News
July 18, 2008
Computerized Tomography Findings In Pediatric Renal Trauma - Indications For Early Intervention?
UroToday.com - The study out of Children's Hospital of Pittsburgh evaluated CT scans for blunt renal
trauma to see if they correlated with the need for operative intervention when urinary extravasation was present.
A total of 17 patients with grade IV blunt renal trauma and urinary extravasation were identified between 2000
and 2007. Each CT scan was reviewed to determine location, size and number of sites of extravasation, as well
as the presence of contrast material in the ipsilateral ureter. These were then compared to the findings at
the time of surgery - whether surgey included stent placement, percutaneous urinoma drainage, angiographic
embolization and nephrectomy.
Read entire article here.
July 15, 2008
Increased Risk Of Kidney Stone Disease Due To Global Warming, Predicts UT Southwestern Researchers
Global warming is likely to increase the proportion of the population affected by kidney stones by expanding the higher-risk
region known as the "kidney-stone belt" into neighboring states, researchers at UT Southwestern Medical Center and UT Dallas have found.
Dehydration is one of the risk factors linked to kidney-stone disease, and the paper suggests global warming will exacerbate this
effect. The researchers predict that by 2050, higher temperatures will cause an additional 1.6 million to 2.2 million kidney-stone
cases, representing up to a 30 percent growth in some areas.
Read entire article here.
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Information
Prostate cancer is the second leading cause of death
among men. In 2002 it is estimated that 30,200 men will die from prostate
cancer and 189,000 men will be diagnosed (American Cancer Society Facts
& Figures 2002). The incidence of prostate cancer increases with age with
75% of all prostate cancers being diagnosed in men over the age of 65.
Prostate Cancer Management
The critical focus for the treatment of prostate cancer is to treat those cancers
where it is necessary, and not to treat those that do not need it.
Decisions
about the best management of prostate cancer can be complex and depend upon the:
- Pathology of the cancer (unlike other cancers, prostate cancer often progresses very slowly)
- Stage of the disease (non-metastatic (localized or locally advanced), metastatic or hormone refractory)
- Age and general health of the patients at diagnosis
- The impact that treatment can have on quality of life, including sexual activity.
- Patient's preference for treatment
- PSA at diagnosis
Please visit the National Prostate Cancer Coalition for more information.
August is National Immunization Awareness Month
Vaccine-preventable disease levels are at or near record lows. However, we cannot take high immunization coverage
levels for granted. To continue to protect America's children and adults, we must obtain maximum immunization coverage
in all populations, establish effective partnerships, conduct reliable scientific research, implement immunization
systems, and ensure vaccine safety.
Read more ....
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KIDNEY STONE
GENERAL INFORMATION
What is a kidney stone?
A kidney stone is a rock or particle crystal in the urinary tract formed by
substances in urine.
- Kidney stones affect 10% of men and 5% of women aged 30-50. Children and
teenagers also get kidney stones.
- They vary in size from a grain of sand to the size of a tennis ball.
Regardless of the size, they are one of the most painful medical problems
known.
- Kidney stones can cause permanent damage to the kidneys if not treated
appropriately.
- Recurrence is common. Men have a 67% recurrence rate.
What causes a kidney stone?
No one really knows. The most common theory is called supersaturation
crystallization. In this theory, dehydration causes calcium phosphates,
oxalates, urea, uric acids, citrates, complex mucoproteins or other trace
elements in urine to combine and crystallize.
- Some studies show that dehydration increases the chances of having stones.
Drinking plenty of water may prevent kidney stones. People living in the
southeastern U.S. have more kidney stones than people living elsewhere, and it
is thought that the cause may be related to temperature and dehydration.
- Studies have been conflicting on the relationship of minerals in water to
kidney stones. Some studies show hard water (water with excessive calcium
sulfate) contributes to kidney stone formation, while other studies show soft
water (with excessive sodium carbonate) contributes to a greater incidence of
stone disease. Yet other studies demonstrate that trace elements in water may
be the culprit.
- A high fat diet seems to be related to kidney stones. Eating a high
protein diet, dark green leafy vegetables, tea, and chocolate may increase the
chance of forming kidney stones.
- Kidney stones tend to run in families.
Symptoms of a kidney stone
Kidney stones are very common and dangerous. If kidney stones are not treated
properly, permanent kidney damage can result.
- A typical stone attack is a sudden pain occurring at night or in the early
morning. The pain starts in the loin and radiates around the abdomen down into
the groin.
- Nausea and vomiting are common. Often you cannot sit or lie still.
- Kidney stones are often confused with other diseases such as acute
appendicitis, gastroenteritis, colitis and other bowel disorders. Occasionally
those complaining of back pain for months, or even years, are found to have
large kidney stones.
What to expect if a stone is suspected
- Because most kidney stones cause blood in the urine, the first test
usually performed is a urinalysis and then a simple x-ray of the abdomen is
taken to find the stone.
- An intravenous pyelogram (IVP)is often needed. In this procedure, a small
amount of dye is injected through a vein, and x-rays are taken to find out
exactly where the stone is and how big it is.
- Sometimes an ultrasound is used instead of an IVP, especially to avoid
allergic dye reactions.
- In rare cases, a computed tomography (CAT) scan is necessary.
- If kidney stones begin to recur, a metabolic stone evaluation of urine and
blood samples should be done to see if an underlying cause can be found.
Six different treatment options
1. Extracorporeal shock wave lithotripsy
Shock wave lithotripsy is often used to treat kidney stones. It is one of the
most important technological advances in kidney stone treatment. It has a
success rate of 98%.
All lithotripters are not alike. There is a
new lithotripter that is dramatically better than others. Older machines use
technology that's about 20 years old. They require a substantial amount of
anesthesia, more x-rays, and a water bath. Not only does the new lithotripter
allow you to skip the water bath, and probably the anesthesia, it treats more
types of kidney stones (including those especially painful ones in the ureter)
and can cut treatment time in half!
- In shock wave lithotripsy, a machine called a lithotripter is used to
generate a shock wave outside of the body. The shock wave is focused on the
kidney stone, which breaks into tiny pieces and passes painlessly. This is an
outpatient procedure.
- The more advanced lithotripters do not require general anesthesia or water
baths. In addition, they can treat stones in the ureter, avoiding
ureteroscopy.
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The Kidney Stone Center in Bloomington, Indiana, is one of the few
places in the country that offers the new, advanced lithotripter, the Doli50
manufactured by the Dornier Corporation. Treatment by these new lithotripters
is dramatically different than by the old types of machines. Be sure to find
a new Doli50 lithotripter for your next kidney stone treatment. |
2. Ureteroscopy
Used for stones in the lower ureter, this treatment has a 95% success rate.
- Ureteroscopy can be done as an outpatient procedure under anesthesia.
- A small telescope is passed through the bladder to the stone. The stone is
removed using a small basket or is broken up using a very small shock wave
probe.
- Following the procedure, a small silicone tube is left inside the ureter
for 5-7 days to help relieve swelling.
3. Percutaneous nephrostolithotomy
If a kidney stone is larger than 3 centimeters (over 1 inch), a percutaneous
nephrostolithotomy is often used for treatment.
- Instruments are passed through a small tract passing through the side of a
patient into the kidney to break up the kidney stone.
- This procedure requires general anesthesia and hospitalization.
4. Electrohydraulic lithotriptor
This procedure uses shockwaves produced by a small internal probe to break up
kidney stones.
- Commonly used for small kidney stones.
- Requires general anesthesia.
5. Open stone surgery
Rarely used anymore, this procedure requires a large incision and prolonged
hospitalization.
6. Observation
Some kidney stones do not cause any pain. If small, they will pass on their
own. Larger stones get stuck in narrow parts of the kidney and ureter, causing
intense pain.
The best treatment for small, non-painful kidney stones usually is to allow
them to pass on their own. An x-ray 1-2 weeks after discovery helps track how
the stone is progressing.
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