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1.
Rev. inf. cient ; 98(2): 184-195, 2019. tab
Article in Spanish | LILACS (Americas) | ID: biblio-1016805

ABSTRACT

Introducción: la resistencia combinada a múltiples antibióticos en algunas de las principales bacterias patógenas en humanos está aumentando en los últimos años y está generando una importante amenaza para la salud pública. Objetivo: caracterizar a las gestantes con urosepsis que presentaron resistencia antimicrobiana de Escherichia coli aislada en urocultivos y atendidas en el Hospital General Docente "Dr. Agostinho Neto" de Guantánamo durante el periodo enero-junio de 2017. Método: se realizó un estudio descriptivo, transversal y retrospectivo en el Hospital General Docente Dr. Agostinho Neto de Guantánamo, en el periodo enero a junio 2017. El universo de estudio quedó constituido por 58 gestantes. Las variables estudiadas fueron: edad, paridad, factores de riesgo y resistencia. Se utilizó como medida de resumen la frecuencia absoluta y la frecuencia relativa (por ciento). Resultados: el mayor número de gestantes con urosepsis causada por Escherichia coli se encontraban en el grupo de edades entre los 19 y 29 para un 48,3 por ciento. La urosepsis en etapas anteriores al embarazo se identificó en el 48,3 por ciento de las multíparas, solo 11 de las primíparas (19,0 por ciento). La anemia se diagnosticó en 28 gestantes (48,3 por ciento), la diabetes mellitus tipo II en 11 pacientes para un 19,0 por ciento. En 33 gestantes (57 por ciento), se presentó resistencia al ácido nalidíxico, en 28 al sulfaprim (48,2 por ciento) y en el 40 por ciento a la amoxicilina+ácido clavulánico un total de 23 pacientes. Conclusiones: la urosepsis por Escherichia coli predominó en gestantes comprendidas entre los 19 y 29 años, multíparas, con esta entidad en etapas anteriores al embarazo, anemia, multigestas y con diabetes mellitus. Se presentó resistencia al ácido nalidíxico, sulfaprim, amoxicilina + ácido clavulánico y cefalexina(AU)


Introduction: the combined resistance to multiple antibiotics in some of the main pathogenic bacteria in humans is increasing in recent years and is generating a major threat to public health. Objective: to characterize pregnant women with urosepsis who presented antimicrobial resistance of Escherichia coli isolated in urocultures and treated in the General Teaching Hospital Dr. Agostinho Neto of Guantanamo during the period from January to June 2017. Method: a descriptive study was carried out, transversal and retrospective in the General Teaching Hospital "Dr. Agostinho Neto" of Guantánamo, in the period January to June 2017. The universe of study was constituted by 58 pregnant women. The variables studied were: age, parity, risk factors and resistance. The absolute frequency and the relative frequency (percent) were used as a summary measure. Results: the greater number of pregnant women with urosepsis caused by Escherichia coli were in the age group between 19 and 29 for 48.3 percent. Urosepsis in stages prior to pregnancy was identified in 48.3 percent of the multiparous women, only 11 of the primiparous women (19.0 percent). Anemia was diagnosed in 28 pregnant women (48.3 percent), diabetes mellitus type II in 11 patients for 19.0 percent. In 33 pregnant women (57 percent), there was resistance to nalidixic acid, in 28 to sulfaprim (48.2 percent) and in 40 percent to amoxicillin + clavulanic acid a total of 23 patients. Conclusions: Urosepsis due to Escherichia coli predominated in pregnant women between 19 and 29 years of age, multiparous, with this condition in stages before pregnancy, anemia, multigesta and with diabetes mellitus. There was resistance to nalidixic acid, sulfaprim, amoxicillin + clavulanic acid and cephalexin(AU)


Introdução: a resistência combinada a múltiplos antibióticos em algumas das principais bactérias patogénicas em seres humanos está a aumentar nos últimos anos e está gerando uma ameaça significativa para a saúde pública. Objectivo: Para caracterizar as mulheres grávidas com urosepsis apresentando resistência antimicrobiana de E. coli isoladas a partir de culturas de urina e tratados no geral Ensino Dr. Agostinho Neto Hospital Guantánamo durante o período de Janeiro a Junho de 2017. Métodos: Um estudo descritivo, transversal e retrospectivo, no geral Ensino Dr. Agostinho Neto Hospital Guantánamo, no período de janeiro a junho de 2017. o grupo de estudo foi composto por 58 mulheres grávidas. As variáveis estudadas foram: idade, paridade, fatores de risco e resistência. A frequência absoluta e a frequência relativa (por cento) foram usadas como uma medida resumida. Resultados: o maior número de mulheres grávidas com urosepsis causada por E. coli foram no grupo de idade entre 19 e 29-48,3 por cento. Urosepsis em fases anteriores de gravidez foi identificada em 48,3 por cento dos multíparas, apenas 11 primíparas (19,0 por cento). Anemia foi diagnosticada em 28 mulheres grávidas (48,3 por cento), diabetes mellitus do tipo II em 11 pacientes de 19,0 por cento. Em 33 mulheres grávidas (57 por cento), ácido nalidíxico resistência é apresentado na sulfaprim 28 (48,2 por cento) e 40 por cento de Amoxicilina um total de 23 pacientes. Conclusões: urosepsis por E. coli predominou em mulheres grávidas entre 19 e 29 anos de idade, multíparas, com esta entidade em estágios iniciais da gravidez, anemia, diabetes mellitus e multigravidas. Houve resistência ao ácido nalidíxico, sulfaprim, amoxicilina + ácido clavulânico e cefalexina(AU)


Subject(s)
Humans , Pregnancy , Urinary Tract Infections/etiology , Drug Resistance, Microbial , Escherichia coli , Epidemiology, Descriptive , Cross-Sectional Studies , Retrospective Studies
2.
Rev. inf. cient ; 98(6): 755-764, 2019. tab
Article in Spanish | LILACS (Americas) | ID: biblio-1049291

ABSTRACT

Introducción: en el municipio Guantánamo no se ha esclarecido la sensibilidad de la bacteria Escherichia coli a los diferentes antimicrobianos que se utilizan en las infecciones del tracto urinario. Objetivo: determinarlos patrones de resistencia antimicrobiana de esta bacteria aisladas en urocultivos de pacientes adultos ambulatorios con esta infección en el municipio Guantánamo. Método: se realizó un estudio descriptivo y transversal de enero a marzo de 2019 en el Laboratorio de Microbiología del Centro Provincial de Higiene, Epidemiología y Microbiología de Guantánamo. El universo se conformó por el total de pacientes (N=567) con urocultivos positivos, de los que se seleccionó una muestra constituida por aquellos con urocultivo positivo en los que se aisló la bacteria Escherichia coli (n=341). Resultados: las cepas de Escherichia coli mostraron una resistencia menor del 18,0 por ciento para la cefalexina, gentamicina, kanamicina, ciprofloxacina y la nitrofurantoina. Los antibióticos betalactámicos (ampicillin y amoxicilina) y macrólidos (azitromicina) mostraron resistencia de 61,6, 64,6 y 54,5 por ciento , respectivamente. La resistencia del cotrimoxazol y ácido nalidíxico osciló entre 25,0 al 28,6 por ciento . Fue alta la sensibilidad de Escherichia coli a la nitrofurantoína (92,9 por ciento ). Se encontraron patrones de ultirresistencia en 57 cepas (16,6 por ciento ). Conclusiones: en el territorio guantanamero, la prescripción de antimicrobianos del tipo de la cefalexina, la gentamicina, la kanamicina, la ciprofloxacina y la nitrofurantoina parecen ser las opciones más beneficiosas para la terapia de las ITU por Escherichia coli(AU)


Introduction: the sensitivity of the Escherichia coli bacteria to the different antimicrobials used in urinary tract infections has not been clarified in the Guantanamo municipality. Objective: to determine the antimicrobial resistance patterns of this bacterium isolated in urine cultures of outpatient adults with this infection in the municipality of Guantanamo. Method: a descriptive and cross-sectional study was carried out from January to March 2019 in the Microbiology Laboratory of the Provincial Center of Hygiene, Epidemiology and Microbiology of Guantanamo. The universe was formed by the total number of patients (N=567) with positive urine cultures, from which a sample consisting of those with positive urine culture was selected in which the Escherichia coli bacteria were isolated (n=341). Results: Escherichia coli strains showed a resistance less than 18.0 percent for cephalexin, gentamicin, kanamycin, ciprofloxacin and nitrofurantoin. The beta-lactam antibiotics (ampicillin and amoxicillin) and macrolides (azithromycin) showed resistance of 61.6, 64.6 and 54.5 percent, respectively. The resistance of cotrimoxazole and nalidixic acid ranged from 25.0 to 28.6 percent. The sensitivity of Escherichia coli to nitrofurantoin was high (92.9 percent). Multiresistance patterns were found in 57 strains (16.6 percent). Conclusions: in the Guantanamo territory, the prescription of antimicrobials of the type of cephalexin, gentamicin, kanamycin, ciprofloxacin and nitrofurantoin seem to be the most beneficial options for the therapy of UTIs by Escherichia coli(AU)


Introdução: a sensibilidade da bactéria Escherichia coli aos diferentes antimicrobianos utilizados nas infecções do trato urinário não foi esclarecida no município de Guantánamo. Objetivo: determinar os padrões de resistência antimicrobiana desta bactéria isolada em urinas de adultos ambulatoriais com esta infecção no município de Guantánamo. Método: um estudo descritivo e transversal foi realizado de janeiro a março de 2019 no Laboratório de Microbiologia do Centro Provincial de Higiene, Epidemiologia e Microbiologia de Guantánamo. O universo foi formado pelo número total de pacientes (N=567) com culturas de urina positivas, das quais foi selecionada uma amostra composta por pacientes com cultura de urina positiva, na qual as bactérias Escherichia coli foram isoladas (n=41). Resultados: as cepas de Escherichia coli apresentaram resistência inferior a 18,0 por cento para cefalexina, gentamicina, canamicina, ciprofloxacina e nitrofurantoína. Os antibióticos beta-lactâmicos (ampicilina e amoxicilina) e os macrólidos (azitromicina) apresentaram resistência de 61,6, 64,6 e 54,5 por cento, respectivamente. A resistência do cotrimoxazol e ácido nalidíxico variou de 25,0 a 28,6 por cento. A sensibilidade de Escherichia coli à nitrofurantoína foi alta (92,9 por cento). Padrões de multirresistência foram encontrados em 57 cepas (16,6 por cento). Conclusões: no território de Guantánamo, a prescrição de antimicrobianos do tipo de cefalexina, gentamicina, canamicina, ciprofloxacina e nitrofurantoína parece ser a opção mais benéfica para o tratamento de ITU por Escherichia coli(AU)


Subject(s)
Humans , Urinary Tract Infections/etiology , Drug Resistance, Microbial , Escherichia coli/isolation & purification , Epidemiology, Descriptive , Cross-Sectional Studies , Prospective Studies
3.
Arch. argent. pediatr ; 116(2): 126-132, abr. 2018. tab, ilus
Article in English, Spanish | LILACS (Americas), BINACIS | ID: biblio-887458

ABSTRACT

Introducción. En los estudios realizados se encontró que la duración de la lactancia tiene un efecto reductor sobre las infecciones frecuentes en los niños durante el período de lactancia. Objetivo. El objetivo de este estudio fue abordar la asociación entre la duración de la lactancia y las enfermedades infecciosas frecuentes en los niños hasta los 5 años de edad para demostrar los efectos protectores de la leche materna. Población y métodos. Se incluyeron 411 lactantes nacidos en Rize, Turquía, entre enero de 2011 y diciembre de 2011. Este estudio de cohorte, prospectivo duró cinco años; en este período, se realizaron 11 entrevistas con cada madre de los lactantes. Se dividió a los lactantes en dos grupos: amamantados durante más y menos de 12 meses, y se estudió la asociación entre la lactancia y las infecciones, como otitis media aguda, gastroenteritis aguda, infección respiratoria aguda e infección urinaria. Resultados. De los 411 nacimientos, se incluyeron 270 lactantes, 193 (71,5%) recibieron lactancia durante más de 12 meses y 77 (28,5%), durante menos de 12 meses. Los lactantes del primer grupo tuvieron menos casos de otitis media aguda y gastroenteritis aguda (n = 77; 28,52%) en comparación con los lactantes amamantados durante menos de 12 meses en el período de cinco años (p < 0,05). Conclusiones. Con este estudio se detectó que la lactancia durante más de 12 meses reduce significativamente las infecciones frecuentes durante la niñez, como la otitis media y la gastroenteritis durante los primeros cinco años de vida.


Introduction.The studies conducted revealed that breastfeeding duration has a reducing effect on common infectious diseases in the children during breastfeeding period. Objective. The aim of the present study was to address the association between breastfeeding duration and common infectious diseases in the children until 5 years of age to show long-term protective effects of the breast milk. Material and methods. The study included 411 infants who were born in Rize (Turkey) between January 2011 and December 2011. The present prospective-cohort study lasted for 5 years and 11 interviews were conducted with each mother of the infants during this period. The infants were divided into two groups as those who were breastfed more and less than 12 months and the association between breastfeeding and infections such as acute otitis media, acute gastroenteritis, acute respiratory tract infections and acute urinary system infections was investigated. Results. Of 270 infants 193 (71.5%) were breastfed longer than 12 months and 77 (28.5%) were breastfed less than 12 months. Infants in the first group had less acute otitis media and acute gastroenteritis (n= 77, 28.52%) when compared with the infants breastfed less than 12 months during 5-year period (p <0.05). Conclusion. The present study detected that breastfeeding duration longer than 12 months significantly reduces the common childhood infections such as otitis media and gastroenteritis during the first 5 years of life.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Otitis Media/prevention & control , Respiratory Tract Infections/prevention & control , Urinary Tract Infections/prevention & control , Breast Feeding , Gastroenteritis/prevention & control , Otitis Media/etiology , Otitis Media/epidemiology , Respiratory Tract Infections/etiology , Respiratory Tract Infections/epidemiology , Time Factors , Turkey , Urinary Tract Infections/etiology , Urinary Tract Infections/epidemiology , Prospective Studies , Follow-Up Studies , Protective Factors , Gastroenteritis/etiology , Gastroenteritis/epidemiology
4.
Acta fisiátrica ; 25(1): 36-39, mar. 2018.
Article in English | LILACS (Americas) | ID: biblio-998489

ABSTRACT

There is scarce data about intra-hospital complications in acute traumatic spinal cord injury (TSCI). Objective: To report characteristics of complications in patients with TSCI in a major trauma center. Method: This is a cross-sectional study with 434 patients with acute TSCI from 2004 to 2014. Outcomes were frequency and description of complications, length of hospital stay (LOS), and causes of increased LOS. Results: Patients presented at least 1 complication in 82.2% of the cases: urinary tract infection (UTI) = 64.4%, pressure ulcers (PU) = 50.6%, and pneumonia = 23.7%. Pneumonia, intubation and cases of surgical corrections for PU were independently associated with increased LOS. Conclusion: UTIs and PUs were the most frequent complications. Investigating its causes and consequences is paramount in the care of patients with SCI. Possible reasons for such complications could comprise time, and frequency of repositioning in bed. Investigating intra-hospital complications is paramount in SCI centers.


Há poucos dados sobre complicações hospitalares em pacientes com LMT aguda. Objetivo: Reportar as características de complicações em pacientes com LMT em um grande centro de trauma. Método: Estudo transversal com 434 pacientes com LMT aguda de 2004 a 2014. Os desfechos foram a frequência e característica das complicações, o tempo de internação (TDI), e fatores associados com seu aumento. Resultados: Incidência de complicações foi 82,2%, sendo as mais frequentes: infecção do trato urinário (ITU)=64,4%, úlcera de pressão (UP)= 50,6% e pneumonia= 23,7%. Pneumonia, intubação, e ser submetido a qualquer cirurgia para UP foram independentemente associados com aumento do TDI. Conclusão: ITUs e UP foram as complicações mais prevalentes, e devem ser melhor estudadas para melhor atenção a LMT. As investigações sobre as complicações na lesão medular traumática devem ser mandatórias nos centros e unidades dedicadas ao tratamento da Lesão Medular.


Subject(s)
Spinal Cord Injuries/complications , Length of Stay , Pneumonia/etiology , Urinary Tract Infections/etiology , Brazil , Cross-Sectional Studies , Pressure Ulcer/etiology
5.
Arch. argent. pediatr ; 115(5): 311-314, oct. 2017. ilus
Article in Spanish | LILACS (Americas), BINACIS | ID: biblio-887384

ABSTRACT

Trichosporon asahii es un hongo ubicuo que se ha aislado como parte de la microbiota humana. Recientemente, se ha visto una emergencia de este patógeno en infecciones tanto localizadas como sistémicas. En unidades de cuidados intensivos pediátricos para quemados, existen escasos reportes de infecciones del tracto urinario por este microorganismo. Se describen 2 pacientes pediátricos con internación prolongada por quemaduras extensas y múltiples tratamientos antibióticos previos. Ambos presentaron sepsis por infección del tracto urinario asociada a sonda vesical por Trichosporon asahii. En ambos pacientes, se realizó el recambio de la sonda vesical y tratamiento con voriconazol por 10 días, con buena evolución. En los casos presentados, debido a la ausencia de otros aislamientos microbiológicos y a la buena respuesta al tratamiento antifúngico junto con el recambio de la sonda vesical, se asumió al Trichosporon asahii como el probable agente causal de la sepsis.


Trichosporon asahii is a ubiquitous fungus that has been isolated as part of human microbiota. There has been an emergence of this pathogen in recent years, causing superficial and deep seated infections. There are scarce reports of urinary tract infections in pediatric intensive care burn units caused by this agent. We describe the cases of 2 pediatric patients with prolonged hospitalization due to severe burns that had received several antibiotic courses for previous infections. Both presented sepsis secondary to catheter related urinary tract infection by Trichosporon asahii. Both patients underwent urinary catheter replacement and were treated effectively with voriconazole for 10 days. In the cases presented, sepsis was assumed to be due to Trichosporon asahii since no other microorganism was identified and the patients showed favorable outcome with the prescribed treatment with voriconazole and replacement of the urinary catheter.


Subject(s)
Humans , Male , Child, Preschool , Urinary Tract Infections/etiology , Sepsis/etiology , Catheter-Related Infections/etiology , Trichosporonosis/etiology , Urinary Catheters/adverse effects , Burn Units , Burns/complications
6.
Rev. cuba. med. mil ; 45(2): 0-0, abr.-jun. 2016. ilus
Article in Spanish | LILACS (Americas) | ID: biblio-960535

ABSTRACT

Introducción: la pielonefritis xantogranulomatosa es una enfermedad infecciosa, inflamatoria, crónica e inusual que afecta el parénquima renal. El tratamiento definitivo es la nefrectomía. Objetivos: presentar un nuevo caso de pielonefritis xantogranulomatosa, así como la secuencia diagnóstica y terapéutica adoptada. Métodos: paciente masculino de 61 años de edad, con antecedentes de hipertensión arterial, diabetes mellitus tipo II e infecciones urinarias a repetición, que asistió al cuerpo de guardia del Hospital Militar Central Dr. Luis Días Soto, por presentar dolor lumbar y en flanco derechos, de 2meses de evolución, intenso y punzante, asociado a fiebre de 40̊ C, escalofríos y marcada toma del estado general. En el examen del hemiabdomen derecho presentaba una masa tumoral de unos 10cm de diámetro, dolorosa, ligeramente movible y de superficie lisa. El urocultivo reportó Escherichiacoli. El ultrasonido abdominal evidenció una imagen compleja en el riñón derecho, y la tomografía axial computarizada un tumor heterogéneo, que medía 10,7x7, 6 cm de contornos regulares, que distorsionaba la grasa perirrenal con densidades de hasta 73 UH. Resultados: el paciente fue sometido a nefrectomía total derecha transperitoneal, por sospecha de tumor renal, proceder que transcurrió sin complicaciones. Los hallazgos microscópicos de la pieza quirúrgica revelaron infiltración de linfocitos, histiocitos y macrófagos llenos de lípidos, compatible con pielonefritis xantogranulomatosa. La evolución fue satisfactoria. Conclusiones: aunque el diagnóstico definitivo de la pielonefritis xantogranulomatosa es histopatológico, la forma tumoral de presentación de la misma, es uno de los diagnósticos diferenciales a tener en cuenta en pacientes diabéticos con infecciones recurrentes del tracto urinario(AU)


Introduction: Xanthogranulomatous pyelonephritis is an infectious, inflammatory, chronic, and unusual disease that affects the renal parenchyma. The definitive treatment is nephrectomy. Objectives: Present a new case of xanthogranulomatous pyelonephritis, as well as the diagnostic and therapeutic sequence adopted. Methods: A 61-year-old male patient with a history of hypertension, type II diabetes mellitus and recurrent urinary tract infections attended Dr. Luis Díaz Soto Central Military Hospital, for presenting intense and stabbing lumbar and right flank pain, of 2 months of evolution, associated with fever of 40 ° C, chills and marked the general condition. In the examination of the right abdomen a tumor mass was found of about 10 cm in diameter, painful, slightly movable and of smooth surface. The urine culture reported escherichiacoli. Abdominal ultrasound showed a complex image in the right kidney, and computed tomography scan showed a heterogeneous tumor, measuring 10.7x7.6 cm of regular contours, distorting the perirenal fat with densities of up to 73 UH. Results: The patient underwent transperitoneal right total nephrectomy, due to suspicion of renal tumor. This procedure had no complications. Microscopic findings of the surgical specimen revealed infiltration of lymphocytes, histiocytes, and lipid-filled macrophages, consistent with xanthogranulomatous pyelonephritis. The evolution was satisfactory. Conclusions: Although the definitive diagnosis of xanthogranulomatous pyelonephritis is histopathological, the tumoral presentation form is one of the differential diagnoses to be considered in diabetic patients with recurrent urinary tract infections(AU)


Subject(s)
Humans , Male , Middle Aged , Urinary Tract Infections/etiology , Pyelonephritis, Xanthogranulomatous/diagnostic imaging , Nephrectomy/adverse effects
7.
Einstein (Säo Paulo) ; 14(1): 47-51, Jan.-Mar. 2016. tab
Article in English | LILACS (Americas) | ID: lil-778499

ABSTRACT

ABSTRACT Objective To determine the incidence of infections in a population of systemic lupus erythematosus individuals and the characteristics of infections regarding original site, as well as to study the possible associations between infections and treatment. Methods An analytical retrospective study using data from medical charts of systemic lupus erythematosus patients from a single university hospital. A total of 144 patients followed up for five years were included. Data collected comprised age of patients and age at onset of lupus, sex and ethnicity, disease duration before the study period, medications, cumulative dose of prednisone, occurrence of infections and their original site. Results The most frequent infections were urinary tract infections (correlated to use of prednisone − p<0.0001 and cyclophosphamide − p=0.045), upper airways infections (correlated to use of prednisone − p=0.0004, mycophenolate mofetil − p=0.0005, and cyclosporine − p=0.025), and pneumonia (associated to prednisone − p=0.017). Conclusion Prednisone was the drug more often associated with presence of infections, pointing to the need for a more judicious management of this drug.


RESUMO Objetivo Determinar a incidência de infecções em uma população com lúpus eritematoso sistêmico e a caracterização das mesmas quanto aos locais de origem, assim como estudar possíveis associações das infecções com a terapêutica utilizada. Métodos Estudo retrospectivo analítico utilizando dados de prontuários de indivíduos com lúpus eritematoso sistêmico de um único hospital universitário. Foram investigados 144 pacientes acompanhados pelo período de 5 anos. Os dados coletados incluíam idade do paciente e idade de início do lúpus, sexo e etnia, tempo de duração da doença antes do período do estudo, medicamentos administrados, dose cumulativa de prednisona, ocorrência de infecções e seu local de origem. Resultados As infecções mais observadas foram as do trato urinário (correlacionadas com o uso de prednisona − p<0,0001, e ciclofosfamida − p=0,045), infecções das vias aéreas superiores (correlacionadas com o uso de prednisona − p=0,0004, micofenolato de mofetila − p=0,0005 e ciclosporina − p=0,025) e pneumonia (correlacionadas ao uso de prednisona − p=0,017). Conclusão A prednisona foi o medicamento mais associado com a presença de infecções, apontando para a necessidade de um manejo mais judicioso desse medicamento.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Lupus Erythematosus, Systemic/epidemiology , Photosensitivity Disorders/complications , Respiratory Tract Infections/etiology , Respiratory Tract Infections/drug therapy , Urinary Tract Infections/etiology , Urinary Tract Infections/drug therapy , Brazil/epidemiology , Prednisone/therapeutic use , Incidence , Retrospective Studies , Follow-Up Studies , Antirheumatic Agents/therapeutic use , Cyclophosphamide/therapeutic use , Hospitals, University/statistics & numerical data , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/drug therapy , Anti-Inflammatory Agents/therapeutic use
8.
Int. braz. j. urol ; 41(3): 552-555, May-June 2015. tab
Article in English | LILACS (Americas) | ID: lil-755861

ABSTRACT

ABSTRACTIntroduction:

The Foley catheter has been widely assumed to be an effective means of draining the bladder. However, recent studies have brought into question its efficacy. The objective of our study is to further assess the adequacy of Foley catheter for complete drainage of the bladder.

Materials and Methods:

Consecutive catheterized patients were identified from a retrospective review of contrast enhanced and non-contrast enhanced computed tomo-graphic (CT) abdomen and pelvis studies completed from 7/1/2011-6/30/2012. Residual urine volume (RUV) was measured using 5mm axial CT sections as follows: The length (L) and width (W) of the bladder in the section with the greatest cross sectional area was combined with bladder height (H) as determined by multiplanar reformatted images in order to calculate RUV by applying the formula for the volume (V) of a sphere in a cube: V=(ϖ/6)*(L*W*H).

Results:

RUVs of 167 (mean age 67) consecutively catheterized men (n=72) and women (n=95) identified by CT abdomen and pelvis studies were calculated. The mean RUV was 13.2 mL (range: 0.0 mL-859.1 mL, standard deviation: 75.9 mL, margin of error at 95% confidence:11.6 mL). Four (2.4%) catheterized patients had RUVs of >50 mL, two of whom had an improperly placed catheter tip noted on their CT-reports.

Conclusions:

Previous studies have shown that up to 43% of catheterized patients had a RUV greater than 50 mL, suggesting inadequacy of bladder drainage via the Foley catheter. Our study indicated that the vast majority of patients with Foley catheters (97.6%), had adequately drained bladders with volumes of <50 mL.

.


Subject(s)
Aged , Female , Humans , Male , Drainage/instrumentation , Urinary Catheters , Urinary Bladder , Urinary Catheterization/instrumentation , Organ Size , Retrospective Studies , Sex Factors , Tomography, X-Ray Computed , Treatment Outcome , Urinary Retention , Urinary Tract Infections/etiology
9.
Arq. bras. oftalmol ; 78(2): 89-93, Mar-Apr/2015. graf
Article in English | LILACS (Americas) | ID: lil-744287

ABSTRACT

Purpose: To assess the cytotoxicity and genotoxicity of intravitreal adalimumab treatment in an animal experimental model using cytological and molecular techniques. Methods: Eighteen rabbits were randomly assigned to three groups: control, adalimumab treatment, and placebo. Cytotoxicity on retinal cells was evaluated using flow cytometry assays to determine the level of apoptosis and necrosis. Genotoxicity was evaluated by comet assays to assess DNA damage, and quantitative real-time polymerase chain reaction (qPCR) was used to evaluate expression of apoptosis-inducing caspases (8 and 3). Results: No cytotoxicity or genotoxicity was observed in any of the two treatment groups (adalimumab and placebo) following intravitreal administration compared with the control group. Flow cytometry analysis revealed that more than 90% of the cells were viable, and only a low proportion of retinal cells presented apoptotic (~10%) or necrotic (<1%) activity across all groups. Molecular damage was also low with a maximum of 6.4% DNA degradation observed in the comet assays. In addition, no increase in gene expression of apoptosis-inducing caspases was observed on retinal cells by qPCR in both the adalimumab and placebo groups compared with the control group. Conclusion: The use of adalimumab resulted in no detectable cytotoxicity or genotoxicity on retinal cells for up to 60 days upon administration. These results therefore indicate that adalimumab may be a safe option for intravitreal application to treat ocular inflammatory diseases in which TNF-α is involved. .


Objetivo: Acessar a citotoxicidade e genotoxicidade do tratamento intravítreo de adalimumabe em um modelo experimental animal utilizando técnicas citológicas e moleculares. Métodos: Dezoito coelhos foram aleatoriamente selecionados em três grupos: controle, tratamento intravítreo com adalimumabe e placebo. Os efeitos tóxicos nas células da retina foram avaliados através de ensaios de citometria de fluxo, para a determinação de atividade apoptótica e necrótica. A genotoxidade foi avaliada através de ensaios cometa para determinar danos ao DNA e através de PCR em tempo real para avaliar a expressão genética de caspases (8 e 3) promotoras de apoptose celular. Resultados: Não foram detectadas citotoxicidade e genotoxidade nos dois grupos de tratamento, adalimumabe e placebo, em comparação com o controle. A citometria de fluxo determinou que mais de 90% das células eram viáveis após o tratamento, e uma pequena quantidade de células da retina apresentaram apoptose (~10%) ou necrose (<1%) em todos os grupos. O dano molecular também foi baixo com uma degradação no DNA de no máximo 6,4% detectados nos ensaios cometa. Adicionalmente, não foram observados aumentos na expressão genética das caspases que induzem a apoptose através dos ensaios de PCR em tempo real. Conclusão: O tratamento intravítreo com adalimumabe não promoveu nenhuma citotoxicidade e genotoxicidade detectável em células da retina por até sessenta dias. Estes resultados, portanto, indicam que o adalimumabe pode ser uma opção segura para o tratamento de doenças oculares inflamatórias em que o TNFα está envolvido. .


Subject(s)
Humans , Catheter-Related Infections/prevention & control , Cross Infection/prevention & control , Infection Control/methods , Medical Records Systems, Computerized , Population Surveillance/methods , Urinary Tract Infections/prevention & control , Catheter-Related Infections/epidemiology , Cross Infection/epidemiology , Hospitals/statistics & numerical data , Poisson Distribution , Program Evaluation , Pennsylvania/epidemiology , Regression Analysis , Retrospective Studies , Urinary Tract Infections/epidemiology , Urinary Tract Infections/etiology
10.
Korean Journal of Urology ; : 811-816, 2015.
Article in English | WPRIM (Western Pacific) | ID: wprim-93642

ABSTRACT

PURPOSE: To evaluate the medium-term efficacy and safety of transobturator four-arm polypropylene mesh in the treatment of high-stage anterior vaginal wall prolapse and concomitant stress urinary incontinence (SUI). MATERIALS AND METHODS: Between September 2010 and August 2013, a prospective single-center trial was performed to evaluate women with stage> or =3 anterior vaginal wall prolapse with or without SUI who presented to Labbafinejad Hospital, Teheran, Iran, and underwent anterior vaginal wall repair with polypropylene mesh. Pre- and postoperative evaluation included history; physical examination using the Pelvic Organ Prolapse Quantification system and cough stress test, both before and after reduction of prolapsed structures; Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ); urinalysis and culture; and a postvoid residual assessment. Complications were reported at a mean of 2 years of follow-up. RESULTS: A total of 71 patients underwent cystocele repair with the transobturator four-arm polypropylene mesh. Seven of the patients were lost to follow-up. There were no perioperative complications. The anatomical success rate was 87.5%. The subjective success rate was 92.1%. The PFDI and PFIQ were significantly improved after surgery (p<0.001). Among those with the simultaneous complaint of SUI, 82% were cured without any additional procedure. Three patients (4.6%) experienced vaginal mesh extrusion. Two patients (3.1%) reported worsening of dyspareunia after surgery. CONCLUSIONS: The four arms polypropylene mesh is an effective device for simultaneous correction of anterior vaginal wall prolapse and SUI with a low complication rate at a medium-term follow-up. The majority of the subgroup with concomitant SUI were cured without a second simultaneous procedure.


Subject(s)
Aged , Aged, 80 and over , Cystocele/complications , Female , Follow-Up Studies , Humans , Middle Aged , Polypropylenes , Postoperative Complications , Prospective Studies , Quality of Life , Surgical Mesh , Treatment Outcome , Urinary Incontinence, Stress/complications , Urinary Tract Infections/etiology
11.
Korean Journal of Urology ; : 817-822, 2015.
Article in English | WPRIM (Western Pacific) | ID: wprim-93641

ABSTRACT

PURPOSE: We aimed to analyze the characteristics of urinary retention (UR) in female inpatients managed with medical treatments. MATERIALS AND METHODS: We retrospectively analyzed the medical records of female inpatients referred to the department of urology for UR at our institution from January 2009, to December 2014. UR was defined as a difficulty in self-voiding despite a sufficient urine volume or >300-mL postvoid residual. The data included patients' age, body mass index (BMI), ambulatory status, medical and surgical history, classes of taking drugs, and urinary tract infection. RESULTS: A total of 182 women were included as retention group, mean age of 72.64±12.94 years and BMI of 22.94±3.10 kg/m2. In the chi-square analysis, cardiovascular disorders (p=0.000), diabetes mellitus (p=0.008), metastatic malignancy (p=0.008), chronic renal disorders (p=0.028) were found significantly. In the multiple logistic regression analysis, cardiovascular disorders (p=0.002; odds ratio [OR], 0.491), metastatic malignancy (p=0.013; OR, 2.616) were found to increase the risk of UR. The most common surgical history was anti-incontinence surgery (7.2%). In term of medication use, the most prescribed agents were nonsteroidal anti-inflammatory drugs (NSAIDs) (53.8%). The patients taking multiple drugs with antimuscarinic effects except of NSAIDs, narcotics and diuretics were 48 (26.4%). Urinary tract infection was identified in 43 patients (23.6%). CONCLUSIONS: UR in females managed with medical treatments could be occurred occasionally. We think that thorough attentions are needed for UR to patients with cardiovascular disorders including diabetes mellitus, metastatic malignancy, chronic renal disorders urinary tract infection, and more careful interests when managing with drugs with antimuscarinic effects.


Subject(s)
Age Factors , Aged , Aged, 80 and over , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Cardiovascular Diseases/complications , Diabetes Complications , Female , Hospitalization , Humans , Kidney Diseases/complications , Middle Aged , Muscarinic Antagonists/adverse effects , Neoplasm Metastasis , Retrospective Studies , Risk Factors , Urinary Retention/diagnosis , Urinary Tract Infections/etiology
12.
JPMA-Journal of Pakistan Medical Association. 2015; 65 (1): 90-92
in English | IMEMR (Eastern Mediterranean) | ID: emr-153798

ABSTRACT

Urethral duplication is quite a rare congenital anomaly with ill-defined aetiology. Patients often present with penile deformity, recurrent urinary infections, urinary incontinence, serosal discharge from the accessory urethra, and difficulty in urinating. Urethral duplication is most commonly grouped according to the Efmann classification. It has 3 main types as Type I, II, and III. There is no consensus on its therapy. There are non-surgical solutions, including follow-up without therapy, as well as many surgical options, including urethral reconstruction. Anatomical urethra and the external sphincter should absolutely be delineated when a surgery is contemplated. We herein report the case of a two-year-old male patient referred to our clinic with recurrent urinary infection, bilateral hydronephrosis and difficulty in urinating who was diagnosed with urethral duplication. We discuss our findings with review of the relevant literature


Subject(s)
Humans , Male , Urinary Tract Infections/etiology , Recurrence , Hydronephrosis
14.
Int. braz. j. urol ; 40(4): 539-545, Jul-Aug/2014. tab
Article in English | LILACS (Americas) | ID: lil-723964

ABSTRACT

Introduction To determine the parameters affecting the outcome of ureteroneocystostomy (UNC) procedure for vesicoureteral reflux (VUR). Materials and Methods Data of 398 patients who underwent UNC procedure from 2001 to 2012 were analyzed retrospectively. Different UNC techniques were used according to laterality of reflux and ureteral orifice configuration. Effects of several parameters on outcome were examined. Disappearance of reflux on control VCUG or absence of any kind of UTI/symptoms in patients without control VCUG was considered as clinical improvement. Results Mean age at operation was 59.2 ± 39.8 months and follow-up was 25.6 ± 23.3 months. Grade of VUR was 1-2, 3 and 4-5 in 17, 79, 302 patients, respectively. Male to female ratio was 163/235. UNC was performed bilaterally in 235 patients and intravesical approach was used in 373 patients. The frequency of voiding dysfunction, scar on preoperative DMSA, breakthrough infection and previous surgery was 28.4%, 70.7%, 49.3% and 22.4%, respectively. Twelve patients (8.9%) with postoperative contralateral reflux were excluded from the analysis. Overall clinical improvement rate for UNC was 92%. Gender, age at diagnosis and operation, laterality and grade of reflux, mode of presentation, breakthrough infections (BTI) under antibiotic prophylaxis, presence of voiding dysfunction and renal scar, and operation technique did not affect the surgical outcome. However, the clinical improvement rate was lower in patients with a history of previous endoscopic intervention (83.9% vs. 94%). Postoperative UTI rate was 27.2% and factors affecting the occurrence of postoperative UTI were previous failed endoscopic injection on univariate analysis and gender, preoperative BTI, postoperative VUR state, voiding dysfunction on multivariate analysis. Surgery related complication rate was 2% (8/398). These were all low grade complications (blood transfusion in 1, hematoma under incision ...


Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Cystostomy/adverse effects , Postoperative Complications/etiology , Ureterostomy/adverse effects , Urinary Tract Infections/etiology , Vesico-Ureteral Reflux/surgery , Cystostomy/methods , Follow-Up Studies , Retrospective Studies , Statistics, Nonparametric , Treatment Outcome , Ureterostomy/methods , Urination Disorders/etiology , Vesico-Ureteral Reflux/complications
17.
J. bras. nefrol ; 36(1): 10-17, Jan-Mar/2014. tab, graf
Article in Portuguese | LILACS (Americas) | ID: lil-704677

ABSTRACT

Introdução: A associação entre refluxo vesicoureteral primário e infecções do trato urinário pode acarretar em dano renal permanente. Há, na literatura, a tendência de cura espontânea deste refluxo em crianças e marcante declínio na indicação do tratamento cirúrgico. Objetivo: Estudar a evolução dos refluxos vesicoureterais primários associados a quadros de infecções urinárias de repetição, em pacientes do serviço de Nefrologia Pediátrica da nossa instituição, avaliando os casos nos quais houve cura mediante tratamento conservador apenas, e aqueles nos quais foi necessária a intervenção cirúrgica. Métodos: Analisamos os prontuários dos pacientes com infecções urinárias de repetição associadas ao diagnóstico de refluxo vesicoureteral primário. Os dados coletados diziam respeito aos parâmetros: sexo, idade do diagnóstico da primeira infecção urinária, idade do diagnóstico de RVU, número de infecções urinárias, grau de refluxo, resultado da urocultura, função renal, cicatrizes renais, outras malformações do trato urinário e intervenção cirúrgica ou conservadora. A Análise estatística foi descritiva e realizada com o programa SPSS. Resultados: Dentro do subgrupo de pacientes com graus IV e V, notou-se 63,6% dos casos evoluindo para intervenção cirúrgica e 36,4%, para resolução por intervenção conservadora. Naqueles com graus I, II e III, 38,5% evoluíram para tratamento cirúrgico, contra 61,5%, para resolução por conduta conservadora. Dentre os pacientes com presença de refluxo vesicoureteral bilateralmente,72,7% tiveram evolução cirúrgica. Não se ...


Introduction: The relationship between urinary tract infections and primary vesicoureteral reflux may lead to permanent renal damage. In the literature an increasing number of spontaneous cure of vesicoureteral reflux in children and the significant decrease in surgical therapy has been observed. Objective: To study the evolution of primary vesicoureteral reflux associated with recurring urinary tract infections settings in patients of the Pediatric Nephrology department of our institution, evaluating cases in which cure was achieved through conservative therapy only and those in which surgical intervention was required. Methods: We analyzed records and collected data refers to parameters: sex, age upon the diagnosis of primary urinary infection, age upon diagnosis of vesicoureteral reflux, number of urinary tract infections, vesicoureteral reflux grade; renal function, renal scaring, other malformation of urinary tract, and surgical or conservative intervention. Statistical analysis was descriptive and conducted with the SPSS program. Results: Within the subgroup of patients with grade IV and V, 63.6% of the cases evolved to surgical intervention and 36.4% to conservative intervention. In those with grades I, II, and III, 38.5% evolved to surgical treatment against 61.5% for conservative approach. Among those with bilateral vesicoureteral reflux, 72.7% had to undergo surgical intervention. No relationship was observed between the vesicoureteral reflux grade and the presence of renal scaring. Conclusion: Patients with low grade vesicoureteral reflux and recurring urinary tract infections tend to experience spontaneous reflux resolution with good renal evolution in the long term in a way that surgical intervention becomes limited to high grade reflux or when followed by other clinical issues. .


Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Urinary Tract Infections/etiology , Urinary Tract Infections/therapy , Vesico-Ureteral Reflux/complications , Vesico-Ureteral Reflux/therapy , Recurrence , Retrospective Studies , Vesico-Ureteral Reflux/surgery
18.
Korean Journal of Urology ; : 536-541, 2014.
Article in English | WPRIM (Western Pacific) | ID: wprim-156582

ABSTRACT

PURPOSE: This study was conducted to determine the predictive value of clinical, laboratory, and imaging variables for the diagnosis of vesicoureteral reflux in children with their first febrile urinary tract infection. MATERIALS AND METHODS: One hundred fifty-three children with their first febrile urinary tract infection were divided into two groups according to the results of voiding cystourethrography: 60 children with vesicoureteral reflux and 93 children without. The sensitivity, specificity, positive and negative predictive value, likelihood ratio (positive and negative), and accuracy of the clinical, laboratory, and imaging variables for the diagnosis of vesicoureteral reflux were determined. RESULTS: Of the 153 children with febrile urinary tract infection, 60 patients (39.2%) had vesicoureteral reflux. There were significant differences between the two groups regarding fever>38degrees C, suprapubic pain, C-reactive protein quantitative level, number of red blood cells in the urine, and results of renal ultrasound and dimercaptosuccinic acid renal scanning (p38.2degrees C and dimercaptosuccinic acid renal scanning and vesicoureteral reflux. Also, there were significant positive correlations between the erythrocyte sedimentation rate, positive urinary nitrite test, hyaline cast, and renal ultrasound and high-grade vesicoureteral reflux. CONCLUSIONS: This study revealed fever>38.2degrees C and dimercaptosuccinic acid renal scanning as the best predictive markers for vesicoureteral reflux in children with their first febrile urinary tract infection. In addition, erythrocyte sedimentation rate, positive urinary nitrite test, hyaline cast, and renal ultrasound are the best predictive markers for high-grade vesicoureteral reflux.


Subject(s)
Biomarkers/metabolism , Blood Sedimentation , C-Reactive Protein/metabolism , Child , Child, Preschool , Cross-Sectional Studies , Female , Fever/etiology , Humans , Infant , Kidney/diagnostic imaging , Male , Predictive Value of Tests , Radiopharmaceuticals , Sensitivity and Specificity , Technetium Tc 99m Dimercaptosuccinic Acid , Urinary Tract Infections/etiology , Vesico-Ureteral Reflux/complications
19.
J. bras. nefrol ; 35(4): 341-345, out.-dez. 2013. ilus
Article in Portuguese | LILACS (Americas) | ID: lil-697094

ABSTRACT

INTRODUÇÃO: As fístulas enterovesicais (FEV) são comunicações patológicas entre a bexiga e as alças intestinais pélvicas. Trata-se de uma rara complicação decorrente de doenças inflamatórias e neoplásicas da pelve, além de casos resultantes de iatrogenia, e associa-se a altos índices de morbimortalidade. RELATO DO CASO: Trata-se de um paciente de 61 anos com um quadro de dor e distensão abdominal, vômitos, parada de eliminação de fezes e flatos. APP: Hipertenso, diabético, com antecedentes de disfunção vesical e infecções do trato urinário de repetição (ITUr) nos últimos três anos. Por meio da realização de ressonância magnética de abdômen e pelve, diagnosticou-se FEV associada à doença diverticular (DDC) do sigmoide. A conduta estabelecida consistiu em colectomia parcial com rebaixamento de colo e cistectomia parcial com colocação cirúrgica de cateter duplo jota à esquerda. DISCUSSÃO: Embora consista de afecção primária do trato digestivo, normalmente o paciente com DDC associada a FEV procura atendimento médico em decorrência de queixas do trato urinário. Nesse caso, a demora no diagnóstico fez com que a queixa principal fosse do trato digestivo e com antecedentes de queixas urinárias. CONCLUSÃO: Apesar de pouco frequente, a ocorrência de ITUr associada à DDC deve ser sempre considerada no diagnóstico diferencial das ITUr pela alta morbimortalidade.


INTRODUCTION: Enterovesical fistula are pathological connections between the bladder and pelvic intestinal segments. It consists of a rare complication of neoplastic and inflammatory pelvic disorders, in addition to iatrogenic or traumatic injuries, and correlates with both high morbidity and mortality indexes. CASE REPORT: Male patient, 61 years old, admitted at the hospital clinics featuring abdominal pain and distension, vomiting and fecal retention. Patient's pathological precedents include high blood pressure, diabetes mellitus, vesical dysfunction and recurrent urinary tract infection on the past three years. Magnetic resonance imaging of abdomen and pelvis revealed enterovesical fistula in association with colon diverticular disease of the sigmoid. Management of choice consisted of partial colectomy with bowel lowering and partial cystectomy with surgical double-J stent insertion. DISCUSSION: Although consisting of a gastrointestinal primary affection, patients with enterovesical fistula usually search for medical help charging urinary tract features. In this particular case, our patient was admitted with gastrointestinal symptoms, reasoned by diagnostic delay, as the patient had already attended at multiple centers with urinary symptoms. CONCLUSION: Despite being an unusual affection, recurrent urinary tract infection associated with colon diverticular disease must always be considered at differential diagnosis of recurrent urinary tract infection as it concurs with high morbidity and mortality.


Subject(s)
Humans , Male , Middle Aged , Diverticulosis, Colonic/complications , Intestinal Fistula/complications , Sigmoid Diseases/complications , Urinary Bladder Fistula/complications , Urinary Tract Infections/etiology , Intestinal Fistula/etiology , Recurrence , Urinary Bladder Fistula/etiology
20.
Rev. latinoam. enferm ; 21(1): 459-468, Jan.-Feb. 2013. tab
Article in English | LILACS (Americas), BDENF | ID: lil-669599

ABSTRACT

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.


Subject(s)
Humans , Urinary Catheterization/methods , Urinary Tract Infections/prevention & control , Urinary Catheterization/adverse effects , Urinary Catheterization/standards , Urinary Tract Infections/etiology
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