Comparison between two shock wave regimens using frequencies of 60 and 90 impulses per minute for urinary stones

PURPOSE: Two different regimens of SWL delivery for treating urinary stones were compared. METHODS: Patients with urinary stones were randomly divided into two groups, one of which received 3000 shocks at a rate of 60 impulses per minute and the other of which received 4000 shocks at 90 impulses per minute. Success was defined as stone-free status or the detection of residual fragments of less than or equal to 3 mm three months after treatment. Partial fragmentation was considered to have occurred if a significant reduction in the stone burden was observed but residual fragments of 3mm or greater remained. RESULTS: A total of 143 procedures were performed with 3000 impulses at a rate of 60 impulses per minute, and 156 procedures were performed with 4000 impulses at 90 impulses per minute. The stone-free rate was 53.1 percent for patients treated with the first regimen and 54.8 percent for those treated with the second one (p = 0.603). The stone-free rate for stones smaller than 10 mm was 60 percent for patients treated with 60 impulses per minute and 58.6 percent for those treated with 90 impulses per minute. For stones bigger than 10 mm, stone-free rates were 34.2 percent and 45.7 percent, respectively (p = 0.483). Complications occurred in 2.3 percent of patients treated with 60 impulses per minute and 3.3 percent of patients treated with 90 impulses per minute. CONCLUSION: No significant differences in the stone-free and complication rates were observed by reducing the total number of impulses from 4000 to 3000 and the frequency from 90 to 60 impulses per minute.

Acesso percutâneo lateral no tratamento da litíase renal / Side percutaneous access in the renal lithiases treatment

A nefrolitotripsia percutânea (NP) é uma das principais formas de tratamento de cálculos renais volumosos. O acesso percutâneo lateral é feito com o paciente em decúbito dorsal horizontal. O estudo objetivou avaliar os resultados de acesso lateral, em posição modificada, no tratamento percutâneo de cálculos renais e também o mesmo associado ao ureteroscópico, em caso de cálculos renais e ureterais concomitantes. Estudou-se 88 pacientes e os resultados foram considerados bem sucedidos em 69,32 por cento. As complicações mais comuns foram febre e sangramento. Concluímos que a NP com acesso lateral apresenta sucesso no tratamento da litíase oferecendo vantagens no posicionamento para realização de procedimento associado à ureteroscopia / Percutaneous nephrolithotripsy (PN) is one of the main alternatives for the treatment of large renal stones. The present study aimed to evoluate the results of the lateral percutaneous approach, in a modified position, for the treatment of kidney stones. We also evaluated the association of the percutaneous with the ureteroscopic treatment in patients with concomitant kidney and ureteral stones. A total of 88 patients selected, 69,32 per cent of patients were considered complete success. The most common complication was the development fever and bleeding. In conclusion the PN using the lateral approach is a safe procedure with a high success rate in the treatment of kidney stones and is a advantageous, for patient positioning especially for the performance of ureteroscopic procedures...

Prostatite crônica: influência sobre a dosagem sérica do PSA / Chronic prostatitis: effect on serum PSA

Analisou-se retrospectivamente 76 pacientes com exame anatomopatológico de hiperplasia benigna da próstata, sendo que 21 tiveram diagnóstico secundário de prostatite crônica. O material prostático foi obtido através de RTU em 64 pacientes, prostatectomia transvesical em 7 e biópsia transretal em 5. O peso médio da glândula prostática, nos grupos com e sem prostatite crônica foi semelhante, sendo que o PSA apresentou média de 5,1 ng/ml nos pacientes apenas com hiperplasia benigna da próstata. A presença de prostatite crônica levou o percentual de falsos positivos para adenocarcinoma prostático ao toque retal. Conclui-se que a prostatite crônica näo interfere de forma significativa no valor do PSA sérico em pacientes com hiperplasia benigna da próstata

Transplantes renal com arterias multiplas: experiencia com tecnicas de reconstruçao vascular / Renal transplantation with multiple arteries: experience with several techniques of vascular reconstruction

Os autores apresentam sua experiencia em transplante renal com a utilizaçao de rins com arterias multiplas. Foram utilizados 23 rins nestas condiçoes empregando-se 6 tecnicas diferentes de reconstruçao vascular, com excelente resultado evidenciado por perfusao imediata e boa funçao renal tardia

Estudo comparativo randomizado de cefadroxil e trimetoprim-sulfametoxazol no tratamento da infecçäo do trato urinário / Comparative randomized study of cefadroxil and trimethoprim-sulphamethoxazole in the treatment of urinary tract infection

Realizou-se um estudo aberto, aleatório para comparar o cefadroxil com o co-trimoxazol no tratamento das infecçöes do trato urinário em adultos. Cefadroxil foi usado na posologia de 500 mg cada 12 horas e co-trimoxazol foi administrado com um comprimido contendo 160 mg de trimetoprim e 800 mg de sulfametoxazol, cada 12 horas