Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 9.912
Filtrar
1.
Beijing Da Xue Xue Bao Yi Xue Ban ; 51(4): 653-659, 2019 Aug 18.
Artigo em Chinês | MEDLINE | ID: mdl-31420617

RESUMO

OBJECTIVE: To establish predictive models based on random forest and XGBoost machine learning algorithm and to investigate their value in predicting early stone-free rate (SFR) after flexible ureteroscopic lithotripsy (fURL) in patients with renal stones. METHODS: The clinical data of 201 patients with renal stones who underwent fURL were retrospectively investigated. According to the stone-free standard, the patients were divided into stone-free group (SF group) and stone-residual group (SR group). We compared a number of factors including patient age, body mass index (BMI), stone number, stone volume, stone density and hydronephrosis between the two groups. For low calyceal calculi, renal anatomic parameters including infundibular angle (IPA), infundibular width (IW), infundibular length (IL) and pelvic calyceal height (PCH), would be measured. We brought above potential predictive factors into random forest and XGBoost machine learning algorithm respectively to develop two predictive models. The receiver operating characteristic curve (ROC curve) was established in order to test the predictive ability of the model. Clinical data of 71 patients were collected prospectively to validate the predictive models externally. RESULTS: In this study, 201 fURL operations were successfully completed. The one-phase early SFR was 61.2%. We built two predictive models based on random forest and XGBoost machine learning algorithm. The predictive variables' importance scores were obtained. The area under the ROC curve (AUROC) of the two predictive models for early stone clearance status prediction was 0.77. In the study, 71 test samples were used for external validation. The results showed that the total predictive accuracy, predictive specificity and predictive sensitivity of the random forest and XGBoost models were 75.7%, 82.6%, 60.0%, and 81.4%, 87.0%, 68.0%, respectively. The first four predictive variables in importance were stone volume, mean stone density, maximal stone density and BMI in both random forest and XGBoost predictive models. CONCLUSION: The predictive models based on random forest and XGBoost machine learning algorithm can predict postoperative early stone status after fURL for renal stones accurately, which will facilitate preoperative evaluation and clinical decision-making. Stone volume, mean stone density, maximal stone density and BMI may be the important predictive factors affecting early SFR after fURL for renal stones.


Assuntos
Cálculos Renais , Litotripsia , Humanos , Aprendizado de Máquina , Estudos Retrospectivos , Resultado do Tratamento , Ureteroscopia
2.
Khirurgiia (Mosk) ; (6): 60-64, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31317942

RESUMO

AIM: To evaluate the efficacy of the most common endoscopic transpapillary interventions for choledocholithiasis in randomized controlled trial. MATERIAL AND METHODS: There were 90 patients with choledocholithiasis who were randomized into 3 groups: main, clinical comparison 1, clinical comparison 2. In the main group A (n=30), patients underwent endoscopic partial papillosphincterotomy combined with balloon dilatation, in the group of clinical comparison 1 (n=30) - endoscopic papillosphincterotomy, in the group of clinical comparison 2 (n=30) - endoscopic papillosphincterotomy with mechanical lithotripsy. RESULTS: The greatest number of complications (38%) was observed in the group of clinical comparison 2. Less morbidity was noted in the group of clinical comparison 1 (19%). Minimum number of complications was observed in the main group (6%). Acute pancreatitis was diagnosed in groups of clinical comparison 1 and 2 as a rule, whereas only 3% of patients had this complication in the main group. Cholangitis was predominantly observed in the group of clinical comparison 2, in other groups this complication occurred in 3% of patients. Bleeding was observed only in the groups of clinical comparison 1 and 2 (10 and 13%, respectively). Loss of the lithotripter rope (3%) was detected only in the group of clinical comparison 2. CONCLUSION: Endoscopic partial papillosphincterotomy with balloon dilatation is advisable for choledocholithiasis due to minimal risk of intra- and postoperative complications.


Assuntos
Coledocolitíase/cirurgia , Esfinterotomia Endoscópica/métodos , Coledocolitíase/terapia , Dilatação/efeitos adversos , Dilatação/instrumentação , Humanos , Litotripsia/métodos , Esfinterotomia Endoscópica/efeitos adversos , Resultado do Tratamento
3.
Arch Esp Urol ; 72(6): 590-595, 2019 Jul.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31274124

RESUMO

OBJECTIVE: To evaluate incidence, clinical, radiological and laboratory features of spontaneous upper urinary tract rupture (s-UUTR) due to ureteric stones and discuss their management. METHODS: Out of 1629 patients admitted to the Emergency Department (ED) for renal colic from January 2015 to December 2016 and studied by kidney US and contrast enhanced CT (CECT), 31 patients had a s-UUTR categorized in 3 stages: a) local spread, b) free fluid, c) urinoma. Presentation, therapeutic procedures and outcomes were registered. RESULTS: S-UUTR is reported in 1.9% of renal colic. The stone was most commonly identified at the vesicoureteric junction (VUJ) (61.3%) and mean (standard deviation, SD) stone size was 5.71 mm (2.31). S-UUTR was most frequently located in a calyx (54.84%). 26 patients (83.87%) had a clinical presentation of a renal colic, 3 cases (9.68%) had an atypical presentation and 2 (6.45%) presented an acute abdomen. In 26 cases a J-J stent (83,87%) was placed, 3 patients underwent primary ureteroscopic lithotripsy (9.67%); in 1 patient (3.23%) a nephrostomy was inserted and in 1 case (3.23%) active surveillance was adopted. Cases who underwent sole urinary derivation were revaluated after 30 days: ureteroscopic lithotripsy was performed in 48.15% of the cases; extracorporeal shock wave lithotripsy in 3.7%; in 22.2% of cases a CT demonstrated the spontaneous expulsion of the stone. 7 patients were lost at follow-up. The patient undergoing an active surveillance spontaneously expelled the stone. CONCLUSIONS: S-UUTR is a rare radiological sign of a renal colic most commonly located in a calyceal fornix. A high incidence of s-UUTR is caused by small distal ureteral stones in which a spontaneous passage is reasonable. Clinical presentation usually does not arise the suspicion of s-UUTR. In our experience, most patients were actively treated with good results but a conservative approach can be offered in selected cases.


Assuntos
Litotripsia , Cálculos Ureterais , Humanos , Cálculos Renais , Estudos Prospectivos , Resultado do Tratamento
4.
Urologiia ; (2): 15-20, 2019 Jun.
Artigo em Russo | MEDLINE | ID: mdl-31162895

RESUMO

BACKGROUND: The drug Canephron N is a combination of extracts of centaury, lovage and rosemary. Moderate antispasmoic, anti-inflammatory, antioxidant, diuretic and antimicrobial effects are of great interest for urological practice. The optimal combination of components that were made of herbal medicine allows to use their synergistic effect for prevention of recurrence of urinary stone disease. The experience of using the drug Canephron in clinical practice is of great interest. AIM: to clarify the clinical efficiency of Canephron N in patients with urinary stone disease after surgical treatment and to evaluate the changes in diuresis and calcium excretion. MATERIALS AND METHODS: The results of using the drug Canephron after surgical treatment of urinary stone disease are provided. The changes in diuresis and calcium excretion in 75 patients undergone surgical treatment of urinary stone disease were studied. Patients after ureteroscopy, percutaneous nephrolithotomy and extracorporeal shock-wave lithotripsy were prescribed treatment to prevent stone formation including herbal drug Canephron N. RESULTS: At baseline, there was negative correlation between 24-hours diuresis and calcium excretion in all groups. During follow-up, a positive correlation between 24-hours diuresis and calcium excretion was found in patients receiving Canephron N and other types of treatment. The average follow-up was 390 days. During this period, recurrence was noted in 1 patient receiving Canephron, 4 patients in patients who took other drugs and in 5 patients who didnt receive any treatment. CONCLUSION: Risk factors of stone formation persist after surgical treatment of urinary stone disease. This is reflected in a negative correlation between 24-hour diuresis and calcium excretion. During treatment, a positive correlation between diuresis and calcium excretion was noted in patients with urinary stone disease. The use of drugs that affect stone formation as well as herbal medicine Canephron N allow to obtain comparable ratio of diuresis and calcium excretion.


Assuntos
Fitoterapia , Extratos Vegetais/uso terapêutico , Cálculos Urinários/tratamento farmacológico , Cálculos Urinários/cirurgia , Cálcio/urina , Diurese/efeitos dos fármacos , Humanos , Litotripsia , Nefrolitotomia Percutânea , Extratos Vegetais/farmacologia , Prevenção Secundária , Ureteroscopia , Cálculos Urinários/prevenção & controle , Cálculos Urinários/urina
6.
Expert Rev Med Devices ; 16(7): 581-588, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31149847

RESUMO

INTRODUCTION: Percutaneous transluminal angioplasty (PTA) currently remains the endovascular treatment of choice in a large percentage of patients suffering from peripheral artery disease (PAD). However, the mechanism of angioplasty itself can cause some extent of arterial dissection leading to early vessel restenosis/reocclusion. Current endovascular imaging studies have reported a higher rate of arterial dissection than previously reported in literature and advocated the correlation of dissection with poor patency. Thus, there is the need of developing devices to minimize dissection and bailout stenting. AREAS COVERED: The present review focuses on newly-developed balloon angioplasty technologies designed to minimize arterial wall distress and consequently the rate of dissections. Available literature regarding three new specialty balloons is being reviewed, highlighting their value and limitations. Authors' future perspective about the benefits of utilizing specialty balloons towards a metal free and dissection free future is also provided. EXPERT OPINION: By understanding the mechanism of angioplasty and thus developing devices which cause minimal or no arterial wall distress, the rate of dissections and bailout stenting can be minimized and long-term clinical outcomes of endovascular therapy can be optimized.


Assuntos
Angioplastia com Balão/efeitos adversos , Doença Arterial Periférica/etiologia , Doença Arterial Periférica/cirurgia , Angioplastia com Balão/instrumentação , Cateterismo Cardíaco , Humanos , Litotripsia , Resultado do Tratamento
7.
Pan Afr Med J ; 32: 109, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31223399

RESUMO

Extracorporeal shock wave lithotripsy-related pain is the largest limiting factor in this technique. Our study aimed to compare the effectiveness of different types of analgesics for pain management used during ESWL sessions. We conducted a prospective study of 300 patients with urinary lithiasis justifying ESWL treatment. The patients were randomized to three groups: group I, included 100 patients who received intramuscular injection of 2cc of physiological saline solution (placebo), group II included 100 patients who received intramuscular injection of ketoprofen 100mg while group III included 100 patients who received lidocaine and prilocaine topical cream. Visual Analog Scale (VAS) was used to assess pain 10 minutes after and at the end of the session. Mean VAS score 10 minutes after and at the end of ESWL session was 3.7 and 4.91 respectively. There was no significant difference among the three groups with respect to: epidemiological data (age, sex, BMI, patient's history) and the characteristics of the renal stone (side, size, location, presence or not of double-J ureteral catheter). Eleven patients in the Group I terminated treatment early, with a significant difference compared to the other groups (p=0.003). VAS score 10 minutes after and at the end of ESWL session was statistically higher in Group I compared to Groups II and III (p < 0.001). Moreover, ESWL session was significantly more effective in Groups (II and III) compared to Group I (p<0.001). Pain treatment is necessary during ESWL sessions. Two painkillers molecules were assessed, which showed good pain control as well as an increase in the effectiveness of lithotripsy.


Assuntos
Analgésicos/administração & dosagem , Cálculos Renais/terapia , Litotripsia/métodos , Dor/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anestésicos Locais/administração & dosagem , Anti-Inflamatórios não Esteroides/administração & dosagem , Feminino , Humanos , Cetoprofeno/administração & dosagem , Combinação Lidocaína e Prilocaína/administração & dosagem , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Medição da Dor , Estudos Prospectivos , Adulto Jovem
8.
Pan Afr Med J ; 32: 110, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31223400

RESUMO

This study aims to discuss the role of open surgery in the treatment of renal lithiasis, including coralliform stones, with the advent of new less invasive techniques. We report a series of 53 cases of coralliform stones whose data were collected in our Hospital during a period of 7 years, from January 2011 to January 2018. The patients underwent open nephrolithotomy by lombotomy. The mean post-operative length of stay was 10 days. The immediate and early postoperative outcomes were simple in 36 patients, 6 patients underwent blood transfusion, 2 had severe sepsis in the postoperative period, 5 had infection of the wall and 4 had urinary fistula, secondarily managed by endoscopic drainage. Residual stones were found in 9 cases (16.9%). Stones were essentially treated by extracorporeal lithotripsy. Late outcomes were characterized by renal atrophy in 2 patients, lithiasic recurrence in 9 patients, an improvement in creatinine clearance in 9 patients and a slight worsening in 5 patients. Open surgery presents the risk of multiple complications and it is not recommended for first-line treatment of renal lithiasis. However it is important to determine which patients would benefit from open nephrolithotomy.


Assuntos
Cálculos Renais/cirurgia , Litotripsia/métodos , Nefrolitotomia Percutânea/métodos , Complicações Pós-Operatórias/epidemiologia , Transfusão de Sangue/estatística & dados numéricos , Drenagem/métodos , Endoscopia/métodos , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Sepse/epidemiologia , Resultado do Tratamento , Fístula Urinária/epidemiologia
9.
Urologiia ; (1): 23-27, 2019 Apr.
Artigo em Russo | MEDLINE | ID: mdl-31184013

RESUMO

AIM: To obtain the information about functional state of kidneys in patients with urolithiasis before and after treatment, as well as to study the damaging effect of different types of energy used for fragmentation of high-density stones. MATERIALS AND METHODS: A total of 105 patients aged from 25 to 62 years with high-density stones were undergone to lithotripsy. In Group 1 (n=38), Group 2 (n=32) and Group 3 (n=35) contact laser lithotripsy, contact ultrasound lithotripsy and extracorporeal shock-wave lithotripsy was used, respectively. In all cases the clinical and biochemical blood and urine tests were performed as well as leukocyte migration inhibition test, selective proteinuria, a urine level of inteleukin-18 (IL-18) and urine NGAL (lipocalin-2) were assessed. The first examination was done the day before lithotripsy and the next ones were performed after 3 hours, on the 1st and 5th day after the intervention. RESULTS: In all cases dense unilateral kidney stones of size 0.8-2 cm were detected. The stone-free rate after contact lithotripsy was 92.8%. After ESWL, the stone-free rate after two weeks was 94.9%. The average duration of lithotripsy in the Group 1, 2 and 3 was 40+/-3.8 min, 35+/-2.3 min and 32+/-3.6 min, respectively. Based on the level of biomarkers of AKI, laser lithotripsy allows to achieve stone fragmentation with the least damage. CONCLUSION: Our study proves that IL-18, NGAL, leukocyte migration inhibition test and selective proteinuria allows to diagnose AKI at early stages, as well as to objectively assess the functional state of the kidneys after lithotripsy. The obtained data proves that laser lithotripsy is the safest method as assessed by damaging effects on the kidney parenchyma.


Assuntos
Cálculos Renais , Rim , Litotripsia a Laser , Litotripsia , Nefrolitíase , Adulto , Biomarcadores , Humanos , Rim/lesões , Cálculos Renais/terapia , Litotripsia/efeitos adversos , Litotripsia a Laser/efeitos adversos , Pessoa de Meia-Idade , Nefrolitíase/terapia
10.
JSLS ; 23(2)2019.
Artigo em Inglês | MEDLINE | ID: mdl-31223226

RESUMO

Background and Objectives: The purpose of this study was to compare two methods (transperitoneal laparoscopic ureterolithotomy [TLU] and a combination of ureteroscopic lithotripsy [UL] with retrograde intrarenal surgery [RIRS]) designed for the treatment of large proximal ureteral calculi so that their associated complications and stone-free rates could be assessed. Methods: A total of 100 patients from three different hospitals who were diagnosed with large upper ureteral stones (≥15 mm) were treated via TLU (n = 48) or UL-RIRS (n = 52). They were treated between March 2012 and May 2014. The study compared the complications, success rate, patient characteristics, and the operation time between the two groups. Results: The immediate stone clearance rate after a single session was higher in the TLU group than in the UL-RIRS group (100% vs 73.1%, P = .005). However, there was no significant difference in the stone-free rates between the two groups three months after the last procedure was performed (100% vs 96.1%, P = .655). Regarding patients with a history of early-failure extracorporeal shock-wave lithotripsy, there was no significant difference in the stone-free rate between the two groups three months after the last procedure (100% vs 94.4%, P > .05). Further, overall complication rates between the groups were not statistically different (P = .261). Conclusion: This study demonstrates that TLU is an effective and safe procedure to treat large impacted upper ureteral stones. When compared to UL-RIRS, TLU showed equivalent efficacy and safety, though there were failed first-line treatments.


Assuntos
Laparoscopia , Litotripsia/métodos , Cálculos Ureterais/terapia , Ureteroscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
11.
Arch Esp Urol ; 72(4): 353-359, 2019 05.
Artigo em Espanhol | MEDLINE | ID: mdl-31070130

RESUMO

OBJECTIVES: Extracorporeal shock wave lithotripsy is a minimally invasive therapeutic option for the treatment of renal-ureteral lithiasis. The aim of this study was to analyze the results and complications of shock wave extracorporeal lithotripsy treatment with the Dornier Gemini® Generator EMSE 220f-XXP device in patients with renal and ureteral lithiasis. MATERIAL AND METHODS: Retrospective study including 377 patients with renal or ureteral lithiasis with indication for treatment with extracorporeal shock wave lithotripsy. The following variables were analyzed, age, sex, body mass index, lithiasis size, lithiasis location, presence of urinary diversion, number of lithotripsy sessions, number of shock waves, fluoroscopy time, wave energy, applied focal energy coefficient, efficiency coefficient, lithiasic fragmentation, lithiasic clearance, residual lithiasis, presence of lithiasis and complications. The results were analyzed with SPSS 17.0 considering statistical significance p≤0.05. RESULTS: Of the 377 patients, 213 were men and 164 women, with a mean age of 51.28 ± 12.77 years. The mean size of the stones in maximum diameter was 11.77 ± 6.13 mm. Lithiasis fragmentation occurred in 81.9% of cases, with a percentage of residual lithiasis after the first session of 58.7% and a total or partial expulsion rate of lithiasis fragments of 68.3%, with global success at the end of sessions of lithotripsy of 69.8%. The overall Efficiency Ratio was 0.42, higher in upper calyx 0.51 and lower in medium calyx 0.35, with significant differences (p<0.05). The only differences were found in relation to the success of lithotripsy treatment (75% versus 64.6%, p=0.02), according to lithiasis size (≤10 mm maximum diameter in comparison to >10 mm). In patients with a DJ catheter there is a higher percentage of residual lithiasis (p=0.006). CONCLUSIONS: Treatment with extracorporeal lithotripsy in small lithiasis and in well-selected patients obtains good results with a low rate of complications regardless of sex and body mass index.


Assuntos
Cálculos Renais , Litotripsia , Ureter , Cálculos Ureterais , Adulto , Idoso , Feminino , Humanos , Rim , Cálculos Renais/terapia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
12.
Curr Urol Rep ; 20(7): 36, 2019 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-31104149

RESUMO

PURPOSE OF REVIEW: The link between metabolic syndrome (MetS)/obesity and kidney stone disease (KSD) has gained importance over recent years due to the increasing prevalence and healthcare burden worldwide. This review analyses the literature exploring the link between MetS/obesity and KSD and the impact that obesity has on KSD management. RECENT FINDINGS: Metabolic syndrome has been shown to increase an individual's risk of developing kidney stone disease, with insulin resistance forming a core component of the pathophysiology. The body habitus of an individual also influences the type of intervention that is most appropriate, with flexible ureteroscopy increasingly being the preferred option in obese patients. It is important for urologists to consider the features of metabolic syndrome to effectively manage episodes of KSD in obese patients. In addition, better quality evidence is required to effectively compare different treatment options in this group of patients.


Assuntos
Cálculos Renais/complicações , Síndrome Metabólica/complicações , Obesidade/complicações , Humanos , Resistência à Insulina , Cálculos Renais/terapia , Litotripsia , Síndrome Metabólica/terapia , Obesidade/terapia , Ureteroscopia
15.
Artigo em Alemão | MEDLINE | ID: mdl-30999351

RESUMO

The diagnosis of obstructive urolithiasis in small ruminants frequently results in a multitude of decisions that have to be made by the consulted practitioner. Factors that influence the decision for therapy (or euthanasia) are the type of the animal's use, economic aspects and specific options of the veterinarian practice as well as emotional aspects depending on the owners of small ruminants kept as companion animals. The present article aims to present the currently available methods of therapy to facilitate a decision by the practicing veterinarian based on the present state of the science. Naturally, the individual method of choice may differ from the scientific point of view depending on the practitioner's evaluation.


Assuntos
Doenças das Cabras/terapia , Doenças dos Ovinos/terapia , Urolitíase/veterinária , Amputação/veterinária , Animais , Cistotomia/veterinária , Cabras , Litotripsia/métodos , Litotripsia/veterinária , Litotripsia a Laser/veterinária , Masculino , Pênis/cirurgia , Ovinos , Cirurgia Plástica/veterinária , Uretra/cirurgia , Obstrução Uretral/etiologia , Obstrução Uretral/terapia , Obstrução Uretral/veterinária , Bexiga Urinária/cirurgia , Cateterismo Urinário/instrumentação , Cateterismo Urinário/métodos , Cateterismo Urinário/veterinária , Urolitíase/complicações , Urolitíase/terapia
16.
Artigo em Alemão | MEDLINE | ID: mdl-31013525

RESUMO

OBJECTIVE: Description of clinical experience with two different lithotripsy modalities for treatment of urethral stones in dogs. MATERIAL AND METHODS: Retrospective analysis (October 2016 - November 2017) of medical records from dogs with urinary stones that underwent transurethral pneumatic or laser lithotripsy. RESULTS: In 28 male and 5 female dogs, either pneumatic lithotripsy (39 %) or laser lithotripsy (61 %) was performed. In the urethra, stone free rates of 100 % in females and over 85 % in males could be achieved using either fragmentation modality. In 3 of 28 (11 %) male dogs, after fragmentation of urethral stones, urethral patency was impaired because of endoscopically suspected polypoid urethritis requiring urethrostomy. In 8 out of 28 (29 %) male dogs and in 1 of 5 (20 %) female dogs, an additional lithocystotomy was necessary to achieve stone-free status in the lower urinary tract. CONCLUSION AND CLINICAL RELEVANCE: Transurethral pneumatic or laser lithotripsy of urinary stones is a successful procedure in dogs. Major pathological conditions of the urethral mucosa may require further surgical or interventional methods for the restoration of a functional urethra.


Assuntos
Doenças do Cão/terapia , Litotripsia a Laser/veterinária , Litotripsia/veterinária , Doenças Uretrais/veterinária , Cálculos Urinários/veterinária , Animais , Cães , Feminino , Litotripsia/métodos , Masculino , Registros/veterinária , Estudos Retrospectivos , Doenças Uretrais/terapia , Cálculos Urinários/terapia
17.
Herzschrittmacherther Elektrophysiol ; 30(2): 168-176, 2019 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31016389

RESUMO

The management of patients with a cardiac implantable electronic device (CIED) poses a particular challenge in the peri-interventional and perioperative medical environment due to the many forms of possible electromagnetic interference. Although the devices encountered nowadays are of increasing complexity, the vast majority of procedures can be safely performed in patients. The existing position statements and recommendations, however, have a low level of evidence and are often contradictory. In the context of intraoperative electrocauterization, one of the most important sources of electromagnetic interference in the medical environment, recent studies have suggested an increasingly pragmatically perioperative CIED management, which is not represented in the existing recommendations. This article gives an example of these newer findings and reports the currently used and appropriately adapted perioperative CIED management protocol. Extracorporeal shock wave lithotripsy was thought to cause severe interference in CIED patients based on older studies and in vitro experiments. Although electromagnetic interference is possible, clinical observations with modern devices show that the procedure can generally be safely applied in CIED patients. Physiotherapy often utilizes a variety of electromechanical devices, which can be a relevant source of electromagnetic interference. Although some of these therapies can be safely used, coordination with the responsible CIED unit is recommended.


Assuntos
Desfibriladores Implantáveis , Fenômenos Eletromagnéticos , Litotripsia , Marca-Passo Artificial , Humanos , Modalidades de Fisioterapia
18.
Urol Clin North Am ; 46(2): 273-285, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30961860

RESUMO

This article reviews new advances in ultrasound technology for urinary stone disease. Recent research to facilitate the diagnosis of nephrolithiasis, including use of the twinkling signal and posterior acoustic shadow, have helped to improve the use of ultrasound examination for detecting and sizing renal stones. New therapeutic applications of ultrasound technology for stone disease have emerged, including ultrasonic propulsion to reposition stones and burst wave lithotripsy to fragment stones noninvasively. The safety, efficacy, and evolution of these technologies in phantom, animal, and human studies are reviewed herein. New developments in these rapidly growing areas of ultrasound research are also highlighted.


Assuntos
Litotripsia/métodos , Nefrolitíase/diagnóstico por imagem , Nefrolitíase/cirurgia , Terapia por Ultrassom/métodos , Ultrassonografia/métodos , Humanos , Cálculos Renais/diagnóstico por imagem , Cálculos Renais/cirurgia , Cálculos Urinários/diagnóstico por imagem , Cálculos Urinários/cirurgia
19.
Urol Clin North Am ; 46(2): 207-213, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30961854

RESUMO

Percutaneous nephrolithotomy is the treatment of choice for large renal stones. Larger, straight access tracts allow for use of rigid pneumatic and ultrasonic lithotripsy devices. Through advanced technologies, more efficient fragmentation has become possible, allowing for a variety of treatment options depending on stone location, size, and composition. As novel methods of lithotripsy enter the clinical sphere, it is a requirement that the operating urologist understand the available surgical options and the associated mechanisms used to best treat their patients. This article discusses the mechanisms of basic pneumatic and ultrasonic devices, and examines the data regarding current and novel combination lithotrites.


Assuntos
Litotripsia/instrumentação , Litotripsia/tendências , Terapia por Ultrassom/instrumentação , Ar Comprimido/uso terapêutico , Gases/uso terapêutico , Humanos , Invenções/tendências , Litotripsia/métodos , Nefrolitotomia Percutânea/instrumentação , Nefrolitotomia Percutânea/métodos , Nefrolitotomia Percutânea/tendências , Terapia por Ultrassom/métodos , Terapia por Ultrassom/tendências
20.
Urol Clin North Am ; 46(2): 215-223, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30961855

RESUMO

This comprehensive review updates the advances in extracorporeal lithotripsy, including improvements in external shockwave lithotripsy and innovations in ultrasound based lithotripsy, such as burst wave lithotripsy, ultrasonic propulsion, and histotripsy. Advances in endoscopic technology and training have changed the surgical approach to nephrolithiasis; however, improvements and innovations in extracorporeal lithotripsy maintain its status as an excellent option in appropriately selected patients.


Assuntos
Litotripsia/instrumentação , Litotripsia/métodos , Cálculos Urinários/cirurgia , Ondas de Choque de Alta Energia/uso terapêutico , Humanos , Invenções , Cálculos Renais/cirurgia , Microbolhas/uso terapêutico , Seleção de Pacientes
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA