Journal of endourology
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Journal of endourology · Dec 2013
Urinary cystatin C and NGAL as early biomarkers for assessment of renal ischemia-reperfusion injury: a serum marker to replace creatinine?
To assess application of cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) as biomarkers for renal ischemic injury. We also evaluated the use of allopurinol as a renoprotective agent. A second goal was to assess cystatin C as a biomarker in patients undergoing partial nephrectomy. ⋯ Cystatin C and NGAL both appear to be useful biomarkers of renal injury. Studies with larger numbers are needed, however. Also, allopurinol does exhibit renoprotective effects against ischemic injury.
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Journal of endourology · Dec 2013
Multicenter StudyAdmission rates and costs associated with emergency presentation of urolithiasis: analysis of the Nationwide Emergency Department Sample 2006-2009.
We sought to examine a large nationwide (United States) sample of emergency department (ED) visits to determine data related to utilization and costs of care for urolithiasis in this setting. ⋯ Presentation of urolithiasis to the ED is common, and is associated with significant costs to the medical system, which are increasing over time. Costs and rates of admission differ by region, payer type, and hospital type, which may allow us to identify the causes for cost discrepancies and areas to improve efficiency of care delivery.
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Journal of endourology · Dec 2013
Comparative StudySmall-bore catheter drainage of pleural injury after percutaneous nephrolithotomy: feasibility and outcome from a single large institution series.
A well-known complication of percutaneous nephrolithotomy (PCNL) is pleural injury. Pneumothorax and hydrothorax sustained during PCNL may necessitate the placement of a chest tube. Current literature describes placement of standard chest tubes as well as small-bore catheters for management of hydrothorax sustained during PCNL. This study aims to better delineate the clinical utility and outcomes associated with use of small-bore catheters when compared with standard chest tubes for managing pneumothorax and hydrothorax after PCNL. ⋯ The use of small-bore catheters for management of hydrothorax and pneumothorax have reasonable clinical outcomes when compared with standard large-bore chest tubes after PCNL.
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Journal of endourology · Dec 2013
Does baseline radiography of the kidneys, ureters, and bladder help facilitate stone management in patients presenting to the emergency department with renal colic?
A baseline kidneys, ureters, and bladder (KUB) radiograph, at the time of computed tomography (CT) for ureteral stones, might aid interpretation of future KUBs. The CT scout radiograph might render the baseline KUB redundant, however. We sought to assess the diagnostic utility of baseline KUB for patients with ureteral stones. ⋯ The addition of a baseline KUB to the CT scout film improves the ability of urologists to determine stone outcome when following patients with KUB imaging and might reduce the subsequent need for additional imaging.
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Journal of endourology · Dec 2013
Comparative StudyRenal cryoablation versus robot-assisted partial nephrectomy: Washington University long-term experience.
American Urological Association guidelines endorse partial nephrectomy as the preferred treatment for patients with small renal masses, while considering patients with significant comorbidities potential candidates for ablative therapy. We compared perioperative, renal functional, and oncologic outcomes of renal cryoablation and robot-assisted partial nephrectomy (RAPN) based on our long-term institutional experience. ⋯ Cryoablation and RAPN are safe alternatives for managing renal masses amenable to nephron-sparing interventions, offering acceptable morbidity and excellent renal preservation. While RAPN offers improved DFS, for those willing to undergo close postoperative monitoring and accept the potential need for re-treatment of recurrent disease, cryoablation offers excellent long-term CSS.