Current Issue : October-December
Volume : 2023
Issue Number : 4
Articles : 5 Articles
Background Urinary incontinence (UI) is a common worldwide rising health issue among women with a prevalence
of 5 to 70%. Stress urinary incontinence (SUI) is the most common subtype of UI. There are different treatments for UI,
including AUS (artificial urinary sphincter) implantation, as one of the surgical options for treating SUI. The aim of this
study was to determine the complication rate of AUS, exclusively in female patients with SUI, which resulted from ISD
(intrinsic sphincter deficiency). We also compared the complication rate between minimally invasive (laparoscopic or
robotic surgery) and open approaches.
Methods Scopus, PubMed, Web of Science, Embase, and Google Scholar were searched for studies regarding complications
in AUS implantation surgery, from the beginning of the project to March 2022. After screening and reviewing
of full text, the general characteristics of the study and study population including follow-up time, type of surgery,
and the number of complications that occurred such as necrosis, atrophy, erosion, infection, mechanical failure, revision,
and leak, were extracted.
Results We found that atrophy occurred in 1 of 188 (0.53%) patients treated with minimally invasive surgery and in 1
of 669 (0.15%) patients treated with open surgery. None of the 17 included studies reported the occurrence of necrosis
in the patients under study. Erosion occurred in 9 of 188 (4.78%) patients treated with minimally invasive surgery
and in 41 of 669 (6.12%) patients treated with open surgery. Infection occurred in 12 of 188 (6.38%) patients treated
with minimally invasive surgery and in 22 of 669 (3.2%) patients treated with open surgery. The mechanical failure
occurred in 1 of 188 (0.53%) patients treated with minimally invasive surgery and in 55 of 669 (8.22%) patients treated
with open surgery. Reconstructive surgery occurred in 7 of 188 (3.72%) patients treated with minimally invasive surgery
and in 95 of 669 (14.2%) patients treated with open surgery. Leaks occurred in 4 of 188 (2.12%) patients treated
with minimally invasive surgery and in 6 of 669 (0.89%) patients treated with open surgery. The type of surgery was
associated with a statistically significant increase in mechanical failure (p-value = 0.067) and infection (p-value = 0.021),
and reconstructive surgery (p-value = 0.049). Out of the 857 participats in the study,469 were studied for less than five
years and 388 were studied for more than five years.21 of 469 (4.4%) (p-value = 0.08) patients and 81 of 388 (20.8%)
(p-value = 0.001) patients required reconstructive surgery. Erosion occurred in 23 of 469 (4.9%) (p-value = 0.01)patients with following time less than five years and in 27 of 388 (6.9%) (p-value = 0.001) patients with following time more
than five years.
Conclusion The use of artificial urinary sphincters in the treatment of UI causes complications such as atrophy, erosion,
and infection; the amount of which is influenced by the surgical method and the duration of using the artificial
urinary sphincter. It seems that the use of new surgical methods, such as laparoscopic surgery, is useful in reducing
the incidence of complications....
Background Extra-capillary hypercellularity is a common finding in crescentic glomerulonephritis (GN) and
focal segmental glomerulosclerosis (FSGS). In diabetic nephropathy (DN), extra-capillary hypercellularity is often
observed as a finding of complications such as IgA nephropathy or microscopic polyangiitis superimposed on DN.
However, in rare cases, epithelial cell proliferation may accompany DN. We experienced a case of nodular diabetic
glomerulosclerosis with marked extra-capillary hypercellularity and revealed the origin of this atypical lesion using
Case presentation A man in his 50 s was admitted to the hospital with nephrotic syndrome, and a renal biopsy was
performed. Diffuse nodular lesions and extra-capillary hypercellularity were observed, but the results of serological
examination or immunofluorescent assays did not implicate any other crescentic GN. Immunostaining for claudin-1
and nephrin was performed to identify the origin of the extra-capillary lesions. Given the clinical course and pathological
findings, a diagnosis of DN-associated extra-capillary cell proliferation was made.
Conclusions Extra-capillary hypercellularity, which resembles FSGS or crescentic GN, is a rare finding in DN and
should therefore be treated with caution. In such cases, co-staining for claudin-1 and nephrin may facilitate the diagnosis
Background Super-mini-percutaneous nephrolithotomy (SMP) is feasible and safe in adults and children with
moderate-size renal calculi, but the use of SMP to remove larger calculi has yet to be determined. This study aimed to
review the efficacy (stone-free rate, SFR) and safety of SMP in treating urinary calculi.
Methods PubMed, the Cochrane Library, and Embase were searched for eligible studies published up to May 2021.
The primary outcome was the SFR. The secondary outcomes were the complications (using the Clavien-Dindo
grading system), pain score, hospitalization days, and mean hemoglobin decline. All analyses were performed using
the random-effects model. Nine studies (2433 patients with SMP and 2178 controls) were included.
Results SMP was not associated with an improved SFR in patients with calculi (RR = 1.05, 95%CI: 0.99–1.11). There
were no differences in the occurrence of Clavien-Dindo I (RR = 0.95, 95%CI: 0.67–1.35) and Clavien-Dindo II (RR = 0.91,
95%CI: 0.58–1.42) complications between SMP and the control procedures. There were more Clavien-Dindo III
complications with SMP than with the control procedures (RR = 0.71, 95%CI: 0.55–0.91), but none of the individual
complications significantly differed between the two groups. Clavien-Dindo I fever appeared to be higher with SMP
than with the control procedure (RR = 0.64, 95%CI: 0.50–0.83).
Conclusion In terms of efficacy, there were no differences between SMP and other procedures in treating urinary
calculi. Clavien-Dindo I fever and Clavien-Dindo III complications might be more frequent with SMP than other
Karyomegalic interstitial nephritis (KIN) is a rare cause of chronic interstitial nephritis characterized by enlarged renal
tubular epithelial nuclei. The first case of KIN reported in a kidney graft was in 2019. Here, we report the first case
of KIN in 2 brothers receiving kidneys from 2 different unrelated living donors. A male kidney transplant recipient
with focal segmental glomerulosclerosis as the original kidney disease presented with graft impairment and
proteinuria, and graft biopsy revealed KIN. This patient had a brother who was also a kidney transplant recipient
and had one episode of graft impairment and was diagnosed with KIN as well....
Background. The purpose of this study is to construct a knowledge graph of chronic kidney disease (CKD) diagnosis and treatment
with traditional Chinese medicine (TCM), reorganize its knowledge, and display it. It allows the inheritance, development, and
utilization of CKD diagnosis and treatment experiences with TCM in a standard and scientific manner. Methods. First, we
constructed a knowledge framework for TCM diagnosis and treatment on the basis of the Chinese Pharmacopoeia, government
projected textbook, and the current TCM diagnosis and treatment standards. Then, we collected and sorted the electronic medical
records of TCM inpatients, extracting and normalizing the diagnoses, symptoms, syndromes, prescriptions, and other diagnosis
and treatment information, creating the knowledge base of TCM diagnosis and treatment for CKD. Finally, we stored TCM
diagnosis and treatment CKD knowledge in Neo4j graph database, which refers to the knowledge framework and knowledge base.
The frequent patterns and complex network knowledge mining methods are integrated to construct the TCM diagnosis and
treatment CKD knowledge graph. Results. The knowledge graph of CKD diagnosis and treatment with TCM was constructed,
including 807 nodes and 10476 relationships, which are 273 diagnoses, 130 symptoms, 34 syndromes, 370 Chinese herbal
medicine (CHM) nodes, and 5483 diagnosis-symptom, 1349 diagnosis-syndrome, 3644 syndrome-CHM relationships. Conclusion.
The knowledge graph provides rich knowledge of TCM diagnosis and treatment of CKD, which is helpful to inherit the
clinical experience of TCM diagnosis and treatment of CKD and assist clinical diagnosis and treatment of CKD....
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