Objective： To analyze the CT findings of renal masses and to investigate the value of CT imaging in qualitative diagnosis of these diseases. Methods： Twenty-eight cases of renal masses, proven surgically and patholo...Objective： To analyze the CT findings of renal masses and to investigate the value of CT imaging in qualitative diagnosis of these diseases. Methods： Twenty-eight cases of renal masses, proven surgically and pathologically, were retrospectively analyzed. Pre- and post-contrast CT scans were performed in all cases. Results： Twenty-one of 28 cases （75%） were diagnosed as having malignant tumors with 16 cases of renal cell carcinoma （RCC） showing as irregular-shaped low density soft tissue mass with no or slight enhancement. Ten of 21 cases were diagnosed as having carcinoma of the renal pelvis showing as soft tissue mass in renal pelvis with no or slight enhancement. Three of 21 cases were diagnosed as having nephroblastoma （Wilms＇ tumor） showing as larger irregular lobucated mass with no enhancement. Three of 28 cases （11%） of benign tumors were diagnosed as having angiomyolipoma （AML）. Two cases showed a mixed density mass while another case showed iso-density mass. The soft tissue part of the tumor showed enhancement while the area of fat didn＇t show any enhancement of the contrast medium. Four of 28 （14%） included 3 cases of renal cysts showing as classic cystic lesions with clear-margin. No enhancement was found. In the remaining one case of renal abscess, CT showed a mixed density mass of soft tissue and cyst with slight enhancement of soft tissue part while no enhancement of cystic part. Conclusion： Pre-contrast and post-contrast CT scans in combination with history play an important role in the diagnosis of renal展开更多
AIM： To understand factors associated with quality of life （QOL）, examine types of QOL instruments, and determine need for further improvements in QOL assessment.METHODS： The method used databases （Pubmed, Google...AIM： To understand factors associated with quality of life （QOL）, examine types of QOL instruments, and determine need for further improvements in QOL assessment.METHODS： The method used databases （Pubmed, Google scholar） and a bibliographic search using key words QOL, end stage renal disease, Hemodialysis, Peritoneal dialysis, instruments to measure QOL, patients and qualitative/quantitative analysis published during 1990 to June 2014. Each article was assessed for sample size, demographics of participants, study design and type of QOL instruments used. We used WHO defnition of QOL. RESULTS： For this review, 109 articles were screened, out of which 65 articles were selected. Out of 65 articles, there were 19 reports/reviews and 12 question-naire manuals. Of the 34 studies, 82% were quantita-tive while only 18% were qualitative. QOL instruments measured several phenomenon such as physical/psychological health, effects and burdens of kidney dis-ease, social support etc. those are associated with QOL. Few studies looked at spiritual beliefs, cultural beliefs, personal concerns, as per the WHO defnition. Telemedicine and Palliative care have now been successfully used however QOL instruments seldom addressed those in the articles reviewed. Also noticed was that longitudinal studies were rarely conducted. Existing QOL instruments only partially measure QOL. This may limit validity of predictive power of QOL. CONCLUSION： Culture and disease specific QOL in-struments that assess patients’ objective and subjective experiences covering most aspects of QOL are urgently needed.展开更多
Objective:This study aimed to examine the effects of mindfulness meditation on trait mindfulness,perceived stress,emotion regulation,and quality of life in end-stage renal disease patients undergoing hemodialysis.Meth...Objective:This study aimed to examine the effects of mindfulness meditation on trait mindfulness,perceived stress,emotion regulation,and quality of life in end-stage renal disease patients undergoing hemodialysis.Methods:An experimental study with repeated measures design was conducted among a sample of 74 end-stage renal disease patients undergoing hemodialysis between January and May 2021 in the dialysis center at Jahra hospital,Kuwait.The patients were randomly assigned to the experimental(n?37)and control groups(n?37).The experimental group participated in 30-min mindfulness meditation sessions(three sessions a week for five weeks)held during their hemodialysis sessions;the participants in the control group were instructed to sit with their eyes closed and relaxed for 30 min three times a week for five weeks during hemodialysis sessions.The dependent variables of both groups were measured at baseline(T0),middle of intervention(T1),and end of intervention(T2)using the Mindful Attention Awareness Scale(MAAS),Perceived Stress Scale(PSS),Emotion Regulation Questionnaire(ERQ),and Kidney Disease Quality of Life(KDQOL-36)questionnaire.The study was registered in the ClinicalTrial.gov(Identifier:NCT05176730).Results:The repeated measures ANOVA(within-subject)results for the experimental group showed that mindfulness meditation had significantly decreased perceived stress by the end of the intervention.Also,mindfulness meditation improved mindfulness,emotion regulation,and kidney disease-related quality of life in the experimental group,and this improvement occurred significantly at both T1 and T2.The repeated measures ANOVA(within and between-subject)results showed that the experimental group,as compared to the control group,had lower perceived stress,higher trait mindfulness,higher emotional regulation,and higher kidney disease-related quality of life over time.Conclusions:The positive findings of this study offer health policy-makers and hospital administrators a promising tool to use with patients undergoing hemodialysis as a way to manage stress and improve quality of life.However,this study should be replicated in multiple settings with follow-up assessments.展开更多
Increased abdominal imaging has led to an increase in the detection of the incidental small renal mass(SRM). With increasing recognition that the malignant potential of SRMs is heterogeneous, ranging from benign(15%-2...Increased abdominal imaging has led to an increase in the detection of the incidental small renal mass(SRM). With increasing recognition that the malignant potential of SRMs is heterogeneous, ranging from benign(15%-20%) to aggressive(20%), enthusiasm for more conservative management strategies in the elderly and infirmed, such as active surveillance(AS), have grown considerably. As the management of the SRM evolves to incorporate ablative techniques and AS for low risk disease, the role of renal mass biopsy(RMB) to help guide individualized therapy is evolving. Historically, the role of RMB was limited to the evaluation of suspected metastatic disease, renal abscess, or lymphoma. However, in the contemporary era, the role of biopsy has grown, most notably to identify patients who harbor benign lesions and for whom treatment, particularly the elderly or frail, may be avoided. When performing a RMB to guide initial clinical decision making for small, localized tumors, the most relevant questions are often relegated to proof of malignancy and documentation(if possible) of grade. However, significant intratumoral heterogeneity has been identified in clear cell renal cell carcinoma(ccRCC) that may lead to an underestimation of the genetic complexity of a tumor when single-biopsy procedures are used. Heterogeneous genomic landscapes and branched parallel evolution of ccRCCs with spatially separated subclones creates an illusion of clonal dominance when assessed by single biopsies and raises important questions regarding how tumors can be optimally sampled and whether future evolutionary tumor branches might be predictable and ultimately targetable. This work raises profound questions concerning the genetic landscape of cancer and how tumor heterogeneity may affect, and possibly confound, targeted diagnostic and therapeutic interventions. In this review, we discuss the current role of RMB, the implications of tumor heterogeneity on diagnostic accuracy, and highlight promising future directions.展开更多
目的探讨四川地区开展中国公民逝世后器官捐献(donation after citizen death,DCD)肾移植的临床效果。方法回顾性分析四川大学华西医院2012年1月—2016年3月完成的97例DCD肾移植的供者及受者资料。供者53例,其中男40例,女13例;年龄7个月...目的探讨四川地区开展中国公民逝世后器官捐献(donation after citizen death,DCD)肾移植的临床效果。方法回顾性分析四川大学华西医院2012年1月—2016年3月完成的97例DCD肾移植的供者及受者资料。供者53例,其中男40例,女13例;年龄7个月~54岁(中位年龄28岁,下、上四分位数分别为15、45岁);死亡原因:颅脑外伤21例,颅脑肿瘤12例,脑血管意外15例,缺血缺氧性脑病4例,脑积水1例。受者97例,其中男71例,女26例;年龄18~66(中位年龄39岁,下、上四分位数分别为30、44岁)。根据供者捐献类型将受者分为C-Ⅰ类(36例)和C-Ⅲ类(61例)2组,分别分析供受者基线情况、围手术期情况,受者术后肾功能、感染发生、人肾存活等。结果无原发性肾无功能发生,26例受者发生延迟肾功能恢复。C-Ⅰ类和C-Ⅲ类患者术后1周[(226.71±187.46)、(249.94±249.84)μmol/L,P=0.636]、1个月[(136.32±63.34)、(157.37±147.83)μmol/L,P=0.428]、3个月[(110.51±25.26)、(115.02±36.60)μmol/L,P=0.527]及12个月[(103.42±21.57)、(104.18±39.36)μmol/L,P=0.911]时肌酐水平差异均无统计学意义。C-Ⅰ类和C-Ⅲ类患者术后早期急性排斥反应发生率(13.9%、19.7%,P=0.469)及并发症等情况差异均无统计学意义。术后1年,C-Ⅰ类和C-Ⅲ受者人存活率(91.7%、93.4%)和移植肾存活率(100.0%、91.8%)差异均无统计学意义(P>0.05)。结论尽管DCD肾脏移植术后延迟肾功能恢复发生率偏高,但总体效果良好,是扩大供肾来源的有效途径。展开更多
文摘Objective： To analyze the CT findings of renal masses and to investigate the value of CT imaging in qualitative diagnosis of these diseases. Methods： Twenty-eight cases of renal masses, proven surgically and pathologically, were retrospectively analyzed. Pre- and post-contrast CT scans were performed in all cases. Results： Twenty-one of 28 cases （75%） were diagnosed as having malignant tumors with 16 cases of renal cell carcinoma （RCC） showing as irregular-shaped low density soft tissue mass with no or slight enhancement. Ten of 21 cases were diagnosed as having carcinoma of the renal pelvis showing as soft tissue mass in renal pelvis with no or slight enhancement. Three of 21 cases were diagnosed as having nephroblastoma （Wilms＇ tumor） showing as larger irregular lobucated mass with no enhancement. Three of 28 cases （11%） of benign tumors were diagnosed as having angiomyolipoma （AML）. Two cases showed a mixed density mass while another case showed iso-density mass. The soft tissue part of the tumor showed enhancement while the area of fat didn＇t show any enhancement of the contrast medium. Four of 28 （14%） included 3 cases of renal cysts showing as classic cystic lesions with clear-margin. No enhancement was found. In the remaining one case of renal abscess, CT showed a mixed density mass of soft tissue and cyst with slight enhancement of soft tissue part while no enhancement of cystic part. Conclusion： Pre-contrast and post-contrast CT scans in combination with history play an important role in the diagnosis of renal
文摘AIM： To understand factors associated with quality of life （QOL）, examine types of QOL instruments, and determine need for further improvements in QOL assessment.METHODS： The method used databases （Pubmed, Google scholar） and a bibliographic search using key words QOL, end stage renal disease, Hemodialysis, Peritoneal dialysis, instruments to measure QOL, patients and qualitative/quantitative analysis published during 1990 to June 2014. Each article was assessed for sample size, demographics of participants, study design and type of QOL instruments used. We used WHO defnition of QOL. RESULTS： For this review, 109 articles were screened, out of which 65 articles were selected. Out of 65 articles, there were 19 reports/reviews and 12 question-naire manuals. Of the 34 studies, 82% were quantita-tive while only 18% were qualitative. QOL instruments measured several phenomenon such as physical/psychological health, effects and burdens of kidney dis-ease, social support etc. those are associated with QOL. Few studies looked at spiritual beliefs, cultural beliefs, personal concerns, as per the WHO defnition. Telemedicine and Palliative care have now been successfully used however QOL instruments seldom addressed those in the articles reviewed. Also noticed was that longitudinal studies were rarely conducted. Existing QOL instruments only partially measure QOL. This may limit validity of predictive power of QOL. CONCLUSION： Culture and disease specific QOL in-struments that assess patients’ objective and subjective experiences covering most aspects of QOL are urgently needed.
基金funding from Jordan University of Science and Technology,Deanship of Research.
文摘Objective:This study aimed to examine the effects of mindfulness meditation on trait mindfulness,perceived stress,emotion regulation,and quality of life in end-stage renal disease patients undergoing hemodialysis.Methods:An experimental study with repeated measures design was conducted among a sample of 74 end-stage renal disease patients undergoing hemodialysis between January and May 2021 in the dialysis center at Jahra hospital,Kuwait.The patients were randomly assigned to the experimental(n?37)and control groups(n?37).The experimental group participated in 30-min mindfulness meditation sessions(three sessions a week for five weeks)held during their hemodialysis sessions;the participants in the control group were instructed to sit with their eyes closed and relaxed for 30 min three times a week for five weeks during hemodialysis sessions.The dependent variables of both groups were measured at baseline(T0),middle of intervention(T1),and end of intervention(T2)using the Mindful Attention Awareness Scale(MAAS),Perceived Stress Scale(PSS),Emotion Regulation Questionnaire(ERQ),and Kidney Disease Quality of Life(KDQOL-36)questionnaire.The study was registered in the ClinicalTrial.gov(Identifier:NCT05176730).Results:The repeated measures ANOVA(within-subject)results for the experimental group showed that mindfulness meditation had significantly decreased perceived stress by the end of the intervention.Also,mindfulness meditation improved mindfulness,emotion regulation,and kidney disease-related quality of life in the experimental group,and this improvement occurred significantly at both T1 and T2.The repeated measures ANOVA(within and between-subject)results showed that the experimental group,as compared to the control group,had lower perceived stress,higher trait mindfulness,higher emotional regulation,and higher kidney disease-related quality of life over time.Conclusions:The positive findings of this study offer health policy-makers and hospital administrators a promising tool to use with patients undergoing hemodialysis as a way to manage stress and improve quality of life.However,this study should be replicated in multiple settings with follow-up assessments.
文摘Increased abdominal imaging has led to an increase in the detection of the incidental small renal mass(SRM). With increasing recognition that the malignant potential of SRMs is heterogeneous, ranging from benign(15%-20%) to aggressive(20%), enthusiasm for more conservative management strategies in the elderly and infirmed, such as active surveillance(AS), have grown considerably. As the management of the SRM evolves to incorporate ablative techniques and AS for low risk disease, the role of renal mass biopsy(RMB) to help guide individualized therapy is evolving. Historically, the role of RMB was limited to the evaluation of suspected metastatic disease, renal abscess, or lymphoma. However, in the contemporary era, the role of biopsy has grown, most notably to identify patients who harbor benign lesions and for whom treatment, particularly the elderly or frail, may be avoided. When performing a RMB to guide initial clinical decision making for small, localized tumors, the most relevant questions are often relegated to proof of malignancy and documentation(if possible) of grade. However, significant intratumoral heterogeneity has been identified in clear cell renal cell carcinoma(ccRCC) that may lead to an underestimation of the genetic complexity of a tumor when single-biopsy procedures are used. Heterogeneous genomic landscapes and branched parallel evolution of ccRCCs with spatially separated subclones creates an illusion of clonal dominance when assessed by single biopsies and raises important questions regarding how tumors can be optimally sampled and whether future evolutionary tumor branches might be predictable and ultimately targetable. This work raises profound questions concerning the genetic landscape of cancer and how tumor heterogeneity may affect, and possibly confound, targeted diagnostic and therapeutic interventions. In this review, we discuss the current role of RMB, the implications of tumor heterogeneity on diagnostic accuracy, and highlight promising future directions.
文摘目的探讨四川地区开展中国公民逝世后器官捐献(donation after citizen death,DCD)肾移植的临床效果。方法回顾性分析四川大学华西医院2012年1月—2016年3月完成的97例DCD肾移植的供者及受者资料。供者53例,其中男40例,女13例;年龄7个月~54岁(中位年龄28岁,下、上四分位数分别为15、45岁);死亡原因:颅脑外伤21例,颅脑肿瘤12例,脑血管意外15例,缺血缺氧性脑病4例,脑积水1例。受者97例,其中男71例,女26例;年龄18~66(中位年龄39岁,下、上四分位数分别为30、44岁)。根据供者捐献类型将受者分为C-Ⅰ类(36例)和C-Ⅲ类(61例)2组,分别分析供受者基线情况、围手术期情况,受者术后肾功能、感染发生、人肾存活等。结果无原发性肾无功能发生,26例受者发生延迟肾功能恢复。C-Ⅰ类和C-Ⅲ类患者术后1周[(226.71±187.46)、(249.94±249.84)μmol/L,P=0.636]、1个月[(136.32±63.34)、(157.37±147.83)μmol/L,P=0.428]、3个月[(110.51±25.26)、(115.02±36.60)μmol/L,P=0.527]及12个月[(103.42±21.57)、(104.18±39.36)μmol/L,P=0.911]时肌酐水平差异均无统计学意义。C-Ⅰ类和C-Ⅲ类患者术后早期急性排斥反应发生率(13.9%、19.7%,P=0.469)及并发症等情况差异均无统计学意义。术后1年,C-Ⅰ类和C-Ⅲ受者人存活率(91.7%、93.4%)和移植肾存活率(100.0%、91.8%)差异均无统计学意义(P>0.05)。结论尽管DCD肾脏移植术后延迟肾功能恢复发生率偏高,但总体效果良好,是扩大供肾来源的有效途径。
