Publications by authors named "Denstedt J"
Article Synopsis
- - This case report discusses a unique instance where a 58-year-old female with newly diagnosed systemic sclerosis experienced scleroderma renal crisis, leading to bilateral exudative retinal detachments and severe hypertension.
- - The patient initially presented with vision issues and was found to have malignant hypertension and other symptoms like sclerodactyly, resulting in her diagnosis of diffuse systemic sclerosis and Sjogren's syndrome.
- - After intensive care treatment for her hypertension, the patient's vision and ocular issues improved within three months, highlighting the importance of systemic screening for causes of malignant hypertension, particularly in the presence of systemic sclerosis.
Article Synopsis
- - Over the last 30 years, miniaturized percutaneous nephrolithotomy (mPCNL) has gained popularity due to its potential to reduce complications compared to standard procedures, but there's still debate over best practices and management strategies that hinders wider use.
- - An international panel of urology experts developed a consensus document on mPCNL to provide a comprehensive framework for practice, which included reviewing literature, identifying research gaps, and conducting surveys to gather expert opinions.
- - The study revealed 58 key questions on mPCNL practices, and consensus was achieved on 30 questions, affirming mPCNL as an effective technique for treating upper urinary tract stones in both adults and children.
Introduction: Endoscopic Combined Intrarenal Surgery (ECIRS) has emerged as a promising technique for the management of large and complex kidney stones, potentially offering advantages over traditional Percutaneous Nephrolithotomy (PCNL). This study aims to evaluate best practices, outcomes, and future perspectives associated with ECIRS.
Materials And Methods: A comprehensive PubMed search was conducted from 2008 to 2024, using MESH terms and the following key words: "ECIRS" and "Endoscopic Combined Intrarenal Surgery" The search yielded 157 articles, including retrospective cohort studies, two randomized controlled trials (RCTs), and four meta-analyses comparing ECIRS with PCNL.
Introduction: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy, known to present with ocular manifestations in rare cases.
Case Presentation: We describe the case of a 9-year-old previously healthy male who developed a 2-day history of periocular swelling and was found on MRI to have a large sphenoidal mass. Further work up showed involvement of the spinal cord, iliac crests, and kidneys.
Background: Inquiry of microbiota involvement in kidney stone disease (KSD) has largely focussed on potential oxalate handling abilities by gut bacteria and the increased association with antibiotic exposure. By systematically comparing the gut, urinary, and oral microbiota of 83 stone formers (SF) and 30 healthy controls (HC), we provide a unified assessment of the bacterial contribution to KSD.
Results: Amplicon and shotgun metagenomic sequencing approaches were consistent in identifying multi-site microbiota disturbances in SF relative to HC.
Background: Urinary stone disease (USD) historically has affected older men, but studies suggest recent increases in women, leading to a near identical sex incidence ratio. USD incidence has doubled every 10 years, with disproportionate increases amongst children, adolescent, and young adult (AYA) women. USD stone composition in women is frequently apatite (calcium phosphate), which forms in a higher urine pH, low urinary citrate, and an abundance of urinary uric acid, while men produce more calcium oxalate stones.
View Article and Find Full Text PDFObjective: The holmium:yttrium-aluminium-garnet laser (Ho:YAG) has been the gold standard for laser lithotripsy over the last three decades. After demonstrating good efficacy, the thulium fiber laser (TFL) has been recently released in the market and the initial clinical results are encouraging. This article aims to review the main technology differences between the Ho:YAG laser and the TFL, discuss the initial clinical results with the TFL as well as the optimal settings for TFL lithotripsy.
View Article and Find Full Text PDFPurpose: The gold standard for managing postoperative ocular fibrosis in glaucoma surgery is the chemotherapeutic mitomycin C (MMC) despite its association with significant adverse effects. This study compares in vitro the antifibrotic efficacy and cytotoxicity of the small-molecule TGFβ1 inhibitor SB-431542 (SB) to MMC.
Methods: To measure collagen contraction, human Tenon's capsule fibroblasts (HTCFs) embedded in a three-dimensional collagen lattice were exposed to 0.
Mastering a surgical skill requires experience and repetition, yet opportunities for surgical trainees to gain real experience are variable and limited by case load. Surgical simulators have emerged in an attempt to overcome these limitations. However, the few currently available skills simulators for flexible endoscopy are costly, have limited accessibility and versatility, lack portability, and require dedicated time for practice.
View Article and Find Full Text PDFBackground: Retrograde intrarenal surgery (RIRS) has become the preferred treatment modality for nephrolithiasis. However, because of ongoing uncertainties regarding the optimal perioperative management, operative technique, and postoperative follow-up, as well as a lack of standardization for outcome reporting, consensus is needed to achieve more uniform clinical practice worldwide.
Objective: To develop recommendations for RIRS on the basis of existing data and expert consensus.
Article Synopsis
- - Flexible ureteroscopy is a common method for treating urinary stones but comes with high costs and durability issues, leading to the development of single-use flexible ureteroscopes since 2011.
- - A review of studies shows single-use scopes are lightweight with a deflection capacity of 300 degrees, have stone-free rates comparable to reusable scopes (60-95%), and lower operative times (54-86 minutes).
- - While single-use flexible ureteroscopes offer improved image quality and reduced weight, institutions need to conduct their own cost-benefit analyses to determine if these devices are a viable option based on local factors.
A Profound Past and a Very Bright Future: Minimally Invasive Urology.
Urol Clin North Am
February 2022
Context: Although percutaneous nephrolithotomy (PCNL) has been performed for decades and has gone through many refinements, there are still concerns regarding its more widespread utilization because of the long learning curve and the potential risk of severe complications. Many technical details are not included in the guidelines because of their nature and research protocol.
Objective: To achieve an expert consensus viewpoint on PCNL indications, preoperative patient preparation, surgical strategy, management and prevention of severe complications, postoperative management, and follow-up.
Background: The aim of this study was to reach a consensus in the classification and standardized reporting for the different types of PCNLs.
Methods: The RAND/UCLA appropriateness methodology was used to reach a consensus. Thirty-two statements were formulated reviewing the literature on guidelines and consensus on PCNLs, and included procedure specific details, outcome measurements and a classification for PCNLs.
Ureteral stents are commonly used to prevent urinary obstruction but can become colonized by bacteria and encrusted, leading to clinical complications. Despite recent discovery and characterization of the healthy urinary microbiota, stent-associated bacteria and their impact on encrustation are largely underexplored. We profile the microbiota of patients with typical short-term stents, as well as over 30 atypical cases (all with paired mid-stream urine) from 241 patients.
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