Scand J Urol Nephrol
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Scand J Urol Nephrol · Jan 2004
ReviewTraditional and non-traditional risk factors as contributors to atherosclerotic cardiovascular disease in end-stage renal disease.
Cardiovascular disease (CVD) remains the main cause of morbidity and mortality in patients with end-stage renal disease (ESRD). Although traditional risk factors, such as diabetes mellitus, hypertension, dyslipidemia and advanced age, are prevalent in ESRD patients they may not be sufficient by themselves to account for the high prevalence of CVD in patients with this condition. Thus, the search for other, non-traditional, risk factors that may be involved in the pathogenesis of uremic CVD has been an area of intense study. ⋯ Thus, it could be speculated that suppression of the vicious cycle of malnutrition, inflammation and atherosclerosis (MIA syndrome) would improve survival in dialysis patients. Recent evidence has demonstrated strong associations between inflammation and both increased oxidative stress and endothelial dysfunction in ESRD patients. As there is not yet any recognized, or even proposed, treatment for ESRD patients with chronic inflammation it would be of obvious interest to study the long-term effect of various anti-inflammatory treatment strategies on the nutritional and cardiovascular status as well as outcome of these patients.
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Scand J Urol Nephrol · Jan 2004
Management of urinary incontinence after bulboprostatic anastomotic urethroplasty for posterior urethral obstruction secondary to pelvic fracture.
To present our experience of the management of urinary incontinence after bulboprostatic anastomotic urethroplasty for post-traumatic posterior urethral obstruction secondary to pelvic fracture. ⋯ The proximal sphincteric mechanism should be fully evaluated before performing bulboprostatic anastomosis. Placement of a bladder tube is a good option for managing urinary incontinence. Vesicourethral fistulae are an unrecognized cause of urinary incontinence following transpubic urethroplasty. Visual urethrotomy should only be used in short, passable strictures.