The Perspectives of Biomarkers in Predicting the Survival of the Renal Graft.

Kidney transplantation (KT) is currently the elective approach for patients with end-stage renal disease. Although it is a safe choice for these patients, the early complications can lead to graft dysfunction. One of the most redoubtable complications is delayed graft function (DGF), having no specific treatment. The effects of DGF on the graft survival are large enough to justify the formulation of specific biological protocols. Therefore, discovering biomarkers of acute impairment in renal transplanted patients is required. Creatinine is a poor marker to establish the kidney injury. Estimated glomerular filtration rate together with creatinine is ready to approximately measure the kidney function. Different serum and urine proteins are being studied as possible predictive biomarkers for delayed graft function. This review will concentrate on recent and existing research which provide insight concerning the contribution of some molecules for the estimation and evaluation of graft function after kidney transplantation. Further studies examining various aspects of DGF after KT are urgently needed to address a hitherto less-known clinical question.

[Identification and investigation of clusters during the COVID-19 pandemic Experiences from the canton of Vaud]. / Traçage rétrospectif et gestion des clusters pendant l'épidémie de Covid-19 - Applications dans le canton de Vaud.

Persons with SARS-CoV2 can be contagious with few or no symptoms. They can infect others in private, during education or work without knowing it. Few so-called super-propagators can thus initiate clusters of infections and chains of transmission. Isolation of new cases and quarantine of their contacts (forward contact tracing) often does not uncover such situations. Adding detailed backward investigations of events and places with elevated risk of transmission can increase the identification of potentially infected persons. These can then be quarantined, and chains of transmission be interrupted. We describe the principles and challenges of cluster investigation, epidemiological methods and IT tools that we deve loped at the Centre for contact tracing, Vaud. Knowledge of this method is useful in general clinical practice during a pandemic.

La plupart des personnes infectées par le SARS-CoV-2 sont contagieuses même si elles présentent peu ou pas de symptômes. Quelques individus, dits superpropagateurs, peuvent ainsi être à l'origine de clusters d'infections et de chaînes de transmission. L'isolement des nouveaux cas et la mise en quarantaine de leurs contacts ne permettent généralement pas de découvrir de telles situations. L'ajout d'enquêtes rétrospectives centrées sur la recherche de clusters peut accroître l'identification des personnes potentiellement infectées. Nous décrivons les principes et les défis de l'investigation par cluster, les méthodes épidémiologiques et les outils informatiques que nous avons développés au Centre de traçage du canton de Vaud. La connaissance de cette méthode est utile en pratique clinique lors d'une pandémie.

Angle grinder as surgical tool for incarcerated penoscrotal steel ring.

Penile strangulation with concomitant scrotal entrapment by a steel ring is an extremely rare urological emergency that requires immediate intervention. Any delay may lead to irreversible complications. Metal rings increase penile engorgement and are usually associated with an attempt to improve sexual pleasure or to maintain a prolonged erection. The removal of steel rings can be challenging and may require a multidisciplinary approach. We present a unique case report of an 18-year-old male with a penoscrotal steel ring retained for 24 hours that was safely removed using an angle grinder as a surgical tool.

Coronary stent entrapment.

A 64-year-old woman with a history of coronary artery bypass and coronary angioplasty with unexpanded stent entrapment blocked in the circumflex coronary artery and left main is now presenting with crescendo angina pectoris. The Department of Cardiovascular Surgery established that a new surgical intervention presents a very high risk. In this condition, we decide for elective percutaneous coronary intervention for stent restenosis, which is a very difficult procedure in the particular condition of unexpanded stent blocked in the circumflex coronary artery and left main.