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RISS 인기검색어
- 검색키워드
- 저자 : Joel M. Vetter (검색결과 3 건)
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Aaron M. Potretzke,Alyssa M. Park,Tyler M. Bauman,Jeffrey A. Larson,Joel M. Vetter,Brian M. Benway,Alana C. Desai 대한비뇨의학회 2016 Investigative and Clinical Urology Vol.57 No.6
Purpose: The goal of this study was to compare the rate of systemic inflammatory response syndrome (SIRS) in high-risk patients undergoing percutaneous nephrolithotomy (PCNL) between patients who received 7, 2, or 0 days of preoperative antibiotics. Materials and Methods: We retrospectively reviewed a series of consecutive PCNLs performed at our institution. Patients with infected preoperative urine cultures were excluded. High-risk patients were defined as those with a history of previous urinary tract infection (UTI), hydronephrosis, or stone size ≥2 cm. Patients were treated with 7, 2, or 0 days of preoperative antibiotic prophylaxis prior to PCNL. All patients received a single preoperative dose of antibiotics within 60 minutes of the start of surgery. Fisher exact test was used to compare the rate of SIRS by preoperative antibiotic length. Results: Of the 292 patients identified, 138 (47.3%) had sterile urine and met high-risk criteria, of which 27 (19.6%), 39 (28.3%), and 72 (52.2%) received 7, 2, and 0 days of preoperative antibiotics, respectively. The 3 groups were similar in age, sex, and duration of surgery (p>0.05). There was no difference in the rate of SIRS between the groups, with 1 of 27 (3.7%), 2 of 39 (5.1%) and 3 of 72 patients (4.2%) meeting criteria in the 7, 2, and 0 days antibiotic groups (p=~1). Conclusions: Extended preoperative antibiotic prophylaxis was not found to reduce the risk of SIRS after PCNL in our institutional experience of high-risk patients. For these patients, a single preoperative dose of antibiotics is sufficient.
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Electronic nutritional intake assessment in patients with urolithiasis: A decision impact analysis
Avory M. Heningburg,Anand Mohapatra,Aaron M. Potretzke,Alyssa Park,Alethea G. Paradis,Joel Vetter,Adrienne N. Kuxhausen,Leslie D. McIntosh,Anthony Juehne,Alana C. Desai,Gerald L. Andriole,Brian M. Ben 대한비뇨의학회 2016 Investigative and Clinical Urology Vol.57 No.3
Purpose: To evaluate a physician's impression of a urinary stone patient's dietary intake and whether it was dependent on the medium through which the nutritional data were obtained. Furthermore, we sought to determine if using an electronic food frequency questionnaire (FFQ) impacted dietary recommendations for these patients. Materials and Methods: Seventy-six patients attended the Stone Clinic over a period of 6 weeks. Seventy-five gave consent for enrollment in our study. Patients completed an office-based interview with a fellowship-trained endourologist, and a FFQ administered on an iPad. The FFQ assessed intake of various dietary components related to stone development, such as oxalate and calcium. The urologists were blinded to the identity of patients' FFQ results. Based on the office-based interview and the FFQ results, the urologists provided separate assessments of the impact of nutrition and hydration on the patient's stone disease (nutrition impact score and hydration impact score, respectively) and treatment recommendations. Multivariate logistic regressions were used to compare pre-FFQ data to post-FFQ data. Results: Higher FFQ scores for sodium (odds ratio [OR], 1.02; p=0.02) and fluids (OR, 1.03, p=0.04) were associated with a higher nutritional impact score. None of the FFQ parameters impacted hydration impact score. A higher FFQ score for oxalate (OR, 1.07; p=0.02) was associated with the addition of at least one treatment recommendation. Conclusions: Information derived from a FFQ can yield a significant impact on a physician's assessment of stone risks and decision for management of stone disease.
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Tyler M. Bauman,Aaron M. Potretzke,Alec J. Wright,Joel M. Vetter,Theodora A. Potretzke,R. Sherburne Figenshau 대한비뇨의학회 2017 Investigative and Clinical Urology Vol.58 No.4
Purpose: To create a simple model using clinical variables for predicting lipid-poor angiomyolipoma (AML) in patients with small renal masses presumed to be renal cell carcinoma (RCC) from preoperative imaging. Materials and Methods: A series of patients undergoing partial nephrectomy (PN) for renal masses ≤4 cm was identified using a prospectively maintained database. Patients were excluded if standard preoperative imaging was not consistent with RCC. Chi square and Mann-Whitney U analyses were used to evaluate differences in characteristics between patients with AML and other types of pathology. A logistic regression model was constructed for multivariable analysis of predictors of lipid-poor AML. Results: A total of 730 patients were identified that underwent PN for renal masses ≤4 cm between 2007–2015, including 35 with lipid-poor AML and 620 with RCC. In multivariable analysis, the following features predicted AML: female sex (odds ratio, 6.89; 95% confidence interval, 2.35–20.92; p<0.001), age <56 years (2.84; 1.21–6.66; p=0.02), and tumor size <2 cm (5.87; 2.70–12.77; p<0.001). Sex, age, and tumor size were used to construct the BEnign Angiomyolipoma Renal Susceptibility (BEARS) index with the following point values for each particular risk factor: female sex (2 points), age <56 years (1 point), and tumor size <2 cm (2 points). Within the study population, the BEARS index distinguished AML from malignant lesions with an area under the curve of 0.84. Conclusions: Young female patients with small tumors are at risk for having lipid-poor AML despite preoperative imaging consistent with RCC. Identification of these patients may reduce the incidence of unnecessary PN for benign renal lesions.
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