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Biomedical subjects

C Vaessen

Publications and source records attributed to C Vaessen.

7 recordsLinked to original sources

Use of the SCOT solution in kidney transplantation: preliminary report.

SUBJECT: This article reports preliminary findings relating to the use of a new preservation solution, the Solution de Conservation des Organes et des Tissus (SCOT), in renal transplantation. This fourth-generation solution combines an extracellular-like composition with 20 kDa polyethylene-glycol, known for its cell-protection capacity and immunocamouflage properties. METHODS: We have reported preliminary data obtained in 29 transplantations (25 cadaveric donors and 4 living related donors) between December 2004 and November 2005. The SCOT solution was used for both in situ flush and static preservation. We compared primary organ nonfunction and delayed graft function rates as well as blood creatinine levels in recipients of grafts processed with SCOT solution, versus University of Wisconsin solution (paired for age with the previous group) and with EuroCollins solution (historic data). RESULTS: We observed delayed graft-function in 10% of the SCOT-processed group, 14% in the University of Wisconsin solution group, and 23% of the EuroCollins group. No case of primary organ nonfunction was reported. Creatinine levels in both SCOT and University of Wisconsin solution groups were similar. We did not observe any humoral or cellular graft rejection in the first 3 months after transplantation. In light of these preliminary results, the use of SCOT is safe for kidney preservation in the human setting. Further experience is warranted to assess the clinical consequences of its immunocamouflage properties as described in animal models.

Adenosine↗

Complications for radical cystectomy. Impact of the American Society of Anesthesiologists score.

OBJECTIVES: To report the perioperative events after radical cystectomy and urinary diversion in bladder cancer in terms of major and minor complications and to seek statistical relationships with patient's characteristics and surgical procedures. METHODS: One hundred and sixty-one radical cystectomies performed in the modern era in two academic hospitals were reviewed. Preoperative patients characteristics (age, sex, hemoglobin, total protein, weight and height) and perioperative data (operative time, type of urinary diversion, associated procedures, blood transfusion, seniority of the surgeon) were recorded. Perioperative morbidity was defined by any adverse event during hospital stay or within 30 days after surgery, those requesting an additional stay of more that 3 days in the intensive care unit or a reoperation being classified as major complications. Significant relationships were sought for classes by Student's t test for comparison of quantitative variables and Yate's corrected chi(2) test for categorical variables. Spearman's rank correlation test was used for comparison of quantitative variables. RESULTS: Major complications were observed in 41 patients (25.5%) and resulted in 14 reoperations (8.7% reoperation rate). Most of them were diversion-related and were statistically related to the ASA score > or =3 (p<0.01, 5.7 odds ratio). Compared to sophisticated means of diversion, cutaneous diversion resulted in minimal operative time and hospital stay. No relationships between age, body mass index, biological parameters, type of diversion, associated procedure, surgeon's experience and postoperative complications could be evidenced. Uneventful recovery resulted in a 16.6 days mean hospital stay, minor complications induced a significant 3.8 days additional stay and major complications resulted in major lengthening of hospital stay (21.2 days mean additional stay). CONCLUSION: ASA scores equal to or greater than 3 were associated with major complications and most specially those related to the type of urinary diversion. Therefore, we recommend special care in the selection of the type of urinary diversion and further preoperative evaluation inclusive of nutritional assessment.

Aged↗

Evaluation of male sexual function by the International Index of Erectile Function after deep dorsal vein arterialization of the penis.

PURPOSE: The objective of vascular surgery for erectile dysfunction is to provide long-term improvement of erectile function. We evaluated that claim after deep dorsal vein arterialization by a cross-sectional study of multifaceted male sexual function with the validated International Index of Erectile Function (IIEF). MATERIALS AND METHODS: We performed a mail survey of male sexual function after deep dorsal vein arterialization in 68 consecutive literate men who underwent surgery between 1984 and 1998 for severe erectile dysfunction. The IIEF questionnaire and a questionnaire on patient characteristics were answered in a self-administered and nominative manner. Scores of the responders pertaining to the 5 domains of male sexuality were compared with those of the control groups used for the psychometric validation of the IIEF. RESULTS: Of the patients 38 (55.9%) with a mean age plus or minus standard deviation of 46.5 +/- 11.9 years responded. Mean followup was 61.2 +/- 34.7 months. Compared to controls with erectile dysfunction controls men who underwent deep dorsal vein penile arterialization had significantly higher scores for erectile function, sexual desire, orgasmic function, intercourse satisfaction and overall satisfaction. Conversely compared with normal controls these patients reported significantly lower erectile function, orgasmic function, intercourse satisfaction and overall satisfaction scores, whereas sexual desire scores were similar in the 2 groups. No correlations were noted of the 5 IIEF domains with the duration of followup after arterialization. When erectile function scores were graded, 25.0% and 28.1% of patients reported no and or mild dysfunction, respectively, while 15.6% still complained of severe erectile dysfunction. CONCLUSIONS: Long-term improvement in the various aspects of male sexual function was observed after deep dorsal vein penile arterialization in a significant proportion of patients.

Coitus↗

Conservative management of ureteric stones.

The authors review the current conservative management of ureteric stones. The physiopathology of the renal colic is analyzed with its implications in the medical treatment. The role of NSAID is enhanced. Stone size and stone location are to be considered when evaluating the possibility of spontaneous passage of the stone. Stones less than 3 mm in diameter of the lower ureter will pass spontaneously in 90% of the cases while stones more then 6 mm in the upper ureter will not pass in most cases. The role of stone dissolution in uric acid and cystine stones is discussed. SWL is not controversial in the management of upper stones less than 15 mm in size. The authors report their experience with SWL of ureteric stones in upper, middle or lower ureteric stones with a success rate of respectively 87%, 65% and 84%.

Anti-Inflammatory Agents, Non-Steroidal↗

[Medical treatment of ureteral calculi].

Antiinflammatory drugs are the first choice in the treatment of the acute nephretic colic. This is due to their fast and direct action on the ureteral wall. The use of antispasmodics are still controversial and opioïds are not indicated. During the acute crisis, an hydric restriction should be associated to the medical treatment. After the crisis an increase of diuresis could help to "wash out" the stone. A spontaneous elimination can be expected, especially if the stone is small and located in the third part of the ureter. The ureteral rupture is rare but serious and must be treated by antibiotics and some time to be drained. The rapidity of a more aggressive treatment is function of numerous factors.

Acute Disease↗

[Calculi: interventional treatment].

Extracorporeal shock wave lithotripsy is actually the most popular treatment in the urolithiasis. However, different factors influence the choice of the best treatment. Great progresses appeared in the conception of performing endoscopic material which led to minimize morbidity. Percutaneous approach is very popular but require expensive material and trained operator. Indications for open surgery were reduced but didn't completely disappear. We review in the next paragraph the literature of the last five years.

Adolescent↗

[Transrectal prostatic biopsy: the role of preventive measures].

Biopsies are indispensable for the diagnosis of the adenocarcinoma of the prostate. Multiple transrectal ultrasound-guided prostatic biopsies are accurate and sure. However, haemorrhagic and infectious complications are not rare. The anamnesis and the intermission of anticoagulant drugs are the best prophylaxis to prevent haemorrhagic complications. The advantage of prophylactic antibiotic therapy has not been absolutely demonstrated. Nevertheless, before biopsies, bacteriuria must be treated. Indeed, pre-biopsy bacteriuria seems to be correlated to septic complications after the procedure.

Adenocarcinoma↗