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2.
Rev. ANACEM (Impresa) ; 15(1): 33-39, 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1281420

ABSTRACT

INTRODUCCIÓN: El cólico renal es una condición médica común en los servicios de urgencia. Representa la manifestación clínica más frecuente de urolitiasis, cuya patogenia es multifactorial, con tasas de prevalencia varía de 1% a 20% y una recurrencia a 10 años del 42% al 50%. OBJETIVO: Establecer el perfil clínico-epidemiológico, como también el diagnóstico y manejo de los pacientes hospitalizados por cólico renal en el Hospital Clínico Herminda Martín (HCHCM). MATERIAL Y MÉTODO: Estudio descriptivo retrospectivo en pacientes hospitalizados con diagnóstico de cólico renal en el HCHM de Chillán en el período marzo 2014-marzo 2019. Se estudiaron las variables: sexo, edad, presentación clínica de ingreso, factores de riesgo asociados, motivo de hospitalización, resultados imagenológicos y manejo clínico. Resultados. El 52,45% correspondió a pacientes de sexo masculino, encontrándose la mayor cantidad de pacientes en el intervalo de 40-49 años. La obesidad, antecedente de urolitiasis e hipertensión arterial fueron las patologías asociadas más frecuentes. En la mayoría de los pacientes, el motivo de la hospitalización fue la refractariedad al tratamiento analgésico, alcanzando un 86,76%. El 56,37% de los pacientes recibió manejo médico expulsivo y a un 19,11% de los pacientes se le realizó una intervención quirúrgica durante la hospitalización. CONCLUSIÓN: El perfil de éstos pacientes no sólo permite establecer medidas que podrían evitar un evento litiásico, sino que además se demuestra la necesidad de realizar un manejo óptimo que puede evitar reconsultas, sobrecarga de los servicios de urgencia, aumento de días cama y complicaciones.


INTRODUCTION: Renal colic is a common condition in the emergency department. It represents the most frequent clinical manifestation of urolithiasis, whose prevalence rate varies between 1% to 20%. Its pathogenesis is multifactorial, with a recurrence of 10 years from 42-50%. OBJECTIVE: Establish the clinical-epidemiological profile, as well as the diagnosis and management of patients hospitalized for renal colic at the Herminda Martín Clinical Hospital(HCHM). MATERIALS AND METHODS: A retrospective descriptive study of hospitalized patients diagnosed with renal colic at the HCHM, March 2014-March 2019, the variables were studied: sex, age, the clinical presentation of admission, associated risk factors, the reason for hospitalization, imaging results, and management. Results: 52.45% were male patients, with the highest number of patients in the range of 40-49 years. Obesity, a history of urolithiasis and hypertension, occurred more frequently within the associated pathologies. In most patients, refractable to analgesic treatment was the reason for hospitalization, reaching 86.76%. 56.37% of patients received expulsion medical management, and 19.11% of patientshad surgeryduring hospitalization. CONCLUSION: The profile of these patients not only allows them to establish measures that could prevent a lithiasis event but also shows the need for effective management of patients who can avoid reconsults, an overload of emergency services, increasedbed days and complications


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Renal Colic/diagnosis , Hospitalization , Kidney Diseases/diagnosis , Epidemiology, Descriptive , Retrospective Studies , Emergency Service, Hospital/statistics & numerical data , Renal Colic/surgery , Renal Colic/epidemiology , Renal Colic/diagnostic imaging
3.
Pesqui. vet. bras ; 40(12): 1002-1009, Dec. 2020. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1155035

ABSTRACT

Chronic kidney disease (CKD) is characterized by irreversible morphostructural lesions that can progressively evolve to chronic renal insufficiency and kidney failure. It is known that the heart and kidneys are closely related, and that communication between these organs occurs through a variety of pathways; subtle physiological changes in one of them are compensated by the other. Histopathological cardiac evaluation through routine staining presents a limitation to identify specific or discreet lesions in the cardiomyocytes. This study aimed to evaluate serum troponin levels in cats with CKD, associated with clinical and pathological findings, as well as to correlate the morphostructural cardiac lesions to determine their distribution through macroscopic and histological assessments and anti-cardiac troponin C (cTnC) immunohistochemistry (IHC). To this end, 20 cats (18 diagnosed with CKD and two controls) were selected. Anti-human cTnC IHC was conducted after necropsy and separation in eight regions of each collected heart. Heart fragments from two cats without CKD were used as controls. The anti-human cTnC antibody is useful in detecting cardiac lesions and has shown decreased expression in cardiomyocytes of cats with CKD. Serum troponin was above the reference values in 11/18 (61.11%) animals and decreased expression for the cTnC antibody was observed in individual cardiomyocytes in 9/18 (50%) animals. It was verified that the number of regions with decreased expression for the cTnC antibody in cardiomyocytes is significantly correlated with serum troponin. The anti-human cTnC antibody has been found effective in detecting cardiac lesions and has shown decreased expression in the cardiomyocytes of cats with CKD. Correlation was observed between increased serum cTnI and loss of immunoreactivity at anti-cTnC antibody IHC in cats with CKD, which proves damage to cardiomyocytes secondary to kidney disease.(AU)


A doença renal crônica (DRC) é caracterizada por lesões morfoestruturais irreversíveis, que podem evoluir progressivamente para insuficiência renal crônica e falência renal. Sabe-se que o coração e os rins mantêm estreita relação e a comunicação entre esses órgãos ocorre por uma variedade de vias; alterações fisiológicas sutis em um desses órgãos são compensadas pelo outro. A avaliação histopatológica cardíaca mediante a colorações rotineiras são limitadas para identificar lesões específicas ou discretas em cardiomiócitos. O presente trabalho teve como objetivos avaliar os níveis séricos de troponina em gatos com DRC, associados aos achados clínico-patológicos, bem como correlacionar as lesões cardíacas morfoestruturais, a fim de determinar a distribuição destas, por meio da avaliação macroscópica, histológica e imuno-histoquímica com anti-cTnC. Neste estudo foram selecionados 20 gatos (18 diagnosticados com DRC e 2 animais controle). Para a aplicação da técnica de imuno-histoquímica anti-troponina C humana, necropsias foram realizadas e cada coração coletado separadamente em 8 regiões. Fragmentos do coração de 2 gatos sem lesão cardíaca foram utilizados como controle. O anticorpo anti-TnC humano é útil na detecção de lesões cardíacas e apresentou expressão diminuída em cardiomiócitos de gatos com DRC. Em 11/18 animais (61,11%) a troponina sérica encontrava-se acima dos valores de referência e foram observadas diminuição da expressão para anticorpo-cTnC em cardiomiócitos individuais em 9/18 (50%). Notou-se que o número de regiões com diminuição da expressão para anticorpo-cTnC em cardiomiócitos está significativamente correlacionado com a troponina sérica. O anticorpo anti-TnC humano se mostrou eficaz para detectar lesões cardíacas e demonstrou diminuição da expressão nos cardiomiócitos de gatos com DRC. Houve correlação entre o aumento da CTnI sérica e perda da imunorretividade na avaliação imuno-histoquímica com anticorpo anti-TnC em gatos com DRC o que comprova danos em cardiomiócitos secundários a doença renal.(AU)


Subject(s)
Animals , Cats , Immunohistochemistry , Cats/injuries , Heart , Kidney , Kidney Diseases/diagnosis , Kidney Diseases/pathology , Troponin
4.
J. bras. nefrol ; 42(2): 219-230, Apr.-June 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1134817

ABSTRACT

Abstract There are more than 150 different rare genetic kidney diseases. They can be classified according to diagnostic findings as (i) disorders of growth and structure, (ii) glomerular diseases, (iii) tubular, and (iv) metabolic diseases. In recent years, there has been a shift of paradigm in this field. Molecular testing has become more accessible, our understanding of the underlying pathophysiologic mechanisms of these diseases has evolved, and new therapeutic strategies have become more available. Therefore, the role of nephrologists has progressively shifted from a mere spectator to an active player, part of a multidisciplinary team in the diagnosis and treatment of these disorders. This article provides an overview of the recent advances in rare hereditary kidney disorders by discussing the genetic aspects, clinical manifestations, diagnostic, and therapeutic approaches of some of these disorders, named familial focal and segmental glomerulosclerosis, tuberous sclerosis complex, Fabry nephropathy, and MYH-9 related disorder.


Resumo As doenças renais genéticas raras compreendem mais de 150 desordens. Elas podem ser classificadas segundo achados diagnósticos como (i) distúrbios do crescimento e estrutura, (ii) doenças glomerulares, (iii) tubulares e (iv) metabólicas. Nos últimos anos, houve uma mudança de paradigma nesse campo. Os testes moleculares tornaram-se mais acessíveis, nossa compreensão sobre os mecanismos fisiopatológicos subjacentes a essas doenças evoluiu e novas estratégias terapêuticas foram propostas. Portanto, o papel do nefrologista mudou progressivamente de mero espectador a participante ativo, parte de uma equipe multidisciplinar, no diagnóstico e tratamento desses distúrbios. O presente artigo oferece um panorama geral dos recentes avanços a respeito dos distúrbios renais hereditários raros, discutindo aspectos genéticos, manifestações clínicas e abordagens diagnósticas e terapêuticas de alguns desses distúrbios, mais especificamente a glomeruloesclerose segmentar e focal familiar, complexo da esclerose tuberosa, nefropatia de Fabry e doença relacionada ao MYH9.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adult , Genetic Diseases, Inborn/genetics , Kidney/physiopathology , Kidney Diseases/congenital , Kidney Diseases/diagnosis , Thrombocytopenia/congenital , Thrombocytopenia/diagnosis , Thrombocytopenia/therapy , Tuberous Sclerosis/therapy , Genetic Testing/methods , Fabry Disease/diagnosis , Fabry Disease/genetics , Fabry Disease/therapy , Interdisciplinary Communication , Glomerular Filtration Rate/physiology , Hearing Loss, Sensorineural/diagnosis , Genetic Diseases, Inborn/diagnosis , Kidney Tubules/pathology , Metabolic Diseases/pathology , Nephrology/standards
5.
Rev. Col. méd. cir ; 159(1): 23-25, abr 2020. tab
Article in Spanish | LILACS, LIGCSA | ID: biblio-1247543

ABSTRACT

Objetivo: determinar la presencia de proteinuria en habitantes de una aldea de la región costera de Santa Rosa, Guatemala, julio del año 2019. Material y métodos: estudio descriptivo y transversal, en una muestra de 575 habitantes de la aldea Casas Viejas, captada por durante cuatro jornadas médicas. Las muestras de orina fueron analizadas con tiras reactivas. Resultados: de los habitantes que participaron, 55.48 % (319) fueron de sexo femenino, la mediana de edad fue de 24 años, el 39.820% (229) estudiante y el 85.2 % (490) sin antecedentes patológicos. De los factores predisponentes de enfermedad renal, el 56.170% (323) consume antiinflamatorios no esteroideo -AINES-, el 82.26 % (473) bebidas carbonatadas, el 13.570% (78) bebidas alcohólicas; la mediana de consumo de agua fue de 6 vasos diarios y 13.22 % (76) han estado expuestos a agroquímicos. Proteinuria se documentó en 8.87 % (51) de los habitantes. Conclusiones: más de la mitad de los sujeto de estudio son de sexo femenino y sin antecedentes patológicos; de los factores predisponentes a enfermedad renal los más frecuentes son el consumo de -AINES-, bebidas carbonatadas y la hidratación inadecuada. Nueve de cada cien sujetos de estudio presentan proteinuria.


Objetive: to establish urine protein presence in inhabitants of a small village of the coastal region in Santa Rosa, Guatemala. July 2019. Material y methods: Descriptive and transversal study performed on 575 persons from Casas Viejas village, using a nonprobabilistic sampling. Proteinuria was determined by urine test strips. Results: Of the persons studied, 55.48% (319) were female, mean age was 24 years old, 39.82% (229) were students and 85.25% had no pathological background. Predisposing factors of kidney disease were noted, 56.17% (323) consumed Non-steroidal Anti-inflammatory Drugs (NSAIDs), 82.26% (473) consumed carbonated drinks, 13.57% (78) alcoholic beverages, the mean water consumption was 6 glasses per day, and 13.22% (76), were exposed to agrochemical pesticides. Proteinuria was found in 8.87% (51) of the sample. Conclutions: more than half of population were female and didn´t showed pathological signs. Predisposing factors to kidney disease were, frequent NSAIDs use, carbonated drinks consumption a no adequate hydration. Nine of each one hundred people studied presented urine protein.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Proteinuria/epidemiology , Pesticides/adverse effects , Proteinuria/diagnosis , Proteinuria/urine , Alcohol Drinking/adverse effects , Carbonated Beverages/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Prevalence , Cross-Sectional Studies , Risk Factors , Drinking , Guatemala/epidemiology , Kidney Diseases/diagnosis , Kidney Diseases/urine , Kidney Diseases/epidemiology
6.
Int. braz. j. urol ; 46(1): 15-25, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1056363

ABSTRACT

ABSTRACT Sarcoidosis is a multisystem granulomatous disease characterized by epithelioid noncaseating granulomas associated with clinical and radiologic findings. The cause of this disease is still uncertain. Sarcoidosis affects mostly lungs and lymph nodes and is not usually considered a urological disease, therefore, this etiology may be overlooked in several urological disorders, such as hypercalcemia, hypercalciuria and nephrolithiasis. It affects all races and genders. This review aims to describe the urological manifestations of sarcoidosis and to elucidate how the disease may affect the management of numerous urological conditions.


Subject(s)
Humans , Sarcoidosis/pathology , Kidney Diseases/pathology , Sarcoidosis/diagnosis , Sarcoidosis/therapy , Biopsy , Chronic Disease , Hypercalciuria/diagnosis , Hypercalciuria/pathology , Hypercalcemia/diagnosis , Hypercalcemia/pathology , Kidney Diseases/diagnosis , Kidney Diseases/therapy
7.
Rev. chil. pediatr ; 91(1): 51-57, feb. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1092787

ABSTRACT

Resumen: Introducción: La nefropatía falciforme (NF) es una complicación poco estudiada en la edad pediátrica, que se manifiesta en diferentes formas, incluyendo la glomerulopatía y la tubulopatía. Objetivo: Descri bir las complicaciones renales agudas y crónicas de niños con anemia de células falciformes (ACF). Pacientes y Método: Estudio de cohorte restrospectiva. Se incluyeron pacientes pediátricos con diagnóstico confirmado de enfermedad de células falciformes que tuvieran estudio nefro-urológico. Se consignó patrón electroforético de hemoglobina, presencia y tipo de afectación renal, y presencia de compromiso cardiológico. Se realizó análisis bivariado para comparar pacientes con y sin NF. Resultados: Se incluyeron 79 pacientes, 59.5% hombres, siendo el patrón electroforético más fre cuente Hb-SS (60.9%). La NF se presentó en el 70% de ellos, con una edad de 114 meses (RIQ 65-157). Las alteraciones más frecuentemente encontradas fueron hiperfiltración glomerular, mi croalbuminuria, lesión renal aguda, hipertensión arterial e hipostenuria. En el análisis bivariado, un ecocardiograma anormal fue más frecuente en los pacientes con NF (84,8% vs 54,3% p = 0,01), así como tuvieron una tendencia a mayor uso de medicamentos nefrotóxicos (74,5% vs 54,2% p = 0,07). Conclusiones: Nuestros hallazgos sugieren que la nefropatía falciforme puede presentarse a tempra na edad, siendo muy frecuente la hiperfiltración glomerular. Las complicaciones cardiopulmonares en ACF se podrían asociar con la presencia NF.


Abstract: Introduction: Sickle cell nephropathy (SCN) is a poorly studied complication of pediatric patients. It appears in different forms, including glomerulopathy, and tubulopathies. Objective: To describe acute and chronic renal complications in patients with sickle cell anemia (SCA). Patients and Method: Re trospective study. Pediatric patients with confirmed diagnosis of sickle cell disease were included who had a nephro-urology study. Hemoglobin electrophoresis pattern, presence and type of renal involvement, and presence of cardiac involvement were recorded. Bivariate analysis was perfor med to compare patients with and without SCN. Results: 79 patients were included, 59.5% of them were men, and the most frequent electrophoresis pattern was Hb-SS (60.9%). The SCN oc curred in 70% of patients with an average age of 114 months (RIQ 65-157). The most frequently observed alterations were glomerular hyperfiltration, microalbuminuria, acute kidney injury, ar terial hypertension, and hyposthenuria. In the bivariate analysis, an abnormal echocardiogram result was presented more frequently in patients with SCN (84.8% vs. 54.3% p = 0.01), as well as more frequent use of nephrotoxic drugs (74.5% vs. 54.2% p = 0.07). Conclusions: Our findings suggest that sickle cell nephropathy may occur at an early age, where glomerular hyperfiltration is very common. Cardiopulmonary complications in patients with SCA may be related to the presence of SCN.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Anemia, Sickle Cell/complications , Kidney Diseases/diagnosis , Kidney Diseases/etiology , Acute Disease , Chronic Disease , Prevalence , Retrospective Studies , Risk Factors , Glomerular Filtration Rate , Kidney Diseases/physiopathology , Kidney Diseases/epidemiology
8.
Ann. afr. méd. (En ligne) ; 13(4): 3861-3866, 2020. tab
Article in French | AIM | ID: biblio-1259098

ABSTRACT

Contexte et objectif. L'ampleur réelle des néphropathies congénitales est peu connue en Afrique et notamment en Guinée. L'objectif de cette étude était de déterminer la fréquence des néphropathies congénitales rencontrées. Méthodes. Cette étude documentaire de type descriptif sur la néphropathie congénitale, a été conduite entre les 1er janvier 2007 et 30 juin 2012, dans les services de pédiatrie et de chirurgie pédiatrique de Donka. Les paramètres d'intêret englobaient les données épidémiologiques, cliniques et paracliniques. Résultats. Parmi les 34.448 dossiers colligés, 26 présentaient une néphropathie congénitale. Il s'agissait des néphroblastomes (n=17), des syndromes de jonction pyélo-urétérale (n=6), d'une hydronéphrose sur rein multikystique gauche (n=1), d'un rein multikystique en ptose (n=1) et d'une ectopie rénale (n=1). Le sexe masculin était prépondérant (21/26) avec un sexe ratio de 4,2/1. Les enfants de 29 jours à 2 ans étaient les plus touchés. Conclusion. Les néphropathies congénitales sont paraissent moins fréquentes dans cette institution hospitalière, à cause du manque d'un plateau technique diagnostique optimal. Le diagnostic précoce des néphropathies congénitales devrait être fait dans la période prénatale ce qui permettrait une meilleure prise en charge des enfants affectés


Subject(s)
Academic Medical Centers , Guinea , Kidney Diseases/diagnosis , Kidney Diseases/epidemiology , Multicystic Dysplastic Kidney , Wilms Tumor
9.
Rev. fac. cienc. méd. (Impr.) ; 16(2,n.esp): 58-65, jul.-dic. 2019.
Article in Spanish | LILACS, BIMENA | ID: biblio-1097318

ABSTRACT

La Nefropatía mesoamericana, entidad de reciente definición que se caracteriza por episodios de Insuficiencia Renal Aguda y alta incidencia de Enfermedad Renal Crónica de etiología desconocida. Objetivo:Proporcionar información actualizada sobre Nefropatía mesoamericana de interés para la salud pública. Materiales y métodos: Búsqueda PubMed© utilizando términos Mesoamerican and Nephropathy‖ totalizando 67 resúmenes, seleccionando los que incluyen los últimos avances y puntos de interés clínico-epidemiológico.Resultados: Se postulan teorías basadas en datos de múltiples estudios transversales que tienen implicaciones de importancia para la salud pública y la mitigación en la incidencia de casos, así como para el manejo clínico; a pesar de eso no parece estar a la vista la identificación de la etiología. Conclusión: La falta de definición objetiva de caso sometido a riesgo de Insuficiencia Renal Crónica en zonas y ocupaciones de riesgo elevado para Nefropatía mesoamericana es uno de los obstáculos más importantes para desarrollar estrategias de prevención en salud pública...(AU)


Subject(s)
Humans , Databases, Bibliographic , Renal Insufficiency, Chronic/complications , Kidney Diseases/diagnosis , Renal Replacement Therapy/methods
11.
Prensa méd. argent ; 104(6): 295-298, Ago2018. fig, graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1051313

ABSTRACT

Renal biopsy is a key procedure for the evaluation and management of the renal diseases, in order to establish a certainty diagnosis, to perform an adequate treatment and to determine the prognosis, while it results in a fundamental tool, but not all the medical centers have the necessary requeriments to carry them succesfully so that it can achieve the maximum benefit, lessen the posible complications, since as it is an invasive technique, always exists a certain risk inherent to the procedure, being the technique of choice the percutaneous renal biopsy guided by ultrasound. The aim of this report, is to know the incidence of the reanl pathology, in kidney biopsies in our Hospita, between July 2008 through July 2017, by mean of a descriptive and retrospective study. Two-thousands and eightsi-six reanl biopsies were analyzed in that period, and we analyzed the frequency of the disease diagnosed, the origin of the samples and thir quality, the age range of the population studied, as well as the complications of the method employed


Subject(s)
Humans , Pathology, Clinical , Minimally Invasive Surgical Procedures , Image-Guided Biopsy/methods , Kidney/pathology , Kidney Diseases/diagnosis
12.
Rev. med. interna Guatem ; 22(1): 31-40, 2018 ene.mar. tab
Article in Spanish | LILACS, LIGCSA | ID: biblio-1052723

ABSTRACT

La detección de micro albuminuria permite el rápido diagnóstico de nefropatía incipiente, predecir desarrollo de proteinuria y aumento de mortalidad; siendo la medición en orina de 24 horas Gold standard para su diagnóstico. En sepsis el aumento de permeabilidad vascular favorece paso de sustancias como albúmina y con ello producir micro albuminuria, cuya medición es pronostica de mortalidad en unidad de terapia intensiva. Diseño: estudio descriptivo transversal donde se evaluaron 27 pacientes ingresados en unidad de terapia intensiva de adultos del hospital general de enfermedades debiendo cumplir con: antecedentes de hipertensión arterial y/o diabetes mellitus, tener diagnóstico de choque hipovolémico o séptico, medición de escalas pronosticas de mortalidad y tener examen de orina de 24 horas para evaluar presencia de micro albuminuria, posteriormente se evaluó la condición de egreso como vivo o muerto. Métodos: Se realizó cálculo de Chi2 de homogeneidad o Test Exacto de Fisher para variables categóricas. La normalidad de variables numéricas se determinó con Shaphiro Wilk; si era normal se realizó t de Student de Muestras independientes y de lo contrario U de Mann Whitney. Resultados: Edad media de 50.29 años, principalmente hombres con antecedente de diabetes y diagnóstico de choque séptico. Obteniéndose una media para micro albuminuria en 31.93 mg/dl en pacientes vivos y para fallecidos 58.69 mg/dl. Las escalas pronosticas de mortalidad fueron estadísticamente significativas (p =0.03) para SOFA y (p =0.010) para escala APACHE, así también se obtuvo (p =0.03) para presencia de Micro albuminuria. Conclusiones: La cuantificación de Micro albuminuria en orina de 24 horas en pacientes con estado de choque en unidadde terapia intensiva es un factor pronóstico de mortalidad al ingreso del paciente.(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Albuminuria/urine , Kidney Diseases/diagnosis , Kidney Diseases/mortality , Shock/mortality , Shock, Septic/complications , Diabetes Complications/diagnosis , Hypertension/complications
13.
Arch. argent. pediatr ; 115(5): 294-297, oct. 2017. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-887380

ABSTRACT

El absceso renal representa una patología infrecuente en el recién nacido. Puede presentar consecuencias graves: sepsis con alta mortalidad, cicatrices renales y riesgo de enfermedad renal crónica. Se reporta sobre un recién nacido con absceso renal unilateral a Staphylococcus aureus, con cuadro de septicemia, sin otro foco supurativo ni malformación urinaria, que evolucionó adecuadamente con antibióticos endovenosos, sin tratamiento quirúrgico, aunque con cicatrices renales como secuela. A partir de este caso, se analizan las estrategias de diagnóstico, tratamiento y seguimiento del absceso renal en un neonato y se destaca el diagnóstico precoz para evitar cicatrices renales.


Renal abscess is a rare disease in newborn, but severe consequences can occur: sepsis with high mortality, renal scar formation and risk of chronic renal failure. A neonate with unilateral renal abscess due to Staphylococcus aureus is reported, with septicemia, with no other suppurative focus, nor with urinary malformation, with good clinical evolution with intravenous antibiotics and without surgical treatment, but with renal scars sequel. From this case, the strategies of diagnosis, treatment and followup of the renal abscess in a neonate are analyzed, emphasizing the early diagnosis to avoid renal scars.


Subject(s)
Humans , Male , Infant, Newborn , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Abscess/diagnosis , Abscess/drug therapy , Kidney Diseases/microbiology , Kidney Diseases/diagnosis , Kidney Diseases/drug therapy
14.
Rev. bras. ter. intensiva ; 29(3): 303-309, jul.-set. 2017. tab, graf
Article in Portuguese | LILACS | ID: biblio-899517

ABSTRACT

RESUMO Objetivo: Estabelecer se há superioridade entre os critérios para predizer desfecho clínico desfavorável na lesão renal aguda e nefropatia induzidas por contraste. Métodos: Estudo retrospectivo conduzido em hospital terciário com 157 pacientes submetidos à infusão de contraste radiológico para fins propedêuticos. Resultados: Cumpriram os critérios para inclusão 147 pacientes. Aqueles que cumpriram os critérios de lesão renal aguda induzida por contraste (59) também cumpriram os critérios para nefropatia induzida por contraste (76); 44,3% dos pacientes cumpriram os critérios para o estadiamento pelo sistema KDIGO; 6,4% dos pacientes necessitaram utilizar terapia de substituição renal, e 10,7% dos pacientes morreram. Conclusão: O diagnóstico de nefropatia induzida por contraste foi o critério mais sensível para determinar a necessidade de terapia de substituição renal e óbito, enquanto o KDIGO demonstrou a maior especificidade; na população avaliada, não houve correlação entre o volume de contraste e a progressão para lesão renal induzida por contraste, nefropatia induzida por contraste, diálise de suporte ou óbito.


ABSTRACT Objective: To establish whether there is superiority between contrast-induced acute kidney injury and contrast-induced nephropathy criteria as predictors of unfavorable clinical outcomes. Methods: Retrospective study carried out in a tertiary hospital with 157 patients undergoing radiocontrast infusion for propaedeutic purposes. Results: One hundred forty patients fulfilled the inclusion criteria: patients who met the criteria for contrast-induced acute kidney injury (59) also met the criteria for contrast-induced nephropathy (76), 44.3% met the criteria for KDIGO staging, 6.4% of the patients required renal replacement therapy, and 10.7% died. Conclusion: The diagnosis of contrast-induced nephropathy was the most sensitive criterion for renal replacement therapy and death, whereas KDIGO showed the highest specificity; there was no correlation between contrast volume and progression to contrast-induced acute kidney injury, contrast-induced nephropathy, support dialysis or death in the assessed population.


Subject(s)
Humans , Adult , Aged , Aged, 80 and over , Renal Replacement Therapy/statistics & numerical data , Contrast Media/adverse effects , Acute Kidney Injury/diagnosis , Intensive Care Units , Prognosis , Severity of Illness Index , Prevalence , Retrospective Studies , Sensitivity and Specificity , Disease Progression , Contrast Media/administration & dosage , Acute Kidney Injury/chemically induced , Acute Kidney Injury/epidemiology , Kidney Diseases/diagnosis , Kidney Diseases/chemically induced , Kidney Diseases/epidemiology , Middle Aged
15.
J. vasc. bras ; 16(2): f:150-l:161, abr.-jun. 2017. tab, graf
Article in Portuguese | LILACS | ID: biblio-859624

ABSTRACT

A doença renovascular aterosclerótica é a principal causa de hipertensão secundária. A história natural da doença demonstra taxas de progressão de 4 a 12% ao ano. Entre os métodos de tratamento existe a angioplastia com stent de artérias renais; porém, poucos estudos clínicos demonstraram seus resultados a longo prazo. Esta revisão sistemática da literatura se propõe a apresentar os resultados a longo prazo (acima de 24 meses) da angioplastia com stent de artérias renais na doença aterosclerótica em relação à função renal e aos níveis pressóricos no controle da hipertensão. Foi realizada uma ampla pesquisa, utilizando os termos apropriados, nas bases de dados LILACS, EMBASE, SCIELO, Cochrane Library e MEDLINE. De um total de 2.170 referências, apenas sete artigos contemplavam todos os critérios de inclusão. Conclui-se que, a longo prazo, há uma estabilização da função renal, redução dos níveis pressóricos e diminuição do número de classes de medicamentos anti-hipertensivos


Atherosclerotic renovascular disease is the most important cause of secondary hypertension. The natural history of the disease reveals progression rates of 4 to 12% per year. Angioplasty with renal artery stenting is one treatment option; but there are few studies that have reported long-term results. The objective of this systematic literature review is to discuss the long-term results (at least 24 months) of angioplasty with stenting of renal arteries for atherosclerotic disease, in terms of renal function and blood pressure levels for control of hypertension. A thorough search was conducted of LILACS, EMBASE, SCIELO, Cochrane Library, and MEDLINE using the appropriate terms. Just seven out of 2170 references identified met all inclusion criteria. It was concluded that over the long term renal function was stabilized, blood pressure levels were reduced, and the number of classes of antihypertensive medication decreased


Subject(s)
Humans , Male , Female , Aged , Angioplasty/methods , Atherosclerosis/diagnosis , Atherosclerosis/therapy , Renal Artery Obstruction/diagnosis , Renal Artery Obstruction/therapy , Stents , Treatment Outcome , Antihypertensive Agents/therapeutic use , Database , Hypertension, Renovascular/diagnosis , Hypertension, Renovascular/therapy , Kidney Diseases/diagnosis , Kidney Diseases/therapy , Renal Artery , Sex Factors
16.
Arch. endocrinol. metab. (Online) ; 60(6): 532-536, Nov.-Dec. 2016. tab, graf
Article in English | LILACS | ID: biblio-827787

ABSTRACT

ABSTRACT Objectives To identify a clinical profile and laboratory findings of a cohort of hypoparathyroidism patients and determine the prevalence and predictors for renal abnormalities. Materials and methods Data from medical records of five different visits were obtained, focusing on therapeutic doses of calcium and vitamin D, on laboratory tests and renal ultrasonography (USG). Results Fifty-five patients were identified, 42 females and 13 males; mean age of 44.5 and average time of the disease of 11.2 years. The most frequent etiology was post-surgical. Levels of serum calcium and creatinine increased between the first and last visits (p < 0.001 and p < 0.05, respectively); and serum levels of phosphate decreased during the same period (p < 0.001). Out of the 55 patients, 40 had USG, and 10 (25%) presented with kidney calcifications. There was no significant difference in the amount of calcium and vitamin D doses among patients with kidney calcifications and others. No correlation between serum and urinary levels of calcium and the presence of calcification was found. Urinary calcium excretion in 24h was significantly higher in patients with kidney calcification (3.3 mg/kg/d) than in those without calcification (1.8 mg/kg/d) (p < 0.05). Conclusions The reduction of hypocalcemia and hyperphosphatemia suggest an effectiveness of the treatment, and the increase in serum creatinine demonstrates an impairment of renal function during follow-up. Kidney calcifications were prevalent in this cohort, and higher urinary calcium excretion, even if still within the normal range, was associated with development of calcification. These findings suggest that lower rates of urinary calcium excretion should be aimed for in the management of hypoparathyroidism.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Pseudohypoparathyroidism/blood , Hypoparathyroidism/blood , Phosphates/blood , Vitamin D/therapeutic use , Calcinosis/diagnosis , Calcium/urine , Calcium/blood , Calcium/therapeutic use , Retrospective Studies , Ultrasonography , Creatinine/blood , Hypoparathyroidism/etiology , Hypoparathyroidism/drug therapy , Kidney Diseases/diagnosis , Nephrocalcinosis/complications , Nephrocalcinosis/diagnostic imaging
19.
J. health inform ; 8(1): 17-25, jan.-mar. 2016. graf, ilus, tab
Article in Portuguese | LILACS | ID: biblio-1074

ABSTRACT

Objetivo: Investigar o uso de técnicas para extração de conhecimento de diagnósticos provenientes de laudos de biópsia renal. Métodos: Foram aplicadas técnicas de extração de conhecimento em um conjunto de laudos de biópsia renal do Serviço de Patologia do Hospital do Rim e Hipertensão, São Paulo. Resultados: Foram extraídos 694 diagnósticos completos diferentes do conjunto de 3.018 laudos. Foi obtida uma árvore de três níveis diagnósticos e uma nuvem de palavras com os termos extraídos dos diagnósticos. A extração de terminologia resultou em 206 termos candidatos únicos que ocorreram 20.599 vezes no corpus avaliado. Conclusão: O resultado da extração de terminologia apresentou-se como satisfatório para criar uma taxonomia sobre biópsia renal. A árvore com ligação entre diagnósticos pode auxiliar novos profissionais em treinamento na área de patologia para confecção dos laudos.


Objective: To present techniques for extracting knowledge of diagnosis from renal biopsy reports. Methods: Knowledge extraction techniques were applied in a set of reports of the Pathology service of the Kidney and Hypertension Hospital. Results: From 3,018 reports 694 different complete diagnoses were extracted. A tree with three diagnostic levels and a word cloud with terms extracted from diagnoses were obtained. The terminology extraction resulted in 206 unique candidate terms that occurred 20,599 times in the evaluated corpus. Conclusion: The results of terminology extraction is suitable to create a taxonomy about renal biopsy. Trees with link between diagnoses can help new professionals in the area of pathology for writing the reports.


Objetivo: Investigar el uso de técnicas de extracción de conocimiento a partir de los informes de diagnóstico de la biopsia renal. Métodos: técnicas de extracción de conocimientos se aplicaron a un conjunto de informes de biopsia renal del Servicio de Patología del Hospital do Rim e Hipertensão, Sao Paulo. Resultados: Se obtuvieron 694 diagnósticos completos diferentes de un conjunto de 3.018 informes. Se obtuvo un árbol de tres niveles de diagnóstico y una nube de palabras con los términos extraídos de diagnóstico. La extracción de terminología resultó en 206 términos candidatos únicos que se produjeron 20.599 veces el corpus nominal. Conclusión: El resultado de la extracción de terminología se presentó como satisfactoria para crear una taxonomía acerca de biopsia renal. El árbol con la conexión entre el diagnóstico puede ayudar a los profesionales jóvenes en formación en el área de la patología para la preparación de informes.


Subject(s)
Biopsy, Needle , Data Mining , Kidney Diseases/classification , Kidney Diseases/diagnosis , Terminology as Topic
20.
J. bras. nefrol ; 38(1): 42-48, jan.-mar. 2016. tab, graf
Article in Portuguese | LILACS | ID: lil-777496

ABSTRACT

Resumo Introdução: As glomerulopatias são as doenças renais mais frequentemente diagnosticáveis por biópsia. O levantamento epidemiológico das glomerulopatias permite identificar sua distribuição e principais etiologias e serve de subsídio para definição de estratégias de prevenção e tratamento. Objetivo: O presente estudo pretende identificar a frequência e a correlação clínico-patológica das glomerulopatias diagnosticadas por biópsia no HC-UFPR durante 5 anos. Métodos: Foram realizadas 131 biópsias no período de 1 de janeiro de 2008 a 31 de dezembro de 2012, submetidas à microscopia óptica e de imunofluorescência. Todas as lâminas de microscopia óptica foram revistas por um patologista. Dados clínicos e laboratoriais e resultados da microscopia de imunofluorescência foram obtidos por revisão dos prontuários. Resultados: Foram reanalisados 128 de 131 casos; 46,5% foram obtidos em homens. A idade média de realização da biópsia foi 43 anos para os homens e 38 anos para as mulheres. Em 99 casos identificou-se a indicação da biópsia; 49,5% apresentaram síndrome nefrótica; 17,17%, insuficiência renal aguda e 15,15% insuficiência renal crônica; 8,08%, síndrome nefrítica; 6,06%, proteinúria isolada e 4,04%, hematúria isolada. 61,21% tratavam-se de glomerulopatia secundária, 33,62% glomerulopatia primária e 5,17% não puderam ser classificados. Dentre as glomerulopatias secundárias, a mais frequente foi a nefrite lúpica (49,29%), e, dentre as primárias, glomeruloesclerose segmentar e focal (30,77%) e nefropatia membranosa (25,64%). Conclusão: O paciente com glomerulopatia neste serviço é adulto e portador de síndrome nefrótica. Ao contrário de outros relatos, observamos predomínio das glomerulopatias secundárias, refletindo possivelmente o perfil terciário de atendimento do HC-UFPR.


Resumo Introduction: The glomerulopathies are the most common biopsy-proven kidney diseases. The epidemiological investigation of glomerulopathies allows the identification of their distribution and main causes and enables the development of prevention and treatment strategies. Objective: This study aims to identify the frequency and clinical-pathological correlation of glomerular diseases diagnosed at the HC-UFPR over the period of 5 years. Methods: 131 biopsies were performed between January 1, 2008 and December 31, 2012 and were analysed by light and immunofluorescence microscopy. Histopathological slides were reviewed by a pathologist. Clinical and laboratory data and the immunofluorescence microscopy results were extracted from medical records. The findings were tabulated and analysed. Results: 128 of 131 cases were reanalysed. 46.5% were obtained from men. Patients' age averaged 43 years for men and 38 for women. In 99 cases, the indication of biopsy was identified; 49.5% cases presented nephrotic syndrome, 17.17%, acute renal failure and 15.15%, chronic renal failure; 8.08%, nephritic syndrome; 6.06%, isolated proteinuria and 4.04% isolated hematuria. In 61.21% an underlying disease related to the glomerulopathy could be identified; 33.62% corresponded to primary disease and in 5.17% of cases the nature of the glomerulopathy could not be determined. Among secondary glomerulopathies, the most frequent was Lupus Nephritis (49.29%), and among the primary, Focal Segmental Glomerulosclerosis (30.77%) and Membranous Nephropathy (25.64%). Conclusion: The average patient with glomerulopathy in this service is an adult with nephrotic syndrome. Unlike other reports, secondary glomerulopathies were predominant. These findings may reflect the tertiary characteristic of the assistance at HC-UFPR.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Kidney Diseases/diagnosis , Kidney Diseases/pathology , Biopsy , Lupus Nephritis/diagnosis , Brazil , Glomerulosclerosis, Focal Segmental/diagnosis , Glomerulonephritis, Membranous/diagnosis , Retrospective Studies , Tertiary Care Centers , Nephrotic Syndrome/diagnosis
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