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Acta cir. bras ; 31(supl.1): 8-12, 2016. tab
Article in English | LILACS (Americas) | ID: lil-779767


PURPOSE : Bladder augmentation is an effective surgical procedure for increasing bladder capacity and reducing pressure on the urinary system. It is indicated for patients with anomalies such as spina bifida, myelomeningocele, urethral valve and bladder exstrophy, who progress with low tolerance of medication. CASES : This was a retrospective study conducted on pediatric patients submitted to bladder augmentation from 2000 to 2011. RESULTS : 34 patients aged 4 to 17 years were submitted to bladder augmentation, 30 of them with an ileal loop and 4 with a ureter.A continent urinary shunt was performed in 16 patients, the Mitrofanoff conduit was associated in 15, and the Macedo technique was used in one. Mean follow-up was 34.35 months (1 to 122 months). Mean creatinine was 1.5 ng/ml (0.4 to 7.5 ng/ml) preoperatively and 1.78 ng/ml postoperatively. Three patients required a renal transplant during follow-up. There was improvement or resolution of vesicoureteral reflux in 83.5% of the kidneys on the right and in 75% on the left. Bladder capacity increased, on average, from 152.5 ml to 410 ml. The main complications were vesical lithiasis in 3 patients and conduit perforation in one. CONCLUSION : Bladder augmentation showed good results in this series, preserving renal function in most of the patients.

Humans , Male , Female , Child, Preschool , Child , Adolescent , Postoperative Complications/etiology , Urologic Surgical Procedures/adverse effects , Urinary Bladder Diseases/surgery , Urologic Surgical Procedures/methods , Time Factors , Ureter/surgery , Urinary Bladder/surgery , Urinary Catheterization/adverse effects , Reproducibility of Results , Retrospective Studies , Risk Factors , Follow-Up Studies , Treatment Outcome
Säo Paulo med. j ; 133(6): 517-520, Nov.-Dec. 2015. tab
Article in English | LILACS (Americas) | ID: lil-770144


ABSTRACT CONTEXT AND OBJECTIVES: Urinary tract infections are the most common cause of hospital-acquired infections, and the use of indwelling urinary catheters is a predisposing factor for their development. The aims of this study were to estimate the frequency of pre and postoperative bacteriuria, identify the microorganisms involved, count the colony-forming units, determine the antibiotic sensitivity profile and compare the results from pre and postoperative urinalyses among women undergoing gynecological surgery with implantation of a urinary catheter. DESIGN AND SETTING: Non-controlled prospective observational single-cohort epidemiological study carried out at a university hospital. METHODS: Urine samples were collected before and 24 hours after catheterization for urinalysis, culturing and antibiotic sensitivity testing. Pre and postoperative urinalyses were compared using Wilcoxon and McNemar non-parametric tests. RESULTS: Fifty-one women participated in the study. Escherichia coligrew in six preoperative samples (11.8%) and Klebsiella pneumoniae in one (1.9%), but bacterial growth did not occur in any postoperative sample. Urinalysis showed lower number of pus cells in the postoperative urine samples (P < 0.05). There were no differences in red blood cell counts or in the nitrite and leukocyte esterase tests, between the samples. CONCLUSION: Bacteriuria was found in 13.7% of the preoperative samples. Gram-negative bacteria sensitive to most antibiotics were identified. In the postoperative samples, no bacterial growth was observed. Urinalysis only showed significant reduction of leukocyturia in the postoperative period.

RESUMO CONTEXTO E OBJETIVOS: As infecções urinárias são a causa mais comum de infecções hospitalares, e o uso de cateteres de demora é fator predisponente para o seu desenvolvimento. Os objetivos deste estudo foram estimar a frequência de bacteriúria pré e pós-operatória, identificar os germes encontrados, a contagem de unidades formadoras de colônias e o perfil de sensibilidade aos antibióticos, além de comparar os resultados dos exames de urina pré- e pós-operatórios em mulheres submetidas a cirurgias ginecológicas com cateterismo vesical. TIPO DE ESTUDO E LOCAL: Estudo epidemiológico, observacional, de coorte única, prospectivo, não controlado, realizado em hospital universitário. MÉTODOS: Amostras de urina foram colhidas antes da cateterização e após 24 horas para urinálise, cultura e antibiograma. Os resultados da urinálise no pré- e pós-operatório foram comparados utilizando-se os testes não paramétricos de Wilcoxon e McNemar. RESULTADOS: Participaram do estudo 51 mulheres. Houve crescimento de Escherichia coli em seis amostras pré-operatórias (11,8%) e deKlebsiella pneumoniae em uma (1,9%), mas não houve crescimento bacteriano em nenhuma amostra pós-operatória. A urinálise mostrou menor quantidade de piócitos na amostra de urina pós-cirúrgica (P < 0,05). Não houve diferença quanto ao número de hemácias e às reações para nitrito e leucocitesterase, entre as amostras. CONCLUSÃO: Houve bacteriúria em 13,7% das amostras pré-operatórias, sendo identificadas bactérias Gram-negativas sensíveis à maioria dos antibióticos. Não foi observado crescimento bacteriano nas amostras pós-operatórias. A urinálise mostrou somente redução significativa da leucocitúria no pós-operatório.

Adolescent , Adult , Aged , Female , Humans , Middle Aged , Young Adult , Anti-Bacterial Agents/therapeutic use , Antibiotic Prophylaxis/methods , Bacteriuria/microbiology , Bacteriuria/prevention & control , Gynecologic Surgical Procedures/adverse effects , Urinary Catheterization/adverse effects , Urinary Catheters/adverse effects , Colony Count, Microbial , Cross Infection/microbiology , Escherichia coli/isolation & purification , Klebsiella/isolation & purification , Microbial Sensitivity Tests , Postoperative Period , Preoperative Period , Prospective Studies , Statistics, Nonparametric , Time Factors , Urinalysis
Rev. chil. infectol ; 31(3): 274-279, jun. 2014. tab
Article in Spanish | LILACS (Americas) | ID: lil-716978


We conducted a clinical trial to determine the impact of coating surfaces with copper in reducing hospital-acquired infections, mortality associated with nosocomial infections and antimicrobial costs in the UCI. The study took place at Carlos Van Buren Hospital, Valparaíso, Chile. No differences in the frequency of nosocomial infections were found. Not in rates of ventilator-associated pneumonia (p = 0.9), nor in catheter- associated urinary tract infection (p = 0.9) or in central venous catheter associated bacteremia (p = 0.3). There were no differences in infection-free survival (p = 0.9). There were less costs of antimicrobials in patients in which copper was used. The fact that the sample size was not completed could explain that no significant differences in infections were found. Conclusion: The use of copper as a surface in the ICU showed no statistically significant differences in rates of nosocomial infections during the study period, however, these results could be related to the sample size.

Introducción: Las infecciones nosocomiales incrementan la mortalidad y costos en las instituciones de salud. El revestimiento con cobre, de superficies de alto contacto en la unidad clínica en torno a los pacientes, reduce la colonización bacteriana de las mismas. Objetivo: Determinar el impacto del revestimiento de las superficies con cobre en la disminución de las infecciones intrahospitalarias, la mortalidad asociada a las infecciones intrahospitalarias y los costos en antimicrobianos en pacientes hospitalizados en UCI adultos en el Hospital Carlos Van Buren. Pacientes y Métodos: Estudio prospectivo, comparativo, mayo de 2011-mayo de 2012. Asignación aleatoria de pacientes adultos ingresados en UCI, que permanecieran al menos por 24 h en dicha unidad, a unidades de aislamiento recubiertas (n: 7) o no recubiertas con cobre (n: 7). Resultados: Ingresaron al estudio 440 pacientes, 217 pacientes (49,3%) en el grupo sin cobre y 223 en el grupo con cobre (50,7%). No se encontraron diferencias en la frecuencia de infecciones intrahospitalarias en ambos grupos. Tampoco se encontraron diferencias significativas en las tasas de neumonía asociada a ventilación mecánica (p = 0,9), infección urinaria asociada a catéter urinario (p = 0,9) y bacteremias asociada a catéter venoso central (p = 0,3). Tampoco se encontraron diferencias en la sobrevida libre de infección (p = 0,9). Se encontró un gasto menor de antimicrobianos en pacientes atendidos en unidades revestidas con cobre. Durante el período del estudio no se completó el tamaño de muestra y las diferencias no significativas podrían deberse a este hecho. Conclusión: El uso del cobre como revestimiento de las superficies hospitalarias en UCI, mostró diferencia en la tasa de bacteriemia asociada a dispositivos venosos, aunque no significativa, y no mostró diferencia en neumonías e infecciones urinarias. Las diferencias no significativas pueden deberse a que no se completó el tamaño de la muestra. Se observó un mayor gasto de antimicrobianos en pacientes de unidades no cobrizadas, lo que plantea una nueva área de investigación.

Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Copper , Cross Infection , Infection Control/methods , Bacteremia/economics , Bacteremia/mortality , Bacteremia/prevention & control , Catheterization, Central Venous/adverse effects , Chile/epidemiology , Cross Infection/economics , Cross Infection/mortality , Cross Infection/prevention & control , Fomites/microbiology , Intensive Care Units , Prospective Studies , Pneumonia, Ventilator-Associated/economics , Pneumonia, Ventilator-Associated/mortality , Pneumonia, Ventilator-Associated/prevention & control , Urinary Catheterization/adverse effects , Urinary Tract Infections/economics , Urinary Tract Infections/mortality , Urinary Tract Infections/prevention & control
Int. braz. j. urol ; 40(1): 80-86, Jan-Feb/2014. tab, graf
Article in English | LILACS (Americas) | ID: lil-704170


Purpose: To evaluate the long term outcomes of permanent Memotherm urethral stent in the treatment of recurrent bulbar urethral stricture. Materials and Methods: Twenty patients who underwent permanent Memotherm urethral stent implantation due to recurrent bulbar urethral stricture following previous unsuccessful surgical procedure from 1996 to 2002 were included in the study. Long-term outcomes of the patients were evaluated. Results: The overall success rate was 87.5% at the end of the tenth year. There was discomfort in implantation area in eight patients about 1 month following the procedure. These patients were treated with alpha-blocker and anti-inflammatory drugs. Stone formation was observed at the urethral stent implantation area in two patients. Post-void dripping has been observed in 15 patients up to the postoperative 3rd month. Stress urinary incontinence was observed in a patient with a 1-year follow-up. Partial stent migration was observed in two patients. None of the patients experienced pain during erection. Conclusion: Memotherm urethral stent is a minimal invasive surgical procedure which can be safely and effectively used in patients with recurrent urethral stricture. .

Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Stents , Urethral Stricture/surgery , Urinary Catheterization/methods , Follow-Up Studies , Postoperative Complications , Prosthesis Implantation/methods , Recurrence , Stents/adverse effects , Time Factors , Treatment Outcome , Urethral Stricture/complications , Urinary Catheterization/adverse effects , Urinary Incontinence, Stress/etiology
Korean Journal of Urology ; : 768-771, 2014.
Article in English | WPRIM (Western Pacific) | ID: wprim-227266


Urinary catheterization is a common procedure, particularly among patients with neurogenic bladder secondary to spinal cord injury. Urethral catheterization is associated with the well-recognized complications of catheter-associated urinary tract infections and limited genitourinary trauma. Unintentional ureteral cannulation represents a rare complication of urethral catheterization and has been previously described in only eight cases within the literature. We describe two cases of aberrant ureteral cannulation involving two patients with quadriplegia. These cases along with prior reports identify the spastic, insensate bladder and altered pelvic sensorium found in upper motor neuron syndromes as major risk factors for ureteral cannulation with a urinary catheter.

Aged , Female , Humans , Male , Middle Aged , Spinal Cord Injuries/complications , Ureter/injuries , Urinary Bladder, Neurogenic/etiology , Urinary Catheterization/adverse effects
Rev. gaúch. enferm ; 34(3): 46-54, set. 2013. graf, tab
Article in Portuguese | LILACS (Americas), BDENF | ID: lil-695255


O objetivo do estudo foi identificar complicações ocorridas em pacientes receptores de transplante renal. Coorte histórica realizada em hospital universitário entre janeiro de 2007 e janeiro de 2009 com amostra de 179 pacientes; dados coletados retrospectivamente em base de dados e prontuário e, em seguida, analisados estatisticamente. A média de idade dos pacientes foi de 43 (DP=13,7) anos, sendo 114 (63,7%) homens, 95 (65,1%) não fumantes e 118 (66,3%) receptores de doadores falecidos. As principais complicações foram rejeição 68 (32,1%) e infecção 62 (29,2%). Houve associação estatisticamente significativa entre rejeição e mediana dos dias de internação (p<0,001); dias de uso de cateter venoso central (p=0,010) e status tabágico (p=0,008); infecção e cateter venoso central (p=0,029), mediana dos dias de internação (p<0,001) e tempo de uso de sonda vesical (p=0,009). Concluiu-se ser importante diminuir os dias de internação e a permanência de cateteres, o que pode ser levado em consideração no planejamento do cuidado de enfermagem.

El objetivo del estudio fue identificar las complicaciones en los pacientes que recibieron trasplante renal. Cohorte histórica realizada en hospital universitario de enero/2007 hasta enero/2009 con una muestra de 179 pacientes, los datos recogidos retrospectivamente de la história clínica de los pacientes y analizados estadísticamente. La edad promedio de los pacientes fue 43(SD=13,7) años, 114(63,7%) hombres, 95(65,1%) no fumadores y 118(66,3%) receptores de donantes fallecidos. Las principales complicaciones fueron rechazo 68(32,1%) e infección 62(29,2%). Hay asociación estadísticamente significativa entre el rechazo y la mediana de días de hospitalización (p<0,001); días de uso de catéter venoso central (p=0,010) y tabaquismo (p=0,008); infección y catéter venoso central (p=0,029); mediana de días de hospitalización (p<0,001) y tiempo de uso del catéter urinario (p=0,009). Se concluye que es importante reducir los días de hospitalización y la permanencia de los catéteres, que puede ser considerado en la planificación de los cuidados de enfermería.

The objective of the study was to identify the complications in patients that have received a renal transplant. A Historical cohort performed in a university hospital from January/2007 through January/2009 with a sample of 179 patients; data collected retrospectively from the medical history of patients and submitted to statistical analyses. Mean age of patients was 43(SD=13.7) years, 114(63.7%) men, 95(65.1%) non smokers and 118(66.3%) received the graft from a deceased donor. The main complications were rejection 68(32.1%) and infection 62(29.2%). There was statistical significance between rejection and median days of hospital stay (p<0.001); days of use of central venous catheter (p=0,010) and smoking status (p=0.008); infection and central venous catheter (p=0.029); median days of hospital stay (p<0,001) and time of use of urinary catheter (p=0,009).It was concluded that it is important to reduce the days of hospital stay and permanence of catheters, which may be considered in the planning of nursing care.

Adult , Female , Humans , Male , Middle Aged , Graft Rejection/epidemiology , Infections/epidemiology , Inpatients/statistics & numerical data , Kidney Transplantation , Postoperative Complications/epidemiology , Brazil , Catheter-Related Infections/epidemiology , Catheterization, Central Venous/adverse effects , Catheterization, Central Venous , Cohort Studies , Hospitals, University/statistics & numerical data , Length of Stay/statistics & numerical data , Reoperation/statistics & numerical data , Smoking/epidemiology , Socioeconomic Factors , Tissue Donors/statistics & numerical data , Urinary Catheterization/adverse effects , Urinary Catheterization
Article in English | IMSEAR (South-East Asia), GHL | ID: sea-156337


Haematuria following decompression of a distended bladder is a well known condition. The bleeding in such cases originates in the bladder and resolves spontaneously. We describe an elderly man who had bleeding from the kidney following decompression of the bladder. This resulted in an extensive search for an upper tract tumour as a cause for haematuria.

Aged , Chronic Disease , Hematuria/etiology , Hemorrhage/diagnosis , Hemorrhage/etiology , Humans , Kidney Diseases/diagnosis , Kidney Diseases/etiology , Male , Ureteroscopy , Urinary Catheterization/adverse effects , Urinary Retention/therapy
Rev. latinoam. enferm ; 21(1): 459-468, Jan.-Feb. 2013. tab
Article in English | LILACS (Americas), BDENF | ID: lil-669599


OBJECTIVE: to seek the best evidence available in the literature concerning the knowledge produced and related to the techniques of intermittent and indwelling urinary catheterization, so as to place the nursing care given to patients submitted to urinary catheterization on a scientific foundation and to prevent urinary tract infections. METHOD: the literature search was undertaken in the Pubmed and Cochrane databases for the development of the integrative review. The sample was of 34 articles. These were analyzed by two independent researchers using an instrument adapted for ascertaining the level of evidence and the grade of recommendation, in addition to the use of the Jadad scale. RESULTS: the evidence available related to the nursing care for patients submitted to urinary catheterization is: the infection rate in the urinary tract does not alter whether the perineum is cleaned with sterile water or not, or with the use of povidone-iodine solution or chlorhexidine; or using clean or sterile technique. The use of an intermittent catheter with clean technique results in low rates of complications or infections compared to the use of an indwelling catheter. The removal of the catheter in up to 24 hours after surgery and the use of an antimicrobial-impregnated or hydrophilic-coated catheter reduce urinary tract infection . CONCLUSIONS: there are controversies in relation to periurethral cleansing technique, the type of material the catheter is made of, and some procedures for the maintenance and removal of the catheter. This review's results represent an updating of the nurse's conducts and decision-making for the prevention of urinary tract infections in urinary catheterization.

OBJETIVO: buscar as melhores evidências disponíveis na literatura sobre o conhecimento produzido e relacionado à técnica de cateterismo urinário intermitente e de demora, para embasar cientificamente o cuidado de enfermagem prestado ao paciente, submetido ao cateterismo urinário, e prevenir infecção do trato urinário. MÉTODO: a busca foi realizada nas bases de dados PubMed e Cochrane para o desenvolvimento da revisão integrativa. A amostra foi composta por 34 artigos. Esses foram analisados por dois pesquisadores independentes, usando-se instrumento adaptado para verificar o nível de evidência e grau de recomendação, além da utilização da escala de Jadad. RESULTADOS: as evidências disponíveis, relacionadas aos cuidados de enfermagem aos pacientes submetidos ao cateterismo urinário, são: a taxa de infecção no trato urinário não altera com a higienização do períneo com água estéril ou não, com o uso de solução de iodo-povidine ou clorexidine, ou aplicando técnica limpa ou estéril. O uso do cateter intermitente com técnica limpa implica em menores taxas de complicações e infecções em comparação com a de demora. A remoção do cateter em até 24 horas após cirurgia e o uso do cateter impregnado com antimicrobiano e de revestimento hidrofílico reduz a incidência de infecção do trato urinário. CONCLUSÕES: existem controvérsias em relação à técnica de higienização periuretral, tipo de material do cateter e alguns procedimentos para a manutenção e remoção do cateter. Os resultados desta revisão representam atualização das condutas e tomada de decisão do enfermeiro para a prevenção de infecção do trato urinário no cateterismo urinário.

OBJETIVO: buscar las mejores evidencias disponibles en la literatura sobre el conocimiento producido y relacionado a la técnica de cateterismo urinario intermitente y de demora para apoyar científicamente el cuidado de enfermería prestado al paciente sometido al cateterismo urinario y precaver infección del trato urinario. MÉTODO: La busca fue realizada en las bases de datos PubMed y Cochrane para el desarrollo de la revisión integrativa. La muestra fue de 34 artículos. Éstos fueron analizados por dos investigadores independientes usando instrumento adaptado para verificar el nivel de evidencia y grado de recomendación, además de la utilización de la escala de Jadad. RESULTADOS: las evidencias disponibles relacionadas a la atención de enfermería a los pacientes sometidos al cateterismo urinario son: la tasa de infección en el trato urinario no altera con la higienización del perineo con agua estéril o no, con el uso de solución de iodo-povidona o clorhexidina; o aplicando técnica aseada o estéril. El uso del catéter intermitente con técnica aseada implica en menores tasas de complicaciones e infecciones en comparación con la de demora. La remoción del catéter en hasta 24 horas pos cirugía y el uso del catéter impregnado con antimicrobiano y de revestimiento hidrofílico reduce incidencia de infección del trato urinario. CONCLUSIONES: existen controversias con relación a la técnica de higienización periuretral, tipo de material del catéter y algunos procedimientos para el mantenimiento y remoción del catéter. Los resultados de esta revisión representan actualización de las conductas y tomada de decisión del enfermero para la prevención de infección del trato urinario en el cateterismo urinario.

Humans , Urinary Catheterization/methods , Urinary Tract Infections/prevention & control , Urinary Catheterization/adverse effects , Urinary Catheterization/standards , Urinary Tract Infections/etiology
Medical Forum Monthly. 2012; 23 (3): 41-43
in English | IMEMR (Eastern Mediterranean) | ID: emr-124994


To compare the outcome of three way foleys catheter removed on 2[nd] and 5[th] day after Transurethral resection of Prostate for BPH regarding postoperative retention of urine, urine culture and hospital stay. Quasi Experimental study. This study was carried out in Department of Urology, University of Medical and health sciences Jamshoro from July 2010 to December 2011. This study consisted of 50 patients were divided in two groups. Group A for catheter was removed on 2nd post operative day of Trans Uretheral resection of prostate and group B for catheter was removed on 5th Post Operative Day of Trans Uretheral resection of prostate, each group consist of 25 patients. Detailed History was taken from all the patients with special regard to the urinary retention. Inclusion criteria were that all diagnosed as case of BPH on the basis of history and investigations. Exclusion criteria included unfit patients for general anesthesia, presented with chronic urinary retention, hematological disorders, pre operative infected urine and concurrent uretheral structure. Re-catheterization were in 2 patients [8%] group A and 1 patient [4%] in group B. Post operative urine culture growth of organism [bacteriuria] were 1 patient [4%] A and 3 patients [12%] in group B. Duration of hospital stay in group A was 5.68 as compared to the patients in group B was 8.44 days. In conclusion, early catheter removal had a dramatic impact on hospital stay. Catheters can be removed early after transurethral resection of prostate with no increase in morbidity and maintain the efficacy of the procedure, resulting in considerable savings to their patients. Our study confirms the safety of an irrigation-free and early catheter removal policy after TURP

Humans , Male , Urinary Catheterization/adverse effects , Catheterization , Urinary Retention/surgery
Arch. méd. Camaguey ; 15(1): 1-11, ene.-feb. 2011.
Article in Spanish | LILACS (Americas) | ID: lil-584282


Las infecciones nosocomiales detectadas en cuidados progresivos se asocian a procederes invasivos. Objetivo: valorar el comportamiento de algunas infecciones nosocomiales en una unidad de cuidados intermedios. Método: se realizó un estudio descriptivo transversal de las infecciones intrahospitalarias asociadas a procederes invasivos durante el período (2005-2007) en la unidad de cuidados intermedios polivalente en el Hospital Universitario Manuel Ascunce Domenech de Camagüey. El universo de estudio lo constituyeron 4799 pacientes que ingresaron consecutivamente durante el trienio evaluado, de ellos 277 presentaron al menos una infección nosocomial, la muestra quedó conformada por 164 pacientes con factores de riesgo extrínseco y seleccionado por le método aleatorio simple. Se tuvieron en cuenta tres factores de riesgo: ventilación mecánica artificial, catéter venoso central y sonda vesical. Resultados: más de la mitad de los infecciones correspondieron a pacientes mayores de sesenta años. La neumonía asociada a la ventilación fue la más frecuente con el mayor porciento de defunciones. Se destacó el grupo de las enterobacterias en las infecciones asociadas a catéteres centrovenosos y sondas urinarias. Conclusiones: la neumonía asociada a la ventilación fue la infección nosocomial más frecuente y fue la responsable del mayor número de defunciones.

Nosocomial infections detected in an intermediate care unit are associated to invasive procedures. Objective: to assess the behavior of some nosocomial infections in an intermediate care unit. Method: a cross-sectional descriptive study on intrahospital infections associate to invasive procedures was performed from 2005 to 2007 in the polyvalent intermediate care unit at the University Hospital Manuel Ascunce Domenech of Camagüey. The study universe was constituted by 4799 patients admitted consecutively during the evaluated triennium, of them 277 presented a nosocomial infection at least, the sample was conformed by 164 patients with extrinsic risk factors and selected by simple random method. Three risk factors were taking into account: artificial mechanical ventilation, central venous catheter and vesical tube. Results: more than the half of infections corresponded to patients older than sixty years. Pneumonia associated to the ventilation was the most frequent with the biggest percent of deaths. The enterobacteria group in the infections associated to centrovenous catheters and urinary tubes stood out. Conclusions: pneumonia associated to the ventilation was the most frequent nosocomial infection and it was the responsible for the biggest number of deaths.

Humans , Critical Care , Urinary Catheterization/adverse effects , Catheterization, Central Venous/adverse effects , Cross Infection/epidemiology , Risk Factors , Respiration, Artificial/adverse effects , Cross-Sectional Studies , Epidemiology, Descriptive
Urology Annals. 2011; 3 (2): 108-109
in English | IMEMR (Eastern Mediterranean) | ID: emr-124069


Neonatal bladder rupture is rare as a complication of bladder obstruction due to abnormal anatomy or iatrogenic causes. The present study describes the case of a 3-day-old infant with ascites due to bladder perforation secondary probably to manual decompression of the bladder. The infant underwent successful surgical repair of the perforation

Humans , Female , Rupture, Spontaneous/surgery , Infant, Newborn, Diseases , Iatrogenic Disease , Urinary Catheterization/adverse effects , Ascites , Urinary Bladder Diseases/surgery
Journal of Kerman University of Medical Sciences. 2011; 18 (3): 228-234
in Fa | IMEMR (Eastern Mediterranean) | ID: emr-125097


Some Candida species especially Candida albicans are known as flora of human and animals body and coexist in skin, throat and gastrointestinal and urinary tracts. They can primarily be colonized in hospitalized patients and cause diseases. Resent studies have reported increasing rate of candidauria in intensive care unit [ICU] patients. The aim of this study was to determine the frequency of candiduria in ICU patients with urinary tract catheterization. In a descriptive cross-sectional study, 110 hospitalized patients in ICU over 18 years old who had more than 7 days urinary tract catheter were studied. Urine sample was taken immediately after catheter replacement and sent to the laboratory in less than 1 hour and analyzed. Data collection was done by a questionnaire and check list. A total of 110 patients including 65 men [59.1%] and 45 women [40.9%] were studied of whom 29 ones [26.4%] had candiduria based on urine culture. Candida albicans was the most common species [34.3%]. Risk factors of candiduria were age, duration of hospitalization and urinary tract catheterization, using more than two antibiotics, corticosteroid consumption, and diabetes mellitus. Due to the increasing rate of candida infection in hospitalized patients especially ICU patients, more attention for prevention of candiduria especially in those with candiduria risk factors is recommended

Humans , Male , Female , Intensive Care Units , Urine/microbiology , Urinary Catheterization/adverse effects , Hospitalization , Risk Factors , Cross-Sectional Studies , Surveys and Questionnaires
Rev. bras. eng. biomed ; 26(2): 91-98, ago. 2010. ilus
Article in Portuguese | LILACS (Americas) | ID: lil-619155


O cateter uretral de longa permanência tem papel de destaque para pacientes com retenção urinária, com obstrução debexiga, com danos neurológicos e outras doenças. A urina contém sais minerais, que em pH alcalino se precipitam,cristalizam-se e bloqueiam o cateter urológico. A cristalização dos componentes iônicos da urina ocorre em presença de urease, enzima produzida por Proteus mirabilis. Esta bactéria tem a capacidade de aderir a superfícies inanimadas e formar biofilme. O objetivo deste estudo foi observar a formação de biofilme cristalino na superfície luminal de cateter urológicode látex siliconizado, por meio de microscópio eletrônico de varredura, após a canalização de urina artificial infectada com Proteus mirabilis. O experimento foi realizado in vitro,em sistema de fluxo dinâmico. A urina artificial, composta de sais de cálcio, magnésio, fosfatos, uréia e albumina deovo, foi infectada com Proteus mirabilis ATCC 25933. O fluxo da urina canalizada foi interrompido após a cristalização dos componentes iônicos. A cristalização foi observada após a alcalinização da urina. A microscopia eletrônica de varredura demonstrou a presença de cristais e morfologiastípicas de bacilos embutidos em massa amorfa. O presente estudo mostrou que a incrustação pode limitar o uso decateter urológico de longa permanência.

The indwelling urethral catheter has an important role for patients with urinary retention, bladder obstruction, neurological damage and other diseases. Urine contains minerals which precipitate in alkaline pH, crystallize and block the urological catheter. Thecrystallization of the ionic components of urine occurs in the presence of urease, an enzyme produced by Proteus mirabilis. This bacterium adheres to inanimate surfaces and forms biofilms. The aim of this study was to investigate the formation of crystalline biofilm on the luminal surface of siliconized latex catheters by means of scanning electron microscope, after channeling artificialurine infected with Proteus mirabilis. The experiment was performed in vitro using a dynamic flow system. The artificial urine compounds were salts of calcium, magnesium, phosphates, urea and egg albumin, and it was infected with Proteus mirabilis ATCC 25933. The urine flow was stopped after crystallization of the ionic components. Crystallization was observed afteralkalinization of urine. Scanning electron microscopy showed the presence of crystals and morphologies typical of bacilli embedded in an amorphous mass on the internal lumen of the catheter. Thepresent study showed that catheter encrustation may limit the use of long-term indwelling catheter.

Humans , Biofilms , Urinary Catheterization/adverse effects , In Vitro Techniques , Proteus Infections , Proteus mirabilis/pathogenicity
Saudi Medical Journal. 2010; 31 (9): 999-1004
in English | IMEMR (Eastern Mediterranean) | ID: emr-117668


To evaluate the effects of the different types of manipulation on prostate total specific antigen [tPSA], free prostate specific antigen [fPSA], and free-to-total prostate specific antigen [f/tPSA]. A total of 160 males were enrolled from January 2006 to December 2009 in the Urology Department, Beijing Anzhen Hospital affiliated to the Capital Medical University, Beijing, China. Of these patients, 23 had digital rectal examination [DRE], 21 had urethral catheterization, 28 had rigid cystoscopy, 35 had prostate biopsy, 35 underwent transurethral resection of the prostate [TURP], and 18 underwent suprapubic prostatectomy. Blood samples were taken before, at 24 hours, and 4 weeks after the manipulation for PSA tests. The DRE had no significant effect on PSA. Catheterization and cystoscopy exerted significant increases in tPSA at 24 hours. However, these small increases may not be clinically significant. The fPSA and f/tPSA were not significantly changed. There was a marked increase in tPSA and fPSA, associated with a decrease in f/tPSA at 24 hours after biopsy. No significant alterations were found in tPSA, fPSA, and f/tPSA at 4 weeks after catheterization, cystoscopy, and biopsy. The TURP and prostatectomy caused significant increases in tPSA and fPSA at 24 hours, associated with decreases in f/tPSA. The tPSA and fPSA values were below the baseline levels at 4 weeks after TURP and prostatectomy, however, f/tPSA remained constant. The DRE, catheterization, and cystoscopy had no crucial effect on PSA. Prostatic biopsy, TURP and prostatectomy significantly affected the PSA levels, and their longitudinal courses should be considered while evaluating different forms of PSA levels

Humans , Male , Middle Aged , Aged , Prostate/metabolism , Digital Rectal Examination/adverse effects , Biopsy, Needle/adverse effects , /adverse effects , Transurethral Resection of Prostate/adverse effects , Urinary Catheterization/adverse effects , Prostatectomy/adverse effects
Rev. Esc. Enferm. USP ; 43(4): 865-871, dez. 2009. tab
Article in Portuguese | LILACS (Americas), BDENF | ID: lil-534386


O estudo, do tipo crossover, objetivou comparar o uso de dois cateteres para cateterismo intermitente limpo em crianças com urostomias continentes, no que se refere ao manejo, complicações e custos diretos. Cumpridas as exigências éticas, foi desenvolvido em um Hospital Infantil, em São Paulo. As crianças que, juntamente com seus responsáveis, consentiram em participar da investigação, foram submetidas à utilização consecutiva de cateter tradicional e do cateter pré-lubrificado, durante um mês cada um. Nesse período, as crianças preencheram os instrumentos de coleta de dados e foram acompanhadas pelas pesquisadoras semanalmente, por meio de visitas domiciliares e consultas hospitalares, que incluíram a coleta quinzenal de culturas qualitativas e quantitativas de urina. Os dados foram analisados utilizando-se os testes de Wilcoxon e Kaplan Meyer. Onze crianças completaram o estudo. Os resultados mostraram diferenças estatisticamente significativas apenas quanto aos custos diretos (p=0,003), superiores para o cateter pré-lubrificado.

The objective of this crossover study was to compare the use of two catheters for clean intermittent catheterization in continent children with a urostomy, in terms of their handling, complications and direct costs. This study complied with all ethical requirements and was developed at a Children's Hospital in the city of São Paulo. The children who, together with their guardians, agreed to participate in the study were submitted to the consecutive use of both the traditional and the pre-lubricated catheter, for one month each. During that period, the children completed the data collection instruments and were followed by the researchers once a week through home visits and hospital consultations, including quantitative and qualitative urine cultures that were performed every other week. Data analysis was performed using Wilcoxon and Kaplan-Meier tests. Eleven children completed the study. Statistical significant differences were found only for costs (p=0.003), which were higher for pre-lubricated catheters.

El estudio, del tipo crosover, objetivó comparar el uso de dos catéteres para cateterismo intermitente limpio en niños con urostomías continentes, en lo que se refiere al manejo, complicaciones y costos directos. Cumplidas las exigencias éticas, fue desarrollado en un Hospital Infantil, en São Paulo. Los niños que, juntamente con sus responsables, consintieron en participar de la investigación, fueron sometidos a la utilización consecutiva de catéter tradicional y de catéter lubrificado, durante un mes cada uno. En ese período, las niños llenaron los instrumentos de recolección de datos y fueron acompañados por las investigadoras semanalmente, por medio de visitas domiciliares y consultas hospitalarias, que incluyeron a recolección quincenal de culturas cualitativas y cuantitativas de orina. Los datos fueron analizados utilizando las pruebas de Wilcoxon y Kaplan Meyer. Once niños completaron el estudio. Los resultados mostraron diferencias estadísticamente significativas apenas en lo que se refiere a costos directos (p=0,003), superiores para el catéter lubrificado.

Adolescent , Child , Female , Humans , Male , Ureterostomy , Urinary Catheterization , Urinary Diversion , Cross-Over Studies , Prospective Studies , Urinary Catheterization/adverse effects , Urinary Catheterization/economics , Urinary Catheterization/methods