. A plain abdominal radiograph was requested which showed a metallic foreign body in the pelvis. We failed to remove the IUD by cystoscopic forceps because it had strongly invaded into the uterine and bladder wall. Despite previous papers suggesting open or laparoscopic surgeries in this situation (1, 2), we performed a modified cystoscopic extraction technique. We made a superficial cut in the bladder mucosa and muscle with J - hook monopolar electrocautery and extracted it completely with gentle traction. This technique can decrease the indication of open or laparoscopic surgery for extraction of intravesical IUDs. In the other side of the coin, this technique may increase the risk of uterovesical fistula. Therefore, the depth of incision is important and the surgeon should cut the bladder wall superficially with caution. Although present study is a case report which is normally classified as with low level of evidence, it seems that our modified cystoscopic extraction technique is a safe and useful method for extraction of partially intravesical IUDs.

14.
Int J Health Care Qual Assur ; 32(1): 2-10, 2019 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-30859863

RESUMO

PURPOSE: Adherence to preventive recommendations improves clinical outcomes and is compulsory for long-term prevention in urolithiasis patients. Service quality can affect patients' adherence to treatment and care. The purpose of this paper is to compare perceived service quality, using the SERVQUAL model, between urolithiasis patients who were nonadherent to their follow-up visits and those who were adherent, in a stone prevention clinic, Tehran, Iran. DESIGN/METHODOLOGY/APPROACH: This was a cross-sectional study on patients with urolithiasis referred to the Shahid-Labbafinejad Hospital stone prevention clinic between 2010 and 2014. All patients withdrawing from follow-up visits were selected as the nonadherent group. Patients with follow-up visits were randomly selected and appointed as the adherent group. Data included demographic, service quality (assessed using the SERVQUAL) and a questionnaire about the reason for withdrawal from follow-up visits. Man-Whitney U test, χ2 and binary logistic regression were used for data analyses. FINDINGS: In total, 531 nonadherent and 51 adherent patients entered the study. SERVQUAL results revealed that patients' expectations were significantly higher than their perceptions in all five service quality dimensions in both groups. The adherent group had better-quality scores. Responsibility, assurance and empathy scores significantly increased patient adherence odds. RESEARCH LIMITATIONS/IMPLICATIONS: Uni-center design; missing data, such as socioeconomic status and disease severity, which may influence treatment adherence; and missing data regarding adherence to medication and dietary advice were limitations. PRACTICAL IMPLICATIONS: Service quality needs to be improved in all dimensions. ORIGINALITY/VALUE: Since responsiveness, assurance and empathy dimensions determined patients' adherence, giving special attention to these dimensions could improve patient adherence.


Assuntos
Assistência Ambulatorial/organização & administração , Atitude Frente a Saúde , Cooperação do Paciente/estatística & dados numéricos , Prevenção Primária/organização & administração , Qualidade da Assistência à Saúde , Urolitíase/prevenção & controle , Centros Médicos Acadêmicos , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Irã (Geográfico) , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente/estatística & dados numéricos , Estudos Retrospectivos , Medição de Risco , Estatísticas não Paramétricas
15.
Exp Clin Transplant ; 17(Suppl 1): 250-253, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30777568

RESUMO

OBJECTIVES: It is usually assumed that an active livingdonor transplant program inhibits the growth of a deceased-donor kidney transplant program. In our 33-year experience, we found the contrary to be true. MATERIALS AND METHODS: From 1984 until 2017, we performed a total of 4966 kidney transplant procedures. All cases were registered through the Collaborating Transplant Study (Heidelberg, Germany). RESULTS: During the first 16 years, only living-donor kidney transplant procedures were done. Our first unrelated living-donor kidney transplant procedure was in 1986 and involved a wife to husband donation. This breakthrough in our country was the first in our unrelated living-donor kidney transplant program. In 2000, the Iranian Parliament passed the deceased-donor transplant act, and we have started deceased-donor kidney transplants since then. Despite a jam-packed living-donor kidney transplant program, our deceased-donor kidney transplant program has grown steadily since then and now comprises more than 50% of our kidney transplant procedures. When we compared the outcome of these programs, the 5-year survival from Collaborating Transplant Study report of 3527 cases of 114 living-related donor procedures was 90%. The 5-year survival rates for living unrelated-donor (n = 2689) and deceased-donor (n = 724) transplant procedures were 88% and 83%, respectively (P = .001). CONCLUSIONS: Our data showed that deceased-donor kidney transplant procedures have steadily increased despite an active unrelated living-donor kidney transplant program. Wait lists for kidney transplant can be significantly reduced by following our model, both in developed and in developing countries.


Assuntos
Países em Desenvolvimento , Transplante de Rim/métodos , Doadores Vivos/provisão & distribução , Doadores não Relacionados/provisão & distribução , Listas de Espera , Feminino , Sobrevivência de Enxerto , Humanos , Irã (Geográfico) , Transplante de Rim/efeitos adversos , Transplante de Rim/mortalidade , Transplante de Rim/tendências , Masculino , Avaliação de Programas e Projetos de Saúde , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Listas de Espera/mortalidade
16.
Urol J ; 16(5): 475-477, 2019 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-30805915

RESUMO

PURPOSE: Vesicourethral anastomosis (VUA) represents a challenging step of open radical prostatectomy (ORP) because of limitation of space in the depth of male pelvis, lack of control on knots during tightening which subse-quently causes inadequate coupling of VUA or breakdown of knots, and also extremely difficult reapplication of sutures. To facilitate this step of ORP, we have developed a simple and reproducible technique and reported our 8-year experience. MATERIALS AND METHODS: We used two extra-long DeBakey tissue forceps to approximate the bladder neck to the urethral stump. We found it more beneficial than Babcock clamp especially in obese patients with excess fatty tissue in the pelvic area. In this technique, the surgeon's assistant creates more space for the surgeon's hand by sweeping the fatty tissue away from the anastomotic area and then pushes the reconstructed bladder neck down while the sutures are being tied. RESULTS: We analyzed data from 200 patients with prostatic cancer who underwent open radical prostatectomy performed from 2009 to 2017. There were only 2 sutures disrupted during knot tying. In two cases (1%), drain output was more than 30 mL/day on postoperative day 2 and drainage was left in place for a longer duration. With the help of medications, time voiding and dedicated pelvic floor exercise whenever needed,.the goal of full urinary continence (0- 1 pad/day) was achieved in 85%, 94% and 98% of patients immediately after catheter removal, 3 months and 6 months after surgery, respectively. Eight patients (4%) developed urethral stricture. CONCLUSION: The surgical technique has been shown to be an independent predictor of urinary continence. We introduce a new simple modification of vesicourethral anastomosis during RP. Using this technique; in addition to reducing anastomotic disruption rate and increasing knot tying control, postoperative urinary continence after ORP may also be improved.

17.
Int Braz J Urol ; 45(2): 340-346, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30735332

RESUMO

PURPOSE: Hypercalciuria is one of the risk factors for calcium kidney stone formation (the most common type of urinary stones). Although vitamin D deficiency is prevalent among urolithiasis patients, the effect of vitamin D supplementation on urine calcium in these patients is still unclear. MATERIALS AND METHODS: In this retrospective study, medical and laboratory tests records of 26 patients with recurrent calcium kidney stones and vitamin D deficiency treated with 50000IU vitamin D per week for 8-12 weeks were analyzed. The changes in 24-hour urine calcium (24-h Ca), serum 25-hydroxyvitamin D (25 (OH) D), serum parathormone (PTH), other 24-hour urine metabolites and calculated relative supersaturations of calcium oxalate (CaOxSS), calcium phosphate (CaPSS) and uric acid (UASS) were assessed. Moreover, correlations between changes in 24-h Ca and other aforementioned variables were assessed. RESULTS: Serum 25 (OH) D and 24-h Ca increased after vitamin D supplementation, while serum PTH decreased (p < 0.001, for all analyses). The levels of 24-hour urine sodium and urea increased significantly (p = 0.005 and p = 0.031, respectively). The levels of CaOxSS and CaPSS increased, but the changes were not significant (p = 0.177, and p = 0.218, respectively). There were no correlations between the changes in 24-h Ca and serum 25 (OH) D or PTH. CONCLUSIONS: The result of current study suggests that although urine Ca increased in vitamin D supplemented patients, this increase was not associated with the increase in serum vitamin D and may be due to other factors such as dietary factors. Further randomized clinical trials considering other factors associated with urine Ca are warranted.


Assuntos
Cálcio/urina , Urolitíase/urina , Deficiência de Vitamina D , Vitamina D/uso terapêutico , Vitaminas/uso terapêutico , Idoso , Suplementos Nutricionais , Feminino , Humanos , Hipercalciúria/complicações , Masculino , Pessoa de Meia-Idade , Hormônio Paratireóideo/sangue , Estudos Retrospectivos , Vitamina D/administração & dosagem , Vitamina D/sangue , Deficiência de Vitamina D/tratamento farmacológico , Deficiência de Vitamina D/etiologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-30587086

RESUMO

The current study aimed to examine the impact of POLR2E rs1046040 and rs3787016 polymorphisms on prostate cancer (PCa) risk in a sample of southeast Iranian population. The present case-control study was performed on 178 patients with PCa and 180 benign prostatic hyperplasia (BPH). Genotyping of the variants was done by mismatch PCR-RFLP. The findings showed that the rs3787016 C > T variant significantly increased the risk of PCa in codominant (OR = 1.84, 95% CI = 1.12-3.03, P = 0.018, CT vs CC), dominant (OR = 1.88, 95% CI = 1.63-3.05, P = 0.011, CT + TT vas CC) and allele (OR = 1.77, 95% CI = 1.52-2.72, P = 0.010, T vs C) inheritance model. Regarding rs1046040 C > T polymorphism, the findings revealed that the CT genotype significantly increased the risk of PCa compared to the CC genotype (OR = 1.60, 95% CI = 1.03-2.49, P = 0.043). Furthermore, rs3787016 CT/rs1046040 CC as well as rs3787016 CT/rs1046040 CT increased the risk of PCa compared to the CC/CC genotype (p = 0.029 and p = 0.014, respectively). Haplotype analysis proposed that rs3787016 T/rs1046040 C significantly increased the risk of PCa compared to C/C (p = 0.037). No significant association was observed between POLR2E variants and clinicopathological characteristics of PCa patients. In conclusion, the findings propose that POLR2E variants may be a risk factor for susceptibility to PCa in a sample of Iranian population.


Assuntos
RNA Polimerases Dirigidas por DNA/genética , Polimorfismo de Nucleotídeo Único/genética , Neoplasias da Próstata/genética , RNA Longo não Codificante/genética , Estudos de Casos e Controles , RNA Polimerases Dirigidas por DNA/metabolismo , Genótipo , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , RNA Longo não Codificante/metabolismo , Fatores de Risco
19.
Immunol Lett ; 205: 78-83, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30447308

RESUMO

Urinary stones are the third most commonly reported urinary tract disease. Kidney stones are one of the most common types of urinary stones that most of them (70-80%) are calcium oxalate. Oxalic acid is highly oxidized organic compounds, which found in dietary and produced by the intestinal microflora. Oxalyl CoA decarboxylase is a key enzyme and plays an important role in oxalate degradation. In this study, the Oxalyl CoA decarboxylase gene which contains an -histidine tag was cloned in pET 28a (+) and expressed in Escherichia coli BL21 (DE3). The purified Oxalyl CoA decarboxylase protein was injected into rabbit for immunization. The antibody against Oxalyl CoA decarboxylase protein was used in ELISA assy. eventually, this ELISA system was used for patients with calcium oxalate kidney stones. ELISA analysis of serum samples of patient white calcium oxalate kidney stones showed that 88.8% of patient was lacking in antibody against Oxalyl CoA decarboxylase. This study suggests that antibodies against oxalyl-co-decoxylase proteins are useful in the detection of urinary tract stones and It can be used to measure oxalyl CoAdecoxylase enzymes in a simple method.


Assuntos
Proteínas de Bactérias/imunologia , Carboxiliases/metabolismo , Testes Diagnósticos de Rotina/métodos , Ensaio de Imunoadsorção Enzimática , Cálculos Renais/diagnóstico , Proteínas Recombinantes de Fusão/imunologia , Animais , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Oxalato de Cálcio/análise , Carboxiliases/genética , Clonagem Molecular , Escherichia coli/genética , Escherichia coli/metabolismo , Feminino , Humanos , Imunoglobulina G/sangue , Cálculos Renais/sangue , Cálculos Renais/química , Coelhos , Kit de Reagentes para Diagnóstico , Proteínas Recombinantes de Fusão/genética
20.
Urol J ; 16(1): 6-11, 2019 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-30058063

RESUMO

PURPOSE: Nowadays, there are many physical and chemical methods available for urinary stone analysis. According to the latest guidelines, infrared spectroscopy (IR) or x-ray diffraction (XRD) are the two preferred methods in this issue. Therefore, we decided to do a practical comparison between the two above-mentioned techniques with a reference method in order to set up a proper analysis method in our clinical laboratories. MATERIALS AND METHODS: A total of 60 kidney stones were obtained at Labbafinejad hospital through open surgery or percutaneous nephrolithotomy. Then stone analysis techniques included both a morphological examination by SEM (Scanning Electron Microscopy) and internal structure analysis by EDAX (Elemental distribution analysis X-ray), XRD, IR and wet chemical analysis. SEM together with EDAX (SEM-EDAX) was considered as reference methods. RESULTS: The results of XRD had the highest agreement with SEM-EDAX analysis (93%), while the total agreement of FTIR and wet chemical analysis was 81% and 71% respectively. The agreement of FTIR for calcium oxalate stones was acceptable (90%), but for uric acid and cystine stones was challenging (65% and 76% respectively). CONCLUSION: Our results revealed that XRD is more reliable than FTIR; but considering cost issues, FTIR is more suitable for routine clinical laboratory. Moreover, wet chemical analysis, which is routinely used in our laboratories is insufficient for stone analysis and it is mandatory to be replaced by techniques that are more accurate.


Assuntos
Cálculos Renais/química , Cálculos Renais/ultraestrutura , Espectroscopia de Infravermelho com Transformada de Fourier , Difração de Raios X , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Microscopia Eletrônica de Varredura , Pessoa de Meia-Idade , Adulto Jovem
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