673 research outputs found
Calyceal rupture and perirenal urinoma as a presenting sign of recurrent ovarian cancer
No full textBackground. Rupture of the urinary collecting system with peripelvic extravasation of urine is an uncommon pathologic condition usually associated with ureteral obstruction from calculi. Case. We report a patient with calyceal rupture and peripelvic extravasation of urine secondary to distal ureteral obstruction by recurrent ovarian carcinoma. Diagnosis was established with computed tomography and renal scans. Placement of an indwelling ureteral stent via a nephrostomy resolved the urinoma. Conclusion. Gynecologic oncologists should be aware that calyceal rupture is a potential complication of gynecologic malignancy. Causes of perirenal urinary extravasation and approaches to diagnosis and management are reviewed. (C) 2001 Academic Press
Citrate anticoagulation during CVVH in high risk bleeding patients
No full textBackground: Regional citrate anticoagulation (RCA) is an effective form of anticoagulation for continuous renal replacement therapy (CRRT) in patients with contraindications to heparin. Its use has been very limited, possibly because of the need for special infusion solutions and difficult monitoring of the metabolic effects.
Objective: To investigate the safety and the feasibility of an RCA method for continuous veno-venous hemofiltration (CVVH) using commercially available replacement fluid.
Methods: We evaluated 11 patients at high risk of bleeding, requiring CVVH. RCA was performed using commercially available replacement fluid solutions to maintain adequate acid-base balance. We adjusted the rate of citrate infusion to achieve a post-filter ionized calcium concentration [iCa] 250 ml/min. When needed, we infused calcium gluconate to maintain systemic plasma [iCa] within the normal range.
Results: Twenty-nine filters ran for a total of 965.5 h. Average filter life was 33.6 +/- 20.5 h. Asymptomatic hypocalcemia was detected in 6.9% of all samples. No [iCa] values < 0.9 mmol/L were observed. Hypercalcemia (1.39 +/- 0.05 mmol/L) occurred in 2.5% of all samples. We observed hypematremia (threshold 153 mmol/L) and alkalosis (threshold 7.51) in only 9.3% and 9.4% respectively of all samples, mostly concomitantly. No patient showed any signs of citrate toxicity.
Conclusions: We developed a protocol for RCA during CVVH using commercially available replacement fluid that proved safe, flexible and applicable in an Intensive Care Unit (ICU) setting
Integrating the PD-L1 Prognostic Biomarker in Non-Muscle Invasive Bladder Cancer in Clinical Practice-A Comprehensive Review on State-of-the-Art Advances and Critical Issues
No full textBladder cancer (BC) is one of the most prevalent cancers worldwide. Non-muscle invasive bladder cancer (NMIBC), comprising the majority of initial BC presentations, requires accurate risk stratification for optimal management. This review explores the evolving role of programmed cell death ligand 1 (PD-L1) as a prognostic biomarker in NMIBC, with a particular focus on its implications in the context of Bacillus Calmette-Guérin (BCG) immunotherapy. The literature suggests a potential association between elevated PD-L1 status and adverse outcomes, resistance to BCG treatment, and disease progression. However, conflicting findings and methodological issues highlight the heterogeneity of PD-L1 assessment in NMIBC, probably due to the complex biological mechanisms that regulate the interaction between PD-L1 and the tumor microenvironment. The identification of PD-L1 as a prognostic biomarker provides ground for tailored therapeutic interventions, including immune checkpoint inhibitors (ICIs). Nevertheless, challenges such as intratumoral heterogeneity and technical issues underscore the need for standardized protocols and larger, homogeneous trials. This review contributes to the ongoing debate on the personalized management of NMIBC patients, focusing on the advances and perspectives of incorporating PD-L1 as a biomarker in this setting
External validation of Cormio nomogram for predicting all prostate cancers and clinically significant prostate cancers
No full textRecently, the Cormio et al. nomogram has been developed to predict prostate cancer (PCa) and clinically significant PCa using benign prostatic obstruction parameters. The aim of the present study was to externally validate the nomogram in a multicentric cohort
Unsuspected diagnosis of uterine leiomyosarcoma after laparoscopic myomectomy.
No full textNo abstract availabl
A unified framework to catalogue and classify digital games based on interaction design and validation through clustering techniques
No full textThe digital games industry has grown exponentially due to the diversification of games and the increasing multiplicity of the user target base. The market explosion and the great variety make digital game cataloguing and classification challenging issues whose effectiveness can advance scientific research and address design, development and distribution. Firstly, the present study reviews previous cataloguing for video and serious games through systematic literature review and, joining together the findings from the literature review, develops a unified cataloguing model based on five definitions. This model can aid designers in tailoring their applications and contribute to disseminating game design knowledge in academic research. Then, a matrix that correlates design principles and the cataloguing model’s metadata is applied to the cataloguing model, obtaining a unified classification system. Together, they offer a comprehensive framework for understanding the multifaceted landscape of digital games, addressing the limitations of existing domain-specific approaches and providing a versatile tool for game designers. Research validation exploits a two-stage cluster analysis using agglomerative hierarchical and k-means clustering on the data extracted from a sample of digital games. The results show the framework's effectiveness in categorizing digital games without a clear-cut distinction between video and serious games. The system's application in real-world scenarios suggests its potential to guide game development. Future work will refine the proposal based on feedback from digital game designers, expanding the research scope to include a broader range of games
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