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Yang G, Cui T, Cao Y, Yang X, Wang S, Enikeev M, He M. EXPRESS: Can weight-adjusted waist circumference index become a single anthropometric predictor of prostate specific antigen concentration? An NHANES analysis (2003-2010). J Investig Med 2024:10815589241252356. [PMID: 38644377 DOI: 10.1177/10815589241252356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Recent studies have introduced the weight-adjusted waist circumference index (WWI) as a viable obesity indicator that may better reflect centripetal obesity and its associated risks. In examining the connection between WWI and prostate-specific antigen (PSA), this study leveraged data from the National Health and Nutrition Examination Survey (NHANES) 2003-2010, including 5732 participants. Our initial analysis indicated a significant positive association between WWI and PSA levels. However, subsequent models that adjusted for covariates such as age, race, and a range of metabolic and cardiovascular health-related factors revealed that the strength and significance of this relationship were attenuated. Model 1 showed a highly significant correlation (P < 0.0001). Yet, in Model 2, which accounted for age and race, the association softened (P = 0.0520). Moreover, when a full spectrum of health covariates was included in Model 3, the association was no longer significant (P = 0.9775). These findings suggest that while an unadjusted correlation exists, its potential use as a diagnostic predictor is limited without considering the broader health context. Therefore, it is crucial to review such data with multiple considerations in mind, and extensive attention should be paid to the evaluation of covariates.
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Affiliation(s)
- Guodong Yang
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991, Moscow, 8 Russia
| | - Te Cui
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991, Moscow, 8 Russia
| | - Yu Cao
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991, Moscow, 8 Russia
| | - Xinyi Yang
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991, Moscow, 8 Russia
| | - Shuowen Wang
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991, Moscow, 8 Russia
| | - Mikhail Enikeev
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991, Moscow, 8 Russia
| | - Mingze He
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991, Moscow, 8 Russia
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Jubber I, Morhardt DR, Griffin J, Cumberbatch M, Glover M, Zheng Y, Rehman I, Loynes C, Hussain SA, Renshaw SA, Leach SD, Cunliffe VT, Catto JWF. Analysis of the distal urinary tract in larval and adult zebrafish reveals homology to the human system. Dis Model Mech 2023:316638. [PMID: 37293698 PMCID: PMC10387350 DOI: 10.1242/dmm.050110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/30/2023] [Indexed: 06/10/2023] Open
Abstract
Little is known about the distal excretory component of the urinary tract in Danio rerio (zebrafish). This component is affected by many human diseases and disorders of development. Here, we undertook multi-level analyses to determine the structure and composition of the distal urinary tract in the zebrafish. In silico searches identified uroplakin 1a, 2-like and 3-like genes in the zebrafish genome (orthologues to genes that encode urothelium-specific proteins in humans). In situ hybridization demonstrated uroplakin-1a expression in the zebrafish pronephros and cloaca from 96 hours post-fertilisation. H&E sectioning of adult zebrafish demonstrated two mesonephric ducts uniting into a urinary bladder which leads to a distinct urethral opening. Immunohistochemistry identified Uroplakin 1a and 2 expression and Gata3 expression in zebrafish urinary bladder cell layers that match human urothelial expression. Fluorescent dye injections demonstrated zebrafish urinary bladder function, including urine storage, intermittent micturition, and a urethral orifice separate from the larger anal canal and rectum. Our findings reveal homology between the urinary tracts of zebrafish and humans and offer the former as a model system to study disease.
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Affiliation(s)
- Ibrahim Jubber
- Department of Oncology and Human Metabolism, University of Sheffield, Sheffield, UK
- Department of Urology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Duncan R Morhardt
- Department of Molecular and Systems Biology, Dartmouth Cancer Center, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Jonathan Griffin
- Department of Oncology and Human Metabolism, University of Sheffield, Sheffield, UK
- Department of Histopathology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
- Healthy Lifespan and Neuroscience Institute, Department of Biosciences, University of Sheffield, Sheffield, UK
| | - Marcus Cumberbatch
- Department of Oncology and Human Metabolism, University of Sheffield, Sheffield, UK
- Department of Urology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Maggie Glover
- The Bateson Centre and Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Yang Zheng
- Department of Molecular and Systems Biology, Dartmouth Cancer Center, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Ishtiaq Rehman
- Department of Oncology and Human Metabolism, University of Sheffield, Sheffield, UK
| | - Catherine Loynes
- The Bateson Centre and Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Syed A Hussain
- Department of Oncology and Human Metabolism, University of Sheffield, Sheffield, UK
- Department of Medical Oncology, Weston Park Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Stephen A Renshaw
- The Bateson Centre and Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Steven D Leach
- Department of Molecular and Systems Biology, Dartmouth Cancer Center, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Vincent T Cunliffe
- The Bateson Centre and Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
- School of Biosciences, University of Sheffield, Firth Court, Western Bank, Sheffield, UK
| | - James W F Catto
- Department of Oncology and Human Metabolism, University of Sheffield, Sheffield, UK
- Department of Urology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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Kisu I, Iida M, Shiraishi T, Iijima M, Nakamura K, Matsuda K, Hirao N. Real-time intraoperative ureter visualization with a novel Near-Infrared Ray Catheter during laparoscopic hysterectomy for gynecological cancer. J Gynecol Oncol 2021; 32:e93. [PMID: 34708595 PMCID: PMC8550933 DOI: 10.3802/jgo.2021.32.e93] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/21/2021] [Accepted: 08/28/2021] [Indexed: 02/03/2023] Open
Abstract
Ureteral injuries are well-known complications of gynecologic surgery, with a higher prevalence in laparoscopic surgery than in laparotomy [1]. The use of near-infrared fluorescent imaging navigation is currently being considered a novel method to identify the ureters intraoperatively and prevent ureteral injuries [2]. The Near-Infrared Ray Catheter (NIRC) fluorescent ureteral catheter is a newly developed device, containing a fluorescent resin that can be recognized by near-infrared irradiation. We found few reports on the use of this catheter in laparoscopic surgery for colon and rectal cancer [34], but no reports in gynecologic surgery. We demonstrate the feasibility, safety, and potential usefulness of the real-time intraoperative visualization of the ureters using a novel NIRC fluorescent ureteral catheter in laparoscopic hysterectomy for endometrial cancer. A 30-year-old woman with early grade 1 endometrioid carcinoma was treated with medroxyprogesterone acetate for fertility preservation. After achieving complete response, she got pregnant and underwent cesarean section. The recurrence of atypical endometrial hyperplasia one year post-delivery prompted a total laparoscopic hysterectomy. Before the laparoscopic surgery began, the NIRC fluorescent ureteral catheters were placed in the ureters under the obtainment of informed consent from the patient. During the surgery, the catheters were successfully visualized by near-infrared fluorescence observation, which helped identify the ureters clearly and prevent ureteral injuries. This novel ureteral imaging navigation is expected to be an effective tool in cases of obesity, severe pelvic adhesion, deep infiltrating endometriosis, and malignancy in gynecologic laparoscopic surgery to clearly identify the ureter and to reduce the risk of ureteral injury.
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Affiliation(s)
- Iori Kisu
- Department of Obstetrics and Gynecology, Federation of National Public Service Personnel Mutual Aid Associations, Tachikawa Hospital, Tokyo, Japan.,Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
| | - Miho Iida
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Tetsuro Shiraishi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Moito Iijima
- Department of Obstetrics and Gynecology, Federation of National Public Service Personnel Mutual Aid Associations, Tachikawa Hospital, Tokyo, Japan
| | - Kanako Nakamura
- Department of Obstetrics and Gynecology, Federation of National Public Service Personnel Mutual Aid Associations, Tachikawa Hospital, Tokyo, Japan
| | - Kiyoko Matsuda
- Department of Obstetrics and Gynecology, Federation of National Public Service Personnel Mutual Aid Associations, Tachikawa Hospital, Tokyo, Japan
| | - Nobumaru Hirao
- Department of Obstetrics and Gynecology, Federation of National Public Service Personnel Mutual Aid Associations, Tachikawa Hospital, Tokyo, Japan
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Mourão TC, de Oliveira RAR, Favaretto RDL, Santana TBM, Sacomani CAR, Bachega W, Guimarães GC, Zequi SDC. Should obesity be associated with worse urinary continence outcomes after robotic-assisted radical prostatectomy? a propensity score matching analysis. Int Braz J Urol 2021; 48:122-130. [PMID: 34472768 PMCID: PMC8691228 DOI: 10.1590/s1677-5538.ibju.2021.0457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/14/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose: To analyze the association between obesity and urinary incontinence rate in men submitted to robot-assisted radical prostatectomy (RARP) in a high-volume cancer center. Materials and Methods: We reported 1.077 men who underwent RARP as the primary treatment for localized prostate cancer from 2013 to 2017. Patients were classified as non-obese (normal BMI or overweight) or obese men (BMI ≥30kg/m2). They were grouped according to the age, PSA level, D’Amico risk group, Gleason score, ASA classification, pathological stage, prostate volume, salvage/adjuvant radiotherapy, perioperative complications, and follow-up time. Urinary continence was defined as the use of no pads. For the analysis of long-term urinary continence recovery, we conducted a 1:1 propensity-score matching to control confounders. Results: Among the obese patients, mean BMI was 32.8kg/m2, ranging 30 - 45.7kg/m2. Only 2% was morbidly obese. Obese presented more comorbidities and larger prostates. Median follow-up time was 15 months for the obese. Complications classified as Clavien ≥3 were reported in 5.6% of the obese and in 4.4% of the non-obese men (p=0.423). Median time for continence recovery was 4 months in both groups. In this analysis, HR was 0.989 for urinary continence recovery in obese (95%CI=0.789 - 1.240; p=0.927). Conclusions: Obese can safely undergo RARP with similar continence outcomes comparing to the non-obese men when performed by surgeons with a standardized operative technique. Future studies should perform a subgroup analysis regarding the association of obesity with other comorbidities, intending to optimize patient counseling.
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Affiliation(s)
- Thiago Camelo Mourão
- Departamento de Uro-Oncologia, Hospital da Beneficência Portuguesa de São Paulo, São Paulo, SP, Brasil.,Escola de Pós-Graduação, Fundação Antônio Prudente, AC Camargo Cancer Center, São Paulo, SP, Brasil
| | | | - Ricardo de Lima Favaretto
- Departamento de Uro-Oncologia, Hospital da Beneficência Portuguesa de São Paulo, São Paulo, SP, Brasil
| | - Thiago Borges Marques Santana
- Departamento de Uro-Oncologia, Hospital da Beneficência Portuguesa de São Paulo, São Paulo, SP, Brasil.,Divisão de Urologia, AC Camargo Cancer Center, São Paulo SP, Brasil
| | | | - Wilson Bachega
- Divisão de Urologia, AC Camargo Cancer Center, São Paulo SP, Brasil
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Qian S, Liang C, Ding Y, Wang C, Shen H. Preoperative hydronephrosis predicts adverse pathological features and postoperative survival in patients with high-grade upper tract urothelial carcinoma. Int Braz J Urol 2021; 47:159-168. [PMID: 33047921 PMCID: PMC7712693 DOI: 10.1590/s1677-5538.ibju.2020.0021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/29/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose: Epidemiological studies reported conflicting results about preoperative hydronephrosis in upper tract urothelial carcinoma (UTUC). This study aimed to investigate the association between preoperative hydronephrosis and pathologic features and oncologic outcomes in patients with UTUC treated by radical nephroureterectomy (RNU). Materials and Methods: This was a retrospective, single-center cohort study of 377 patients treated by RNU without perioperative chemotherapy between January 2001 and December 2014. Logistic regression, Cox regression, and survival analyses were performed. Results: Among the 226 patients with high-grade UTUC, 132 (58%) had preoperative hydronephrosis. Multivariable logistic regression revealed that hydronephrosis was independently associated with advanced pT stage (P=0.017) and lymph node or lymphovascular invasion (P=0.002). Median follow-up was 36 months (interquartile range: 20-48 months). The 3- and 5-year overall survival (OS) rates in patients with hydronephrosis were significantly lower than in those without hydronephrosis (both P <0.001). The 3- and 5-year cancer-specific survival (CSS) rates in patients with hydronephrosis were significantly lower than in those without hydronephrosis (both P=0.001). Hydronephrosis was independently associated with OS and CSS (P=0.001 and P=0.004, respectively). Among the 151 patients with low-grade UTUC, hydronephrosis was not associated with pathologic features and postoperative survival. Conclusions: Preoperative hydronephrosis was significantly associated with adverse pathologic features and postoperative survival in patients with high-grade UTUC.
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Affiliation(s)
- Subo Qian
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chengcai Liang
- Department of Gastric and Pancreatic Surgery, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangzhou, China
| | - Yu Ding
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chen Wang
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Haibo Shen
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Theva DP, Kuhnen A, Babayan RK, Katz MH. Concurrent urinary and bowel diversion: Surgical modification with sigmoid colon that avoids a bowel anastomosis. Int Braz J Urol 2020; 46:108-115. [PMID: 31851467 PMCID: PMC6968900 DOI: 10.1590/s1677-5538.ibju.2019.0194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 06/19/2019] [Indexed: 11/22/2022] Open
Abstract
Objective: Cystectomy with urinary diversion is the gold standard for muscle invasive bladder cancer. It also may be performed as part of pelvic exenteration for non-urologic malignancy, neurogenic bladder dysfunction, and chronic conditions that result in a non-functional bladder (e.g., interstitial cystitis, radiation cystitis). Our objective is to describe the surgical technique of urinary diversion using large intestine as a conduit whilst creating an end colostomy, thereby avoiding a primary bowel anastomosis and to show its applicability with respect to urologic conditions. Materials and Methods: We retrospectively reviewed five cases from a single institution that utilized the described method of urinary diversion with large intestine. We describe operative times, hospital length of stay (LOS), and describe post-operative complications. Results: Five patients with a variety of urologic and oncologic pathology underwent the described procedures. Their operative times ranged from 5 hours to 11 hours and one patient experienced a Clavien III complication. Conclusion: We describe five patients who underwent this procedure for various medical indications, and describe their outcomes, and believe dual diversion of urinary and gastrointestinal systems with colon as a urinary conduit to be an excellent surgical option for the appropriate surgical candidate.
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Affiliation(s)
- Didi P Theva
- Department of Urology, Boston Medical Center/Boston University School of Medicine Boston
| | - Angela Kuhnen
- Department of Surgery, Division of Colorectal Surgery, Boston Medical Center/Boston University School of Medicine Boston
| | - Richard K Babayan
- Department of Urology, Boston Medical Center/Boston University School of Medicine Boston
| | - Mark H Katz
- Department of Urology, Boston Medical Center/Boston University School of Medicine Boston
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7
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Suyama T, Kanbe S, Maegawa M, Shimizu H, Nakajima K. Prognostic significance of inflammation-based prognostic scoring in patients with upper urinary tract urothelial carcinoma. Int Braz J Urol 2019; 45:541-548. [PMID: 31038863 PMCID: PMC6786111 DOI: 10.1590/s1677-5538.ibju.2018.0251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 02/24/2019] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To investigate whether Glasgow Prognostic Score has prognostic significance in patients with upper urinary urothelial carcinoma. PATIENTS AND METHODS We retrospectively reviewed the clinical records of 74 patients with upper urinary urothelial carcinoma. We set the cut-off value for C-reactive protein as 1.0mg/dL, and 3.5mg/dL for albumin as Glasgow Prognostic Score. Their blood data including albumin and C-reactive protein for Glasgow Prognostic Score and cytokeratin 19 fragment 21-1 as a tumor marker were measured before starting treatment. The patients were stratified into three groups with Glasgow Prognostic Score: The Group-1, albumin ≥3.5g/dL and C-reactive protein < 1.0mg/dL; Group-2, albumin < 3.5g/dL or C-reactive protein ≥1.0mg/dL; Group-3, albumin < 3.5g/dL and C-reactive protein ≥1.0mg/dL. RESULTS The median follow-up for all patients was 26.9 months (range: 10.9-91.1 months), during which 37 (50%) patients died. There was a signifi cant difference in the estimated survival rate among the 3 groups stratified by Glasgow Prognostic Score. The estimated survival rate in the Group-1 was significantly higher than those in Groups 2 and 3. In the univariate analysis C-reactive protein, serum cytokeratin 19 fragment 21-1 and Glasgow Prognostic Score were significant predictors of overall survival. On the multivariate analysis, serum cytokeratin 19 fragment 21-1 and Glasgow Prognostic Score were independently associated with shorter overall survival. CONCLUSION Our review suggests Glasgow Prognostic Score may play as a prognostic predictor for upper urinary urothelial carcinoma.
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Affiliation(s)
- Taisuke Suyama
- Department of Genitourinary, Sanaikai General Hospital (IMS), Japan
| | - Shigeki Kanbe
- Department of Genitourinary, Toho University Omori Medical Center, Japan
| | - Masanobu Maegawa
- Department of Genitourinary, Sanaikai General Hospital (IMS), Japan
| | - Hirofumi Shimizu
- Department of Genitourinary, Sanaikai General Hospital (IMS), Japan
| | - Koichi Nakajima
- Department of Genitourinary, Toho University Omori Medical Center, Japan
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Ochoa-López JM, Gabilondo-Pliego B, Collura-Merlier S, Herrera-Cáceres JO, de Zavaleta MS, Rodríguez-Covarrubias FT, Feria-Bernal G, Gabilondo-Navarro F, Castillejos-Molina RA. Incidence and treatment of malignant tumors of the genito urinary tract in renal transplant recipients. Int Braz J Urol 2018; 44:874-881. [PMID: 29757570 PMCID: PMC6237530 DOI: 10.1590/s1677-5538.ibju.2017.0471] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 04/04/2018] [Indexed: 01/20/2023] Open
Abstract
Purpose: To provide data of the incidence and management of common urological malignancies in renal transplant recipients. Materials and Methods: We conducted a retrospective analysis of a prospective database from August 1967 to August 2015. A descriptive analysis of the sample was performed. Results: Among 1256 consecutive RTR a total of 88 patients developed malignancies (7%). There were 18 genitourinary tumors in the 16 patients (20.45 % of all malignant neoplasms), incidence of 1.27%. The most common neoplasm encounter was renal cancer (38.8%), followed by urothelial carcinoma (33.3%). Median follow-up of transplantation was 197 months (R, 36-336). Mean time from RT to cancer diagnosis 89±70 months (R, 12-276). CsA and AZA was the most common immunosuppression regimen in 68.75%. Mean follow-up after diagnosis was 103±72 months (R 10-215). Recurrence free survival rate of 100%. Overall survival of 89.5% of the sample; there were two non-related cancer deaths during follow-up. Conclusions: The incidence of neoplasms in RTR was lower than in other series, with favorable functional and oncologic results after treatment. This suggests that actions to reduce the risk of these malignancies as well as a strict follow-up are mandatory for an early detection and treatment.
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Affiliation(s)
- Juan Manuel Ochoa-López
- Department of Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México
| | | | - Sylvain Collura-Merlier
- Department of Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México
| | - Jaime O Herrera-Cáceres
- Department of Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México
| | | | | | - Guillermo Feria-Bernal
- Department of Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México
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9
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Garza-Montúfar ME, Treviño-Valdez PD, De la Garza-Salinas LH. [Comorbidities and antimicrobial resistance in urological outpatients with positive urine culture]. Rev Med Inst Mex Seguro Soc 2018; 56:347-353. [PMID: 30521301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND The urinary tract infections are the third cause of infections in Mexico. The inappropriate use of antibiotic has generated the presence of multidrugresistant bacteria. OBJECTIVE To identify the bacterial resistance patterns of the hospital and to detect the present comorbidities that can modify the evolution of urinary tract infection for proper empirical management. METHODS Non-comparative cross-sectional study, positive urine cultures were reviewed in the period from December 2015 to May 2016, in outpatients of urology in the hospital. The obtained growth, bacterial resistance and the comorbidities of each patient were analyzed. RESULTS 190 urine cultures were included. The most frequent bacterium was Escherichia coli. Greater general antibiotic resistance was detected to ceftazidime (91.5%), quinolones (> 65%) and trimethoprim / sulfamethoxazole (58%). The general multiresistance was 66.3%. The antibiotics that showed greater sensitivity were: amikacin, imipenem, nitrofurantoin, meropenem and piperacillin / tazobactam. The most frequent comorbidities were diabetes mellitus, previous use of antibiotics for urinary tract infection and prostatic hyperplasia. CONCLUSION In patients with urinary tract infection in the hospital, the empirical use of nitrofurantoin and amikacin is recommended. Quinolones and trimethoprim / sulfamethoxazole have a high resistance index.
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Affiliation(s)
- María Esther Garza-Montúfar
- Instituto Mexicano del Seguro Social, Hospital General de Zona No. 33, Departamento de Urología. Monterrey, Nuevo León, México
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10
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Al-Mula Abed OWS, Srirangam SJ, Wemyss-Holden GD. Upper Tract Imaging in Patients with Initial or Terminal Hematuria Suggestive of Bleeding from the Lower Urinary Tract: How Often is the Upper Urinary Tract Responsible for the Hematuria? Oman Med J 2018; 33:374-379. [PMID: 30210715 DOI: 10.5001/omj.2018.70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objectives Visible hematuria (VH) is a common urological complaint. A history of initial or terminal VH in men is indicative of a lower urinary tract (LUT) source. A careful clinical history could limit unnecessary extensive upper tract imaging in this group of patients with VH. We conducted a single-center prospective study to examine the usefulness of investigating the upper tract in patients with a history of VH likely from a LUT source (initial and/or terminal VH) with specific reference to the incidence of demonstrable significant upper tract abnormalities. Methods We conducted a single-center prospective study of consecutive male patients presenting with VH over eight months. All patients underwent standard investigations including physical examination, flexible cystoscopy (FC), and radiological imaging (ultrasound scan (USS) and/or computed tomography urogram (CTU)). Those with a clear history of initial or terminal VH were identified for further scrutiny with regards to detectable upper tracts abnormalities. Results In total, 57 patients (aged 23-95 years) with initial or terminal VH were identified. Of these, 56 had FC and nine patients were subsequently diagnosed with a LUT malignancy. With regards to upper urinary tract (UUT), 35 patients (61.4%) had an USS, 46 (80.7%) underwent a CTU, and 25 (43.9%) patients had both. In this group, no UUT malignancy was identified on upper tract imaging. Conclusions Initial or terminal VH patients may not need extensive upper tract imaging. FC is recommended, but a non-invasive USS can be a safe initial investigation for the UUT, with a CTU subsequently considered in those with abnormalities on USS and those with ongoing bleeding. Further combined multicenter analysis will help corroborate these findings and could have several beneficial outcomes including a reduction in investigations cost, patient inconvenience, and ionizing radiation.
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Affiliation(s)
| | - Shalom J Srirangam
- Department of Urology, East Lancashire Hospitals Trust, Blackburn, United Kingdom
| | - Guy D Wemyss-Holden
- Department of Urology, East Lancashire Hospitals Trust, Blackburn, United Kingdom
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11
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Sarhan OM, Helaly AE, Al Otay A, Ghanbar MA, Nakshabandi Z. Isolated low grade prenatally detected unilateral hydronephrosis: do we need long term follow-up? Int Braz J Urol 2018; 44:812-818. [PMID: 29757579 PMCID: PMC6092662 DOI: 10.1590/s1677-5538.ibju.2017.0474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 03/27/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose: To assess the need for postnatal evaluation and the medium term outcome in patients with isolated unilateral low grade prenatally detected hydronephrosis. Materials and Methods: We prospectively selected 424 patients (690 kidney units) with a prenatal diagnosis of urinary tract dilatation between 2010 and 2013. We included only those patients with isolated unilateral low-grade hydronephrosis who underwent at least 2 postnatal ultrasound examinations. The Society for Fetal Urology (SFU) grading system was utilized for assessment of the hydronephrosis. We excluded patients with bilateral dilation or other urological abnormalities. The fate of hydronephrosis including resolution, stability or worsening was documented. Results: A total of 66 infants (44 boys and 22 girls) with antenatally diagnosed unilateral urinary tract dilation (23 right and 43 left) were identified. Ultrasounds showed SFU grade 1 hydronephrosis in 32 patients (48%) and SFU grade 2 hydronephrosis in 34 (52%). After a mean follow-up period of 32 months (range 12 to 60), 37 patients (56%) had complete resolution of hydronephrosis while the remaining 29 were stable (44%). None of our patients developed UTIs during follow-up and none required surgical intervention. Conclusions: Prenatally detected, isolated unilateral low-grade hydronephrosis usually have a favorable prognosis. All cases in our cohort showed either stability or resolution of hydronephrosis without any harmful consequences. Based on our findings on medium-term in this category of patients, long-term follow-up is not warranted.
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Affiliation(s)
- Osama M Sarhan
- Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt.,Division Urology Pediatric, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ahmed El Helaly
- Division Urology Pediatric, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.,Mansoura Health Insurance Hospital, Mansoura, Egypt
| | - Abdulhakim Al Otay
- Division Urology Pediatric, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mustafa Al Ghanbar
- Division Urology Pediatric, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ziad Nakshabandi
- Division Urology Pediatric, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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12
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Brunhara JA, Moscardi PRM, Mello MF, Andrade HS, Carvalho PA, Cezarino BN, Dénes FT, Lopes RI. Transperitoneal laparoscopic pyeloplasty in children: does upper urinary tract anomalies affect surgical outcomes? Int Braz J Urol 2018; 44:370-377. [PMID: 29368877 PMCID: PMC6050553 DOI: 10.1590/s1677-5538.ibju.2017.0224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 11/15/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To assess the feasibility and outcomes of laparoscopic pyeloplasty in children with complex ureteropelvic junction obstruction (UPJO) and compare to children with iso-lated UPJO without associated urinary tract abnormalities. MATERIAL AND METHODS Medical records of 82 consecutive children submitted to transperitoneal laparoscopic pyeloplasty in a 12-year period were reviewed. Eleven cases were con-sidered complex, consisting of atypical anatomy including horseshoe kidneys in 6 patients, pelvic kidneys in 3 patients, and a duplex collecting system in 2 patients. Patients were di-vided into 2 groups: normal anatomy (group 1) and complex cases (group 2). Demographics, perioperative data, outcomes and complications were recorded and analyzed. RESULTS Mean age was 8.9 years (0.5-17.9) for group 1 and 5.9 years (0.5-17.2) for group 2, p=0.08. The median operative time was 200 minutes (180-230) for group 1 and 203 minutes (120-300) for group 2, p=0.15. Major complications (Clavien ≥3) were 4 (5.6%) in group 1 and 1 (6.3%) in group 2, p=0.52. No deaths or early postoperative complications such as: urinoma or urinary leakage or bleeding, occurred. The success rate for radiologic improvement and flank pain improvement was comparable between the two groups. Re-garding hydronephrosis, significant improvement was present in 62 patients (93.4%) of group 1 and 10 cases (90.9%) of group 2, p=0.99. The median hospital stay was 4 days (IQR 3-4) for group 1 and 4.8 days (IQR 3-6) for group 2, p=0.27. CONCLUSIONS Transperitoneal laparoscopic pyeloplasty is feasible and effective for the management of UPJO associated with renal or urinary tract anomalies.
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Affiliation(s)
- João Arthur Brunhara
- Unidade de Urologia Pediátrica, Faculdade de Medicina da Universidade de São Paulo - São Paulo, SP, Brasil
| | | | - Marcos Figueiredo Mello
- Unidade de Urologia Pediátrica, Faculdade de Medicina da Universidade de São Paulo - São Paulo, SP, Brasil
| | - Hiury Silva Andrade
- Unidade de Urologia Pediátrica, Faculdade de Medicina da Universidade de São Paulo - São Paulo, SP, Brasil
| | - Paulo Afonso Carvalho
- Unidade de Urologia Pediátrica, Faculdade de Medicina da Universidade de São Paulo - São Paulo, SP, Brasil
| | - Bruno Nicolino Cezarino
- Unidade de Urologia Pediátrica, Faculdade de Medicina da Universidade de São Paulo - São Paulo, SP, Brasil
| | - Francisco Tibor Dénes
- Unidade de Urologia Pediátrica, Faculdade de Medicina da Universidade de São Paulo - São Paulo, SP, Brasil
| | - Roberto Iglesias Lopes
- Unidade de Urologia Pediátrica, Faculdade de Medicina da Universidade de São Paulo - São Paulo, SP, Brasil
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Abstract
Purpose The aim of this study was to investigate the urinary concentration of epidermal growth factor (EGF) and monocyte chemotactic protein-1 (MCP-1) as reflux nephropathy (RN) biomarkers before and after endoscopic treatment of moderate to severe vesico-ureteral reflux (VUR). Materials and methods A prospective study was carried out on 72 children with moderate to severe VUR. All patients underwent endoscopic treatment using Macroplastique® or Deflux®. Vesico-ureteral reflux resolution was tested by post-operative voiding cystourethrography after 3 months and 2 years. Follow-up urinary samples were collected at that time. Control samples were taken from healthy children with no clinical evidence of renal and bladder disease and no history of UTI. Results In VUR patients, pre-operative urinary EGF levels had a down-regulation when compared to controls. Following successful VUR repair, urinary EGF levels of VUR children progressively increased only at long term follow-up but without returning to normal levels. Urinary MCP-1 levels were highly expressed in pre-operative samples and decreased markedly during early post-operative measurements. Urinary MCP-1 levels did not further decreased in late post-operative follow-up. In fact, these levels remained significantly higher when compared to controls. Conclusions Urinary levels of EGF and MCP-1 may become useful markers for monitoring the response to surgical treatment in VUR patients. Although endoscopic VUR treatment is effective in reducing the inflammatory response, the persistence of significant abnormal levels of inflammatory cytokines (such as urinary MCP-1) at long term follow-up suggests that surgery alone may not completely treat the chronic renal inflammation evidenced in these children.
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Affiliation(s)
- Valentina Pastore
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Fabio Bartoli
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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14
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Aboumarzouk OM, Hasan R, Tasleem A, Mariappan M, Hutton R, Fitzpatrick J, Beatty L, Jones GE, Amer T. Analgesia for patients undergoing shockwave lithotripsy for urinary stones - a systematic review and meta-analysis. Int Braz J Urol 2017; 43:394-406. [PMID: 28338301 PMCID: PMC5462129 DOI: 10.1590/s1677-5538.ibju.2016.0078] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 11/19/2016] [Indexed: 12/26/2022] Open
Abstract
Background Shock wave lithotripsy (SWL) is the first line treatment modality for a significant proportion of patients with upper urinary tracts stones. Simple analgesics, opioids and non-steroidal anti-inflammatory drugs (NSAIDs) are all suitable agents but the relative efficacy and tolerability of these agents is uncertain. Objectives To determine the efficacy of the different types of analgesics used for the control of pain during SWL for urinary stones. Materials and Methods We searched the Cochrane Renal Group’s Specialised Register, MEDLINE, EMBASE and also hand-searched reference lists of relevant articles (Figure-1). Randomised controlled trials (RCT’s) comparing the use of any opioid, simple analgesic or NSAID during SWL were included. These were compared with themselves, each-other or placebo. We included any route or form of administration (bolus, PCA). We excluded agents that were used for their sedative qualities. Data were extracted and assessed for quality independently by three reviewers. Meta-analyses have been performed where possible. When not possible, descriptive analyses of variables were performed. Dichotomous outcomes are reported as relative risk (RR) and measurements on continuous scales are reported as weighted mean differences (WMD) with 95% confidence intervals. Results Overall, we included 9 RCTs (539 participants from 6 countries). Trial agents included 7 types of NSAIDs, 1 simple analgesic and 4 types of opioids. There were no significant differences in clinical efficacy or tolerability between a simple analgesic (paracetamol) and an NSAID (lornoxicam). When comparing the same simple analgesic with an opioid (tramadol), both agents provided safe and effective analgesia for the purpose of SWL with no significant differences. There were no significant differences in pain scores between NSAIDs or opioids in three studies. Adequate analgesia could be achieved more often for opioids than for NSAIDs (RR 0.358; 95% CI 043 to 0.77, P=0.0002) but consumed doses of rescue analgesia were similar between NSAIDs and opioids in two studies (P=0.58, >0.05). In terms of tolerability, there is no difference in post-operative nausea and vomiting (PONV) between the groups (RR 0.72, 95% CI 0.24 to 2.17, P=0.55). One study compared outcomes between two types of NSAIDs (diclofenac versus dexketoprofen). There were no significant differences in any of our pre-defined outcomes measures. Conclusion Simple analgesics, NSAIDs and opioids can all reduce the pain associated with shock wave lithotripsy to a level where the procedure is tolerated. Whilst there are no compelling differences in safety or efficacy of simple analgesics and NSAIDs, analgesia is described as adequate more often for opioids than NSAIDs.
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Affiliation(s)
| | - Rami Hasan
- NHS Greater Glasgow and Clyde, United Kingdom
| | - Ali Tasleem
- NHS Greater Glasgow and Clyde, United Kingdom
| | | | | | | | | | | | - Tarik Amer
- NHS Greater Glasgow and Clyde, United Kingdom
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15
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Pearce SM, Pariser JJ, Malik RD, Famakinwa OJ, Chung DE. Outcomes following Thulium vapoenucleation of large prostates. Int Braz J Urol 2017; 42:757-65. [PMID: 27564287 PMCID: PMC5006772 DOI: 10.1590/s1677-5538.ibju.2015.0424] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 02/01/2016] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Thulium laser VapoEnucleation of the prostate (ThuVEP) is an evolving surgical technique for BPH. Most studies have focused on outcomes in small to médium sized prostates and have originated from Europe and Asia. We sought to describe our experience with ThuVEP for very large prostates in a North American cohort. MATERIALS AND METHODS From December 2010 to October 2014, 25 men underwent Thu-VEP using the CyberTM® (Quantastem, Italy) thulium laser, all with prostate volume >75mL. Data collected included patient demographics, comorbidities, intraoperative parameters, complications, and post-operative outcomes including maximum flow rate (Qmax), post-void residual (PVR), International Prostate Symptom Score (IPSS), and quality of life score (QoL) in one year of follow-up. Statistical analysis was done using Wilcoxon signed-rank test. RESULTS At baseline, mean age was 70±9 years and prostate size was 163±62g. Most patients (84%) were in retention and 10 (40%) patients were on anticoagulation. Seven (28%) patients went home the day of surgery (mean hospital stay: 1.2±1.2d). There were 2 intraoperative complications (8%), both cystotomies related to morcellation. Nine patients (36%) experienced a complication, all within 30 days. There were no Clavien III complications. Significant improvements were seen in Qmax, PVR, IPSS, and QoL score at each time interval to 12-months following surgery (all p<0.05). Of 21 patients initially in retention, all were voiding at last follow-up. CONCLUSIONS Our findings suggest that ThuVEP is an effective treatment for BPH in patients with large prostates with sustained results for one year.
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Affiliation(s)
- Shane M Pearce
- Section of Urology, The University of Chicago Medical Center, Pritzker School of Medicine, Chicago, IL, USA
| | - Joseph J Pariser
- Section of Urology, The University of Chicago Medical Center, Pritzker School of Medicine, Chicago, IL, USA
| | - Rena D Malik
- Section of Urology, The University of Chicago Medical Center, Pritzker School of Medicine, Chicago, IL, USA
| | - Olufenwa J Famakinwa
- Section of Urology, The University of Chicago Medical Center, Pritzker School of Medicine, Chicago, IL, USA
| | - Doreen E Chung
- Section of Urology, The University of Chicago Medical Center, Pritzker School of Medicine, Chicago, IL, USA.,Department of Urology, Columbia University Medical Center, New York, NY, USA
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Abstract
Cancer related to hereditary syndromes corresponds to approximately 5-10% of all tumors. Among those from the genitourinary system, many tumors had been identified to be related to genetic syndromes in the last years with the advent of new molecular genetic tests. New entities were described or better characterized, especially in kidney cancer such as hereditary leiomyomatosis renal cell carcinoma (HLRCC), succinate dehydrogenase kidney cancer (SDH-RCC), and more recently BAP1 germline mutation related RCC. Among tumors from the bladder or renal pelvis, some studies had reinforced the role of germline mutations in mismatch repair (MMR) genes, especially in young patients. In prostate adenocarcinoma, besides mutations in BRCA1 and BRCA2 genes that are known to increase the incidence of high-risk cancer in young patients, new studies have shown mutation in other gene such as HOXB13 and also polymorphisms in MYC, MSMB, KLK2 and KLK3 that can be related to hereditary prostate cancer. Finally, tumors from testis that showed an increased in 8 - 10-fold in siblings and 4 - 6-fold in sons of germ cell tumors (TGCT) patients, have been related to alteration in X chromosome. Also genome wide association studies GWAS pointed new genes that can also be related to increase of this susceptibility.
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Affiliation(s)
| | - George Jabboure
- Department of Pathology, Department of Urology and Department of Oncology, Johns Hopkins University - Baltimore, Maryland, United States
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17
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Saeidi S, Amini Boroujeni N, Ahmadi H, Hassanshahian M. Antibacterial Activity of Some Plant Extracts Against Extended- Spectrum Beta-Lactamase Producing Escherichia coli Isolates. Jundishapur J Microbiol 2015; 8:e15434. [PMID: 25793093 PMCID: PMC4353063 DOI: 10.5812/jjm.15434] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 04/05/2014] [Accepted: 04/12/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The extended-spectrum beta-lactamase (ESBL) -producing Escherichia coli isolates make many serious infections, especially urinary tract infections. OBJECTIVES The purpose of this study was to determine the antibacterial activities of some natural plant extracts against ESBL-producing E. coli isolates, which harbor the TEM gene in urine samples of the patients who have urinary tract infections. MATERIALS AND METHODS Evaluation has to be exactly determined for both methods of disk diffusion test and polymerase chain reaction (PCR), separately. We evaluated 120 strains of E. coli isolates from the urine culture of the patients in Boo-Ali Hospital (Zahedan, south-eastern Iran) who were suffering from urinary tract infections. The ESBL-producing E. coli isolates were evaluated by disk diffusion test and PCR through TEM gene detection. The minimal inhibitory concentration (MIC) of commonly used antibiotics including ceftazidime, ceftriaxon, amikacin, gentamicin and ciprofloxacin along with the MIC of the alcoholic extract of different natural plants including Myrtus communis L (Myrtaceae), Amaranthus retraflexus (Amaranthaceae), Cyminum cuminum L (Apiaceae), Marrubium vulgare (Laminaceae) and Peganum. harmala (Zygrophyllaceae) against the ESBL-producing E. coli isolates, which harbor the TEM genes, were determined using the microdulition method. RESULTS Results of this study showed that in disk diffusion method, 80 samples of E. coli produced ESBLs. In PCR method, the TEM gene distribution in the isolated ESBL-producing organisms was 50 (41.6%). Amikacin was the most effective anti-bacterial agent and ciprofloxacin was the least effective against E. coli isolates. All the natural plant extracts mentioned above, especially P. harmala, were effective against the selected isolates of ESBL-producing E. coli. The most frequent ESBL rate producing E. coli isolates (32 out of 50) had MIC of 2.5 mg/mL in ethanol extract of P. harmala. CONCLUSIONS The alcoholic extract of P. harmala was very effective against the selected ESBL-producing E. coli isolates harboring the TEM gene. Therefore, it could be suggested as an antibacterial agent in the future. More researches are necessary for detecting the mechanism of this plant's behavior and its pharmacological effects.
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Affiliation(s)
- Saeide Saeidi
- Agricultural Biotechnology Research Institute, Zabol University, Zabol, IR Iran
| | - Negar Amini Boroujeni
- Department of Microbiology, Science and Research Branch, Islamic Azad University, Kerman, IR Iran
| | - Hassan Ahmadi
- Agricultural Biotechnology Research Institute, Zabol University, Zabol, IR Iran
| | - Mehdi Hassanshahian
- Department of Biology, Faculty of Sciences, Shahid Bahonar University, Kerman, IR Iran
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Seo MR, Kim SJ, Kim Y, Kim J, Choi TY, Kang JO, Wie SH, Ki M, Cho YK, Lim SK, Lee JS, Kwon KT, Lee H, Cheong HJ, Park DW, Ryu SY, Chung MH, Pai H. Susceptibility of Escherichia coli from community-acquired urinary tract infection to fosfomycin, nitrofurantoin, and temocillin in Korea. J Korean Med Sci 2014; 29:1178-81. [PMID: 25120333 PMCID: PMC4129215 DOI: 10.3346/jkms.2014.29.8.1178] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 05/14/2014] [Indexed: 11/22/2022] Open
Abstract
With increase of multi-drug resistant Escherichia coli in community-acquired urinary tract infections (CA-UTI), other treatment option with a therapeutic efficacy and a low antibiotic selective pressure is necessary. In this study, we evaluated in vitro susceptibility of E. coli isolates from CA-UTI to fosfomycin (FM), nitrofurantoin (NI), temocillin (TMO) as well as trimethoprim-sulfamethoxazole (SMX), ciprofloxacin (CIP) and cefepime (FEP). The minimal inhibitory concentrations were determined by E-test or agar dilution method according to the Clinical and Laboratory Standards Institute guidelines, using 346 E. coli collected in 12 Korean hospitals from March 2010 to February 2011. FM, NI and TMO showed an excellent susceptibility profile; FM 100% (346/346), TMO 96.8% (335/346), and NI 99.4% (344/346). Conversely, resistance rates of CIP and SMX were 22% (76/346) and 29.2% (101/349), respectively. FEP still retained an activity of 98.5%. In Korea, NI and TMO in addition to FM are a good therapeutic option for uncomplicated CA-UTI, especially for lower UTI.
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Affiliation(s)
- Mi-Ran Seo
- Division of Infectious Diseases, Department of Internal Medicine, Hanyang University, Seoul, Korea
| | - Seong-Jong Kim
- Division of Infectious Diseases, Department of Internal Medicine, Hanyang University, Seoul, Korea
| | - Yeonjae Kim
- Division of Infectious Diseases, Department of Internal Medicine, Hanyang University, Seoul, Korea
| | - Jieun Kim
- Division of Infectious Diseases, Department of Internal Medicine, Hanyang University, Seoul, Korea
| | - Tae Yeal Choi
- Department of Laboratory Medicine, Hanyang University, Seoul, Korea
| | - Jung Oak Kang
- Department of Clinical Microbiology, Hanyang University, Guri, Korea
| | - Seong-Heon Wie
- Department of Internal Medicine, St. Vincent's Hospital, School of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Moran Ki
- Department of Preventive Medicine, Eulji University School of Medicine, Daejeon, Korea
| | - Young Kyun Cho
- Department of Internal Medicine, Gil Hospital, Gacheon University, Incheon, Korea
| | - Seung-Kwan Lim
- Department of Internal Medicine, Ajou University Hospital, Suwon, Korea
| | - Jin Seo Lee
- Department of Internal Medicine, Hallym University, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Ki Tae Kwon
- Department of Internal Medicine, Daegu Patima Hospital, Daegu, Korea
| | - Hyuck Lee
- Department of Internal Medicine, Dong-A University Hospital, Busan, Korea
| | - Hee Jin Cheong
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Dae Won Park
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Seong Yeol Ryu
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Moon-Hyun Chung
- Department of Internal Medicine, Inha University Hospital, Incheon, Korea
| | - Hyunjoo Pai
- Division of Infectious Diseases, Department of Internal Medicine, Hanyang University, Seoul, Korea
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Tong YQ, Xin B, Sun SQ. Pyelonephritis Caused Solely by Escherichia hermanii. Jundishapur J Microbiol 2014; 7:e18138. [PMID: 25147714 PMCID: PMC4138642 DOI: 10.5812/jjm.18138] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 03/02/2014] [Accepted: 03/09/2014] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION In contrast with Escherichia coli, the association of E. hermanii with urinary tract infections has not been described. CASE PRESENTATION In this case, E. hermanii was the sole isolate recovered from urine specimens of a pyelonephritis patient. The organism was found to be susceptible to piperacillin-tazobactam, ceftazidime, cefazolin, cefixime, aztreonam, gentamicin, tobramycin, imipenem, meropenem and amikacin, and resistant to amoxicillin. Antibiotic treatment was initiated with oral cefixime (400 mg every 24 hours). The symptoms were relieved within 72 hours after therapy. A urine sample was taken seven days after antibiotic therapy. E. hermanii was no longer isolated. DISCUSSION The present case demonstrates that the uropathogenic E. hermanii clone can cause destruction of the kidneys. During asymptomatic bacteriuria or cystitis, the bacteria remain in the urinary tract. Even when pyelonephritis develops, inflammatory response of the host is still restricted to the urinary tract. These signs mean that uropathogenic E. hermanii may be not very virulent.
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Affiliation(s)
- Yan Qing Tong
- Department of Nephrology, The First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun City, China
- Corresponding author: Yan Qing Tong, Department of Nephrology, The First Affiliated Hospital to Changchun University of Chinese Medicine, Gongnong Road, No 1478, Changchun City, Jilin province, China, P.O.Box: 130021. Tel: +86-43186178717, Fax: +86-43186177222, E-mail:
| | - Bing Xin
- Department of Microbiology, The First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun City, China
| | - Shu Qing Sun
- Department of Microbiology, The First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun City, China
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Lim JH, Jeon SH, Lee JM, Kim L, Cho JH, Ryu JS, Kwak SM, Lee HL, Nam HS. Late-onset distant metastatic upper urinary tract urothelial carcinoma mimicking lung adenocarcinoma. Tuberc Respir Dis (Seoul) 2013; 75:32-5. [PMID: 23946757 PMCID: PMC3741472 DOI: 10.4046/trd.2013.75.1.32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 01/14/2013] [Accepted: 01/17/2013] [Indexed: 12/11/2022] Open
Abstract
Urothelial carcinomas (UCs) can occur in the upper urinary tract or lower urinary tract. Upper urinary tract urothelial carcinoma (UUT-UC) is relatively a rare disease and accounts for only about 5% of UC cases. Sporadic cases of late-onset metastasis, associated with UC of the bladder, have occasionally been reported. In contrast, no late-onset distant metastatic UUT-UC without local recurrence has, to the best of our knowledge, been reported in the English literature. We report an extremely rare case of distant metastatic UC, mimicking lung adenocarcinoma that originated from UUT-UC 12 years previously.
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Affiliation(s)
- Jun-Hyeok Lim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
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Lee JE, Han SH, Cho BC, Park JT, Yoo TH, Kim BS, Park HC, Kang SW, Lee HY, Han DS, Ha SK, Choi KH. Cancer in patients on chronic dialysis in Korea. J Korean Med Sci 2009; 24 Suppl:S95-S101. [PMID: 19194570 PMCID: PMC2633193 DOI: 10.3346/jkms.2009.24.s1.s95] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2008] [Accepted: 12/24/2008] [Indexed: 11/20/2022] Open
Abstract
The study of cancer in patients treated with dialysis in Korea has not been reported. The aim of this study was to investigate the incidence and mortality of cancer among patients on dialysis in Korea. The study subjects were 106 cancer patients (2.3%) out of 4,562 end-stage renal disease (ESRD) patients maintained on hemodialysis (HD) or peritoneal dialysis (PD) at Yonsei University Health System from 1996 to 2005. We excluded patients in whom the diagnosis of cancer preceded dialysis or those who received renal allograft or started dialysis after renal allograft. Seventy-three (69%) of our subjects were male and 33 (31%) were female. The mean age at the time of cancer diagnosis was 57.9+/-11.7 yr. The mean time from the start of dialysis to the diagnosis of cancer was 75.2+/-63.9 months. The most common cancer site was gastrointestinal tract (GIT) (51%) followed by urinary tract (20%), lung (8%), and thyroid (7%). Sixty nine percent of the total mortality was due to cancer. The mean time from diagnosis to death was 2.9+/-2.5 yr. In ESRD patients with cancer, there were no significant differences in mortality rates by dialysis modality. In ESRD patients, the most common cancer was GIT cancer followed by urinary tract cancer. Therefore, careful surveillance of these cancers in ESRD patients is highly recommended.
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Affiliation(s)
- Jung Eun Lee
- Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Hyeok Han
- Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Byoung Chul Cho
- Division of Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Tak Park
- Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Tae Hyun Yoo
- Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Beom Seok Kim
- Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeong Cheon Park
- Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Shin-Wook Kang
- Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ho Yung Lee
- Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dae-Suk Han
- Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Kyu Ha
- Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kyu Hun Choi
- Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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