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The Journal of Small Animal Practice Jun 2018Feline ureteral obstructions are an increasingly recognised and challenging diagnostic and management problem. Many cats with ureteral obstructions are critically ill at... (Review)
Review
Feline ureteral obstructions are an increasingly recognised and challenging diagnostic and management problem. Many cats with ureteral obstructions are critically ill at the time of diagnosis, especially if there is dysfunction of the contralateral kidney. They may present with varying severities of acute kidney injury, electrolyte disturbances, and may have comorbidities such as heart disease that complicate perioperative and long-term management. Medical management, which may consist of rehydration and restoration of intravascular volume with intravenous fluid therapy, osmotic diuresis, ureteral muscle relaxation, and antimicrobials for infection, is important in feline ureteral obstruction patients. Despite medical management, many cats with ureteral obstructions will require decompression of the obstructed kidney to relieve pressure-nephropathy and restore urine flow. However, some cats may be too unstable for traditional medical management and require more emergent intervention to relieve the obstruction and address the life-threatening sequelae to acute kidney injury, such as hyperkalaemia and fluid overload. Both surgical and interventional methods to address ureteral obstructions have been described in veterinary medicine, though debate continues as to the ideal approach.
Topics: Acute Kidney Injury; Animals; Cat Diseases; Cats; Fluid Therapy; Ureteral Obstruction; Urinary Calculi
PubMed: 29767451
DOI: 10.1111/jsap.12844 -
International Journal of Chronic... 2018COPD is characterized by chronic bronchitis, chronic airway obstruction, and emphysema, leading to a progressive and irreversible decline in lung function. Inflammation... (Review)
Review
COPD is characterized by chronic bronchitis, chronic airway obstruction, and emphysema, leading to a progressive and irreversible decline in lung function. Inflammation is central for the development of COPD. Chronic inflammation in COPD mainly involves the infiltration of neutrophils, macrophages, lymphocytes, and other inflammatory cells into the small airways. The contribution of resident airway structural cells to the inflammatory process is also important in COPD. Airway remodeling consists of detrimental changes in structural tissues and cells including airway wall thickening, epithelial metaplasia, goblet cell hypertrophy, and smooth muscle hyperplasia. Persistent airway inflammation might contribute to airway remodeling and small airway obstruction. However, the underlying mechanisms remain unclear. In this review, we will provide an overview of recent insights into the role of major immunoinflammatory cells in COPD airway remodeling.
Topics: Airway Obstruction; Airway Remodeling; Humans; Inflammation; Leukocytes; Macrophages, Alveolar; Neutrophil Infiltration; Pulmonary Disease, Chronic Obstructive
PubMed: 30349237
DOI: 10.2147/COPD.S176122 -
The Urologic Clinics of North America Nov 2015Infected kidney stones refer to stones that form because of urinary tract infections with urease-producing bacteria, secondarily infected stones of any composition, or... (Review)
Review
Infected kidney stones refer to stones that form because of urinary tract infections with urease-producing bacteria, secondarily infected stones of any composition, or stones obstructing the urinary tract leading to pyelonephritis. The mainstay of treatment of infection stones is complete stone removal. Kidney stones that obstruct the urinary tract and cause obstructive pyelonephritis are also frequently referred to as infected stones. Obstructive pyelonephritis is a urologic emergency as it can result in sepsis and even death. Infection stones and obstructive stones causing pyelonephritis are different disease processes, and their workup and management are described separately.
Topics: Anti-Bacterial Agents; Calcium Carbonate; Citrates; Diet; Drug Combinations; Enzyme Inhibitors; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Humans; Lithotripsy; Magnesium Oxide; Nephrostomy, Percutaneous; Pyelonephritis; Staphylococcal Infections; Staphylococcus aureus; Urease; Urinary Calculi; Urinary Tract Infections
PubMed: 26475943
DOI: 10.1016/j.ucl.2015.05.009 -
Current Opinion in Anaesthesiology Feb 2022Anesthesia for pulmonological interventions is a demanding challenge. This article discusses recent innovations and the implications for periinterventional anesthetic... (Review)
Review
PURPOSE OF REVIEW
Anesthesia for pulmonological interventions is a demanding challenge. This article discusses recent innovations and the implications for periinterventional anesthetic management.
RECENT FINDINGS
Interventional pulmonology is a rapidly expanding specialty with very complex diagnostic and therapeutic approaches that include oncological staging, treatment of obstructive and restrictive lung diseases, recanalization of endobronchial obstructions, and retrieval of foreign bodies. With the development of advanced diagnostic and therapeutic interventions, the application is extended to critically ill patients. Current evidence focusing on the anesthetic techniques is presented here.
SUMMARY
The development of new pulmonological methods requires a tailored anesthesiological approach. Their specific impact must be taken into account to ensure patient safety, goal-oriented outcome diagnostics and -quality, successful interventions, and patient comfort.
Topics: Airway Obstruction; Anesthesia; Anesthesiology; Bronchoscopy; Humans; Pulmonary Medicine
PubMed: 34845140
DOI: 10.1097/ACO.0000000000001079 -
Clinics in Colon and Rectal Surgery Jul 2021Obstruction from stricturing Crohn's disease remains one of the most common reasons for intervention. Acute inflammation is often responsive to medications, but chronic... (Review)
Review
Obstruction from stricturing Crohn's disease remains one of the most common reasons for intervention. Acute inflammation is often responsive to medications, but chronic fibrosis is unlikely to respond and will generally go on to require additional treatment. Newer methods, such as endoscopic balloon dilation, are gaining grounds in strictures that are amenable, but with high recurrence and strictures that may not be endoscopically accessible, surgery still plays a key role in the treatment of obstructing Crohn's disease.
PubMed: 34305471
DOI: 10.1055/s-0041-1729926