Urology
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Acute renal failure after a major intra-abdominal operation is, unfortunately, not an infrequent occurrence. Acute tubular necrosis, the most common cause of postoperative renal failure, usually follows a predictable clinical course, with most patients recovering full renal function. We describe a patient who developed acute renal failure after orthotopic liver transplantation. ⋯ Bilateral renal cortical necrosis is an extremely rare cause of renal failure and an even rarer cause of postoperative renal failure. We discuss the diagnosis and management of this uncommon disorder and review the salient literature. Of the approximately 15 known reported cases involving native kidneys after a major nonobstetric abdominal operation in the world literature, we believe this is the first to be related to an orthotopic organ transplant.
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Increasingly, radiation therapists are using neoadjuvant and/or adjuvant androgen deprivation therapy (ADT) in higher-risk patients who are receiving radiation therapy with curative intent. Studies supporting this combination therapy have shown a benefit in patients with locally advanced disease based on the relatively short follow-up time to report, to date. The differing study designs, patient selection criteria, and regimens used in these studies are reviewed and compared, along with the reported outcomes. Trials currently underway will examine the efficacy of ADT (4 to 6 months in duration) in patients with clinically localized prostate cancer with >/=1 high-risk features.