Zimmermanmclaughlin3598
Nephrectomy is the mainstay of treatment for many kidney cancers, but has been correlated with increased incidence of acute kidney injury (AKI) and chronic kidney disease (CKD). Recently, sodium-glucose cotransporter-2 (SGLT2) inhibition has been shown to decrease the incidence of end-stage kidney disease and death in people with type 2 diabetes mellitus (T2D). However, at present, there has been no description of the use of SGLT2 inhibition in patients with T2D and solitary kidney despite the high risk of CKD progression.
To characterize the use of SGLT2 inhibition and kidney function in a series of patients with T2D with prior nephrectomy for renal cell carcinoma (RCC).
Retrospective case series.
University hospital outpatient onco-nephrology clinic.
Patients post-nephrectomy for RCC with T2D who were prescribed an SGLT2 inhibitor.
Serum creatinine, albumin to creatinine ratio (ACR), HgA1c, and blood pressure measurements.
Patients post-nephrectomy with incident use of SGLT2 inhibitor were ide solitary kidneys post-nephrectomy. Larger prospective studies are needed to determine the efficacy and safety of SGLT2 inhibition strategies for kidney protection in patients post-nephrectomy.
SGLT2 inhibition is becoming a standard component of nephrology care to reduce kidney function decline, cardiovascular risk, and mortality. check details To our knowledge, our report is the first to provide longitudinal data on SGLT2 inhibitor usage in patients with T2D and solitary kidneys post-nephrectomy. Larger prospective studies are needed to determine the efficacy and safety of SGLT2 inhibition strategies for kidney protection in patients post-nephrectomy.
Self-management focused interventions to slow chronic kidney disease (CKD) progression are increasingly common. However, valid self-report instruments to evaluate the effectiveness of self-management interventions in CKD are limited.
We sought to develop and conduct preliminary psychometric testing of a patient-informed questionnaire to assess aspects of CKD self-management for patients with CKD categories G2-G5 (not on kidney replacement therapy [KRT]).
Self-administered electronic questionnaires (multiphase).
Online.
Canadian adults with CKD categories G2-G5 (not on KRT).
The CKD-SM questionnaire was developed and tested in 4 phases. First, we used a content coverage matrix to identify potential questionnaire items based on existing self-efficacy questionnaires, self-management theories, and patient-identified priorities. Second, the draft questionnaire was reviewed by a multidisciplinary expert panel using percent acceptance to finalize the questionnaire. Third, we tested an electronic version (not on KRT). The finalized questionnaire assesses aspects of self-management for individuals with CKD and may be particularly helpful as a tool to evaluate self-management interventions among patients with CKD.
We used self-management theories, patient-identified self-management needs, expert review, and conducted preliminary psychometric testing to finalize a CKD self-management questionnaire for patients with G2-G5 CKD (not on KRT). The finalized questionnaire assesses aspects of self-management for individuals with CKD and may be particularly helpful as a tool to evaluate self-management interventions among patients with CKD.Leiomyomas are benign tumours of smooth muscle cells that most often affect the female genital tract, but their metastasis to extra-uterine locations represent rare, yet misunderstood phenomena. The authors present a clinical case of a 42-year-old woman, who underwent a hysterectomy 15 years ago due to myomas, admitted with multiple pulmonary nodules and abdominal mass, diagnosed by imaging tests, in the context of haemoptysis. The anatomopathological exams of the pulmonary and abdominal lesions were compatible with the diagnosis of benign metastatic leiomyoma. Benign metastatic leiomyoma is a rare condition that particularly affects women of childbearing age, with a history of hysterectomy for uterine fibroids. Hence, this entity must be considered in the differential diagnosis of women with pulmonary nodules of uncertain aetiology.
The aim of the current study was to evaluate the prevalence of coronavirus disease (COVID-19) in methanol-poisoned patients admitted to two toxicology academic centers during the COVID-19 outbreak and determine their clinical features and chest/brain computed tomography (CT) findings.
Methanol-poisoned patients who had been referred during the COVID-19 pandemic were evaluated for signs and symptoms of COVID-19 by chest CT scans and/or polymerase chain reaction test.
A total of 62 patients with confirmed methanol poisoning were enrolled in the study, with a median (interquartile range) age of 35 (28-44) years. Thirty-nine (62.9%) survived. Nine (14.5%) were diagnosed to have COVID-19, of whom four survived. There was a significant correlation between COVID-19 disease and a history of alcohol consumption (
= 0.036; odds ratio 1.7; 95% confidence interval, 1.3-2.2). Univariate analysis showed significant differences between infected and noninfected patients regarding their urea and time for first and second hemodialysis sessions, as well as the duration of ethanol administration.
In conclusion, during the pandemic, specific attention should be paid to patients with a history of alcohol ingestion and elevated creatinine, loss of consciousness, and severe acidosis as these signs/symptoms could be present in both COVID-19 and methanol poisoning, making differentiation between the two challenging.
In conclusion, during the pandemic, specific attention should be paid to patients with a history of alcohol ingestion and elevated creatinine, loss of consciousness, and severe acidosis as these signs/symptoms could be present in both COVID-19 and methanol poisoning, making differentiation between the two challenging.
Urinary catheterization (UC) is a conventional perioperative measure for major abdominal operation. Optimization of perioperative catheter management is an essential component of the enhanced recovery after surgery (ERAS) programme. We aimed to investigate the risk factors of urinary retention (UR) after open colonic resection within the ERAS protocol and to assess the feasibility of avoiding urinary drainage during the perioperative period.
A total of 110 colonic-cancer patients undergoing open elective colonic resection between July 2014 and May 2018 were enrolled in this study. All patients were treated within our ERAS protocol during the perioperative period. Data on patients' demographics, clinicopathologic characteristics, and perioperative outcomes were collected and analysed retrospectively.
Sixty-eight patients (61.8%) underwent surgery without any perioperative UC. Thirty patients (27.3%) received indwelling UC during the surgical procedure. Twelve (10.9%) cases developed UR after surgery necessitating UC. Although patients with intraoperative UC had a lower incidence of post-operative UR [0% (0/30) vs 15% (12/80),
=
0.034], intraoperative UC was not testified as an independent protective factor in multivariate logistic analysis. The history of prostatic diseases and the body mass index were strongly associated with post-operative UR. Six patients were diagnosed with post-operative urinary-tract infection, among whom two had intraoperative UC and four were complicated with post-operative UR requiring UC.
Avoidance of urinary drainage for open elective colonic resection is feasible with the implementation of the ERAS programme as the required precondition. Obesity and a history of prostatic diseases are significant predictors of post-operative UR.
Avoidance of urinary drainage for open elective colonic resection is feasible with the implementation of the ERAS programme as the required precondition. Obesity and a history of prostatic diseases are significant predictors of post-operative UR.
Total gastrectomy for carcinoma in the remnant stomach (CRS) remains a technically demanding procedure. Whether robotic surgery is superior, equal, or inferior to laparoscopic surgery in patients with CRS is unclear. This study was designed to compare the efficacy and safety of robotic total gastrectomy (RTG) and laparoscopic total gastrectomy (LTG) for the treatment of CRS.
In this cohort study, we retrospectively analysed the data from patients who underwent RTG or LTG for CRS at Southwest Hospital (Chongqing, China) between May 2006 and October 2019. The surgical outcomes, post-operative complications, and survival outcomes between the two groups were compared.
Compared with LTG, RTG was associated with similar effective operation time (272.0 vs 297.9 min,
=
0.170), higher total costs (105,967.2 vs 81,629.5 RMB,
<
0.001), and less estimated blood loss (229.2 vs 288.8 mL,
=
0.031). No significant differences were found between the robotic and laparoscopic groups in terms of conversion rate, time to first flatus, time to first soft diet, post-operative hospital stay, post-operative complications, R0 resection rate, and number of retrieved lymph nodes (all
>
0.05). The 3-year disease-free survival and 3-year overall survival rates were comparable between the two groups (65.5% vs 57.5%,
=
0.918; 69.0% vs 60.0%,
=
0.850, respectively).
RTG is a safe and feasible procedure for the treatment of CRS and could serve as an optimal treatment for CRS.
RTG is a safe and feasible procedure for the treatment of CRS and could serve as an optimal treatment for CRS.
Colorectal cancer (CRC) is one of the most common cancers in China. However, detailed clinical characteristics and survival information are limited. This study aimed to investigate the potential epidemiological and clinical risk factors affecting the survival of CRC patients in southern China.
Patients with primary CRC between 1994 and 2019 at the First and the Sixth Affiliated Hospitals of Sun Yat-sen University (Guangzhou, China) were included. Clinical characteristics and survival outcomes were collected from medical records. The Kaplan-Meier method was used to estimate overall survival (OS) and progression-free survival (PFS), and Cox's proportional-hazards regression model was used to estimate hazard ratios and 95% confidence intervals.
Of all 13,328 patients, 60.1% were men; the mean age was 61.3 years; 53.5% had colon cancer. Among all patients, 1,864 (14.0%) were diagnosed with stage IV disease. The 3- and 5-year OS rates were 79.90% and 71.50%, respectively, whereas the 3- and 5-year PFS rates r occurrence, differentiation status, T status, N status, M status, clinical stage, operation, and surgical margin are independent factors associated with the OS of CRC patients.
Due to its limited efficacy and potential toxicity, anti-PD-1 monoclonal antibody is not suitable for all advanced gastric cancer (AGC) patients and predictive biomarkers identifying patients who can benefit from it are urgently needed. This study aimed to evaluate the predictive and prognostic value of inflammatory markers in the context of the systemic inflammatory status and tumour microenvironment.
The study included 58 patients from a prospective study investigating the safety and efficacy of toripalimab in chemorefractory AGC patients. Patient characteristics, treatment outcomes, and haematological parameters were analysed. Immune-cell infiltration and gene expression in tumour tissue were examined using transcriptome sequencing.
In this cohort, the median follow-up time was 4.5 months, the median progression-free survival was 1.9 months, and the median overall survival (OS) was 4.8 months. The objective response rate was 12.1% and th disease control rate (DCR) was 39.7%. Both the baseline blood neutrophil-to-lymphocyte ratio (bNLR) with a cut-point of 2.
