Comparison of powered and conventional air-purifying respirators during simulated resuscitation of casualties contaminated with hazardous substances.

Background: Advanced life support of patients contaminated with chemical, biological, radiological or nuclear (CBRN) substances requires adequate respiratory protection for medical first responders. Conventional and powered air-purifying respirators may exert a different impact during resuscitation and therefore require evaluation. This will help to improve major incident planning and measures for protecting medical staff.

Robotic assisted radical cystectomy: short to medium-term oncologic and functional outcomes.

Purpose: To report short- and medium-term oncological and functional outcomes of the first robotic-assisted laparoscopic radical cystectomy (RARC) series from the UK.

Materials And Methods: Thirty patients underwent RARC between 2004 and 2007 at our unit. We report oncological and functional outcomes of this procedure in 20 patients (17 ileal conduit and three Studer Pouches), who have completed at least 6 months of follow up.

Male breast cancer: a review.

Male breast cancer (MBC) is rare, with the peak age of onset at 71 years. BRCA2 mutations are more frequent than BRCA1 with 20% of cases giving a family history. Risk factors for MBC are poorly understood and include working in high-ambient temperatures and exhaust fume exposure.

Influence of number of retransplants on renal graft outcome.

Background: To assess the influence of number of transplants on the renal graft outcome.

Methods: Retrospective analysis of various factors that could influence the outcome of kidney retransplantation in patients receiving more than one allograft between 1993 and 2005 at our center.

Results: During the 12-year period (1993-2005), 196 patients received more than one renal transplant.

Living-unrelated donor renal transplantation: an alternative to living-related donor transplantation?

Introduction: An increasing number of living-unrelated, kidney donor transplants are being performed in our unit. We present a comparison of living-unrelated (LURD) and living-related donor (LRD) renal transplant outcomes and analyse influencing factors.

Patients And Methods: We retrospectively analysed the outcome of all living-donor renal transplants performed at our centre from 1993 to 2004.

Management of cystinuric patients: an observational, retrospective, single-centre analysis.

Objective: A critical appraisal of the management of patients with cystine stones treated in our unit in the past 6 years and to analyze the outcome of multimodality therapies.

Study Design: An observational, single-centre retrospective study.

Methods: We reviewed the records of all patients with stones referred to our centre over a 6-year period from 1998 to 2005.

Respiratory protection during high-fidelity simulated resuscitation of casualties contaminated with chemical warfare agents.

Emergency room personnel are threatened by secondary poisoning when treating victims affected by chemical warfare agents. Therefore, resuscitation skills practised with respiratory protection equipment in place require evaluation. We investigated the influence of wearing air-purifying respirators on the simulated resuscitation of chemical warfare agent casualties.

Religious delusions: finding meanings in psychosis.

Background: Religious delusions have been reported with varying prevalence from cultures around the world. Their contents, context and significance vary according to cultural and economic mores. In this review we discuss the potential relationship between religious delusions and aspects of culture, in particular religious symbols.

Chylous ascites following radical nephrectomy: a case report.

Introduction: Chylous ascites may result from diverse pathologies. Ascites results either due to blockage of the lymphatics or leak secondary to inadvertent trauma during surgery.

Case Presentation: We report the first case of chylous ascites following radical nephrectomy for a renal cell carcinoma involving the right half of a crossed fused renal ectopia.

Robotics in urology: an update.

Urology has been quick to realise the advantages of surgical robots. We describe the main devices currently in use, the advantages and disadvantages of robotic-assisted surgery and the current and potential urological applications focussing on robot-assisted radical prostatectomy.

Laparoscopic nephrectomy in a patient with ankylosing spondylitis: surgical and anesthetic challenges.

A 55-year-old man with ankylosing spondylitis was referred with left sided loin pain, loin mass, and painless macroscopic hematuria. Physical examination revealed a palpable loin mass, fixed flexion deformity of the lumbar and cervical spines, with severely restricted cervical movement and mouth opening. An ultrasound and computed tomography scan confirmed a 7-cm solid mass in the left kidney.

Laparoscopic retroperitoneal nephrectomy for giant hydronephrosis: when simple nephrectomy isn't simple.

Background And Purpose: Retroperitoneoscopic nephrectomy (RN) for giant hydronephrosis (GH) is regarded as a more challenging procedure than RN for small nonfunctioning kidneys (SNFK). We describe specific technical modifications to facilitate surgery in the GH group and compare outcomes in the two groups.

Patients And Methods: Data were collected in a prospective fashion on all patients undergoing upper urinary-tract laparoscopy at a single institution.

Development of simultaneous anastomotic false aneurysms at both ends of an autologous vein graft caused by methicillin-resistent Staphylococcus aureus (MRSA).

Methicillin-resistant Staphylococcus aureus (MRSA) infection is a well recognised problem, especially in vascular surgical patients with synthetic bypass grafts. This is to our knowledge the first report in the literature of the development of anastomotic false aneurysms at both ends of an autologous vein graft, as a result of MRSA infection within the vascular wall.

Exercise training reduces fatty acid availability and improves the insulin sensitivity of glucose metabolism.

Aims/hypothesis: It is not known whether the beneficial effects of exercise training on insulin sensitivity are due to changes in hepatic and peripheral insulin sensitivity or whether the changes in insulin sensitivity can be explained by adaptive changes in fatty acid metabolism, changes in visceral fat or changes in liver and muscle triacylglycerol content. We investigated the effects of 6 weeks of supervised exercise in sedentary men on these variables.

Subjects And Methods: We randomised 17 sedentary overweight male subjects (age 50 +/- 2.

Cystine calculi: challenging group of stones.

Cystinuria is an autosomal recessive disorder in renal tubular and intestinal transport of dibasic amino acids, which results in increased urinary excretion of cystine, ornithine, lysine and arginine. It affects 1 in 20 000 people and is caused by a defect in the rBAT gene on chromosome 2. Development of urinary tract cystine calculi is the only clinical manifestation of this disease.

Psychological intervention in fluid management.

Background: Hemodialysis is a palliative treatment for patients with established renal failure (ERF), and volume overload is a common problem for hemodialysis patients with low urinary output. Volume overload is thought to be mostly attributable to interdialytic fluid intake by the patient and is associated with an increased symptom burden and the development of serious medical complications. Repeated episodes of volume overload may adversely affect staff-patient relationships and the perception of care in this patient population.

Transplantation of kidneys from deceased adult polycystic donors.

Renal transplantation is the best treatment for end-stage renal disease. The discrepancy between donor organ supply and demand continues to widen. Maximum efforts should be made to make use of donor kidneys and we suggest that polycystic kidneys can be suitable marginal donor organs.

Effects of growth hormone and/or testosterone on very low density lipoprotein apolipoprotein B100 kinetics and plasma lipids in healthy elderly men: a randomised controlled trial.

Objective: To assess the effects of low dose recombinant growth hormone (GH), testosterone (T) and combined GH and T, on lipid profiles and very low density lipoprotein apolipoprotein B (VLDL apoB) metabolism.

Design And Patients: Sixty-nine healthy elderly men (65-80 yr) were studied in a six month double-blind, placebo-controlled trial. Participants were randomised to placebo GH and placebo T (P), GH and placebo T (GH), T and placebo GH (T) or GH and T (GHT).

The role of geranylgeranylated proteins in human mesangial cell proliferation.

The Rho family of guanine 5'-triphosphatases (GTPases) play a key role in regulating cell proliferation, tubulointerstitial fibrosis, and glomerular hemodynamics. The post-translational prenylation of RhoGTPases by the addition of a geranylgeranyl moiety is critical for cellular localization and signaling activity. This study investigates the effects of (i) inhibiting geranylgeranylation (GG) in human mesangial cell (HMC) proliferation and apoptosis, using GGTI 298, a specific inhibitor of GG and (ii) lovastatin, an HMG-coacetyl A-reductase inhibitor, which depletes the availability of prenylation substrates.

Histone deacetylase inhibitors (HDI) cause DNA damage in leukemia cells: a mechanism for leukemia-specific HDI-dependent apoptosis?

Histone deacetylase inhibitors (HDI) increase gene expression through induction of histone acetylation. However, it remains unclear whether increases in specific gene expression events determine the apoptotic response following HDI administration. Herein, we show that a variety of HDI trigger in hematopoietic cells not only widespread histone acetylation and DNA damage responses but also actual DNA damage, which is significantly increased in leukemic cells compared with normal cells.

Randomized double-blind trial of the treatment of chronic plaque psoriasis: efficacy of psoralen-UV-A therapy vs narrowband UV-B therapy.

Objective: To compare the efficacy of oral psoralen-UV-A (PUVA) therapy with that of narrowband UV-B (NB-UVB) therapy in patients with chronic plaque psoriasis.

Design: Double-blind randomized study.

Setting: Phototherapy unit in a university hospital.

Neurohormones and heart failure: the importance of aldosterone.

Heart failure is a major cause of cardiovascular morbidity and mortality and its incidence is on the increase. The pathophysiology of heart failure is multi-factorial but recent studies suggest that aldosterone plays an important and independent role in its progression. Emerging evidence now suggests that aldosterone exerts renal-independent effects.

Optimising adjuvant endocrine treatment of breast cancer with aromatase inhibitors.

There is mounting evidence that aromatase inhibitors (AIs) are superior to tamoxifen as adjuvant treatment for postmenopausal women with oestrogen receptor positive breast cancer. Nevertheless, tamoxifen still remains a useful and relatively nontoxic treatment, and further work is necessary to determine which patients need an AI. In terms of cost-effectiveness, letrozole has been estimated to be superior to tamoxifen.