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Roughly 10% of the world’s population has chronic kidney disease (CKD). In its advanced stages, CKD greatly increases the risk of hospitalization and death. Although kidney transplantation has revolutionized the care of advanced CKD, clinicians have limited ways of assessing donor kidney quality. Thus, optimal donor kidney–recipient matching cannot be performed, meaning that some patients receive damaged kidneys that function poorly. Fibrosis is a form of chronic damage often present in donor kidneys, and it is an important predictor of future renal function. Currently, no safe, easy-to-perform technique exists that accurately quantifies renal fibrosis. We describe a potentially novel photoacoustic (PA) imaging technique that directly images collagen, the principal component of fibrotic tissue. PA imaging noninvasively quantifies whole kidney fibrotic burden in mice, and cortical fibrosis in pig and human kidneys, with outstanding accuracy and speed. Remarkably, 3-dimensional PA imaging exhibited sufficiently high resolution to capture intrarenal variations in collagen content. We further show that PA imaging can be performed in a setting that mimics human kidney transplantation, suggesting the potential for rapid clinical translation. Taken together, our data suggest that PA collagen imaging is a major advance in fibrosis quantification that could have widespread preclinical and clinical impact.

Introduction: Obesity (body mass index [BMI] >35 kg/m2) remains a relative contraindication for kidney transplant, while patients after kidney transplantation (KTX) are predisposed to obesity. The present study aims to investigate the role of bariatric surgery in improving transplant candidacy in patients prior to KTX, as well its safety and efficacy in KTX patients postoperatively. Methods: A systematic search was conducted up to March 2020. Both comparative and non-comparative studies investigating the role of bariatric surgery before or after KTX were considered. Outcomes included change in BMI, rates of mortality and complications, and the rate of patients who underwent KTX following bariatric surgery. Pooled estimates were calculated using the random effects meta-analysis of proportions. Results: Twenty-one studies were eligible for final review; 11 studies investigated the role of bariatric surgery before KTX. The weighted mean BMI was 43.4 (5.7) kg/m2 at baseline and 33.9 (6.3) kg/m2 at 29.1 months followup. After bariatric surgery, 83% (95% confidence interval [CI] 57–99) were successfully listed for KTX and 83% (95% CI 65–97) patients subsequently received successful KTX. Ten studies investigated the role of bariatric surgery after kidney transplant. Weighted mean baseline BMI was 43.8 (2.2) kg/m2 and mean BMI at 19.5 months followup was 34.2 (6.7) kg/m2. Overall, all-cause 30-day mortality was 0.5% for both those who underwent bariatric surgery before or after receiving a KTX. The results of this study are limited by the inclusion of only non-randomized studies, limited followup, and high heterogeneity. Conclusions: Bariatric surgery may be safe and effective in reducing weight to improve KTX candidacy in patients with severe obesity and can also be used safely following KTX.

INTRODUCTION AND OBJECTIVE:In patients with end-stage renal disease, kidney transplantation improves survival. However, due to safety and increased rates of graft failure, severe obesity (BMI > 35k...

Introduction: Our aim was to explore the satisfaction, personal and professional challenges, and practice barriers among female urologists in Canada. Methods: A literature review was completed to design our survey. Trends with respect to career and personal satisfaction were identified, including academic advancement, mentorship, professional challenges, workplace discrimination, family satisfaction, and remuneration, among others. These key themes were formatted into 44 questions, translated into French, and distributed electronically as a survey to 80 female urology staff across Canada. Results: Sixty (75.0%) women completed the survey. Many had been in practice

Introduccion. El programa “Fundamentos de Cirugia Laparoscopica” es un modulo educativo desarrollado por la Society of American Gastrointestinal Endoscopic Surgeons , que incluye el desarrollo de habilidades practicas y conocimientos teoricos en cirugia laparoscopica. Su mision principal es brindar a los residentes de las areas quirurgicas, y a los cirujanos en general, una herramienta adicional en su formacion, para aprender los fundamentos y el conocimiento teorico necesario para la practica de la cirugia laparoscopica, lo que garantizara un mejor desempeno en las salas de cirugia y, por ende, mayor seguridad para los pacientes. Objetivo. Evaluar la efectividad de la telesimulacion para ensenar el componente practico del programa “Fundamentos de Cirugia Laparoscopica” en Colombia. Materiales y metodos. Veinte participantes (10 cirujanos generales y 10 residentes de cirugia general) de dos ciudades de Colombia, participaron en ocho sesiones (una semanal) de entrenamiento en “Fundamentos de Cirugia Laparoscopica” mediante telesimulacion. Se les hizo un examen practico antes de las telesimulaciones, y un examen teorico y practico, al final de las ocho sesiones. Resultados. Utilizando parametros numericos definidos por la Society of American Gastrointestinal Endoscopic Surgeons , se encontro diferencias significativas el examen previo y el posterior. El 100 % de los participantes aprobaron el componente practico del programa. Conclusiones. Este estudio demuestra la efectividad de la telesimulacion para mejorar las habilidades laparoscopicas de participantes sin conocimiento previo del programa “Fundamentos de Cirugia Laparoscopica”, lo que garantizo obtener el puntaje necesario para aprobar la seccion practica del programa. doi: http://dx.doi.org/ 10.7705/biomedica.v33i1.1425

The response of the vascular endothelium to wall shear stress plays a central role in the development and progression of atherosclerosis. Current studies have investigated endothelial response using idealized in vitro flow chambers. Such cell culture models are unable to accurately replicate the complex in vivo wall shear stress patterns arising from anatomical geometries. To better understand this implication, we have created both simplified/tubular and anatomically realistic in vitro endothelial flow models of the human right coronary artery. A post-mortem vascular cast of the human left ventricular outflow tract was used to create geometrically accurate silicone elastomer models. Straight, tubular models were created using a custom made mold. Following the culture of human abdominal aortic endothelial cells within the inner lumen, cells were exposed to steady flow (Re = 233) for varying time periods. The resulting cell morphology was analyzed in terms of shape index and angle of orientation relative to the flow direction. In both models a progressive elongation and alignment of the endothelium in the flow direction was observed following 8, 12, and 24 hours. This change, however, was significantly less pronounced in the anatomical model (as observed from morphological variations indicative of localized flow features). Differences were also observed between the inner and outer walls at the disease-prone proximal region. Since morphological adaptation is a visual indication of endothelial shear stress activation, the use of anatomical models in endothelial genetic and biochemical studies may offer better insight into the disease process.