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1.
Arch. argent. pediatr ; 120(5): 310-316, oct. 2022. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1390872

ABSTRACT

Introducción. El compromiso renal (CR) en niñosinternados con enfermedad por coronavirus2019 (COVID-19, por su sigla en inglés) varía entre el 1,2 % y el 44 %. Dado que existe limitada información local, el objetivo primario de este estudio fue estimar la prevalencia de CR en nuestro medio. Población y métodos. Estudio transversalrealizado en 13 centros de Argentina entre marzo y diciembre de 2020. Se incluyeron pacientes internados con COVID-19, de 1 mes a 18 años y que tuvieran al menos una determinación de creatinina sérica y/o de orina completa.Se excluyeron aquellos con enfermedad renal conocida. Se consideró CR la presencia de lesión renal aguda (LRA), proteinuria, hematuria, leucocituria y/o hipertensión arterial (HTA). Resultados. De 528 historias clínicas elegibles, seincluyeron las de 423 pacientes (el 55,0 % de sexo masculino, mediana de edad 5,3 años). El cuadro clínico fue asintomático en el 31 %, leve en el 39,7 %, moderado en el 23,9 %, grave en el 1,2 %, crítico en el 0,7 %, y el 3,5 % presentó síndrome inflamatorio multisistémico pediátrico (SIMP). Dos pacientes (0,47 %) fallecieron. La prevalencia de CR fue del 10,8 % (intervalo de confianza 95% 8,2-14,2), expresada por leucocituria (16,9 %), proteinuria (16,0 %), hematuria (13,2 %), HTA (3,7 %) y LRA (2,3 %). Ninguno requirió diálisis. Presentar CR se asoció (p <0,0001) con formas graves de enfermedad. Conclusión. La prevalencia de CR en pacientes pediátricos internados con COVID-19 en 13 centros de nuestro país fue del 10,8 % y predominó en las formas clínicas graves.


Introduction. Renal involvement among pediatric patients with coronavirus disease 2019 (COVID-19) ranges between 1.2% and 44%. Given the limited information available locally, the primary objective of this study was to estimate the prevalence of renal involvement in our setting. Population and methods. Cross-sectional study conducted in 13 Argentine sites between March and December 2020. Patients aged 1 month to 18 years hospitalized due to COVID-19 and with at least one measurement of serum creatinine and/or a urinalysis were included. Those with a known kidney disease were excluded. Renal involvement was defined as the presence of acute kidney injury (AKI), proteinuria, hematuria, leukocyturia and/or arterial hypertension (HTN). Results. Among 528 eligible medical records, 423 patients were included (55.0% were males; median age: 5.3 years). The clinical presentation was asymptomatic in 31%; mild, in 39.7%; moderate, in 23.9%; severe, in 1.2%; critical, in 0.7%; and 3.5% had multisystem inflammatory syndrome in children (MIS-C). Two patients (0.47%) died. The prevalence of renal involvement was 10.8% (95% confidence interval: 8.2­14.2); it was described as leukocyturia (16.9%), proteinuria (16.0%), hematuria (13.2%), HTN (3.7%), and AKI (2.3%). No patient required dialysis. Renal involvement was associated with severe forms of disease (p < 0.0001). Conclusion. The prevalence of renal involvement among pediatric patients hospitalized due to COVID-19 in 13 Argentine sites was 10.8%; severe forms of disease prevailed.


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Acute Kidney Injury/etiology , Acute Kidney Injury/epidemiology , COVID-19/complications , COVID-19/epidemiology , Hypertension/epidemiology , Proteinuria/epidemiology , Prevalence , Cross-Sectional Studies , Retrospective Studies , Systemic Inflammatory Response Syndrome , Creatinine , SARS-CoV-2 , Hematuria/etiology , Hematuria/epidemiology
2.
Rev. cientif. cienc. med ; 25(1): 68-72, sept. 2022.
Article in Spanish | LILACS | ID: biblio-1399930

ABSTRACT

Los carcinomas uroteliales son el 4to tumor más común. Pueden ubicarse en el tracto urinario inferior (vejiga y uretra) o en el tracto urinario superior (cavidades renales, pelvis renal y uréter). Presentamos una serie de 3 casos, con cuadro de hematuria macroscópica, documentando tumores uroteliales, realizándose en estos casos un abordaje lumboscópico de riñón y una resección endoscópica del rodete vesical. Se realiza nefroureterectomía lumboscópica con resección de rodete vesical endoscópica transuretral. Los 3 pacientes fueron egresados al segundo día posquirúrgico sin complicaciones y en los tres casos el rodete vesical sin evidencia de actividad tumoral, y actualmente en vigilancia con excelente resultados oncológicos. La nefroureterectomía lumboscópica con resección endoscópica del rodete vesical es una técnica reproducible en manos experimentadas, con iguales resultados oncológicos que el abordaje abierto.


Urothelial carcinomas are the 4th most common tumor. They can be located in the lower urinary tract (bladder and urethra) or in the upper urinary tract (renal cavities, renal pelvis, and ureter). We present a series of 3 cases, with a picture of macroscopic hematuria, documenting urothelial tumors, performing in these cases a lumboscopic approach to the kidney and an endoscopic resection of the bladder rim. Lumboscopic nephroureterectomy was performed with transurethral endoscopic bladder rump resection. The 3 patients were discharged on the second postoperative day without complications and in the three cases the bladder rim without evidence of tumor activity, and currently under surveillance with excellent oncological results. Lumboscopic nephroureterectomy with endoscopic resection of the bladder rim is a reproducible technique in experienced hands, with the same oncological results as the open approach.


Subject(s)
Carcinoma , Urethra , Hematuria , Kidney Pelvis
3.
Rev. cir. (Impr.) ; 74(1): 103-111, feb. 2022. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1388907

ABSTRACT

Resumen Introducción: La embolización de arteria renal (EAR) es un procedimiento percutáneo que ocluye la arteria renal, con la consecuente isquemia del territorio vascular. Sus indicaciones más comunes son la hematuria y el manejo paliativo en cáncer renal metastásico. A pesar del desarrollo técnico y de la experiencia progresiva, los estudios incluyen un número reducido de pacientes y en nuestro país se revisan casos aislados. Objetivo: Describir la experiencia en el Servicio de Salud Valparaíso San Antonio y revisar la literatura existente. Materiales y Método: Realizamos un estudio descriptivo de los pacientes sometidos a EAR por anemia severa secundaria a hematuria, durante los años 2012 a 2020. Posteriormente, realizamos una revisión de la literatura en PubMed, hasta abril de 2020. Resultados: Incluimos 9 pacientes, 6 (66,7%) hombres y 3 (33,3%) mujeres. La mediana de edad fue de 69 años (RIC = 18). La principal causa de la hematuria fue cáncer renal avanzado (7 pacientes). No hubo complicaciones, y se logró éxito clínico en todos los pacientes. Nuestra búsqueda de literatura arrojó 571 referencias y 24 cumplieron con nuestros criterios de elegibilidad. La edad de los pacientes y las causas subyacentes de hematuria fueron variadas. La menor tasa de éxito clínico fue de 65%, sin embargo, 15 estudios (62,5%) reportaron un éxito igual o mayor al 90%. Seis estudios reportaron más de un 10% de pacientes con alguna complicación. Conclusión: Nuestros resultados y la evidencia revisada muestran que la EAR parece ser segura y eficaz en el manejo de anemia severa secundaria a hematuria.


Introduction: Renal artery embolization (RAE) is a percutaneous procedure that occludes the renal artery, with consequent ischemia of the vascular territory. The most common indications include hematuria and palliation for metastatic renal cancer. Despite technical development and progressive experience, studies include a small number of patients and few cases have been published in our country. Aim: To share our experience at Valparaíso-San Antonio Health Service and to review the existing literature. Materials and Method: We performed a retrospective descriptive review of medical records of patients with severe anemia due to hematuria managed with RAE, between 2012 and 2020. Subsequently, we conducted a literature search in PubMed, from inception until April 2020. Results: We included 9 patients. There were 6 (66.7%) males and 3 (33.3%) females with a median age of 69 years (IQR = 18). Main cause of hematuria was advanced kidney cancer (7 patients). There were no complications and clinical success was achieved in all patients. Our literature search yielded 571 references, 24 met our eligibility criteria. The age of patients and the underlying causes of hematuria were varied. The lowest clinical success rate was 65%, however, 15 studies (62.5%) reported a success equal to or greater than 90%. Six studies reported more than 10% of patients with complications. Conclusión: Our results and the studies reviewed show that RAE appears to be safe and effective in the management of patients with severe anemia due to hematuria.


Subject(s)
Humans , Female , Pregnancy , Aged , Renal Artery , Embolization, Therapeutic/methods , Epidemiology, Descriptive , Kidney Transplantation/adverse effects , Embolization, Therapeutic/adverse effects , Hematuria
4.
Pesqui. vet. bras ; 42: e06875, 2022. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1365242

ABSTRACT

It is reported the occurrence of enzootic hematuria (EH) in buffaloes in Brazil after performing an epidemiological survey and clinicopathological analises. To date, EH caused by ingestion of Pteridium esculentum subsp. arachnoideum, a radiomimetic plant popularly known as "bracken fern", has not been described in this species in Brazil. Bovine EH is responsible for high economic losses in Brazil's Southeast Region not only because of the deaths it causes, but also owing to its negative effect on productivity. In São José do Barreiro County, São Paulo, some farmers in areas with a high incidence of bovine EH have been replacing cattle with buffaloes, based on the premise that the latter would be more resistant to poisoning by ingestion of Pteridium spp. However, even though initial observations indicated that buffaloes are indeed less sensitive than cattle to the toxic principle of Pteridium spp., cases of hematuria in this species have been reported. According to preliminary date, EH only occurs in buffaloes over six years of age. Macroscopic examination revealed a thickened urinary vesicle mucosa, along with multiple foci of ulcerated, exophytic, verrucous, and pedunculated lesions. In one of the buffaloes studied, the bladder wall was ruptured and exhibited marked secondary inflammation. Histologically, neoplastic and non-neoplastic changes similar to those described in cattle poisoned by Pteridium spp. were observed. The neoplasms found included papilloma, carcinoma in situ, urothelial carcinoma (low and high grade), inverted, microcystic, and trabecular variants, urothelial carcinoma with divergent differentiation (squamous and glandular), squamous cell carcinoma, lymphangioma, hemangioma, and hemangiosarcoma. There was also coexistence of epithelial and mesenchymal neoplasms. Bovine papillomavirus particles were not detected by polymerase chain reaction in the bladder samples analyzed.


Descreve-se, através de levantamento epidemiológico e avaliação clínico-patológica, a ocorrência de hematúria enzoótica (HE) em búfalos no Brasil. Essa condição, causada pela ingestão da planta radiomimética Pteridium esculentum subsp. arachnoideum, conhecida popularmente como "samambaia" ou "samambaia do campo", até então não havia sido descrita nessa espécie no Brasil. Na Região Sudeste, a HE bovina é responsável por elevadas perdas econômicas, devidas não apenas aos óbitos, mas também em função da queda de produtividade. No município de São José do Barreiro/SP, alguns produtores de áreas com alta incidência de HE bovina, vêm substituindo os bovinos por búfalos, com base na premissa de que estes seriam mais resistentes à intoxicação. Embora, de acordo com observações iniciais, os búfalos realmente sejam menos sensíveis que os bovinos ao princípio tóxico de Pteridium spp., ainda assim, tem-se verificado a ocorrência de casos de hematúria nessa espécie. De acordo com o levantamento inicial, a HE só ocorre em búfalos com idade a partir de seis anos. Ao exame macroscópico, verificou-se a mucosa da bexiga espessa, com múltiplos focos de lesões ulceradas, exofíticas, papiliformes, verrucosas, pedunculadas. Histologicamente, foram observadas alterações neoplásicas e não neoplásicas semelhantes às descritas nos bovinos com HE. Entre as neoplasias foram encontrados papiloma, carcinoma in situ, carcinoma urotelial (baixo e alto grau), variantes invertida, microcística e trabecular, carcinoma urotelial com diferenciação divergente (escamosa e glandular), carcinoma de células escamosas, linfangioma, hemangioma e hemangiossarcoma. Ocorreu também coexistência entre neoplasias epiteliais e mesenquimais. Não foram detectadas partículas de papilomavírus bovino pelo teste PCR nas amostras de bexiga analisadas.


Subject(s)
Animals , Urinary Bladder Neoplasms/veterinary , Buffaloes , Pteridium/poisoning , Hematuria/diagnosis , Hematuria/pathology , Hematuria/epidemiology , Plants, Toxic/poisoning
5.
MedUNAB ; 24(3): 353-358, 202112.
Article in Spanish | LILACS | ID: biblio-1353586

ABSTRACT

Introducción. El compromiso tumoral metastásico del melanoma al tracto genitourinario es frecuente, pero, la metástasis a vejiga es rara, constituye menos del 2% de los casos. Sin embargo, en autopsias realizadas a pacientes con melanoma se ha encontrado metástasis en la vejiga en entre un 18% y un 37% de los casos, lo que la convierte en la segunda en incidencia posterior al adenocarcinoma gástrico. La media de supervivencia suele ser entre 6 - 7.5 meses. El objetivo de este trabajo es presentar el caso de un melanoma metastásico a vejiga, entidad poco frecuente y poco diagnosticada por ser la mayoría de las veces asintomática. Presentación del caso. Paciente femenina de 62 años, con antecedente de melanoma al nivel del primer artejo del pie, con manejo quirúrgico y farmacológico. Consultó por hematuria. La cistoscopia evidenció una lesión única sólida, eritematosa, con necrosis y fácil sangrado y se indicó realizar resección transuretral (RTU). La patología demostró compromiso por melanoma ulcerado metastásico. Se inició manejo de segunda línea (Pembrolizumab) y presentó progresión a miembros superiores y recaída a nivel vesical. La paciente falleció un año después. Discusión. Las metástasis de melanoma al tracto genitourinario son frecuentes, pero las metástasis vesicales aisladas son raras. El tratamiento suele ser RTU de la lesión, cistectomía, quimioterapia y radioterapia. La RTU es curativa para las lesiones restringidas al epitelio, aunque la cistectomía radical suele ser la terapia de elección ante un paciente con un tumor localizado. El Pembrolizumab ha demostrado aumentar la supervivencia. El pronóstico depende del tamaño y profundidad de la invasión. Conclusiones. El compromiso vesical metastásico es poco frecuente y diagnosticado, puede estar presente en pacientes con melanoma, síntomas irritativos urinarios no específicos y hematuria. Suele ser de mal pronóstico, y requiere de manejo quirúrgico asociado a manejo sistémico.


Introduction. Metastatic tumor compromise of melanoma to the genitourinary tract is frequent, but metastasis to the bladder is rare, representing less than 2% of cases. However, autopsies performed on patients with melanoma have found metastases in the bladder in 18-37% of cases, making it the second incidence after gastric adenocarcinoma. The median survival is usually 6 to 7.5 months. The objective of this work is to present the case of a metastatic melanoma to the bladder, a rare and underdiagnosed condition because most of the time it is asymptomatic. Case Presentation. 62-year-old female patient, with a history of melanoma at the level of the first toe, with surgical and pharmacological management. The reason for consultation was hematuria. Cystoscopy revealed a single solid, erythematous lesion with necrosis and easy bleeding, and a transurethral resection (TUR) was indicated. The pathology found compromise for metastatic ulcerated melanoma. Second-line treatment (Pembrolizumab) was started and presented progression to the upper limbs and relapse at the bladder level. The patient died a year later. Discussion. Melanoma metastases to the genitourinary tract are common, but isolated bladder metastases are rare. Treatment is usually TUR of the lesion, cystectomy, chemotherapy, and radiation therapy. TUR is curative for lesions restricted to the epithelium, although radical cystectomy is usually the therapy of choice in patients with a localized tumor. Pembrolizumab has been shown to increase survival. The prognosis depends on the size and depth of the invasion. Conclusions. Metastatic bladder compromise is rare and underdiagnosed, it may be present in patients with melanoma, non-specific urinary irritative symptoms, and hematuria. It tends to have a poor prognosis, and requires surgical management associated with systemic management.


Introdução. O comprometimento do tumor metastático do melanoma no trato geniturinário é comum, mas a metástase na bexiga é rara, constituindo menos de 2% dos casos. Entretanto, em autópsias realizadas em pacientes com melanoma, foi encontrada metástase na bexiga entre 18% e 37% dos casos, o que a torna a segunda em incidência após o adenocarcinoma gástrico. A média de sobrevivência é geralmente entre 6 - 7,5 meses. O objetivo deste trabalho é apresentar o caso de um melanoma metastático na bexiga, uma entidade pouco frequente e subdiagnosticada, pois na maioria das vezes é assintomática. Apresentação do caso. Paciente do sexo feminino, 62 anos, com antecedentes de melanoma no nível do hálux, com manejo cirúrgico e farmacológico. Ela consultou por hematúria. A cistoscopia revelou uma única lesão sólida, eritematosa com necrose e sangramento fácil, e foi indicada uma ressecção transuretral (RTU). A patologia mostrou comprometimento de melanoma ulceroso metastático. O tratamento de segunda linha (Pembrolizumab) foi iniciado e a patologia avançou para os membros superiores e uma recaída no nível da bexiga. A paciente morreu um ano depois. Discussão. As metástases de melanoma para o trato geniturinário são frequentes, mas as metástases vesicais isoladas são raras. O tratamento é geralmente RTU da lesão, cistectomia, quimioterapia e radioterapia. A RTU é curativa para lesões restritas ao epitélio, embora a cistectomia radical seja geralmente a terapia de escolha para um paciente com um tumor localizado. O Pembrolizumab demonstrou aumentar a sobrevivência. O prognóstico depende do tamanho e da profundidade da invasão. Conclusões. O comprometimento vesical metastático é raro e subdiagnosticado, pode estar presente em pacientes com melanoma, sintomas irritantes urinários não específicos e hematúria. Geralmente tem um prognóstico negativo e requer manejo cirúrgico em associação com manejo sistêmico.


Subject(s)
Urinary Bladder Neoplasms , Urology , Hematuria , Melanoma , Neoplasm Metastasis
6.
Arch. argent. pediatr ; 119(6): 414-418, dic. 2021. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1342853

ABSTRACT

El compromiso renal en los pacientes pediátricos con enfermedad por el coronavirus 2019 (COVID-19, por su sigla en inglés) varía entre el 10 % y el 80 %. Dado que existe limitada información sobre su pronóstico, se realizó este estudio con el objetivo de describir la evolución en el corto plazo de pacientes a quienes se les detectó compromiso renal durante la internación por COVID-19. Estudio observacional y transversal que incluyó pacientes entre 1 mes y 18 años con COVID-19 con compromiso renal. Se excluyeron aquellos con patología renal conocida. Se identificaron 27 pacientes con afectación renal, en 14 de ellos se pudo realizar seguimiento para estudiar la evolución renal luego de 3 meses del diagnóstico. Todos habían normalizado los niveles de creatinina plasmática durante la internación y al momento del control ambulatorio, realizado a los 145 días (92-193), todos se encontraban normotensos y con hallazgos urinarios normales, excepto uno que persistía con microhematuria. La evolución fue favorable; la mayoría de los pacientes presentaron remisión completa del compromiso renal.


Renal involvement among pediatric patients with coronavirus disease 2019 (COVID-19) ranges between 10 % and 80 %.Given the limited information about its prognosis, the objective of this study was to describe the short-term course of patients in whom renal involvement was detected during hospitalization due to COVID-19. This was an observational, cross-sectional study in patients aged 1 month to 18 years who had COVID-19 and renal involvement. Those with a known kidney disease were excluded. A total of 27 patients with renal involvement were identified; 14 of them were followed-up to study their disease course for 3 months after diagnosis. All of the patients had achieved normal plasma creatinine levels during hospitalization and, at the time of outpatient follow-up, which took place 145 days (92-193) later, all had normal blood pressure and urinary values, except for 1 patient who continued with microscopic hematuria. Course was favorable; in most patients, renal involvement had fully resolved.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Acute Kidney Injury , COVID-19 , Prognosis , Cross-Sectional Studies , SARS-CoV-2 , Hematuria
7.
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
8.
Rev. bras. ciênc. vet ; 28(3): 132-137, jul./set. 2021. il.
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1363925

ABSTRACT

Hematúria é uma grave manifestação clínica de doença do sistema urinário, ocorrendo sob as formas micro ou macroscópica. Neste artigo relatam-se dois casos de hematúria macroscópica associada à infecção por Leptospira interrogans sorogrupo Canicola. O exame clínico inicial revelou hematúria macroscópica, taquicardia, taquipneia, febre, elevação do tempo de perfusão capilar, hipomotilidade intestinal, além de icterícia da mucosa oral. Leucocitose, proteinúria, glicosúria, piúria e azotemia foram achados comuns aos dois casos. Teste de Soroaglutinação Microscópica foi realizado para titulação de anticorpos contra Leptospira interrogans. Tratamento incluiu medidas terapêuticas de suporte (fluidoterapia), controle da hematúria e antibioticoterapia. Sete dias após manifestação dos sinais clínicos iniciais, ambos animais receberam alta hospitalar após remissão dos sinais clínicos.


Haematuria is a serious clinical manifestation of urinary system disease, occurring in micro or macroscopic forms. In this article two cases of macroscopic haematuria associated with Leptospira interrogans serogroup Canicolainfection are related. The initial clinical examination revealed macroscopic haematuria, tachycardia, tachypnea, fever, increased capillary perfusion time, intestinal hypomotility, in addition to jaundice of the oral mucosa. Leukocytosis, proteinuria, glycosuria, pyuria and azotemia were common findings in both cases. Microscopic serum agglutination test was performed for titration of antibodies against Leptospira interrogans. Treatment included supportive therapeutic measures (fluid therapy), hematuria control and antibiotic therapy. Seven days after the manifestation of the initial clinical signs, both animals were discharged from the hospital without complications.


Subject(s)
Animals , Hematuria/veterinary , Horse Diseases/diagnosis , Leptospirosis/veterinary , Urologic Diseases/veterinary
11.
Rev. bras. ciênc. vet ; 28(1): 57-60, jan./mar. 2021. il.
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1368822

ABSTRACT

Objetivou-se verificar a compatibilidade entre diferentes marcas de tiras reagentes para urinálise, tanto de uso veterinário, como de uso humano, e confrontar os parâmetros semiquantitativos desse instrumento com métodos quantitativos. Para isso, foram analisadas 77 amostras frescas de urina de cães e gatos e testados 04 modelos de tiras reagentes. Quanto à densidade urinária, houve correlação razoável entre os métodos quantitativo e semiquantitativo naquelas amostras com pH ácido, mas não naquelas com pH neutro ou alcalino. Quanto à concentração proteica, houve similaridade de 53,3% a 83,3% entre as marcas testadas e quando comparadas com a análise fotométrica houve uma correlação razoável (rs = 0,69752 a 0,75074). Em ponto de corte de 15mg/dL de proteína, a sensibilidade da tira reagente foi 82,5% e 100% para urina canina e felina, respectivamente. No tocante à hematúria, houve divergência razoável entre a sedimentoscopia e as diferentes marcas de tiras reativas. Quanto à piúria, há uma baixa sensibilidade das tiras em relação às amostras caninas com muitos resultados falso-negativos (33% a 75%), enquanto em amostras felinas a sensibilidade foi de 100%. Assim, independente da marca, as tiras reagentes devem servir apenas como teste rápido de triagem, sendo mais apropriado o uso de métodos quantitativos na avaliação clínica do paciente a partir da urinálise.


The aim was to verify the compatibility between different brands of urinary dipsticks, for both human and veterinary use, and to compare the semiquantitative parameters of this instrument with quantitative methods. For this, 77 fresh samples of urine from dogs and cats were analyzed e and 04 models of reagent strips were tested. Regarding urinary density, a reasonable correlation was observed between the quantitative and semiquantitative methods in those samples with acidic pH, which did not occur in those with neutral or alkaline pH. Regarding the protein concentration, there was similarity from 53.3% to 83.3% between the brands and in the comparative analysis between the control strip and the photometric analysis, there was a reasonable correlation (rs = 0.69752 to 0.75074). In cut-off point of 15mg/dL protein, the sensitivity of the reagent strip was 82.5% and 100% for canine and feline urine, respectively. Regarding hematuria, there was a reasonable divergence of results between sedimentation and tested dipsticks. As for pyuria, there is a low sensitivity of the strips in relation to canine samples with many false negative results (33% to 75%), while in feline samples the sensitivity was 100%. Thus, regardless of the brands, the reagent strips should serve only as a rapid screening test, while the use of quantitative methods in the clinical evaluation of the patient from urinalysis is more appropriate.


Subject(s)
Animals , Cats , Dogs , Reagent Strips/analysis , Cats/urine , Urinalysis/methods , Dogs/urine , Efficiency , Indicators and Reagents/analysis , Proteinuria/veterinary , Pyuria/veterinary , Urine Specimen Collection/methods , Hematuria/veterinary
12.
Article in English | LILACS, COLNAL | ID: biblio-1411051

ABSTRACT

Urethral stricture disease is a relatively common urologic condition with an estimated incidence of 9/100,000 men younger than 65 years. The risk of stricture is markedly increased in patients older than 65 years with an incidence of 21/100,000, which is almost half the incidence for urolithiasis in this population. This indicates the importance and high burden of strictures.[1] Symptomatic patients typically present with obstructive urinary symptoms (e.g., incomplete emptying, straining, weak stream, etc.) and occasionally have a history of recurrent infections, hematuria, bladder stones, or renal failure.[2] More than half of strictures arise in bulbar urethra.


La estenosis uretral es una afección urológica relativamente frecuente, con una incidencia estimada de 9/100.000 varones menores de 65 años. El riesgo de estenosis aumenta notablemente en los pacientes mayores de 65 años, con una incidencia de 21/100.000, que es casi la mitad de la incidencia de urolitiasis en esta población. Esto indica la importancia y la elevada carga de las estenosis.[1] Los pacientes sintomáticos suelen presentar síntomas urinarios obstructivos (por ejemplo, vaciado incompleto, esfuerzo, chorro débil, etc.) y, en ocasiones, tienen antecedentes de infecciones recurrentes, hematuria, cálculos vesicales o insuficiencia renal.[2] Más de la mitad de las estenosis surgen en la uretra bulbar.


Subject(s)
Humans , Constriction, Pathologic , Urolithiasis , Urethral Stricture , Urinary Bladder Calculi , Renal Insufficiency , Reinfection , Hematuria
14.
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
15.
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
16.
Article in English | LILACS, VETINDEX | 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
17.
Hematol., Transfus. Cell Ther. (Impr.) ; 42(3): 255-260, July-Sept. 2020. tab
Article in English | LILACS | ID: biblio-1134040

ABSTRACT

ABSTRACT Introduction: Persistent hematuria is a chronic complication of sickle cell anemia (SCA) which can progress to chronic kidney disease. The practice of early detection of persistent hematuria in children with SCA in steady state is important for timely intervention. Objective: To determine the prevalence of persistent hematuria among children with sickle cell anemia in steady state and compare the result with that of a group of HbAA controls. The outcome will possibly strengthen the health policy on the need for regular screening for persistent hematuria in children with SCA. Methods: Children with sickle cell anemia, aged 2-18 years in steady state, were recruited consecutively from the sickle cell clinic at the University of Nigeria teaching Hospital Enugu. The controls were similarly recruited from the children's outpatient clinic. To determine persistent hematuria, dipstick urinalysis and microscopy were performed for both subjects and controls at enrollment and repeated after four weeks. Results: Out of the 122 children with SCA studied, 5 (4.1%) had persistent hematuria. None (0%) of the 122 age- and gender-matched HbAA controls had persistent hematuria. This difference in prevalence of persistence between HbSS patients and HbAA controls was statistically significant (p= 0.02). Conclusion: Persistent hematuria still occurs significantly more among children with SCA, even among those in steady state. Routine urinalysis at follow-up visits in children with SCA is strongly recommended, as this will aid early detection and prompt management to prevent progression to chronic kidney disease.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Child , Hematuria , Anemia, Sickle Cell
18.
Medicina (Ribeirao Preto) ; 53(2)jul. 2020. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1358311

ABSTRACT

RESUMO: A hematúria é definida como o achado de mais que duas hemácias por campo de aumento na análise microscópica de urina coletada por jato médio. Na sua forma macroscópica, caracteriza-se por sua coloração típica (avermelhada ou marrom), acompanhada pela presença de mais de 106 hemácias/ml na sedimentoscopia. É uma condição que necessita de investigação da causa e apresenta-se com prevalência incerta e definição às vezes imprecisa, mas com vasto diagnóstico diferencial. Dentre as possíveis causas, encontramos a presença do traço falciforme, aparentemente subdiagnosticado, e a síndrome de quebra-nozes, possibilidade mais rara. No caso relatado a seguir, foram diagnosticadas simultaneamente as duas causas acima citadas, descobertas após a investigação do primeiro episódio de hematúria macroscópica em uma mulher jovem previamente hígida. Com o objetivo de chamar a atenção para a concomitância de duas possíveis e incomuns causas de hematúria numa mesma paciente, relatamos o caso a seguir. (AU)


ABSTRACT: Hematuria is defined as the finding more than two red blood cells per field of analysis in the microscopic analysis of the urine collected by the medium jet. In its macroscopic form, it is characterized by its typical coloration (reddish or brown), accompanied by the presence of more than 106 red cells/ml in urinary sediment. It is a condition that needs investigation and it presents itself sometimes with imprecise definition, but with vast differential diagnosis. Among the possible etiologies, there is the presence of the sickle cell trait, apparently underdiagnosed, and the renal nutcracker syndrome, a rarer possibility. In the case reported below, these two findings were diagnosed simultaneously, following an investigation of the first episode of macroscopic hematuria in a young and previously healthy woman. In order to draw attention to the simultaneous presence of two unusual causes of hematuria in the same patient, we report the following case. (AU)


Subject(s)
Humans , Female , Adult , Sickle Cell Trait , Diagnosis, Differential , Renal Nutcracker Syndrome/diagnosis , Hematuria/diagnosis
19.
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
20.
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
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