The Journal of urology
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The Journal of urology · Jul 2009
Ureteral stone location at emergency room presentation with colic.
It is thought that the 3 narrowest points of the ureter are the ureteropelvic junction, the point where the ureter crosses anterior to the iliac vessels and the ureterovesical junction. Textbooks describe these 3 sites as the most likely places for ureteral stones to lodge. We defined the stone position in the ureter when patients first present to the emergency department with colic. ⋯ Proximal ureteral stones were larger in axial and coronal diameter than distal ureteral stones. At emergency department presentation for colic most stones were at the ureterovesical junction and in the proximal ureter between the ureteropelvic junction and the iliac vessels. A few stones were at the ureteropelvic junction and only 1 lodged at the level where the ureter crosses anterior to the iliac vessels, despite the literature stating that these locations are 2 of the 3 most likely places for stones to become lodged.
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The Journal of urology · Jul 2009
ReviewMaintaining a sterile urinary tract: the role of antimicrobial peptides.
The normally sterile urinary tract is constantly challenged by microbial invasion leading to a high prevalence of isolated, recurrent and catheter associated urinary tract infection. The continuous emergence of bacterial resistance following overuse of traditional antibiotics requires the urgent development of alternative treatment strategies. The involvement of innate immune mechanisms in host defense is an emerging field of microbiological research with recent work focusing on the urinary tract. We performed a comprehensive literature review to establish the current level of knowledge concerning the role of innate immunity and specifically antimicrobial peptides within the human urinary tract. ⋯ Although investigation of antimicrobial peptide function in the human urinary tract is at an early stage, it is clear that there is considerable potential for the future design of novel therapeutic strategies. More knowledge is needed concerning the pathway of involvement of antimicrobial peptides in the maintenance of urinary tract sterility and the ways in which this is altered during active infection.
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The Journal of urology · Jul 2009
Comparative StudyLength of positive surgical margin after radical prostatectomy as a predictor of biochemical recurrence.
Length and location of positive surgical margins are independent predictors of biochemical recurrence after open radical prostatectomy. We assessed their impact on biochemical recurrence in a large robotic prostatectomy series. ⋯ Margin status and length are independent predictors of biochemical recurrence following robotic radical prostatectomy. Although longer followup and validation studies are necessary for confirmation, patients with a positive margin less than 1 mm appear to have similar recurrence rates as those with negative margins.
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The Journal of urology · Jul 2009
A population based assessment of perioperative mortality after cystectomy for bladder cancer.
Large variability exists in the rates of perioperative mortality after cystectomy. Contemporary estimates range from 0.7% to 5.6%. We tested several predictors of perioperative mortality and devised a model for individual perioperative mortality prediction. ⋯ The accuracy of our model could potentially be improved with the consideration of additional parameters such as surgical and hospital volume or comorbidity. While better models are being developed and tested we suggest the use of the current model in individual decision making and in informed consent considerations because it provides accurate predictions in 7 of 10 patients.