ABSTRACT
A pesar de los avances tecnológicos, la historia clínica y el examen físico continúan y continuarán siendo la base de un buen enfoque y aproximación diagnóstica correcta, por ésto, la semiología sigue siendo un área muy importante en la medicina. En ésta revisión se plantea una guía sistemática e integral para la evaluación del sistema nefro-urológico en el niño desde las herramienta básicas y fundamentales como la historia clínica, el examen físico con sus componentessemiológicos en lo normal y lo patológico, integrando además los métodos diagnósticos de laboratorio e imagen disponibles en la actualidad, para lograr un buen enfoque y aproximación diagnóstica en niños con enfermedad renal.
Despite technological advances, medical history and physical examination remain the foundation of a good approach and correct diagnosis; semiology remains a very important area in medicine. In this review a systematic and comprehensive guide for the evaluation of nephron urological system in children is presented, with emphasis in medical history, physical examination and semiotic aspects, in normal and pathological conditions; additionally laboratory and imaging studies available to achieve a good diagnostic approach in children with renal disease are presented.
Subject(s)
Humans , Male , Female , Child , Physical Examination/classification , Physical Examination , Physical Examination/methods , Homeopathic Semiology , Nephrology/classification , Nephrology/education , Nephrology/methods , Urology/classification , Urology/methods , Dysuria/classification , Dysuria/complications , Dysuria/diagnosis , Dysuria/epidemiology , Dysuria/pathology , Dysuria/prevention & control , Oliguria/classification , Oliguria/complications , Oliguria/diagnosis , Oliguria/pathology , Oliguria/prevention & controlABSTRACT
The incidence of pathologically documented oliguric A.T.N. following living renal transplantation was studied in 481 cases using different perfusion protocols with comprised together with surface cooling perfusion with 500 ml lactated Ringer's solution at room temperature to which 5000 units heparin were added together with 5 mg verapamil and 2 ml 2% procaine HC1 in the firs group, or 6 ml 2% procaine HC1 in the second and third groups. This was followed in the 3 groups by cold [0C] perfusion of 500 ml lactated Ringer's solution to which 500 units heparin were added. Perfusion time ranged form 3-5 minutes. Oliguric A.T.N. occurred in 6/159 cases [3.8%] of the first group and in 13/227 cases [5.7%] of the second group. Oliguric A.T.N. was not encountered in any of the 95 cases in whom allopurinol was given to both donor and recipient as 300 mg orally 48 and 24 hours preoperatively and using procaine HCL for perfusion. A.T.N. Was not related to the duration of the ischemia time [35-65 minutes], number of arteries or tissue matching which were comparable among the studied groups. Allopurinol is believed to protect against reperfusion injury mediated by free oxygen radicals