INTRODUCTION

Inferior vena cava (IVC) filters entrap emboli from the periphery going to the pulmonary circulation, preventing pulmonary embolism (PE). Studies show that many IVC filter insertions are done for weak or non–guideline directed indications. This study examined the indications for IVC filter insertion in a tertiary care hospital in Metro Manila, adherence to society guidelines, and clinical outcomes after filter insertion.

METHODS

This study is a retrospective cohort involving patients who received an IVC filter from January 2015 to February 2021. The main outcome was the indication for IVC filter. Other outcomes were strength of recommendation for filter placement and postfilter clinical outcomes: all-cause death, venous thromboembolism–related mortality, PE, and filter related complications.

RESULTS

Eighty-three patients received IVC filters from January 2015 to February 2021, and 77 were included in the analysis. Sixty-one percent had moderate to strong indications for the procedure, 49% were due to contraindication to anticoagulation. Thirty-nine percent had unclear indications: 16% concomitantly received therapeutic anticoagulation, whereas 11% had isolated distal deep vein thrombosis. Mean follow-up was 170 days. Postfilter clinical outcomes included all-cause death in 12%, venous thromboembolism–related mortality in 1%, and PE in 3%. Filter complications occurred in 4%. Retrievable IVC filters were used in 51% with attempted removal in 4%, 3% of which were successful.

CONCLUSION

The majority of patients receiving IVC filters in our center had strong to moderate indications for the procedure. The use of retrievable filters and consequent retrieval is low and should be encouraged. Venous thromboembolism–related mortality and filter complications were low, comparable to international data.

Echocardiography ; Laboratories ; Resources ; Surveys And Questionnaires

Objective: Transrectal ultrasound guided biopy is the diagnostic of choice in detecting carcinoma of the prostate. The biopsy can be painful and many would refuse the procedure again without adequate analgesia.he combination of non-steroidal anti-inflammatory drugs (NSAIDs) and opioids work synergistically in relieving pain. The investigators determined that the premedication of celecoxib and tramadol with 10ml intrarectal 2% lidocaine gel would significantly decrease the pain score of patients undergoing prostate biopsy compared to lidocaine gel alone.Methods: Thirty one patients who underwent 12-core prostate biopsy were randomly assigned into two groups. The control received 10ml 2% intrarectal lidocaine gel alone the experimental group was given celecoxib 400mg and tramadol 59mg 2 hours before biopsy plus intrarectal lidocaine gel. Immediately after biopsy, patients were asked to rate the pain score using visual analog scale (VAS).Results: A total of 15 patients assigned for cotrol group and 16 patients for the experimental group, showed similar characteristics in terms of age, prostate volume and prostate specific antigen (PSA) value. The overall mean pain score using visual analog pain scale was 4.1+/-1.7 in the experimental group compares to 5.5+/-1.9 in the control group with signifcant P value of 0.034 using chi-square test. There was a mean pain score decrease of 1.5 from the scale of 1 to 10 in the experimantal group compared to the cotrol.Conclusion: The addition of oral administration of celecoxib 400mg and tramadol 59mg 2 hours before intrarectal 10ml 2% lidocaine gel significantly reduced the pain exprienced by patients during ultrasound guided prostate biopsy as compared to lidocaine gel alone
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OBJECTIVE: Endoscopic surgery is one of the most common minimally invasive surgical techniques applied in the field of urology. The authors developed a mechanical adaptor for commercially available penlight-type LED light that can be used in common endoscopic procedures in urology.

MATERIALS AND METHODS: A four-piece light adaptor device made from medical-grade aluminum steel was crafted and functions as an adaptor for penlight-type LED light in one end and an endoscopic telescope on the other end. In order to determine its function and quality, it was compared to the conventional light source machine used in most endoscopic procedures. The specification of both light sources were compared in terms of light intensity and colour temperature through a light meter. This device was applied clinically by using it in a series of endoscopic procedures.

RESULTS: Application of the device in the endoscopic surgical procedures showed that it functioned well and appropriately. It was able to complete a full course of each operation undertaken.

CONCLUSION: This original an innovative device offers an alternative to the conventional light source equipment available commercially. Based on the authors experience we recommend the use of this adaptor for common endoscopic procedures done in minimally invasive surgery.

Human ; Male ; Female ; Endoscopy ; General Surgery ; Urology ; Minimally Invasive Surgical Procedures ; Inventions ; light ; Equipment and Supplies

OBJECTIVES: To compare the effect of Tramadol, Tramadol/HNBB combination and Tramadol/Alfuzosine combination in the relief of renal colic.

MATERIALS AND METHODS: A total of 82 patients diagnosed with renal colic from May to October 2009 were included in the study. The patients were divided into three groups: Group I (n=27) was given Tramadol (50 mg/capsule orally) only, Group II (n=28) was given Tramadol and Hyoscine-N-Butylbromide (10 mg/tablet orally) and Group III was given Tramadol and Alfuzosine (10 mg/tablet orally). Pain was evaluated using the Visual Analog Scale pre-treatment and post-treatment.

RESULTS: The Visual Analog Scale scores for all groups showed improvement after treatment. The average difference in Visual Analog Scale for Group I was 3.148, Group II was 3.444, and Group III was 3.429. A significant difference was seen in all treatment groups. ANOVA was used to compare the differences between the three treatments. All treatments had comparable results, therefore, no significant difference was seen in the effect of the three treatments.

CONCLUSION: Relief of renal colic was achieved in all groups as seen in a decrease in the Visual Analog Scale Score after giving of treatment, however, the differences for each treatment group was not statistically significant.

Human ; Male ; Female ; Adolescent ; Child ; Renal Colic-Signs and Symptoms, treatment, management ; Visual Analog Scale-Diagnostic Techniques and Procedures ; Tramadol ; Butylscopolammonium Bromide

A 19-year old man presented with acute onset of intractable hypertension with associated dizziness and nausea. Abdominal computed tomography revealed a 7.0cm x 6.27cm x 6.0cm suprarenal mass on the right. The patient was diagnosed to have pheochromocytoma and successfully underwent retroperitoneal laparoscopic adrenalectomy.

Human ; Male ; Young Adult ; Adrenalectomy ; Surgical Procedures, Operative ; Endocrine Surgical Procedures ; Laparoscopy ; Adrenal Gland Neoplasms ; Neoplasms ; Endocrine Gland Neoplasms

OBJECTIVE: This Study was designed to determine the five year biochemical progression free rate of patients with clinically localized prostate cancer stratified to low, intermediate and high risks groups who underwent permanent prostate brachytheraphy.

METHODS: Thirty six patients with a mean age of 67 years diagnosed with clinically localized prostate cancer were treated with Iodine-125 permanent prostate brachytherapy from November 2001 to December 2003. Prostate specific antigen (PSA) failure was defined as having more than +2 increase of serum PSA from the nadir, with PSA nadir set at 0.4 ng/ml. The biochemical recurrence-free rate for the overall and the stratified groups were then calculated.

RESULTS: Twelve patients were lost to follow up leaving twenty-four subjects in the study. The prescribe minimum dose was 145 grays. Median follow-up was 62 months. The over-all 5 year biochemical recurrence-free rate was 58%. Satisfying these patients into low, intermediate, and high group yielded a progression free rate of 80%, 42%, and 5%, respectively.

CONCLUSION: Permanent prostate branchytheraphy is an effective treatment for patients with clinically localized prostate cancers. This reported 5-year biochemical recurrence-free rate at East Avenue Medical Center (EAMC) is comparable with that reported by other centers.

Human ; Male ; Aged 80 And Over ; Aged ; Middle Aged ; Prostate-specific Antigen ; Brachytherapy ; Disease-free Survival ; Prostatic Neoplasms ; Disease Progression ; Radioimmunotherapy ; Iodine Radioisotopes

Objective: To determine the difference in urinary citrate level in Filipino stone formers as compared with non-stone formers in OPD patients seen at East Avenue Medical Center.Methodology: Forty males and females aged 20-70 years who were seen at the East Avenue Medical Center OPD Urology were randomly selected. Collection of the 24 hour urine was done. Urine specimens were sent to the same laboratory for examination and were processed using citrate lyase method.Results: The mean citrate levels seen between non-stone formers and stone formers showed significant difference with a P-value of less than 0.5. The results of the mean citrate difference in both sex and age showed no significant difference with a P-value of more than 0.5.Conclusion: Urinary citrate levels of stone formers are significantly lower than non-formers in our study. The levels of the urinary citrate are comparable to the foreign counterparts' results.
Citrate ; Urolithiasis

Treatment of urinary stone diseases requires radiographic imaging to optimize treatment selection. Non contrast helical computerized tomography (CT) has become the radiographic modality of choice in acute flank pains due to rapid and accurate determination of stone parameters. It was used by some groups to correlate treatment success, however, no specific recommendations have yet resulted from this series. Objective: To determine how non-contrast helical computerized tomography hounsfield unit (HU) measurement of surgically collected calculi correlates with in vitro stone breaking strength. Methodology: The specimens were obtained from patients who underwent open stone surgery at our institution from January 1, 2006 to September 30, 2006. Stones with sizes between 1-2 cm in their greatest dimension wer^ included in the study. In vitro measurement of the individual stone hounsfield unit values was done using the center's Neusoft CT C 3000 Spiral CT Scanner. Breaking strength of each stone was determined using Tinius Olsen low capacity Universal Testing Machine (UTM). Results were recorded and statistical analysis was performed using the Pearson correlation coefficient and linear regression from the commercially available SPSS statistical software. Results: A total of 38 stones were obtained from open stone surgery during the period covered in the study were included. Specimen sizes ranged between 1 to 2 centimers (cm) with an average size of 1.37 cm. The mean hounsfield unit of the stone specimen was at 588.34 HU and an average breaking strength of 57.54 Ib load. The Pearson correlation coefficient between the Hounsfield reading and that of breaking load is r = 0.406. This is indicative of a moderate yet significant (p-0.008) association between the two scores. A linear regression model may be fitted for these two scores with breaking load as dependent variable and hounsfield unit as predictor. A caveat on the model is its low adjusted R-square (16%). The resulting equation was: Estimated Breaking Load = 30.422 + 0.0461 (Hounsfield Unit). Conclusion: The breaking load of a urinary stone has a tendency to have a higher value as the Hounsfield score increases. Hounsfield unit is a predictor for stone's breaking strength but not a sufficient one.

Urinary Calculi ; Urolithiasis

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