Urology
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Indigo carmine is generally believed to be a safe, biologically inert substance. Adverse reactions to the intravenous administration of this dye have been seen only rarely. We report a life-threatening anaphylactoid reaction to indigo carmine that may have been due to either a drug allergy or to its intrinsic serotonergic properties.
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative morbidity is similar in patients anesthetized with epidural and general anesthesia for radical prostatectomy.
To compare the effect of epidural and general anesthesia on the postoperative course and complication rate in patients undergoing radical prostatectomy. ⋯ Intraoperative anesthetic technique was not associated with a different postoperative complication rate in patients undergoing RRP. The very low incidence of complications and the uniform postoperative analgesic regimen may have contributed to the similarity between groups.
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To determine the efficacy of computed tomography of the chest (CTC) and plain radiograph (CXR) in the initial staging process of testicular germ cell tumors. ⋯ CXR alone is preferable for initial chest staging in all patients with SEM and in patients with NSGCT with negative findings on CTA. CTC remains of slight benefit for patients with clinical Stage II and greater NSGCT and to evaluate further suspicious CXR findings in any patient, although it appears not to be necessary in patients who have clinical Stage I disease determined by CTA. These findings have important cost-saving implications.
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Review Case Reports
Dislocation of the testis as a delayed presentation of scrotal trauma.
Traumatic dislocation of the testis is a rare event in which the full extent of the dislocation is present immediately following the initial trauma. We present a case in which the testicular dislocation progressed over a period of four days following the initial scrotal trauma.
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Patients with high-stage nonseminomatous germ cell tumors treated with platinum-based chemotherapy who have residual radiographic evidence of disease and fail to normalize tumor markers present a difficult clinical dilemma. Some authors feel that these patients are not appropriate surgical candidates. Our practice has been to offer certain patients salvage surgery in an attempt for cure. This report is designed to review that experience and critically analyze the results. ⋯ Patients with advanced nonseminomatous germ cell tumor who fail to normalize their serum tumor markers after adequate platinum-based chemotherapy should be considered for surgical resection of all radiographically evident residual disease. In select cases this practice offers the only viable chance for cure.