Urine Problems
Death risk higher in obese kidney transplant cases
|
|
Obese individuals who undergo kidney transplantation are more likely to die and have a poor outcome than their nonobese counterparts, Dutch researchers report.
“Past studies looking at the effect of obesity on transplantation outcomes have yielded conflicting results,” senior author Dr. Andries Hoitsma, from the University Medical Center St. Radboud in Nijmegen, told Reuters Health. “The strength of our study is the large sample size.”
The study, reported in the November issue of Transplant International, included 196 obese patients with a body mass index (BMI) of at least 30 and 1871 nonobese patients. Obese patients were more likely to be female and were typically older than nonobese patients.
Combination therapy appears more effective than single drug for lower urinary tract symptoms
|
|
Men with overactive bladder and lower urinary tract symptoms who received a combination therapy were more likely to report improvement in symptoms than men who received only one medication, according to a study in the November 15 issue of JAMA, a theme issue on men’s health.
Steven A. Kaplan, M.D., of Weill Cornell Medical College, New York, presented the findings of the study today at a JAMA media briefing on men’s health in New York.
Overactive bladder is a syndrome characterized by urinary urgency, usually with increased urination frequency during the day and night. An estimated 10 million men 40 years or older have symptoms consistent with overactive bladder, according to background information in the article. Lower urinary tract symptoms include urinary hesitancy and intermittency and weak urinary stream. Some men with these symptoms do not respond to treatment with common medications.
Pain drugs may raise risk of kidney failure
|
|
The use of nonsteroidal antiinflammatory drugs (“NSAID”), which include pain relievers like ibuprofen (Motrin, Advil) may increase the risk of kidney failure, according to a report in the American Journal of Epidemiology.
“NSAIDs are associated not uncommonly with renal failure,” Dr. James M. Brophy from McGill University in Montreal told Reuters Health. “This rate of renal failure is approximately twice that observed for (heart attack). Clinicians should, therefore, be concerned not only about cardiac but also renal adverse effects and, therefore, restrict NSAID use only for those situations where the benefit is expected to outweigh the risks.”
Drug prescribed for migraines and seizures increases risk of kidney stones
|
|
Topiramate (Topamax), a drug commonly prescribed to treat seizures and migraine headaches, can increase the propensity of calcium phosphate kidney stones, researchers at UT Southwestern Medical Center have found.
A study - the largest cross-sectional examination of how the long-term use of topiramate affects kidney-stone formation - appears in the October issue of the American Journal of Kidney Diseases.
Several case reports have described an association between topiramate and the development of kidney stones, but this complication had not been well recognized and physicians have not informed patients about the risk, the UT Southwestern researchers said. More important, the mechanism of stone formation was largely unknown previously.
Laparoscopic partial nephrectomy using the potassium titnyl phosphate laser in a porcine model
|
|
Working with an 80 watt KTP laser delivered in a noncontact mode via a 600 micron fiber, these authors successfully completed 15 laparoscopic partial nephrectomies in pigs. This was done without clamping any renal vessels.
In only one case additional hemostatic maneuvers were needed. The zone of necrotic tissue on the renal remnant was only 1 mm. The procedure consumed only 4-17 minutes of lasing time; however the overall time to accomplish the nephrectomies averaged 42 minutes due to production of field obscuring smoke by the laser.
Study Reveals How Cells Destroy Faulty Proteins in Cystic Fibrosis
|
|
The cellular system that degrades faulty proteins created by the cystic fibrosis gene has been identified by University of North Carolina at Chapel Hill scientists. Turning off the degradation system allows some proteins to regain their proper shape, offering a new avenue for treatments aimed at curing the disease.
Cystic fibrosis (CF) is a fatal disease caused by a defective gene that produces a misshapen form of the protein cystic fibrosis transmembrane conductance regulator (CFTR). People with cystic fibrosis do not have enough CFTR for their cells to work normally because their bodies quickly destroy the mutant protein.
“Most cases of CF are caused by the inability of faulty CFTR to get in the correct shape, which leads cells to place it in the trash bin,” said senior author Dr. Douglas Cyr, professor of cell and developmental biology at UNC School of Medicine. “Our research helps define the basic mechanism for CF and identify targets for the development of therapeutics designed to get CFTR into shape and allow it function normally in the lung,” Cyr said.
Diagnosis and referrals for kidney disease fall well short of need
|
|
Results of a national study of 304 U.S. physicians, in which “mock” patients’ symptoms were presented for diagnosis, suggest that a sizeable percentage of primary care doctors probably fail to properly diagnose and refer patients with chronic kidney disease (CKD).
Their findings, reported in the August issue of the American Journal of Kidney Diseases, show that of 126 kidney specialists surveyed, 97 percent properly diagnosed CKD and 99 percent would have recommended specialized kidney care for the “patient.” But only 59 percent of the 89 family physicians and 78 percent of 89 general internal medicine physicians fully recognized the signs and symptoms of CKD. And referrals to a nephrologist were made by only 76 percent of the family physicians and only 81 percent of general internists.
“We, as physicians, can certainly do better,” says L. Ebony Boulware, M.D., Assistant Professor of Medicine at The Johns Hopkins University School of Medicine, and lead author of the study.
Cardiac arrest victims make viable kidney donors
|
|
People who are transplanted with a kidney from a victim of out-of-hospital cardiac arrest do very well, new research suggests.
In the United States, transplanted kidneys come from “beating-heart” donors, who include living individuals and those declared brain dead. Previous reports have shown acceptable outcomes when using kidneys from in-hospital cardiac arrest victims, but it was unclear if the same applied to organs taken from out-of-hospital arrest victims.
To investigate, Dr. Ana I. Sanchez-Fructuoso, from Hospital Clinico San Carlos in Madrid, and colleagues compared the outcomes of 320 transplant patients who received a kidney from a non-beating-heart donor and 584 who received a kidney from a beating-heart donor, some of whom were older than 60 years of age.
“Domino” Transplant Program Makes Best Use of Altruistic Donated Kidneys
|
|
A team of Johns Hopkins researchers reporting their early experiences with “domino” kidney donation suggest that wider use of this strategy could effectively double the benefit of the organs from these non-directed, altruistic living donors.
In a paper published in the August issue of the British journal Lancet, the team, led by Robert A. Montgomery, M.D., chief of transplantation at the Johns Hopkins University School of Medicine, show that by serving the needs of multiple recipients, such domino transplants can maximize the benefits of these donors’ altruistic acts.
Under the terms of the domino-paired donation program, a kidney transplant patient who has a willing but incompatible living organ donor is matched with an altruistic, compatible donor. The incompatible kidney from the recipient’s intended donor is then domino-matched with the next compatible patient on the United Network of Organ Sharing (UNOS) waiting list. This strategy can be further used to enable a triple transplant by simply adding an additional incompatible donor-recipient pair to the chain.
Botox effective for overactive bladder: study
|
|
The popular wrinkle treatment Botox may have more than just cosmetic applications for people with a far more pressing quality of life issue than a wish to present an unfurrowed brow in public.
Botox, or botulinum-A toxin, was highly effective in treating patients with severe overactive bladder in a clinical trial and the desired effect lasted for months, according to results presented by researchers at a meeting of the American Urological Association in Atlanta on Sunday.
Allergan Inc., which sells Botox, did not sponsor the study, which was conducted independently by researchers in urology. An Allergan spokeswoman said the company has been “seeing very positive and encouraging trends” in the use of Botox for overactive bladder in its own clinical studies.
Incontinent girls may suffer overactive bladder later
|
|
Women who had urinary problems as children are more likely to have overactive bladder as adults, a new study shows.
The findings suggest that treating childhood urinary symptoms could prevent such problems in adulthood, Dr. Mary Pat Fitzgerald of Loyola University Medical Center in Maywood, Illinois and colleagues say.
The researchers surveyed 2,109 women aged 40 to 69, asking them about current urinary problems as well as whether they had such problems in childhood. Twenty-nine percent of the women reported having urinary incontinence, or leakage of urine, at least once a week, while 12 percent had daily incontinence.
Review examines the management of radiotherapy induced rectourethal fistula
|
|
Rectourethral fistulas (RUF) are a challenging problem observed by urological and colorectal surgeons.
The etiology of RUF includes previous surgery, trauma, inflammatory processes, congenital defects and radiation to the pelvis. An increase in the number of men presenting with RUF has occurred secondary to the increase in the number of men undergoing brachytherapy or a combination of brachytherapy and external beam radiotherapy for the treatment of prostate cancer. Several approaches to the management of these fistulas have been described but series are small and no consensus regarding management has been achieved.
A recent review by Ken Angermeier and colleagues from the Cleveland Clinic discusses their experience with the management of 22 patients with radiation induced rectourethral fistulas. The review is published in the April 2006 issue of the Journal of Urology.
Cystic Fibrosis Research May Benefit from New Sensing Tool
|
|
Researchers are using an innovative, multi-functional sensing tool to investigate adenosine triposphate (ATP) release and its role in cystic fibrosis. The ATP study marks the first application of a novel sensing system developed by a research team led by Christine Kranz at the Georgia Institute of Technology.
This patented technology adds recessed micro- and nano-electrodes to the tip of an atomic force microscope (AFM), creating a single tool that can simultaneously monitor topography along with electrochemical activity at the cell surface.
Rapamycin (sirolimus) may be effective in treating kidney disease
|
|
A widely available drug may be effective in treating kidney disease, report scientists at the University of California, Santa Barbara. They describe the discovery in the online edition of the Proceedings of the National Academies of Science.
The drug is rapamycin, also called sirolimus, and is currently used as an immunosuppressant, to help prevent rejection of a new, transplanted kidney.
One-Year Registry Data for Uterine Fibroid Embolization
|
|
One-year data from the largest, multi-center, prospective voluntary registry on any procedure for benign uterine fibroids showed that over 85 percent of women had significant improvement in symptoms, with 82 percent satisfied with their level of improvement. The Registry, designed to follow the “real world” outcomes for uterine fibroid embolization as it became a mainstream treatment widely available across the country, collected data on symptom relief, quality of life, subsequent care, satisfaction with outcome, and menstrual status on 1,701 women who had non-surgical uterine fibroid embolization (UFE).
The Fibroid Registry for Outcomes Data (FIBROID) also showed women’s quality of life scores improved significantly, and only 2.9 percent of patients required a hysterectomy within a year of having UFE. UFE is a minimally invasive interventional radiology treatment that blocks the blood supply to the fibroid tumors, causing them to shrink and die, and symptoms to subside.
