ABSTRACT
Investigar a eliminação urinária da criança possibilita identificar diagnósticos de enfermagem e planejar adequadamente ações de cuidado. No que diz respeito ao diagnóstico de enfermagem (DE) eliminação urinária prejudicada da NANDA-I, identifica-se a possibilidade de lacunas em suas características definidoras (CD) quando se trata de lactentes, dadas as particularidades na forma como crianças nessa faixa etária manifestam a ocorrência deste diagnóstico. O objetivo do presente estudo foi identificar as manifestações clínicas relatadas na literatura para lactentes com alterações na eliminação urinária. Foi realizada revisão integrativa da literatura, cuja questão norteadora foi: "que manifestações clínicas os lactentes com alterações na eliminação urinária podem apresentar?" Foram consultadas as bases CINAHL, Cochrane, PubMed e LILACS. A busca resultou em 621 artigos. Considerados os critérios de inclusão e exclusão, 21 artigos compuseram a amostra. Os artigos foram lidos e classificados de acordo com seu nível de evidência. Entre as características definidoras identificadas na revisão integrativa e que são contempladas pela NANDA-I destacaram-se retenção urinária e disúria. Foram encontradas outras manifestações clínicas na literatura como passíveis de serem observados em lactentes com prejuízos na eliminação de urina, tais como jato urinário fraco, interrupção na micção, choro ao urinar, hematúria, urina fétida. Os resultados sugerem que outras CDs devem ser estudadas com vistas à sua inclusão na taxonomia da NANDA-I para melhor retratar a condição dos lactentes com o diagnóstico de enfermagem eliminação urinária prejudicada.
Investigating child urinary elimination enables one to identify nursing diagnoses and appropriately plan care actions. Regarding the nursing diagnosis (ND) of impaired urinary elimination, as identified by NANDA-I, gaps can be found in its defining characteristics (DC) when infants are involved, due to particularities of how children in this age group show this diagnosis. The present study aimed to identify the clinical manifestations reported in the literature concerning infants with urinary elimination disorders. An integrative literature review was carried out, whose guiding question was: What clinical manifestations are infants with urinary elimination disorders likely to present? CINAHL, Cochrane, PubMed, and LILACS databanks were consulted, identifying 621 articles. Taking the inclusion and exclusion criteria into account, the sample consisted of 21 articles, which were read and classified according to their evidence level. Among the defining characteristics identified in the integrative review, and that are contemplated by NANDA-I, urinary retention and dysuria proved to be the most prevalent. Other clinical manifestations were also found in the literature as likely to be observed in infants with urine elimination disorders, such as weak urinary stream, interruption of urination, crying when urinating, hematuria, and malodorous urine. Results suggest that other DCs should be studied in an attempt to include these in NANDA-I taxonomy so as to better illustrate the condition of infants with the nursing diagnosis of urinary elimination disorder.
Investigar la eliminación urinaria del niño permite identificar diagnósticos de enfermería y planificar adecuadamente acciones de cuidado. En lo concerniente al diagnóstico de enfermería (DE) alteraciones de la eliminación urinaria, según la NANDA-I, se identifica la posibilidad de que haya lagunas en sus características definitorias (CD) cuando se trata de bebés, dadas las particularidades cómo los niños en esa franja de edad manifiestan tal trastorno. El objetivo del presente estudio fue identificar las manifestaciones clínicas relatadas en la literatura para bebés con alteraciones en la eliminación urinaria. Se realizó una revisión integradora de la literatura en base a la pregunta orientadora: "Qué manifestaciones clínicas pueden presentar los bebés con alteraciones en la eliminación urinaria?" Se investigaron las bases CINAHL, Cochrane, PubMed y LILACS, obteniéndose 621 artículos. Considerados los criterios de inclusión y exclusión, 21 artículos compusieron la muestra. Los artículos se leyeron y clasificaron de acuerdo con su nivel de evidencia. Entre las características definitorias identificadas en la revisión integradora contempladas por la NANDA-I, se destacaron retención urinaria y disuria. Se encontraron otras manifestaciones clínicas en la literatura como pasibles de ser observadas en bebés con trastornos en la eliminación de orina, tales como, chorro de orina débil, interrupción en la micción, llanto al orinar, hematuria, orina fétida. Los resultados sugieren que deben estudiarse otras CD con vistas a su inclusión en la taxonomía de la NANDA-I para retratar mejor la condición de los bebés con el diagnóstico de enfermería alteraciones en la eliminación urinaria.
Subject(s)
Humans , Male , Female , Infant , Infant Care , Nursing Diagnosis , Pediatric Nursing , Child Health , Urination DisordersABSTRACT
The development of infiltrative bladder carcinoma in patients previously treated with radical prostatectomy due to prostate adenocarcinoma represents a challenging perspective. Radical cystectomy remains the best option for invasive bladder cancer, however, there are few reports about the best approach to such individuals. Nevertheless, despite possible technical difficulties found during surgery, the orthotopic urinary shunt is a reasonable option in selected cases.
Subject(s)
Aged , Humans , Male , Adenocarcinoma/secondary , Adenocarcinoma/surgery , Cystectomy , Prostatectomy , Prostatic Neoplasms/pathology , Urinary Diversion , Urinary Bladder Neoplasms/secondary , Urinary Bladder Neoplasms/surgery , Prostatic Neoplasms/surgeryABSTRACT
OBJECTIVES: The risks of identifying prostate cancer (PCa) in patients with serum total PSA (tPSA) between 4 and 10 ng/dl are between 25 and 35 percent. There are no data in Brazil showing the incidence of disease when all variables for PSA assessment are considered altogether, specifically tPSA, free fraction, PSA velocity and PSA stratified by age. The objective in this work was to define the incidence of disease in a population of men with abnormal values of PSA variables and normal digital rectal examination. MATERIALS AND METHODS: Between 1998 and 2003, 273 prostate biopsies were performed by the same radiologist and analyzed by the same pathologist. All patients had a normal digital rectal examination and biopsy had been indicated due to tPSA above 4 ng/dl or free-to-total PSA ratio (F/T PSA) below 15 percent or PSA velocity higher than 25 percent per year or a PSA level regarded as high for the age range. The relationship between these parameters and the positivity for prostate caner was determined. RESULTS: Patients' mean age was 63.8 years, and PCa was identified in 135 cases (49.5 percent). The incidence of PCa, related to unitary variations in tPSA, ranged from the limits of 33 to 80 percent, respectively, in tPSA < 3 and PSA between 15.1 to 20. When the other PSA parameters were assessed (free PSA, PSA according to age, rise velocity) PCa was detected in more than 25.3 percent of cases. CONCLUSION: When patients with normal digital rectal examination are selected for prostate biopsy due to tPSA levels above 4 or F/T PSA ratio lower than 15 percent or PSA velocity higher than 25 percent per year or high PSA for the age range, the incidence of PCa is quite higher than that observed in a population selected exclusively with basis on total PSA value.