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Selected AbstractsReducing sex under the influence of drugs or alcohol for patients in substance abuse treatmentADDICTION, Issue 1 2010Donald A. Calsyn ABSTRACT Aims In a previous report, the effectiveness of the Real Men Are Safe (REMAS) intervention in reducing the number of unprotected sexual occasions among male drug abuse treatment patients was demonstrated. A secondary aim of REMAS was to reduce the frequency with which men engage in sex under the influence (SUI) of drugs or alcohol. Design Men in methadone maintenance (n = 173) or out-patient psychosocial treatment (n = 104) completed assessments at baseline, 3 and 6 months post-intervention. Participants The participants were assigned randomly to attend either REMAS (five sessions containing information, motivational exercises and skills training, including one session specifically targeting reducing SUI) or human immunodeficiency virus (HIV) education (HIV-Ed; one session containing HIV prevention information). SUI during the most recent sexual event served as the primary outcome in a repeated measures logistic regression model. Findings Men assigned to the REMAS condition reporting SUI at the most recent sexual event decreased from 36.8% at baseline to 25.7% at 3 months compared to a increase from 36.9% to 38.3% in the HIV-Ed condition (tintervention = ,2.16, P = 0.032). No difference between the treatment groups was evident at 6-month follow-up. At each assessment time-point, sex with a casual partner versus a regular partner, and being in methadone maintenance versus psychosocial out-patient treatment, were associated with engaging in SUI. Conclusions Overall, a motivational and skills training HIV prevention intervention designed for men was associated with greater reduction in SUI than standard HIV education at the 3-month follow-up. [source] Diverse alcohol drinking patterns in 20 African countriesADDICTION, Issue 7 2009Thomas Clausen ABSTRACT Aims This paper describes drinking patterns in 20 African countries, exploring the extent of abstention, heavy occasional drinking and daily light drinking and how these aspects of drinking are inter-related. Design and participants Data were collected as part of the World Health Survey in 2002,04 and comprise national representative data sets from 20 African countries. A cross-sectional survey of 77 165 adults aged 18 years and older were undertaken by face-to-face interviews in respondent households. Measures Drinking behaviour was assessed in terms of life-time abstention and the following measures over the 7 days immediately preceding interview: high consumption (15 or more drinks); heavy drinking occasions (five or more standard units at at least one session) and daily light drinking (one or two drinks daily). Findings In four countries (Comoros, Mali, Mauritania and Senegal), virtually all respondents were life-time abstainers. The prevalence of current drinkers (previous week) did not exceed one-third in any country. Among current drinkers the prevalence of heavy drinking varied between 7% and 77% and the prevalence of daily light drinkers varied between 0% and 21%. Overall drinking patterns varied significantly between and within the examined African countries. Conclusions African drinking patterns are diverse, and although life-time abstinence dominates in African countries, a single typical pattern of drinking for the African continent, such as the alleged ,all-or-none' pattern, was not observed. [source] Variability of the masticatory process during chewing of elastic model foodsEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 6 2000Claire Lassauzay Many studies show a consistent individual chewing pattern; chewing being governed by a pattern generator and regulated by sensory feedback. The aim of this study was to determine the variation in chewing between sessions, replicates and subjects using elastic model foods. Fifteen young male subjects were selected to chew four food products differing in hardness. Four sessions were performed at 1-wk intervals for each subject and, within each session, the four model foods were presented 3 times each. Jaw movement was recorded simultaneously with masseter and anterior temporalis electromyographic activities. Several chewing characteristics increased progressively from one session to the next; the largest increase occurred from the 1st to the 2nd session, with little difference between the last two sessions. No differences were observed between the samples of the same food product within a session. As mastication progressed, the amplitude and speed of the cycles and the muscular work decreased progressively. The first cycle appeared to be very different from the subsequent for all parameters except for occlusal duration. Thus, under our experimental conditions, the origin and amount of variation in chewing patterns were identified and provide information to improve the accuracy and comparability of results in studies of mastication. [source] Midpoint CD34 measurement as a predictor of PBPC product yield in pediatric patients undergoing high-dose chemotherapy ,JOURNAL OF CLINICAL APHERESIS, Issue 3 2006Rameshwar S. Sidhu Abstract High-dose chemo/radiotherapy of sensitive tumors requires PBPC rescue doses of >3×106 CD34/kg (range: 3,20×106 CD34/kg). Because of the diversity of stem cell treatment protocols and clinical presentation of patients at the time of peripheral blood progenitor cell (PBPC) harvest, the use of the mid-point CD34 positive cell measurement was initiated to predict the final CD34-positive cell product yield/stem cell harvest. The measurement of CD34-positive cells at the mid-point of the initial setting of 5 total blood volumes (TBV) allows for the extension, shortening, or no change in the TBV processing to achieve a maximum goal of CD34-positive cells/kg body weight required for stem cell transplantation. The estimation of mid-point CD34-positive cells guided our center to extend 22 procedures, shorten 26 procedures, and leave 20 procedures unchanged. This investigation addresses three aspects of PBPC collection in pediatric patients: (1) the processing of large blood volumes (more than the defined 3 TBV and maximum up to 13 TBV in one session) to achieve good efficiency of the procedure; (2) the use of the mid-point CD34 measurement at 2.5 of 5 TBV initially set to predict the maximum goal of CD34 cells /kg needed on the same day of PBPC collection; and (3) PBPC collection in pediatric patients <10 kg body weight (as low as 5.8 kg body weight). J. Clin. Apheresis 2006. © 2006 Wiley-Liss, Inc. [source] Treatment of linear and spider telangiectasia with an intense pulsed light sourceJOURNAL OF COSMETIC DERMATOLOGY, Issue 4 2004R A Retamar Summary Background, The flashlamp-pumped pulsed dye laser (585 and 577 nm) has proved to be an effective and safe treatment option in the therapy of linear and spider facial telangiectasia. Nevertheless, the postoperative purpura, which most patients see as cosmetically disfiguring, has always been a matter of concern. Aims, To test the effectiveness and safety of an intense pulsed light source (IPLS), which emits non-coherent light adjustable within the 515,1200 nm range, in the treatment of linear and spider facial telangiectasia. Patients & Methods, One hundred and forty patients with linear and stellate facial telangiectasia were treated with an IPLS. Results, In 94 (67.1%) the results were considered excellent (clearance of 80,100%), 43 (30.7%) showed good results (clearance of 40,80%) and in 3 patients (2.1%) the results were poor (clearance < 40%). Post-treatment side effects were minimal and well tolerated. There were no instances of scarring or other permanent side effects. Owing to the large spot size, a large area could be treated within one session. No anaesthesia was required. Conclusion, IPLS is a highly effective and comparably safe therapeutic alternative to the pulsed dye laser in the treatment of facial telangiectasia. The rate of cosmetically relevant side effects is considerably smaller, patient compliance is excellent and the method can easily be applied in an outpatient setting. [source] Use of cardiac output to improve measurement of input function in quantitative dynamic contrast-enhanced MRIJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 3 2009Jeff L. Zhang PhD Abstract Purpose To validate a new method for converting MR arterial signal intensity versus time curves to arterial input functions (AIFs). Materials and Methods The method constrains AIF with patient's cardiac output (Q). Monte Carlo simulations of MR renography and tumor perfusion protocols were carried out for comparison with two alternative methods: direct measurement and population-averaged input function. MR renography was performed to assess the method's inter- and intraday reproducibility for renal parameters. Results In simulations of tumor perfusion, the precision of the parameters (Ktrans and ve) computed using the proposed method was improved by at least a factor of three compared to direct measurement. Similar improvements were obtained in simulations of MR renography. Volunteer study for testing interday reproducibility confirmed the improvement of precision in renal parameters when using the proposed method compared to conventional methods. In another patient study (two injections within one session), the proposed method significantly increased the correlation coefficient (R) between GFR of the two exams (0.92 vs. 0.83) compared to direct measurement. Conclusion A new method significantly improves the precision of dynamic contrast-enhanced (DCE) parameters. The method may be especially useful for analyzing repeated DCE examinations, such as monitoring tumor therapy or angiotensin converting enzyme-inhibitor renography. J. Magn. Reson. Imaging 2009;30:656,665. © 2009 Wiley-Liss, Inc. [source] Reproducibility of jaw movements in patients with craniomandibular disordersJOURNAL OF ORAL REHABILITATION, Issue 11 2006M. STIESCH-SCHOLZ summary, It has never been investigated, if mandibular movements of patients with craniomandibular disorders (CMD) result in a lower reproducibility of dynamic functional parameters which are used for the individual articulator setting. The aim of the present study was to compare the reproducibility of electronically registered functional parameters in patients with CMD and in a control group. Dynamic functional parameters were recorded in 30 patients and 30 volunteers with a computerized ultrasound system (ARCUSdigma). The whole registration was performed three times during one session and three times at a second session 1 week later. The horizontal condylar inclination in the patient group gave a standard deviation of 2·17° ± 0·95°, indicating poorer reproducibility than in the volunteer group, for which the standard deviation was 1·37° ± 0·42°. The reproducibility of measurements of the Bennett angle was also poorer in the patient group than in the volunteer group, with standard deviations of 1·70° ± 0·62° and 1·22° ± 0·40°, respectively. The standard deviations calculated for determination of incisal inclination during laterotrusion was 3·02° ± 1·49° for patients and 2·30° ± 1·17° for volunteers. The standard deviations for incisal inclination during protrusion was 2·02° ± 0·95° for patients and 2·06° ± 1·82° for volunteers. The reproducibility of measurement of horizontal condylar inclination, Bennett angle and incisal inclination during laterotrusion therefore showed significantly lower reproducibility in the patient group than in the volunteer group (P < 0·05). The overall reproducibility of the measurements was nevertheless good in both groups, with standard deviations under 3·1°, so that an individual setting of an articulator seems useful even in patients with CMD. [source] PANEL PERFORMANCE AND NUMBER OF EVALUATIONS IN A DESCRIPTIVE SENSORY STUDYJOURNAL OF SENSORY STUDIES, Issue 4 2004JÉRÔME PAGÈS ABSTRACT The assessor performance is a key point in a sensory evaluation. In particular, at the end of a session, a decrease of the performance can be feared. We propose to analyze this performance with various criteria: usual ones as the main product effect or the error variance; a new one measuring the perceived products variability. The performance can then be studied all along the session from two points of view: in taking into account the only products tested at a given instant (named instantaneous); in taking into account all the products tested up to a given instant (named cumulative). In the presented example, in spite of the large number of products successively tested by each assessor, the instantaneous performance of the panel shows no significant deterioration. Furthermore, when the number of products tested by each assessor increases, more significant product effects can be obtained thanks to the accumulation of the amount of data. This shows that the number of products that can be reasonably studied by one assessor during one session is generally underestimated. [source] Effects of Stress and Alcohol on Subjective State in HumansALCOHOLISM, Issue 6 2002Anna H. V. Söderpalm Background: There is increasing evidence that stress and hypothalamic-pituitary-adrenal axis activation interact with drugs of abuse and influence drug-taking behaviors. Both studies with laboratory animals and survey data with alcohol users suggest that acute or chronic stressful events increase alcohol intake. One mechanism for the increase in alcohol intake may be that stress alters the subjective effects produced by the drug in ways that enhance the reinforcing properties of alcohol. Therefore, in this study we determined whether an acute social stressor alters subjective responses to ethanol in humans. The stressor was a modified version of the Trier Social Stress Test, an arithmetic task that increases cortisol levels. Methods: Twenty male volunteers participated in two laboratory sessions, in which they performed the Trier Social Stress Test on one session and no task on the other session, immediately before consuming a beverage that contained ethanol (0.8 g/kg in juice) or placebo (juice alone). Eleven subjects received ethanol on both sessions, and nine subjects received placebo on both sessions. Primary dependent measures were self-report questionnaires of mood states. Salivary levels of cortisol were obtained to confirm the effectiveness of the stress procedure. Results: Stress alone produced stimulant-like subjective effects. In the group who received ethanol, stress increased sedative-like effects and decreased stimulant-like effects. Conclusions: At this relatively high dose of ethanol, stress increased sedative effects of alcohol and did not increase desire for more alcohol. It is possible that in some individuals, the increased sedative effects after stress may increase the likelihood of consuming more alcohol. The effects of stress on consumption at this, or lower, doses of alcohol remain to be determined. [source] Quantitative imaging of cartilage morphology at 3.0 Tesla in the presence of gadopentate dimeglumine (Gd-DTPA)MAGNETIC RESONANCE IN MEDICINE, Issue 2 2007Felix Eckstein Abstract MRI-based cartilage morphometry was previously validated in the absence of gadopentate dimeglumine (Gd-DTPA). However, Gd-DTPA is required for compositional (proteoglycan) imaging using delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). Therefore, the effect of Gd-DTPA on cartilage morphometry was studied. A total of 165 female participants (67 with and 98 without osteoarthritis [OA]) were imaged at 3.0 Tesla before and 2 hr after intravenous Gd-DTPA injection. Flip angles in post-Gd-DTPA scans varied between 12° and 35°. Cartilage volume and thickness of post- vs. pre-Gd-DTPA scans showed intraclass correlation coefficients (ICCs) of 0.85 , r , 0.95, mean differences between ,2.1% and +1.1%, and standard deviations (SDs) of differences between 4.7% and 9.2%. Mixed-effect models found no consistent impact of flip angle and OA status on post- vs. pre-Gd-DTPA differences. Accurate morphological measurements of cartilage can be obtained after Gd-DTPA injection, allowing compositional and morphological imaging to be combined into one session. Magn Reson Med 58:402,406, 2007. © 2007 Wiley-Liss, Inc. [source] Reliability of dynamometric passive properties of the pelvic floor muscles in postmenopausal women with stress urinary incontinenceNEUROUROLOGY AND URODYNAMICS, Issue 8 2008Mélanie Morin Abstract The passive properties of the pelvic floor muscles (PFM) might play a role in stress urinary incontinence (SUI) pathophysiology. Aim To investigate the test,retest reliability of the dynamometric passive properties of the PFM in postmenopausal SUI women. Methods Thirty-two SUI postmenopausal women were convened to two sessions 2 weeks apart. In each session, the measurements were repeated twice. The pelvic floor musculature was evaluated in four different conditions: (1) forces recorded at minimal aperture (initial passive resistance); (2) passive resistance at maximal aperture; (3) five lengthening and shortening cycles (Forces and passive elastic stiffness (PES) were evaluated at different vaginal apertures. Hysteresis was also calculated.); (4) Percentage of passive resistance loss after 1 min of sustained stretching was computed. The generalizability theory was used to calculate two reliability estimates, the dependability indices (,) and the standard error of measurement (SEM), for one session involving one measurement or the mean of two measurements. Results Overall, the reliability of the passive properties was good with indices of dependability of 0.75,0.93. The SEMs for forces and PES were 0.24,0.67 N and 0.03,0.10 N/mm, respectively, for mean, maximal and 20-mm apertures, representing an error between 13% and 23%. Passive forces at minimal aperture showed lower reliability (,,=,0.51,0.57) compared with other vaginal openings. The aperture at a common force of 0.5 N was the only parameter demonstrating a poor reliability (,,=,0.35). Conclusion This new approach for assessing PFM passive properties showed enough reliability for highly recommending its inclusion in the PFM assessment of SUI postmenopausal women. Neurourol. Urodynam. 27:819,825, 2008, © 2008 Wiley-Liss, Inc. [source] ERP correlates of online monitoring of auditory feedback during vocalizationPSYCHOPHYSIOLOGY, Issue 6 2009Colin S. Hawco Abstract When speakers hear the fundamental frequency (F0) of their voice altered, they shift their F0 in the direction opposite the perturbation. The current study used ERPs to examine sensory processing of short feedback perturbations during an ongoing utterance. In one session, participants produced a vowel at an F0 of their own choosing. In another session, participants matched the F0 of a cue voice. An F0 perturbation of 0, 25, 50, 100, or 200 cents was introduced for 100 ms. A mismatch negativity (MMN) was observed. Differences between sessions were only found for 200-cent perturbations. Reduced compensation when speakers experienced the 200-cent perturbations suggests that this larger perturbation was perceived as externally generated. The presence of an MMN, and no earlier (N100) response suggests that the underlying sensory process used to identify and compensate for errors in mid-utterance may differ from feedback monitoring at utterance onset. [source] Children's colour choices for completing drawings of affectively characterised topicsTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 3 2003Esther Burkitt Background: This study was designed to explore whether or not children systematically use particular colours when completing drawings of affectively characterised topics. Method: Three hundred and thirty 4,11-year-old children were subdivided into three conditions, colouring in a drawing of a man, a dog, or a tree, respectively. The children completed two test sessions in counterbalanced order. In one session, children rated and ranked ten colours in order of preference. In the other session, children completed three colouring tasks in which they had to colour in three identical figures but which had been given different affective characterisations: a neutrally characterised figure, a figure characterised as nasty, and a figure characterised as nice. Results: It was found that, in all age groups and for all topics, the children used their more preferred colours for the nice figures, their least preferred colours for the nasty figures, and colours rated intermediately for the neutral figures. It was also found that, in all age groups and for all topics, black tended to be the most frequently chosen colour for colouring in the drawings of the negatively characterised figures. By contrast, primary colours were predominantly selected for the neutral figure, while a wide range of mainly primary and secondary colours were chosen for colouring in the nice figure. Conclusions: These results suggest that children are able to alter systematically their use of colour during picture completion tasks in response to differential affective topic characterisations, and that even very young children are able to use colours symbolically. [source] Short-term sprint interval training increases insulin sensitivity in healthy adults but does not affect the thermogenic response to ,-adrenergic stimulationTHE JOURNAL OF PHYSIOLOGY, Issue 15 2010Jennifer C. Richards Sprint interval training (SIT) and traditional endurance training elicit similar physiological adaptations. From the perspective of metabolic function, superior glucose regulation is a common characteristic of endurance-trained adults. Accordingly, we have investigated the hypothesis that short-term SIT will increase insulin sensitivity in sedentary/recreationally active humans. Thirty one healthy adults were randomly assigned to one of three conditions: (1) SIT (n= 12): six sessions of repeated (4,7) 30 s bouts of very high-intensity cycle ergometer exercise over 14 days; (2) sedentary control (n= 10); (3) single-bout SIT (n= 9): one session of 4 × 30 s cycle ergometer sprints. Insulin sensitivity was determined (hyperinsulinaemic euglycaemic clamp) prior to and 72 h following each intervention. Compared with baseline, and sedentary and single-bout controls, SIT increased insulin sensitivity (glucose infusion rate: 6.3 ± 0.6 vs. 8.0 ± 0.8 mg kg,1 min,1; mean ±s.e.m.; P= 0.04). In a separate study, we investigated the effect of SIT on the thermogenic response to beta-adrenergic receptor (,-AR) stimulation, an important determinant of energy balance. Compared with baseline, and sedentary and single-bout control groups, SIT did not affect resting energy expenditure (EE: ventilated hood technique; 6274 ± 226 vs. 6079 ± 297 kJ day,1; P= 0.51) or the thermogenic response to isoproterenol (6, 12 and 24 ng (kg fat-free mass),1 min,1: %,EE 11 ± 2, 14 ± 3, 23 ± 2 vs. 11 ± 1, 16 ± 2, 25 ± 3; P= 0.79). Combined data from both studies revealed no effect of SIT on fasted circulating concentrations of glucose, insulin, adiponectin, pigment epithelial-derived factor, non-esterified fatty acids or noradrenaline (all P > 0.05). Sixteen minutes of high-intensity exercise over 14 days augments insulin sensitivity but does not affect the thermogenic response to ,-AR stimulation. [source] Cytokine Release and Serum Lipoprotein (a) Alterations During HemodialysisARTIFICIAL ORGANS, Issue 5 2000Helen A. Tzanatos Abstract: It has been reported recently that a number of cytokines, mainly tumor necrosis factor , (TNF,), interleukin (IL)-1,, and IL-6, can alter lipid metabolism and produce hyperlipidemia. Studies in hemodialysis (HD) patients have demonstrated increased production of these cytokines during HD. In order to investigate any possible relationship between changes of cytokines and lipid concentrations during HD in the serum of 25 uremic patients on chronic HD using modified cellulose membranes, TNF,, IL-1,, IL-6, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), lipoprotein a (Lp[a]), and total proteins were measured immediately before (pre-HD) and after HD (post-HD), in one session. The post-HD values were corrected according to the hemoconcentration based on the changes in serum total proteins. Serum TNF, and IL-1, levels were significantly increased from 38.24 ± 17.85 pg/ml and 2.60 ± 3.64 pg/ml pre-HD to 48.86 ± 25.21 and 3.49 ± 4.08 pg/ml post-HD, p < 0.001 and p < 0.05 respectively. Also Lp(a) levels presented a statistically significant increase post-HD and were almost doubled (pre-HD: 15.41 mg/dl, to post-HD: 27.39 mg/dl, p < 0.05). Serum IL-6 as well as serum TC, TG, HDL-C, and LDL-C did not show any statistically significant alterations during HD. A significant positive correlation was detected between TNF, and Lp(a) values post-HD (r: 0.413, p: 0.04), but not between pre-HD values. No further relationship between serum cytokines and the other estimated lipid parameters was observed, either between pre- or post-HD values. Our results indicate that release of TNF, and IL-1, during HD have no effect on serum lipids concentration, except on Lp(a). It seems that the acute rise of this lipoprotein during hemodialysis may be related with the TNF, overproduction. [source] The potpourri approach to hyaluronic acid filler injectionsAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 1 2010Adrian C Lim ABSTRACT There is an ever-expanding range of hyaluronic acid fillers with varying physical characteristics available to cosmetic dermatologists. These fillers are commercially packaged in syringes of approximately 1 mL (range 0.5,2 mL) volume. Filler injectors are currently qualitatively and quantitatively restricted to fillers packaged in ready-to-go syringes. Patients often present for pan-facial rejuvenation requiring varying amounts of fillers as well as more than one type/subtype of filler for optimum correction. The potpourri approach allows access to a range of prepared hyaluronic acid filler subtypes that can be used on the same patient in the one session. The potpourri method centres on the use of multiple 31-gauge insulin syringes prepared with a range of different hyaluronic acid filler products that are ready for use. This increases flexibility with filler selection and has the potential to provide better filler-to-tissue match for patients. [source] Chronic kidney disease affects the stone-free rate after extracorporeal shock wave lithotripsy for proximal ureteric stonesBJU INTERNATIONAL, Issue 8 2010Shun-Fa Hung Study Type , Therapy (case series) Level of Evidence 4 OBJECTIVE To investigate the effect of renal function on the stone-free rate (SFR) of proximal ureteric stones (PUS) after extracorporeal shock wave lithotripsy (ESWL), as urinary obstruction caused by PUS can impair renal function, and elevated serum creatinine levels are associated with decreased ureteric stone passage. PATIENTS AND METHODS From January 2005 to December 2007, 1534 patients had ESWL for urolithiasis, 319 having ESWL in situ for PUS; they were reviewed retrospectively. Patients requiring simultaneous treatment of kidney stones, placement of a double pigtail stent, or percutaneous pigtail nephrostomy tube were excluded. We divided patients into groups by chronic kidney disease (CKD) stage according to the estimated glomerular filtration rate (eGFR) of ,60 and <60 mL/min/1.73 m2. Stone-free status was defined as no visible stone fragments on a plain abdominal film at 3 months after ESWL. A logistic regression model was used to evaluate the possible significant factors that influenced the SFR of PUS after ESWL, and to develop a prediction model. RESULTS The overall SFR of PUS (276/319 patients) was 86.5%; the SFR was 93% in patients with an eGFR of ,60 and 50% in those with an eGFR of <60 (P < 0.001). After univariate and multivariate analysis, the three significant factors affecting SFR were an eGFR of ,60, stone width, and gender, with odds ratios (95% confidence intervals) of 19.54 (8.25,46.30) (P < 0.001), 0.67 (0.55,0.82) (P < 0.001) and 0.16 (0.05,0.50 (P = 0.002), respectively. A logistic regression model was developed to estimate the probability of SFR after ESWL, the equation being 1/(1 + exp [,(3.8137 , 0.3967 × (stone width) + 2.9724 × eGFR , 1.8120 × Male)]), where stone width is the observed value (mm), eGFR = 1 for eGFR ,60 and 0 for <60, and male = 1 for male, 0 for female. CONCLUSIONS Gender, eGFR ,60 and a stone width of >7 mm were significant predictors affecting the SFR after one session of ESWL for PUS. [source] Simultaneous bilateral percutaneous nephrolithotomy in childrenBJU INTERNATIONAL, Issue 1 2005Morshed A. Salah In the paediatric section, two papers relating to the upper urinary tract are presented. The first, from Hungary, describes simultaneous bilateral percutaneous nephrolithotomy in 13 patients, where it was deemed feasible; this is the first such report. Authors from London report on unilateral nephrectomy in patients with nephrogenic hypertension, and found that it was successful in normalising blood pressure in patients with renal hypertension with a normal contralateral kidney. OBJECTIVE To evaluate the efficacy of removing bilateral kidney stones simultaneously from children, in one session. PATIENTS AND METHODS Thirteen patients (three girls and 10 boys, 26 kidneys; mean age 8 years, range 3,14) underwent simultaneous bilateral percutaneous nephrolithotomy (PCNL) in the same session, under general anaesthesia, starting with ureteric catheter insertion into both kidneys and using a 26 F adult nephroscope. The mean (range) stone diameter was 2 (1,3.5) cm. Three patients had staghorn stones in one of their kidneys. Ultrasonic disintegration was used; two patients had bilateral and two others unilateral endopylotomy, and one patient had percutaneous suprapubic cystolithotomy in the same session. The mean (range) operative duration was 65 (55,90) min. RESULTS All patients were rendered stone-free; there was no severe bleeding or any other complication. On one side in one of the patients, a second session was needed because of residual stone. The nephrostomy tubes were removed 3 and 4 days after PCNL and the hospital stay was 6 (1,11) days. CONCLUSION The advantages of simultaneous bilateral PCNL are reduced psychological stress, one cystoscopy and anaesthesia, less medication and a shorter hospital stay and convalescence, with considerable savings in cost. In experienced hands this method can be used not only in adults but also in children. To our knowledge this is the only report of this technique in children. [source] | ||||||||||||||||||||||