Publications by authors named "Elizabeth Kwenda"

Alexander Randall first published renal papillary tip findings from stone formers in 1937, paving the way for endoscopic assessment to study stone pathogenesis. We performed a literature search to evaluate the safety of papillary tip biopsy and clinical insights gained from modern renal papillary investigations. A search on the topic of renal papillary biopsy provided an overview of Randall's plaques (RP), classification systems for renal papillary grading, and a summary of procedure type, complications, and outcomes.

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Numerous case reports exist on penile strangulation injuries and extrication methods; however, the care and long-term consequences of penile strangulation injuries have been under-reported. Our aim is to investigate the long-term outcomes and sequalae following penile strangulation injuries. The PubMed Medline database was searched using the keyword string "penile strangulation," "penis strangulation," and "constriction" for all studies reporting outcomes of published penile strangulation injuries.

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Background: The ability of the autonomic nervous system's stress response to impair aspects of cognitive flexibility is known. However, the ability to modulate the sympathetic response and improve these cognitive impairments via nonpharmacological intervention, such as paced breathing (PB), requires further investigation.

Objective: To better elucidate the effects of PB on cognition.

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Muscle-invasive bladder cancer is a life-threatening disease best managed with multimodal therapy. Neoadjuvant chemotherapy prior to cystectomy significantly improves survival with the greatest benefit noted in patients with a complete pathologic response noted at cystectomy. While radical cystectomy is currently an important part of the treatment plan, surgical morbidity remains high.

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Article Synopsis
  • PD-L1 expression is often increased in cancer, helping tumors evade the immune system by inhibiting T cells through interaction with the PD1 receptor.
  • *Tumor-associated hyaluronan (HA), produced by tumor cells, plays a key role in promoting the development of immunosuppressive PD-L1 macrophages in the tumor microenvironment.
  • *The study found that clusters of HA-producing fibroblast-like cells and PD-L1 macrophages form in the tumor and its draining lymph nodes, which may contribute to immune escape and decreased effectiveness of immunotherapy.*
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Article Synopsis
  • - RCC patients often have a higher number of immune-suppressing myeloid cells, particularly myeloid-derived suppressor cells (MDSCs), in their blood, which are linked to immune suppression and inflammation.
  • - A study found that untreated RCC patients had increased monocytic MDSCs expressing PD-L1 (linked to immune suppression) and hyaluronidase 2 (Hyal2, linked to inflammation), suggesting they may play a role in both processes.
  • - Analysis of tumor tissue showed the presence of PD-L1 expressing immune cells in the tumor stroma, indicating that the interaction between these myeloid cells and hyaluronan may fuel both inflammation and immune tolerance in kidney cancer. *
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Existing animal models of renal oxalate excretion utilize either gut or peritoneal cavity for oxalate absorption. Ex vivo renal perfusion is an established tool for graft preservation. We sought to repurpose this concept to study the early pathogenesis of urinary lithiasis.

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Background And Aims: The neutrophil-to-lymphocyte-ratio (NLR) is used as an inflammatory index and has proven to be an accurate prognostic indicator for decompensated cirrhotics; however, its role in patients undergoing transjugular intrahepatic portosystemic shunt (TIPS) has not been evaluated. We examined whether NLR is associated with mortality in decompensated cirrhosis patients undergoing TIPS.

Methods: We performed a retrospective review of 268 decompensated cirrhotics who underwent TIPS from January 2011 to December 2015 at an academic medical center.

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Introduction: Testicular torsion is an emergent condition requiring prompt treatment. Previous studies have suggested transfer of pediatric testicular torsion cases may be detrimental to patient outcomes. Findings have not reached statistical significance.

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Chyluria is a rare diagnosis classically associated with milky-appearing urine. It involves the leakage of chyle into the urinary tract. Although the most common cause of chyluria worldwide is infectious in nature, other noninfectious etiologies have been described.

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Pediatric urolithiasis may coexist with congenital urinary tract abnormalities, complicating conventional methods of stone treatment. Here, we present an effective case of robot-assisted laparoscopy and simultaneous ureteropyeloscopy for the definitive management of pediatric urolithiasis complicated by a congenital ureteral stricture. A 3-year-old girl presented to clinic with an outside noncontrast CT scan showing two 6-7 mm nonobstructing calculi in a mildly distended upper pole moiety of a duplex left kidney.

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The increased presence of myeloid-derived suppressor cells (MDSC) and tumor-associated macrophages (TAM) in tumor tissue has been extensively reported. However, their role in the regulation of hyaluronan (HA) metabolism in the tumor microenvironment has not been established. Here we describe a novel function of tumor-associated myeloid cells related to the enhanced breakdown of extracellular HA in human bladder cancer tissue, leading to the accumulation of small HA fragments with molecular weight (MW) <20 kDa.

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Article Synopsis
  • A 17-year-old male with Zinner syndrome, characterized by a right seminal vesicle cyst and a solitary left kidney, experienced chronic pelvic pain despite previous surgeries for symptom relief.
  • Abdominal and pelvic MRI revealed a cystic structure between the prostate and bladder, leading to a robot-assisted laparoscopic seminal vesiculectomy that identified and resected a dysplastic ureter connected to the cystic structure.
  • Post-surgery, the patient had an uncomplicated recovery and remained symptom-free at a 6-month follow-up, highlighting the importance of recognizing mesonephric duct abnormalities like Zinner syndrome in young males with similar symptoms.
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Purpose Of Review: The aim of the article is to review studies on bone health and oxalate metabolism/therapeutics in the obese rodent model of Roux-en-Y gastric bypass (RYGB) and examine pathways to decrease procedural morbidity.

Recent Findings: Compared with controls, RYGB rodents have up to 40-fold more fat in their stool (steatorrhea) which positively correlates to increased urinary oxalate. These unabsorbed intestinal fatty acids bind calcium and prevent gut calcium oxalate formation, increasing soluble luminal oxalate availability and absorption (enteric hyperoxaluria).

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Purpose Of Review: In addition to traditional risk factors such as low urine volume or hypercalciuria, emerging data suggest that calcium oxalate (CaOx), one of the most common mineral complexes in the urine, elicits a strong immunologic response. This review highlights those studies and projects how future therapies may be directed for kidney stone prevention.

Recent Findings: Over the last 2 years, several groups have studied the response of the immune system to CaOx crystals using cell culture and animal models.

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