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1.
Mali méd. (En ligne) ; 36(2): 45-50, 20210812. Tableaux
Article in English | AIM | ID: biblio-1283919

ABSTRACT

Le rein est une des cibles de Covid-19.L'atteinte peut se présenter sous forme d'une insuffisance rénale aigue (5-35% des patients), d'une hématurie (30-40%) et/ou d'une protéinurie (40-65%). Nous rapportons deux cas d'insuffisance rénale aigue due au Covid-19 au Mali. Il s'agit d'une femme de 63 ans et d'un homme de 60 ans, de race noire et tous deux diabétiques. Les circonstances de découverte de l'insuffisance rénale ont été l'oligurie dans les deux cas et l'hématurie macroscopique totale dans le deuxième cas. Conclusion : Les atteintes rénales deviennent de plus de plus fréquentes au cours de l'infection à Covid-19. Nous suggérons de les rechercher systématiquement dès que le diagnostic de cette infection est posé.


Subject(s)
Humans , Proteinuria , Acute Kidney Injury , COVID-19 , Hematuria , Mali
2.
Article in Chinese | WPRIM | ID: wpr-879603

ABSTRACT

OBJECTIVE@#To explore the genetic basis for a Chinese pedigree affected with X-linked hereditary Alport syndrome.@*METHODS@#Next generation sequencing was carried out for the pedigree. Candidate variant was validated by Sanger sequencing. Pathological changes of renal basement membrane and expression of COL4A5 protein were analyzed by renal biopsy and immunofluorescence assay, respectively.@*RESULTS@#All patients from the pedigree manifested progressive renal damage, gross hematuria, proteinuria and nephrotic syndrome. Renal biopsy of the proband revealed thickening of the basement membrane. No expression of the COL4A5 gene was detected by immunofluorescence. High-throughput sequencing and Sanger sequencing indicated that the proband has carried a c.3706delC (p.1236Pfs*69) variant in exon 41 of the COL4A5 gene. The same variant was also found in his mother and two brothers whom were similarly affected.@*CONCLUSION@#The novel c.3706delC (p.1236Pfs*69) variant of the COL4A5 gene probably underlay the pathogenesis of X-linked hereditary Alport syndrome in this pedigree. Above findings have enriched the spectrum of COL4A5 gene variants and provided a basis for the diagnosis and genetic counseling for the pedigree.


Subject(s)
Collagen Type IV/genetics , Hematuria , High-Throughput Nucleotide Sequencing , Humans , Male , Mutation , Nephritis, Hereditary/genetics , Pedigree
3.
Article in English | ID: biblio-1347991

ABSTRACT

Eosinophilic cystitis is a rare inflammatory disorder characterized by eosinophilic infiltration of entire layers of the bladder wall. The condition has been described in adults, children, and dogs. However, there are no consensus guidelines for the treatment of eosinophilic cystitis. Although human and veterinary literature reviews show some effectiveness in management with corticosteroids, antihistamines, and antibiotics, a variety of serious and frequent side effects are associated with steroid therapy. As a result, steroids are relatively contraindicated for patients with diabetes mellitus and Cushing's syndrome. A five-year-old neutered male chow-chow with controlled diabetes was referred with an 18-month history of malodorous urine, gross haematuria, and dysuria that were nonresponsive to antibiotics. The findings on general examination were unremarkable except for abdominal suprapubic discomfort. The complete blood count and biochemical profile (such as urea and creatinine) were normal except for mild peripheral eosinophilia. Although ultrasonography, bladder contrast radiography, and urine cytology findings indicated malignancy, with the presence of atypical urothelial cells, histopathology confirmed eosinophilic cystitis. Management with cyclosporine was adequate with complete remission of haematuria. This case report presents the first reported successful use of cyclosporine for the treatment of eosinophilic cystitis in a dog with diabetes.(AU)


A cistite eosinofílica é uma doença inflamatória rara caracterizada por infiltração eosinofílica de todas as camadas da parede da bexiga. Essa enfermidade já foi descrita em adultos, crianças e cães. No entanto, não há um consenso de diretrizes sobre o seu tratamento. Mesmo que as literaturas humana e veterinária mostrem alguma eficácia no manejo com corticosteroides, anti-histamínicos e antibióticos, uma variedade de efeitos colaterais graves e frequentes está associada à terapia com esteroides. Dessa forma, o uso de esteroides é relativamente contraindicado para pacientes com diabetes mellitus e síndrome de Cushing, por exemplo. Um chow-chow, macho, castrado, de cinco anos e diabético estável foi encaminhado para atendimento com histórico de urina fétida, hematúria macroscópica e disúria não responsiva a antibióticos há 18 meses. A avaliação dos parâmetros físicos estava dentro dos padrões, exceto por desconforto abdominal suprapúbico à palpação. O hemograma e o perfil bioquímico (como a ureia e a creatinina) estavam dentro da normalidade para a espécie, exceto por eosinofilia periférica leve. Embora a ultrassonografia, a radiografia contrastada da bexiga e os achados da urinálise indicassem malignidade, com a presença de células uroteliais atípicas, a histopatologia confirmou o diagnóstico definitivo de cistite eosinofílica. O manejo com ciclosporina foi satisfatório, com ausência completa da hematúria. Este relato de caso apresenta o primeiro uso documentado de ciclosporina para o tratamento de cistite eosinofílica com sucesso em um cão com diabetes.(AU)


Subject(s)
Animals , Dogs , Cyclosporine , Cystitis , Dogs , Hematuria , Enterobacter , Eosinophilia , Klebsiella pneumoniae
4.
Rev. latinoam. enferm. (Online) ; 29: e3415, 2021. tab
Article in English | LILACS, BDENF | ID: biblio-1280459

ABSTRACT

Abstract Objective: to evaluate the complications of percutaneous renal biopsy based on outcomes and clinical indicators of the Nursing Outcomes Classification. Method: a prospective longitudinal study. The sample consisted of 13 patients submitted to percutaneous renal biopsy, with 65 evaluations. The patients were evaluated in five moments in the 24 hours after the procedure, using an instrument developed by the researchers based on five outcomes (Blood coagulation, Circulation status, Blood loss severity, Pain level, Comfort status: Physical) and 11 indicators. The Generalized Estimation Equation Test was used to compare the scores of the indicators. The project was approved by the institutional ethics committee. Results: in the 65 evaluations, a statistically significant difference was identified in the reduction of the scores of the following nursing outcomes: Blood coagulation, "hematuria" indicator; Circulation status, in the "systolic blood pressure and diastolic blood pressure" indicators and Comfort status: physical, in the "physical well-being" indicator. Conclusion: the evaluated patients did not show major complications. The clinical indicators signaled changes in circulation status, with reduced blood pressure, as well as in blood clotting observed by hematuria, but without hemodynamic instability. The comfort status was affected by the rest time after the procedure.


Objetivo: evaluar las complicaciones de la biopsia renal percutánea con base en los resultados e indicadores clínicos de la Nursing Outcomes Classification. Método: estudio longitudinal prospectivo. La muestra fue de 13 pacientes a los que se les realizó biopsia renal percutánea, con 65 evaluaciones. Los pacientes fueron evaluados en cinco momentos en las 24 horas posteriores al procedimiento, utilizando un instrumento desarrollado por los investigadores con base en cinco resultados (Coagulación sanguínea, Estado circulatorio, Severidad de la pérdida de sangre, Nivel de dolor, Estado de comodidad: física) y 11 indicadores. Se utilizó la Prueba de Ecuación de Estimación Generalizada para comparar los puntajes de los indicadores. El proyecto fue aprobado por el comité ético institucional. Resultados: en las 65 evaluaciones, se identificó una diferencia estadísticamente significativa en la reducción de los puntajes de los resultados de enfermería Coagulación sanguínea, indicador "hematuria"; Estado circulatorio, en los indicadores "presión arterial sistólica y presión arterial diastólica" y en el Estado de comodidad: física, en el indicador de "bienestar físico". Conclusión: los pacientes evaluados no presentaron mayores complicaciones. Los indicadores clínicos apuntaban a cambios en el estado circulatorio, con reducción presión arterial, así como en la coagulación sanguínea verificada por hematuria, pero sin inestabilidad hemodinámica. El estado de comodidad se vio afectado por el tiempo de descanso posterior al procedimiento.


Resumo Objetivo: avaliar as complicações da biópsia renal percutânea com base nos resultados e indicadores clínicos da Nursing Outcomes Classification. Método: estudo longitudinal prospectivo. A amostra foi de 13 pacientes submetidos à biópsia renal percutânea, com 65 avaliações. Os pacientes foram avaliados em cinco momentos nas 24 horas após o procedimento, por meio de um instrumento desenvolvido pelos pesquisadores com base em cinco resultados (Coagulação sanguínea, Estado circulatório, Gravidade da perda de sangue, Nível de dor, Estado de conforto: físico) e 11 indicadores. Utilizou-se o Teste de Equações de Estimação Generalizadas para comparação entre os escores dos indicadores. O projeto foi aprovado pelo comitê de ética institucional. Resultados: nas 65 avaliações foi identificada diferença estatisticamente significativa na redução dos escores dos resultados de enfermagem Coagulação sanguínea, indicador "hematúria"; Estado circulatório, nos indicadores "pressão arterial sistólica e pressão arterial diastólica" e no Estado de conforto: físico, no indicador "bem-estar físico". Conclusão: os pacientes avaliados não apresentaram complicações maiores. Os indicadores clínicos apontaram alterações no estado circulatório, com redução da pressão arterial, bem como na coagulação sanguínea constatada pela hematúria, porém sem instabilidade hemodinâmica. O estado de conforto foi afetado pelo tempo de repouso após o procedimento.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Outcome and Process Assessment, Health Care , Biopsy , Blood Coagulation , Prospective Studies , Longitudinal Studies , Nephrology Nursing , Hematuria , Hemodynamics , Nursing Process
6.
Rev. colomb. nefrol. (En línea) ; 7(1): 130-134, ene.-jun. 2020. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1144380

ABSTRACT

Resumen En pacientes con enfermedad renal se ha reportado la presencia de células renales reactivas, cuyas alteraciones morfológicas severas dificultan su clasificación e interpretación. El conocimiento de las características morfológicas y los patrones de sedimentos en donde se presentan pueden ser de ayuda para su manejo en los departamentos médicos correspondientes. Aquí, nosotros reportamos la presencia de células agrupadas en acinos, con abundante citoplasma, cariomegalia, contornos nucleares irregulares y nucléolos prominentes, acompañados de cilindruria y cuerpos ovales grasos en el sedimento urinario de dos pacientes con diabetes mellitus, las cuales fueron sugestivas de células renales reactivas.


Abstract In patients with kidney disease, the presence of reactive renal cells has been reported. These cells show several morphological alterations that difficult their classification and interpretation. Therefore, the knowledge of its morphological characteristics and sediments patterns where they can be found will helpful for their correct management by medical departments. Here, we reported the presence of renal cells grouped in acinus with abundant cytoplasm, cariomegaly, irregular nuclear contours and prominent nucleoli, accompanied with cilindruria and fatty oval bodies in the urinary sediment of two patients with Diabetes Mellitus, these cells were named as reactive renal cells.


Subject(s)
Humans , Male , Female , Renal Insufficiency, Chronic , Patients , Proteinuria , Diabetes Mellitus , Epithelial Cells , Hematuria , Mexico
7.
Med. UIS ; 33(1): 73-80, ene.-abr. 2020. tab
Article in Spanish | LILACS | ID: biblio-1124988

ABSTRACT

Resumen En el mundo, se ha evidenciado un aumento de los casos de sífilis, de sífilis gestacional y de sífilis congénita. Se presenta el caso de un recién nacido con sífilis congénita, hijo de una madre con sífilis latente de duración indeterminada (VDRL 1:4 diluciones) diagnosticada y tratada a la semana 12 de gestación, VIH negativa, con compañero seronegativo para sífilis; a pesar del tratamiento con tres dosis de 2'400 000 U de penicilina benzatínica, no modificó los títulos del VDRL ni en el control de la semana 25 de gestación, ni en el momento del parto. En el posparto, la madre fue diagnosticada con neurosífilis y recibió tratamiento con penicilina cristalina durante 14 días. El recién nacido fue diagnosticado con sífilis congénita por presentar VDRL 1:4 diluciones, aumento de aminotransferasas, hematuria y proteinuria, recibiendo tratamiento con penicilina cristalina durante 10 días. La paciente evolucionó favorablemente y el control a los 6 meses fue normal. Deben fomentarse medidas útiles en la prevención de la sífilis gestacional: métodos de barrera, conocimiento de la enfermedad y asistencia a control prenatal. Es fundamental identificar y tratar a las gestantes con sífilis mediante tamizaje serológico para prevenir la sífilis congénita; el seguimiento serológico debe ser estricto para verificar la eficacia del tratamiento e investigar las gestantes que no modifican los títulos después del tratamiento. MÉD.UIS.2020;33(1):73-80.


Abstract In the world, there has been an increase in cases of syphilis, gestational syphilis and congenital syphilis. It's presented the case of a newborn with congenital syphilis, son of a mother with latent syphilis of indeterminate duration (VDRL 1: 4 dilutions) diagnosed and treated at week 12 of gestation, HIV negative, with seronegative partner for syphilis; despite treatment with three doses of 2'400 000 U of benzathine penicillin, the VDRL titres remained unaltered on both the control of the 25th week of gestation and at the time of delivery. The mother, in the postpartum period, was diagnosed with neurosyphilis and was treated with crystalline penicillin for 14 days. The newborn was diagnosed with congenital syphilis by presenting 1:4 VDRL dilutions, increased aminotransferases, hematuria and proteinuria; he was treated with crystalline penicillin for 10 days. Useful measures should be promoted in the prevention of gestational syphilis such as barrier methods, knowledge of the disease and assistance to prenatal control. It is mandatory to identify and treat pregnant women with syphilis by serological screening for the disease in order to prevent congenital syphilis. Serological follow-up should be strict to verify the effectiveness of the treatment and to investigate pregnant women who do not modify the titres after treatment. MÉD.UIS.2020;33(1):73-80.


Subject(s)
Humans , Male , Infant, Newborn , Syphilis, Congenital , Syphilis, Latent , Penicillin G Benzathine , Proteinuria , Treponema pallidum , Infant, Newborn , Pregnancy , Syphilis , Transaminases , Hematuria , Neurosyphilis
8.
Medicina (B.Aires) ; 80(1): 84-86, feb. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1125041

ABSTRACT

El síndrome de Klippel-Trenaunay-Weber (SKTW) es una rara malformación venosa que, en general afecta a los miembros inferiores y, más raramente, a los superiores. Se caracteriza por formaciones angiomatosas cutáneas, várices e hipertrofia del miembro afectado. El compromiso genitourinario es sumamente infrecuente. Se presenta el caso de una paciente de 14 años. Ingresó por hematuria macroscópica de 48 h de evolución y metrorragia con grave compromiso hemodinámico. Se encontraba en estudio por presentar un hemangioma en el miembro inferior izquierdo que se extendía hasta la región pelviana. La uretrocistofibroscopía demostró la presencia de múltiples lesiones angiomatosas diseminadas en forma amplia en la vejiga, algunas de ellas con sangrado activo. La angioresonancia mostró una voluminosa formación hipervascularizada en contacto con la pared vesical a la cual desplazaba y fístulas arteriovenosas a nivel pelviano y en el miembro inferior izquierdo confirmando el diagnóstico etiológico. Se realizó una embolización arterial selectiva de los territorios ilíacos interno y externo e inmediatamente después una endocoagulación láser de los focos angiomatosos sangrantes. La hematuria remitió completamente en las 24 h posteriores al procedimiento. La metrorragia asociada al SKTW fue controlada mediante la utilización de análogos LHRH y progestágenos.


Klippel-Trenaunay-Weber syndrome (KTWS) is a rare venous malformation that generally affects the lower limbs and, more infrequently, the upper limbs. It is characterized by cutaneous angiomatous formations, varicose veins and hypertrophy of the affected limb. The involvement of the genitourinary tract is extremely infrequent. We expose the case of a 14 years old female patient who was admitted for macroscopic hematuria of 48 hours of evolution and metrorrhagia with severe hemodynamic decompensation. The patient was under study for presenting a hemangioma in the lower left limb that extended to the pelvic region. Urethrocystofibroscopy showed the presence of multiple wide-spread angiomatous lesions in the bladder, some of them with active bleeding. The angio-resonance showed a voluminous hypervascular formation in contact with the bladder wall showing several arteriovenous fistulas at the pelvic level and in the left lower limb confirming the etiological diagnosis. A selective arterial embolization of the internal and external iliac territories was performed and then, a laser endocoagulation of the bleeding angiomatous foci was carried out. The hematuria completely stopped within 24 hours later of the procedure. The metrorrhagia associated with KTWS was controlled by the use of LHRH analogs and progestogens.


Subject(s)
Humans , Female , Adolescent , Klippel-Trenaunay-Weber Syndrome/surgery , Endovascular Procedures/methods , Metrorrhagia/surgery , Pelvis , Klippel-Trenaunay-Weber Syndrome/pathology , Klippel-Trenaunay-Weber Syndrome/diagnostic imaging , Magnetic Resonance Angiography/methods , Gallbladder Diseases/surgery , Gallbladder Diseases/pathology , Hemangioma/surgery , Hemangioma/pathology , Hematuria/surgery , Hematuria/pathology , Metrorrhagia/pathology
9.
Rev. méd. Chile ; 148(1): 118-122, Jan. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1094214

ABSTRACT

Renal papillary necrosis is an infrequent cause of hematuria characterized by ischemic necrosis of the renal medulla, especially the papilla. Its most common cause is analgesic abuse. Despite being oligo-symptomatic, in many cases its presence is associated with serious functional sequelae. Imaging, especially computed tomography, is essential to make the diagnosis. We report a 63-year-old female studied for an asymptomatic microscopic hematuria whose tomographic study showed a bilateral renal papillary necrosis. No etiology was found, and she evolved with a spontaneous complete remission.


Subject(s)
Humans , Female , Middle Aged , Hematuria , Kidney Papillary Necrosis , Tomography, X-Ray Computed , Kidney Medulla
10.
Rev Assoc Med Bras (1992) ; 66(Suppl 2): 112-117, 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1136381

ABSTRACT

SUMMARY OBJECTIVE We aimed to present a review of renal changes in patients with COVID-19. METHODS We performed a systematic review of the literature to identify original articles regarding clinical, laboratory, and anatomopathological kidney changes in patients infected with SARS-CoV-2 published until May 7, 2020. The search was carried out across PubMed, Scopus, and Embase using the keywords "COVID-19", "coronavirus", "SARS-CoV-2", "kidney injury" and "kidney disease". Fifteen studies presented clinical and laboratory renal changes in patients with COVID-19, and three addressed anatomopathological changes. DISCUSSION Acute kidney injury (AKI) was a relevant finding in patients with COVID-19. There were also significant changes in laboratory tests that indicated kidney injury, such as increased serum creatinine and blood urea nitrogen (BUN), proteinuria, and hematuria. The presence of laboratory abnormalities and AKI were significant in severely ill patients. There was a considerable prevalence of AKI among groups of patients who died of COVID-19. Histopathological analysis of the kidney tissue of patients infected with SARS-CoV-2 suggested that the virus may directly affect the kidneys. CONCLUSION Although COVID-19 affects mainly the lungs, it can also impact the kidneys. Increased serum creatinine and BUN, hematuria, proteinuria, and AKI were frequent findings in patients with severe COVID-19 and were related to an increased mortality rate. Further studies focusing on renal changes and their implications for the clinical condition of patients infected with the novel coronavirus are needed.


RESUMO OBJETIVO Apresentar uma revisão sobre as alterações renais nos pacientes com COVID-19. MÉTODOS Foi realizada uma revisão sistemática de literatura para buscar estudos referentes a pacientes com alterações renais clínicas, laboratoriais e anatomopatológicas durante a infecção por SARS-CoV-2. A busca foi realizada nas bases de dados eletrônicos PubMed, Scopus e Embase, com as palavras-chaves: "COVID-19", "coronavirus", "Sars-CoV-2", "kidney injury" e "kidney disease", para identificar artigos originais publicados na literatura até 07 de maio de 2020. Quinze estudos trouxeram alterações renais clínicas e laboratoriais dos pacientes com COVID-19, e três abordaram análises anatomopatológicas. DISCUSSÃO A Lesão renal aguda (LRA) foi um achado relevante nos pacientes com COVID-19. Houve também alterações significativas nos exames laboratoriais que indicam lesão renal, como o nível de creatinina e ureia séricas, proteinúria e hematúria. As alterações laboratoriais e a LRA foram importantes nos pacientes que desenvolveram o quadro grave da doença. Há considerável prevalência de LRA nos grupos de pacientes que vieram a óbito. Na análise histopatológica de pacientes com SARS-CoV-2 foram encontrados achados renais sugestivos que o vírus poderia ter efeitos diretos sobre o rim. CONCLUSÃO A COVID-19 é uma doença que, apesar de acometer principalmente os pulmões, também acomete os rins. Aumento das escórias nitrogenadas, hematúria, proteinúria e LRA foram achados frequentes em pacientes com quadros graves da COVID-19. Esses achados foram relacionados a maior mortalidade. É necessária a realização de mais estudos com enfoque nas alterações renais e suas implicações no quadro clínico causadas pelo novo coronavírus.


Subject(s)
Humans , Pneumonia, Viral/complications , Coronavirus Infections/complications , Acute Kidney Injury/etiology , Betacoronavirus/isolation & purification , Pneumonia, Viral/metabolism , Pneumonia, Viral/urine , Pneumonia, Viral/epidemiology , Proteinuria/etiology , Urine/chemistry , Coronavirus Infections , Coronavirus Infections/metabolism , Coronavirus Infections/urine , Coronavirus Infections/epidemiology , Creatinine/blood , Acute Kidney Injury/physiopathology , Pandemics , Betacoronavirus , Hematuria/etiology
11.
National Journal of Andrology ; (12): 888-894, 2020.
Article in Chinese | WPRIM | ID: wpr-880287

ABSTRACT

Objective@#To investigate the advantages and disadvantages of point electro-cauterization (PEC) and holmium laser cauterization (HLC) in the treatment of post-ejaculation hematuria.@*METHODS@#From January 2015 to December 2018, 73 patients with post-ejaculation hematuria, aged 24-63 (36.8 ± 4.2) years, underwent PEC (n = 35) or HLC (n = 38) after failure to respond to 3 months of conservative treatment. We compared the hospital days, total hospitalization expenses, maximum urinary flow rate (Qmax), average urinary flow rate (Qavg), Hamilton Anxiety Rating Scale (HAMA) score, postoperative duration of hematuria, and recurrence rate at 3 and 6 months after surgery.@*RESULTS@#All the patients experienced first ejaculation but no post-ejaculation hematuria at 1 month after operation. The recurrence rates were lower in the PEC than in the HLC group at 3 months (5.71% vs 2.63%, P > 0.05) and 6 months postoperatively (8.57% vs 5.26%, P > 0.05). Compared with the baseline, the Qmax was decreased from (18.56 ± 2.53) ml/s to (13.68 ± 3.31) ml/s (P < 0.05) and the Qavg from (14.35 ± 2.26) ml/s to (9.69±1.84) ml/s in the PEC group at 1 month after surgery (P < 0.01), but neither showed any statistically significant difference in the HLC group. Mild to moderate anxiety was prevalent in the patients preoperatively, particularly in those without job or regular income and those with a long disease course or frequent onset, the severity of which was not correlated with age, education or marital status. The HAMA score was decreased from18.65 ± 4.33 before to 12.35 ± 3.63 after surgery in the PEC group (P < 0.01), and from 16.88 ± 2.11 to 6.87 ± 4.36 in the HLC group (P < 0.01). The mean hospital stay was significantly longer in the former than in the latter group ([5.2 + 1.3] vs [3.4 ± 0.5] d, P < 0.01), while the total cost markedly lower ([6.35 ± 1.20] vs [12.72 ± 2.15] thousand RMB ¥, P < 0.05).@*CONCLUSIONS@#Both PEC and HLC are safe and effective for the treatment of post-ejaculation hematuria, with no significant difference in the recurrence rate at 3 and 6 months after operation, but their long-term effect needs further follow-up studies. PEC may increase the risk of negative outcomes of the postoperative urinary flow rate, while HLC has the advantages of better relieving the patient's anxiety, sooner discharge from hospital and earlier recovery from postoperative hematuria, though with a higher total cost than the former.


Subject(s)
Adult , Cautery , Ejaculation , Hematuria/surgery , Holmium , Humans , Laser Therapy , Lasers, Solid-State/therapeutic use , Male , Middle Aged , Treatment Outcome , Young Adult
12.
Rev. cuba. pediatr ; 91(2): e809, abr.-jun. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1003959

ABSTRACT

Introducción: La hematuria es el hallazgo clínico más frecuente entre las enfermedades genitourinarias, después de las infecciones del tracto urinario a cualquier edad. Objetivo: Identificar las características generales y etiología de la hematuria monosintomática en pacientes pediátricos. Métodos: Investigación descriptiva longitudinal y prospectiva con los pacientes atendidos con hematuria monosintomática en el Servicio de Nefrología del Hospital Pediátrico Docente William Soler entre el primero de enero de 2014 y 31 de diciembre de 2015. Resultados: Se reclutaron 45 pacientes. Predominó en escolares (40 por ciento) y adolescentes (40 por ciento), sexo masculino (55,5 por ciento). Se recogió el antecedente personal o familiar de hematuria en 44,5 por ciento y 55,5 por ciento, respectivamente. La urolitiasis familiar estuvo presente en 37,7 por ciento. El tipo de hematuria más frecuente fue la macroscópica (75,8 por ciento), no glomerular (71,2 por ciento), sin proteinuria (77,8 por ciento), y hematíes eumórficos (62,2 por ciento). La causa más frecuente fue la hipercalciuria idiopática (51,1 por ciento) y el 80 por ciento de todos los pacientes solo recibió tratamiento higieno-dietético. En 20 por ciento de los pacientes no se pudo precisar la causa etiológica. Conclusiones: La causa más frecuente de hematuria fue no glomerular (hipercalciuria idiopática) y en aquellos con hematuria cuya causa etiológica no se pudo precisar, es obligado mantener un seguimiento prolongado(AU)


Introduction: Hematuria is the most frequent clinical finding among genitourinary diseases afterwards urinary tract infection at any age. Objective: To identify general characteristics and etiology of monosymptomatic hematuria in in pediatrics patients. Methods: Descriptive, longitudinal and prospective research of the patients by monosymptomatic hematuria attended at the Nephrology service in William Soler Teaching Pediatric Hospital from January 1, 2014 to December 31, 2015. Results: 45 patients were recruited. Schoolchildren (40 percent) were predominant and adolescents (40 percent), and males (55.5 percent). It was collected personal or familial records of hematuria in 44.5 percent and 55.5 percent, respectively. Familial urolithiasis was present in 37.7 percent. The most common type of hematuria was the macroscopic (75.8 percent), non-glomerular (71.2 percent), without proteinuria (77.8 percent) and with eumorphic hematies (62.2 percent). The most frequent etiological cause was idiopathic hypercalciuria (51.1 percent), and 80 percent of all patients only received hygiene-dietetic treatment. In the 20 percent of the patients was not possible to determine the etiological cause. Conclusions: The most frequent cause of hematuria was non-glomerular (idiopathic hypercalciuria); and in those patients with hematuria of non-precised etiological cause, it is mandatory to keep long-term follow-up(AU)


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Hypercalciuria/complications , Hematuria/etiology , Epidemiology, Descriptive , Prospective Studies , Longitudinal Studies
13.
Medicina (B.Aires) ; 79(2): 150-153, abr. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1002622

ABSTRACT

El síndrome del cascanueces es una anomalía vascular en la que se comprime la vena renal izquierda a su paso entre la unión de la aorta y la arteria mesentérica superior, debido a un ángulo muy cerrado entre ambas arterias. Clínicamente puede presentarse como hematuria macro o microscópica, dolor episódico en flanco izquierdo, dolor pélvico, várices gonadales o simplemente cursar de forma asintomática. Presentamos dos casos clínicos, uno de ellos con dolor abdominal tipo cólico nefrítico y hematuria macroscópica y otro estudiado por hipertensión pero con antecedentes de embolización de la vena renal izquierda por varicocele izquierdo. Discutimos los aspectos clínicos, diagnósticos y terapéuticos de este síndrome.


Nutcracker syndrome is a vascular anomaly consisting in the compression of the left renal vein between the superior mesenteric artery and the aorta. Clinical features in nutcracker syndrome include pelvic pain, flank pain, haematuria, gonadal varices or simply asymptomatic. We are presenting two cases, one of them with macroscopic haematuria and flank pain and the other was studied for hypertension but with previous antecedents of left renal vein embolization in the setting of varicocele. We discuss the clinical presentation as well as diagnostic and therapeutic aspects related to this syndrome.


Subject(s)
Humans , Female , Adolescent , Adult , Renal Nutcracker Syndrome/diagnosis , Renal Nutcracker Syndrome/pathology , Renal Veins/pathology , Renal Veins/diagnostic imaging , Renal Nutcracker Syndrome/therapy , Computed Tomography Angiography/methods , Hematuria/diagnosis
14.
Article in Chinese | WPRIM | ID: wpr-776014

ABSTRACT

Bladder cancer is a urological malignant tumor with high morbidity and mortality. Masses protruding into the bladder cavity is an important feature for clinical diagnosis of bladder cancer. However,patients with encrusted bladder cancer(EBC)do not present with masses protruding into the bladder cavity and thus this malignancy is often misdiagnosed. Four patients were admitted in Peking University People's Hospital from July 2015 to February 2017. All of them were males aged 40 to 77 years(mean:58 years). Patients were mainly manifested as frequent urination,urgency,nocturia,and decreased bladder capacity,with or without difficulty of voiding.Although the bladder walls were markedly thickened,there was no obvious mass on imaging scans. Three patients received urodynamic test,which showed the maximum capacity of the bladder was 41 to 128 ml(mean:91 ml). One patient presented with gross hematuria,two patients presented with microscopic hematuria,and the remaining one patient had no hematuria. No mass was observed by cystoscopy. All of the patients were diagnosed with bladder cancer by repeated biopsy or intraoperative frozen section analysis.


Subject(s)
Adult , Aged , Biopsy , Cystoscopy , Hematuria , Humans , Male , Middle Aged , Urinary Bladder Neoplasms , Diagnosis , Pathology
15.
Article in Chinese | WPRIM | ID: wpr-775783

ABSTRACT

Type IV collagen is a component of the extracellular matrix in the basement membrane. Abnormal secretion or assembly of type IV collagen may lead to kidney lesions resulting in numerous nephropathy symptoms, e.g., Alport syndrome, thin basement membrane nephropathy, and focal segmental glomerulosclerosis. Treatment for type IV collagen-related nephropathy includes drugs, kidney transplantation, gene and cell therapy. However, drugs are not always effective, and kidney transplantation is hindered by the shortage of donors. Moreover, basement membrane nephritis often occurs after kidney transplantation. Therefore, gene and cell therapy probably is the most promising treatment for type IV collagen related nephropathies.


Subject(s)
Cell- and Tissue-Based Therapy , Collagen Type IV , Glomerulosclerosis, Focal Segmental , Hematuria , Humans , Nephritis, Hereditary
16.
Korean Journal of Radiology ; : 1627-1637, 2019.
Article in English | WPRIM | ID: wpr-786369

ABSTRACT

Nutcracker syndrome (NCS) is a syndrome caused by compression of the left renal vein (LRV), between the abdominal aorta and the superior mesenteric artery, resulting in hypertension of the LRV and hematuria. Doppler ultrasonography (US) has been commonly used for the diagnosis of NCS. However, several technical issues, such as Doppler angle and sample volume, need to be considered to obtain satisfactory results. In addition, morphologic changes of the LRV and a jetting phenomenon across the aortomesenteric portion of the LRV on contrast-enhanced computed tomography (CECT) are diagnostic clues of NCS. With proper Doppler US and CECT, NCS can be diagnosed noninvasively.


Subject(s)
Aorta, Abdominal , Diagnosis , Hematuria , Hypertension , Mesenteric Artery, Superior , Renal Veins , Tomography, X-Ray Computed , Ultrasonography, Doppler
17.
Article in English | WPRIM | ID: wpr-786124

ABSTRACT

Anti–glomerular basement membrane (GBM) nephritis is characterized by circulating anti-GBM antibodies and crescentic glomerulonephritis (GN) with deposition of IgG along the GBM. In a limited number of cases, glomerular immune complexes have been identified in anti-GBM nephritis. A 38-year-old female presented azotemia, hematuria, and proteinuria without any pulmonary symptoms. A renal biopsy showed crescentic GN with linear IgG deposition along the GBM and mesangial IgA deposition. The patient was diagnosed as concurrent anti-GBM nephritis and IgA nephropathy. Therapies with pulse methylprednisolone and cyclophosphamide administration were effective. Concurrent cases of both anti-GBM nephritis and IgA nephropathy are rare among cases of anti-GBM diseases with deposition of immune complexes. This rare case of concurrent anti-GBM nephritis and IgA nephropathy with literature review is noteworthy.


Subject(s)
Adult , Anti-Glomerular Basement Membrane Disease , Antibodies , Antigen-Antibody Complex , Azotemia , Basement Membrane , Biopsy , Cyclophosphamide , Female , Glomerulonephritis , Glomerulonephritis, IGA , Hematuria , Humans , Immunoglobulin A , Immunoglobulin G , Methylprednisolone , Nephritis , Proteinuria
18.
Article in Chinese | WPRIM | ID: wpr-813255

ABSTRACT

To investigate the correlation of different types of urinary abnormalities or different proteinuria and hematuria with the pathological injury of kidney in IgA nephropathy with isolated hematuria and/or mild proteinuria.
 Methods: Patients with primary IgA nephropathy, isolated hematuria and/or mild proteinuria were enrolled in the Department of Nephrology, the Second Xiangya Hospital, Central South University from January 2013 to January 2018. According to the difference of red blood cell count in urinary sediment and quantitative of 24-hour urinary protein (24 h-UP) during renal biopsy, the patients were grouped in 3 ways: a simple hematuria group, a hematuria and proteinuria group, and a simple proteinuria group; a proteinuria I group, a proteinuria II group, and a proteinuria III group; a hematuria I group, a hematuria II group, and a hematuria III group. The clinical parameters such as age, mean arterial pressure, blood urea nitrogen, serum creatinine, blood uric acid, 24 h-UP, and renal pathological damage were compared.
 Results: A total of 157 patients met the inclusion criteria, including 71 males and 86 females. The most common pathological type was focal and/or segmental glomerulosclerosis. The Lee's classification were dominated by grade III and IV, and the renal pathological injury was heavy. Immunoglobulin deposition was dominated by simple IgA deposition. The most common fluorescence intensity of IgA deposition was +++. 97 (61.78%) patients were accompanied by complement deposition and were mainly composed of simple complement C3 deposition. There were 18 patients (11.47%) in the simple hematuria group, 111 patients (70.70%) in the hematuria and proteinuria group, and 28 patients (17.83%) in the simple proteinuria group. Compared with the simple hematuria group, the proportion of patients with mild injury was lower in the simple proteinuria group, and the proportion of patients with moderate-to-severe injuries was increased (χ2=7.053, P=0.008). Compared with the hematuria and proteinuria group, the proportion of patients with mild injury was lower in the simple proteinuria group, and the proportion of patients with moderate-to-severe injury was increased (χ2=4.294, P=0.038). Compared with the proteinuria I group, the proportion of patients with mild injury was lower in the proteinuria III group, and the proportion of patients with moderate-to-severe injury was increased (χ2=5.433, P=0.020). There was no significant difference in the proportion of patients with renal pathological injury among different hematuria groups (P>0.05).
 Conclusion: The clinical manifestations of patients with IgA nephropathy with hematuria and/or mild proteinuria are inconsistent with renal pathological damage. Some patients with mild clinical manifestations have severe renal pathological damage and the renal pathological damage is more serious in simple proteinuria. The more proteinuria, the heavier the renal pathological damage.


Subject(s)
Creatinine , Female , Glomerulonephritis, IGA , Hematuria , Humans , Kidney , Male , Proteinuria
19.
Article in Korean | WPRIM | ID: wpr-766907

ABSTRACT

PURPOSE: To report a case of extensive choroidal effusion following the Valsalva maneuver under consecutive general anesthesia. CASE SUMMARY: A 41-year-old man who underwent panretinal photocoagulation with proliferative diabetic retinopathy had pars plana vitrectomy and endolaser photocoagulation under general anesthesia due to vitreous hemorrhage. Urology cooperated as the patient had hematuria; the day after the operation, he was transferred to the urology department. Two days after vitrectomy, the patient had an urgent transurethral bladder tumor resection under general anesthesia with suspicion of bladder tumor. At 6 days postoperatively, extensive choroidal effusion was observed from 8 to 10 o'clock on fundus examination and ultrasonography. On day 23 after urological surgery, the choroidal effusion had disappeared without treatment. CONCLUSIONS: Consecutive general anesthesia requires caution, as it is not only burdensome to the body as a whole but may also cause choroidal effusion in the eye.


Subject(s)
Adult , Anesthesia, General , Choroid , Diabetic Retinopathy , Hematuria , Humans , Light Coagulation , Ultrasonography , Urinary Bladder Neoplasms , Urology , Valsalva Maneuver , Vitrectomy , Vitreous Hemorrhage
20.
Korean Journal of Medicine ; : 221-224, 2019.
Article in Korean | WPRIM | ID: wpr-741130

ABSTRACT

Nutcracker syndrome (NCS) refers to left renal vein compression with impaired blood outflow. The etiology of NCS has been attributed to various anatomic anomalies. Posterior NCS is caused by compression of the retroaortic left renal vein between the aorta and spine. The classic symptoms of NCS include left flank pain with gross or microscopic hematuria. The frequency and severity of the syndrome vary from asymptomatic microhematuria to severe pelvic congestion. For this reason, diagnosis of NCS is difficult and often delayed. Here, we report a case of posterior NCS that was incidentally discovered.


Subject(s)
Aorta , Diagnosis , Estrogens, Conjugated (USP) , Flank Pain , Hematuria , Renal Veins , Spine
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