Conclusions: This study details that the 2 procedures may be successfully performed in the outpatient setting, and yet even for more advanced vesicoureteral reflux mini-ureteroneocystostomy achieves greater overall success. This procedure has become our standard of care for unilateral vesicoureteral reflux.”
“OBJECTIVE: To compare Surgical management and case-fatality rates of intracerebral hemorrhage (ICH) in 1988 and 2005.
METHODS: We identified
all adult residents (age, >= 18 years) from the 5-county Greater Cincinnati region who were hospitalized with ICH in 1988 and 2005. Demographics, severity of illness, ICH volume, ICH location, rates and timing of surgery, and 30-day case-fatality this website rate were compared between the groups.
RESULTS: In 1988, 171 ICH patients (67 lobar, 80 deep cerebral, 10 brainstem, and 14 cerebellar) met the study criteria; in 2005, 259 ICH patients (91 lobar, 123 deep cerebral, 19 brainstem, and 26 cerebellar) met the study criteria. In 1988, 16% of the patients had Surgical removal of their ICH versus 7% in 2005 (P =
0.003). In both 1988 and 2005, patients treated with Surgery were younger (P < 0.001) and had a higher percentage of cerebellar hemorrhages than nonsurgical patients. The timing of surgery was similar in 1988 and 2005. In 1988, the 30-day case-fatality rate was 32% in surgical patients versus 50% in nonsurgical patients (P = 0.06). In 2005, the 30-day MK-4827 purchase case-fatality rate was 61% (surgical) versus 45% (nonsurgical) (P = 0.02).
CONCLUSION: The frequency of surgery for ICH was lower in 2005 than in 1988, which may reflect the influence of recent clinical trial data showing no benefit for surgery rather than medical management.
The ICH case-fatality rate was essentially the same in 1988 and 2005. Innovative clinical trials to improve ICH outcomes are warranted.”
“Purpose: Since 1989, we have used the complete primary repair of exstrophy surgical technique to reconstruct the genitourinary system of children born with the exstrophy-epispadias complex based on the assumption that this complex represents a malformation. We initially reported using this technique in HSP inhibitor 1999. We now report a longer term followup of this initial group as well as surgical outcomes in a larger group of children who have undergone this repair for classic bladder exstrophy.
Materials and Methods: Since 1989, we have prospectively followed 39 children who underwent the complete primary repair of exstrophy technique to construct classic bladder exstrophy. Median followup in the original group of patients that we reported in 1999 is 106 months. Median followup in the entire series is 58 months.
Results: Of boys and girls 4 years or older 74% have achieved daytime continence with volitional voiding. Of boys and girls 20% and 43%, respectively, have achieved primary urinary continence without the need for bladder neck reconstruction.