8 research outputs found
Lesión vesical iatrogénica: experiencia de diez años, tratamiento y resultados entre 1999-2009, Kuala Lumpur, Malasia
Introduction: This case series is a retrospective review of iatrogenic bladder injuries treated at our institution Universiti
Kebangsaan Malaysia, Medical Centre, over a ten-year period, from 1999 to 2009.
Materials and methods: A retrospective review of the operating theater database yielded the names and registration
numbers of patients who underwent operative repair of bladder injuries. Patients who sustained bladder injuries due to nonsurgical
reasons (such as traumatic bladder injuries due to pelvic fractures, blunt trauma or penetrating injuries to the pelvis)
were excluded.
Results: There were 12 cases of iatrogenic bladder injury treated during this time. A total of eight injuries occurred during
gynaecological surgery. Five injuries occurred during lower segment caesarean section, two injuries during total abdominal
hysterectomy and bilateral salpingo-oopherectomy, and a single injury during Burch colposuspension. Four out of the five
injuries during caesarian section had a history of previous caesarian section. Of the four remaining non-gynaecological
related injuries, two injuries occurred during hernioplasty, one during exploration of an enterocutaneous fistula and the other
was during laparoscopic appendicectomy.
Conclusion: Iatrogenic bladder injury should be anticipated in patients undergoing caesarean section who have had
multiple previous caesarean sections. Iatrogenic injuries should be identified intra-operatively to enable early repair and the
best outcome. These injuries were adequately assessed by ascending cystography. Continuous repair with absorbable sutures
together with perivesicle drainage and bladder catheterization produces good outcome. Introducción: Esta serie del casos es una revisión retrospectiva de heridas iatrogénicas de vejiga tratadas en la
Universidad Nacional de Malasia entre 1999 y 2009.
Métodos: Se hizo una revisión retrospectiva de la base de datos de la sala de cirugía del Centro Médico de la Universidad
Nacional de Malasia, en individuos a quienes se les realizó cirugía de heridas de vejiga. Se excluyeron los pacientes que
presentaron heridas de vejiga sin cirugía como heridas traumáticas debido a fracturas pélvicas, trauma cerrado o heridas
penetrantes en la pelvis. Resultados: Se encontraron 12 casos de herida de vejiga
iatrogénica tratados entre 1999 y 2009. Ocho heridas ocurrieron
durante cirugía ginecológica, 5 durante cesárea
segmentaria baja, 2 durante histerectomía abdominal total y
salpingo-ooforectomía bilateral y 1 herida durante
colposuspensión de Burch. Las 4 heridas restantes no
ginecológicas fueron: 2 heridas por iatrogenia ocurrida durante
una hernioplastia, una durante exploración de una
fístula entero-cutánea y la otra se presentó durante una
apendectomía laparoscópica.
Conclusión: La herida iatrogénica de la vejiga debe ser
anticipada en pacientes que experimentan cesárea que han
tenido múltiples cesáreas previas. Las heridas iatrogénicas
deben ser identificadas intra-operatoriamente para permitir
reparación temprana y obtener el mejor resultado. Obtuvo
mejores resultados la reparación continua con suturas
absorbibles junto con drenaje vesical mediante catéter. La
cistografía ascendente con 300 ml de contraste es la mejor
opción para el diagnóstico de herida iatrogénica de vejiga y
también para la evaluación de la reparación total
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Targeting codon 158 p53-mutant cancers via the induction of p53 acetylation
Abstract: Gain of function (GOF) DNA binding domain (DBD) mutations of TP53 upregulate chromatin regulatory genes that promote genome-wide histone methylation and acetylation. Here, we therapeutically exploit the oncogenic GOF mechanisms of p53 codon 158 (Arg158) mutation, a DBD mutant found to be prevalent in lung carcinomas. Using high throughput compound screening and combination analyses, we uncover that acetylating mutp53R158G could render cancers susceptible to cisplatin-induced DNA stress. Acetylation of mutp53R158G alters DNA binding motifs and upregulates TRAIP, a RING domain-containing E3 ubiquitin ligase which dephosphorylates IĸB and impedes nuclear translocation of RelA (p65), thus repressing oncogenic nuclear factor kappa-B (NF-ĸB) signaling and inducing apoptosis. Given that this mechanism of cytotoxic vulnerability appears inapt in p53 wild-type (WT) or other hotspot GOF mutp53 cells, our work provides a therapeutic opportunity specific to Arg158-mutp53 tumors utilizing a regimen consisting of DNA-damaging agents and mutp53 acetylators, which is currently being pursued clinically
Low, rather than High, Body Mass Index Is a Risk Factor for Acute Kidney Injury in Multiethnic Asian Patients: A Retrospective Observational Study
Background. Acute kidney injury (AKI) is common in hospitalised patients. The relationship between body mass index (BMI) and the risk of having AKI for patients in the acute hospital setting is not known, particularly in the Asian population. Methods. This was a retrospective, single-centre, observational study conducted in Singapore, a multiethnic population. All patients aged ≥21 years and hospitalised from January to December 2013 were recruited. Results. A total of 12,555 patients were eligible for the analysis. A BMI of <18.5 kg/m2 was independently associated with the development of AKI in hospitalised patients (odds ratio (OR): 1.23 [95% confidence interval [CI]: 1.04–1.44, P=0.01]) but not for overweight and obesity. Subgroup analysis further revealed that underweight patients aged ≥75 and repeated hospitalisation posed a higher risk of AKI (OR: 1.25 [CI: 1.01–1.56], P=0.04; OR: 1.23 [CI: 1.04–1.44], P=0.01, resp.). Analyses by interactions between different age groups and BMI using continuous or categorised variables did not affect the overall probability of developing AKI. Conclusions. Underweight Asian patients are susceptible to AKI in acute hospital settings. Identification of this novel risk factor for AKI allows us to optimise patient care by prevention, early detection, and timely intervention
Ketamine-Associated Ulcerative Cystitis: A Case Report and Literature Review
Ketamine can be abused as a recreational drug, and there has been a recent surge in its usage. The effects of ketamine on the urinary system were unknown until the recent publication of a few case reports. Many doctors are still unaware of this new clinical entity, termed ketamine-associated ulcerative cystitis. We report a case that we encountered and discuss the diagnosis and disease management in addition to a review of the literature
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