International Journal of Urology and Nephrology

International Journal of Urology and Nephrology ISSN 2756-3855 Vol. 11 (1), pp. 001-003, January, 2023. © International Scholars Journals

Short Communication

Current Approach to Bicuspid Aortic Valve: Review

Mehmet Demir

Bursa Yüksek İhtisas Education and Research Hospital Cardiology Department Bursa/Turkey. E-mail: [email protected]; Tel: +90 2242573328

Accepted 04 October, 2022

Abstract

Bicuspid aortic valve (BAV) is the most common congenital cardiac anomaly. The most frequent associated finding is dilation of the proximal ascending aorta secondary to abnormalities of the aortic media. The BAV may function normally throughout life, may develop complications can include aortic valve stenosis or incompetence, endocarditis, aortic aneurysm formation, and aortic dissection. Aortic root dilatation is common in BAV, even when the valve is haemodynamically normal, and consequently aortic dissection usually occurs in previously asymptomatic patients. All patients should therefore be regularly reviewed to identify progressive root dilatation with a view to preempting dissection by prophylactic surgery.

Keyword: bicuspid aortic valve; aortic media abnormality; aortic aneurysm and dissection.

International Journal of Urology and Nephrology ISSN 2756-3855 Vol. 11 (1), pp. 001-004, January, 2023. © International Scholars Journals

Full Length Research Paper

Hypoalbuminaemia associated hypocalcaemia with overt clinical features: A case report

A. A. Amballi¹*, S. A. Ogun² and A. O. Odewabi¹

¹Department of Chemical Pathology and immunology, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria.

²Department of Medicine, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria.

Accepted 22 October, 2022

Abstract

Hypocalcaemia is defined as serum calcium level less than 9.0 mg/100 ml (2.25 Mmol/l). It is often only being considered as a differential diagnosis in the paediatric unit, where it is usually included as part of routine investigations, especially in children with clinical problems such as convulsions, seizure, apathy, muscles weakness, tetany, suspected vitamin D deficiency or maternal hypercalcaemia. In adult patients however, hypocalcaemia is often neglected (especially in private health facilities) except in specialties such as rheumatology, neurology, nephrology and intensive care unit. In this report, neurological manifestations (paraesthesia, delirium, seizure and coma) were presented by the patient. Both anthropometric and biochemical parameters were evaluated in this patient and the results were used to evaluate the patients clinical presentation. The findings revealed that there was malnutrition, which manifested biochemically as hypoalbuminaemia and hypocalcaemia. Calcium replacement therapy satisfactorily returned this patient to stable clinical state, the therapy was done parenterally but gradually. Surprisingly, this patient showed overt clinical features of hypocalcaemia against the popular belief that hypoalbumineamic hypocalcaemia does not have a physiological significance. This report emphasizes the need to include serum calcium estimations in our routine investigations in clinical practice on one hand, and on the other hand, it appears to disagree with the overemphasized rarity of physiologically significant hypocalcaemia due to hypoalbuminaemia.

Key words: Hypocalcaemia, hypoalbuminaemia, overt clinical features.

International Journal of Urology and Nephrology ISSN: 2756-3855 Vol. 10 (9), pp. 001-021, September, 2022. © International Scholars Journals

Review

How and When to Evaluate Testosterone Deficiency: Controversies and Consensus Among Specialties Worldwide

AUTHORS: Sara Q. Perkins¹, David Fumo² MD, Puneet Sindhwani² MD.

ABSTRACT

The worldwide prevalence of testosterone deficiency (TD) is increasing due to an aging population. However there is discrepancy surrounding its diagnosis, both between countries and major specialty societies. The purpose of this review is to compare and contrastcurrent guidelines across the world to assess variability in the diagnosis and evaluation of TD. There were no available guidelines from Asian, African or South American specialty societies in English language literature. Guidelines from Canada, Europe, and the United States, including the American Association of Clinical Endocrinologists (AACE) the American Urologic Association (AUA), and the Endocrine Society are evaluated. A literature search was performed using Pubmed, Uroweb, the AUA and AACE websites to evaluate the most recent guidelines on hypogonadism. Guidelines and the level of evidence supporting these are compiled in Tables. All guidelines concurred that testosterone replacement therapy (TRT) is indicated in patients with symptoms of hypogonadism in combination with biochemically low testosterone but there was no consensus with respect to the cut off -value for low testosterone,diagnostic methodology, preferred assays or screening at risk populations.  This highlights the differences in world health care delivery in the evaluation and treatment of TD and need for further research to build a consensus usingbest available evidence. This article provides the most updated and concise review of the controversies and consensus in the diagnosis and evaluation of TD.

International Journal of Urology and Nephrology ISSN: 2756-3855 Vol. 10 (9), pp. 001-038, September, 2022. © International Scholars Journals

Review Article

Risks, Contraindications and Follow up After Testosterone Replacement Therapy: Lack of Consensus among Specialties and Countries

AUTHORS: Sara Q. Perkins¹, David Fumo² MD, Puneet Sindhwani² MD.

ABSTRACT

The direct to consumer marketing of the “Is it Low T” movement has resulted in an increase of men >40 years old seeking testing for testosterone deficiency (TD) and treatment with testosterone replacement therapy (TRT). The FDA has mandated that TRT inserts should include warnings about a variety of possible risks such as venous thrombosis,prostate cancer, diabetes, and cardiovascular health risks. In response several societies have issued guidelines to address the use of TRT. The purpose of this review is to evaluate the variability in treatment and monitoring of TD and TRT. A literature search was performed to evaluate the most recent guidelines on TD. There were no available guidelines from Asian, African or South American specialty societies published English language literature. Guidelines from Canada, Europe, and the United States including the American Association of Clinical Endocrinologist (AACE) the American Urologic Association(AUA), and the Endocrine Society are evaluated. Comparisons between guidelines are compiled in Tables and their level of evidence evaluated. All guidelines were in concurrence that a desire to maintain male fertility should be universally considered a contraindication to TRT. While other contraindications and risks associated with TRT such as cardiovascular disease or prostate cancer varied widely. Follow up assessment recommendations such as cardiac, bone density, and digital rectal exam also are non-congruent. The guidelines on TD reflect the lack of consensus between specialty societies, paucity of data, and need for further research on testosterone replacement treatment of TD.

International Journal of Urology and Nephrology ISSN 2756-3855 Vol. 10 (4), pp. 001-012, April, 2022. © International Scholars Journals

Full Length Research Paper 

Eculizumab as a therapeutic option for refractory lupus nephritis and lupus associated thrombotic microangiopathy: A review of current evidence

Patrick Goorkiz (MD)¹, John Wing Li (MMed (clin epi), FRACP) ², Bhadran Bose MBBS, FRACP^1,2

¹University of Sydney, Royal Prince Alfred Hospital, Camperdown, NSW Australia.

²Department of Renal Medicine, Nepean Hospital, Kingswood, NSW, Australia.

Accepted 02 September, 2021

Abstract

Lupus nephritis is a severe complication of systemic lupus erythematosus, leading to significant morbidity and mortality. The optimal choice and duration of therapy for lupus nephritis, especially in refractory disease and those associated with thrombotic microangiopathy, remains elucidated. The importance of complement activation in the disease process is gaining recognition; thus, complement blockade by eculizumab (terminal complement inhibitor) is advocated as a possible treatment option. This review summarises the latest evidence of eculizumabin treating refractorylupus nephritis with or without associated thrombotic microangiopathy. Eculizumab was successful in 19/22 cases of lupus nephritis, regarding dialysis cessation and improvement in clinical and biochemical parameters. However, there were significant complications such as nausea, vomiting, fungaemia and Streptococcus pneumonia infection. In conclusion, eculizumab might be an effective treatment for refractory lupus nephritis with or without thrombotic microangiopathy, but further clinical trials are warranted.

Key words: Eculizumab, complement, lupus nephritis, refractory, thrombotic microangiopathy. 

International Journal of Urology and Nephrology ISSN 2756-3855 Vol. 10 (4), pp. 001-007, April, 2022. © International Scholars Journals

Full Length Research Paper

The consequences of the effects of the chemotherapeutic drug (vincristine) in organs and the influence on the bioavailability of two radio-biocomplexes used for bone evaluations in balb/c female mice 

Deise Mara Machado de Mattos^1,2,7*, Diré, G. F.^1,2,4,5, Lima, R. C.¹, Almeida, A. C. C.¹, Bellucio D.⁴, Azevedo, C. S. S.¹, Azevedo, S. S. S.¹, Nascimento, S. F.¹, Borba, H. R.⁴, Carvalho, J.J.⁵ and Bernardo Filho, M^2,6

¹Universidade Estácio de Sá. Centro de Ciências da Saúde. Rio de Janeiro, RJ, Brazil.

²Universidade do Estado do Rio de Janeiro, Instituto de Biologia Roberto Alcantara Gomes, Departamento de Biofísica e Biometria, Rio de Janeiro, RJ, Brazil.

³Universidade do Estado do Rio de Janeiro, Instituto de Biologia Roberto Alcantara Gomes, Departamento de Histologia, Rio de Janeiro, RJ, Brazil.

⁴Universidade Federal Rural do Rio de Janeiro, Instituto de Biologia, Departamento de Biologia Animal, Laboratório de Atividade Anti-helmíntica de Plantas. Seropédica, Rio de Janeiro, RJ, Brazil.

⁵Centro Universitário da Zona Oeste- UEZO, Avenida Manuel Caldeira de Alvarenga, 1203. Campo Grande, RJ 23070- 200, Brazil.

⁶Instituto Nacional do Câncer, Coordenadoria de Pesquisa, Praça Cruz Vermelha, Rio de Janeiro, RJ, Brazil.

⁷Universidade Estácio de Sá, Instituto das Ciências da Saúde, Centro de Pesquisas da Saúde - Campus R9, Rua André Rocha, 838, Taquara - Jacarepaguá, Rio de Janeiro, RJ, Brasil, 22740-361.

Accepted 16 October, 2021

Abstract

The development of animal model to evaluate the toxicological action of compounds used as pharmaceutical drugs is desired. The model described in this work is based on the capability of drugs to alter the bioavailability of radiopharmaceuticals (radiobiocomplexes) labeled with technetium-99 m (^99mTc). There are evidences that the bioavailability or the pharmacokinetic of radiobiocomplexes can be modified by some factors, as drugs, due to their toxicological action in specific organs. Vincristine is a natural product that has been utilized in oncology. The vincristine effect on the bioavailability of the radiobiocomplexes ^99mTc-methylenediphosphonic acid ( ^99mTc-MDP) and ^99mTc-pyrophosphate (^99mTc-PYP) in Balb/c female mice was evaluated. The fragments of kidney were processed to light microscopy and transmission electron microscopy. The aim of this work was to study at structural and ultrastructural levels the alterations caused by vincristine in organs. One hour after the last dose of vincristine, ^99mTc-PYP or ^99mTc-MDP was injected, the animals were sacrificed and the percentage of radioactivity (%ATI) was determined in the isolated organs. Concerning ^99mTc-PYP, the %ATI (i) decreased in spleen, thymus, lymph nodes (inguinal and mesentheric), kidney, lung, liver, pancreas, stomach, heart and brain and (ii) increased in bone and thyroid. Concerning ^99mTc-MDP, the %ATI (iii) decreased in spleen, thymus, lymph nodes (inguinal and mesentheric), kidney, liver, pancreas, stomach, heart, brain, bone, ovary and uterus. In conclusion, the toxic effect of vincristine in determined organs could be responsible for the alteration of the uptake of the studied radiobiocomplexes.

Key words: Radiobiocomplexes, vincristine, drug interaction, nuclear medicine, oncology.