International urology and nephrology
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The continued evolution of stone treatment modalities, such as endourologic procedures, open surgery and shock wave lithotripsy, makes the assessment of continuous outcomes are essential. Pediatric urolithiasis are an important health problem allover the world, especially in Middle East region. We evaluate the safety, efficacy and factors affecting success rate and clearance of stones in children treated with shock wave lithotripsy. ⋯ This study showed that SWL in pediatric age group for both renal and ureteral stone is cost effective, safe with an acceptable re-treatment rate; however children with large stone burden or previous urologic surgery have low success rate.
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Severe acute pancreatitis is a common critical disease, which may cause severe complications such as sepsis and multiple organ dysfunction syndrome (MODS), and has a high mortality. A 31-year-old woman with 25-weeks pregnancy presented with hyperlipidemic pancreatitis, sepsis and MODS. ⋯ The treatment turned out to be very successful. We suggest that early intervention by blood purification therapy, and CVVH combined with HP could be effective in severe acute pancreatitis.
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Multicenter Study
The effect of insurance status on outcomes after partial nephrectomy.
Privately insured patients may have favorable health outcomes when compared to those covered by federally funded initiatives. This study explored the effect of insurance status on five short-term outcomes after partial nephrectomy (PN). ⋯ Patients with private insurance undergoing PN have better short-term outcomes, when compared to their publicly insured counterparts.
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Intraoperative penile erections following the initiation of either regional or general anaesthesia is rare; however, when it occurs in patients undergoing urologic procedures it may delay, or even cancel the planned surgery. The aetiology is unclear. Various treatments proposed for producing detumescence are not always effective. Use of intracavernous alpha-adrenergic agonists is an efficient and rapid but short-lasting treatment. Furthermore, repeated intracavernous injections of vasoactive drugs may be harmful. Dexmedetomidine is a potent, selective α(2)-adrenoreceptor agonist. In our study, we evaluated the effect of dexmedetomidine on intraoperative penile erection. ⋯ This study demonstrated that 0.5 μg/kg intravenous injection of dexmedetomidine is a simple, effective and safe method for immediate relief of intraoperative penile erection with high success rate.
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Evaluation of potential candidates for testosterone replacement therapy (TRT) includes a complete medical history, physical examination, and hormonal screening. The choice of testosterone assay is important in clinical decision making. ⋯ There is no apparent association between TRT and the development of prostate cancer. The administration of exogenous testosterone is not a means of reversing the aging process in men with normal testosterone levels, but it may offer considerable benefit for those with hypogonadism.