Emerging concepts in the treatment of intracranial aneurysms: stents, coated coils, and liquid embolic agents

Endovascular techniques for the treatment of intracranial aneurysms are rapidly evolving. Modifications of more traditional coils have been introduced. Such modifications include newer coils coated with various polymers to increase both coil thrombogenicity and degree of aneurysm packing. In addition, newer coil designs aimed at improving the conformability of the coil to the aneurysm have been used with promising preliminary results. The availability of a newer generation of stents specifically designed for intracranial navigation allows for more effective treatment of aneurysms with wide necks, which usually have been considered unsuitable for optimal endovascular treatment. Endovascular alternatives to coil embolization, such as liquid embolic materials, also have been explored for the treatment of intracranial aneurysms, with varying results. We summarize the rationale for use of these newer devices and early clinical experiences. Areas of current research and future directions of endovascular aneurysm treatment also are discussed.     

Colonic perforation complicating percutaneous nephrolithotomy

A case of colonic perforation complicating percutaneous nephrolithotomy in a 64-year-old woman is reported. Nonoperative management was successful with the creation of a controlled colocutaneous fistula by pulling the nephrostomy tube back from the kidney to the colon and the use of an elemental diet and antibiotics. Internal urinary drainage was not necessary.     

Bariatric Bypass Surgery to Resolve Complicated Childhood Morbid Obesity: Case Report Study

Children obesity has become one of the most important public health problems in many countries worldwide. Although the awareness of childhood obesity as a modifiable health risk is high, but many societies do not prioritize this issue as a health care problem, which may lead to comorbidities and even premature death. Despite the rising interest in bariatric surgery for children, only laparoscopic sleeve gastrectomy (LSG) is being considered in resolving childhood obesity who failed other dietary or drug therapies; however many of LSG procedures failed to reduce the weight in children or resulted in complications postsurgery.Here, we present a novel bariatric procedure to clue out a female child 13 years old presented with Legg–Calvé–Perthes disease-associated morbid obesity. The surgical bariatric technique applied both fundal resection and surgical bypass in pediatric obesity using the Elbanna novel bariatric technique.Bariatric surgical bypass may be considered in complicated-childhood cases who failed all other options.     

Trajectories of glomerular filtration rate and progression to end stage kidney disease after kidney transplantation

1. Download : Download high-res image (426KB)
2. Download : Download full-size image