2021

Optimising patients with long-term spinal cord injury for nephrectomy: A review of pre-, peri- and post-operative factors to safeguard outcomes (2021)

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Type of publication:
Journal article

Author(s):
*Donati-Bourne J.; *Mohamed W.G.E.; *Pillai P.; *O'Dair J.; Kasmani Z.; Bhatt R.I.

Citation:
Journal of Clinical Urology; 2021, Volume: 14 issue: 2, page(s): 78-84

Abstract:
Objectives: To review the potential challenges a urologist may encounter when embarking on simple/partial/radical nephrectomy in patients with long-term spinal cord injury and propose strategies to pre-empt and manage these.
Material(s) and Method(s): Comprehensive literature review via PubMed, MEDLINE and Google Scholar searching for relevant scientific articles published to date in English. Recommendations for strategies to safeguard surgical outcomes discussed with a panel of experienced upper-tract urologists.
Result(s): Pre-operative considerations: – urethral assessment via flexible cystoscopy due to higher incidence of urethral pathology in spinal cord injury; – assessing for chronic constipation and distended bowel; and – considering glomerular filtration rate assessment by radio-isotope techniques, such as 51chromium-EDTA Perioperative considerations: – adequate theatre staffing for safe patient transfer; and – planned choice of incision, due to higher incidence of previous abdominal surgery, stoma bags and/or foreign body devices. Post-operative considerations: – ensuring attending medical staff are trained to recognise autonomic dysreflexia; – early remobilisation with physiotherapists experienced in treating spinal cord injury; and – attentive antibiotic stewardship due to higher risk of hospital-acquired or urinary infections
Conclusion(s): Patients with long-term spinal cord injury pose significant potential challenges in the pre-, periand post-operative stages of nephrectomy. Familiarisation and optimisation of such factors is recommended to safeguard outcomes.
Level of Evidence: Not applicable for this multicentre audit.

Thyrotoxicosis and the consumption of bovine thyroid tissue (2021)

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Type of publication:
Journal article

Author(s):
S Senthilkumaran, *F Benita, P Thirumalaikolundusubramanian, K Swaminathan

Citation:
QJM : monthly journal of the Association of Physicians; Jul 2021; vol. 114 (no. 4); p. 253-254

Abstract:
Thyrotoxicosis due to consumption of bovine thyroid tissue is called hamburger thyroiditis. Despite bovine meat consumption in India and Asia, it is surprising to note that very few thyrotoxicosis from food contamination has been reported from Asia. We report a case of exogenous thyrotoxicosis due to bovine thyroid tissue consumption probably for the first time from Asia, to create an awareness of this entity among physicians and practitioners and others to consider this entity while handling patients with features of thyrotoxicosis of recent onset.