Epidemiology and Management of Lithiasis of the Submandibular Gland: Study of 38 Cases

Sialolithiasis is the most common disease of salivary glands. It mainly affects the submandibular gland. Its diagnosis is based on clinical and radiological signs. Treatment is surgical. The aim of our study was to determine the epidemiological; clinical; therapeutic and evolutionary lithiasis of the submandibular gland. This was a retrospective study of 38 patients operated on for calculi of the submandibular gland during the period between January 2010 to December 2013 at the ENT department and head and neck surgery at the hospital August 20; Ibn Rushd Hospital in Casablanca. 63% of patients were male with a mean age of 43 years. The main reason for consultation represented by submandibular swelling (34 cases). All our patients had a cervical ultrasound. Resection of the submandibular gland was performed in 35 patients. The postoperative complications were noted in 6 patients. Monitoring patients; 6 to 12 months after surgery were noted only one case of recurrence

Clinical importance and prevalence of testicular microlithiasis in pediatric patients / Importância clínica e prevalência de microlititíase testicular em pacientes pediátricos

PURPOSE: To evaluate the prevalence of testicular microlithiasis among pediatric patients with inguinoscrotal affections. METHODS: Between January 2005 and January 2010, we evaluated, prospectively 1504 children ranging from 1 to 15 years with inguinoscrotal affections with a high-frequency ultrasound system, which employs a 10-MHz transducer. RESULTS: Testicular microlithiasis was identified in 20 testes of eleven children (0.71 percent of 1504 patients evaluated), through an ultrasound scan. Testicular microlithiasis was found in 5 children with cryptorchidism (3.93 percent of 127 patients), 4 children with retractile testes (14.8 percent of 27 patients), 1 child with a hypotrophic testis (100 percent of 1 patient), and 1 child with inguinal hernia (0.07 percent of 1349 patients). The children with testicular microlithiasis were submitted to annual physical examinations and ultrasound evaluations. CONCLUSIONS: Testicular microlithiasis was a rare condition and occurred in 0.7 percent of the subjects studied. The association with cryptorchidism, retractile and hypotrophic testis was significant.

OBJETIVO: Avaliar a prevalência de microlitíase testicular entre pacientes pediátricos com afecções inguinoescrotais. MÉTODOS: Estudo prospectivo entre janeiro de 2005 a janeiro de 2010, utilizando ultrasonografia escrotal em 1504 crianças (de 1 a 15 anos) com afecções inguinoescrotais. RESULTADOS: Microlitíase testicular foi identificada em 20 testículos de 11 crianças (0,71 por cento dos 1504 pacientes). 5 crianças com criptorquidia (3,93 por cento de 127 pacientes), 4 com testículo retrátil (14,8 por cento de 27 pacientes), 1 com hipotrofia testicular e 1 com hérnia inguinal (0,07 por cento de 1349 crianças). As crianças foram avaliadas anualmente com exame físico e ultrassonografia inguinoescrotal. CONCLUSÕES: A microlitíase testicular é uma entidade rara, ocorrendo em 0,7 por cento dos pacientes pediátricos com afecções inguinoescrotais. A associação com a criptorquidia, testículo retrátil e a hipotrofia testicular foi significativa.

Prevalencia de enfermedades hepáticas en una población rural de alta montaña: estudio clínico, bioquímico y ecográfico / Prevalence of liver diseases in a small rural community isolated in tne mountain heights: clinical, biochemical and ultrasonographic study

En este estudio clínico, bioquímico y ecográfico se evaluó la prevalencia de hepatopatías en Lara, una comunidad rural aislada de alta montaña en Tucumán, provincia con la máxima prevalencia de infección por HAV en niños de Argentina. Lara carece de agua potable, electricidad y cloacas. Se estudiaron 102 habitantes, lo que representa el 41% de la población. El anti-HBc y anti-HCV fueron negativos en todos los casos. Ningún niño presentó anormalidades hepáticas. El 41% de los adultos refirió ingesta alcohólica y el 12% transfusiones. Se observó incremento leve de ALT en 3 casos (6%). La ecografía demostró esteatosis en 8 individuos (16%), litiasis vesicular en 7 (14%), microcalcificaciones en 5 (10%) y quistes de aspecto parasitario en 4 (8%). La prevalencia de infección por HAV en Lara fue de 89% en adultos y 35% en niños, siendo significativamente menor que la de los niños de la ciudad de Tucumán con nivel socioeconómico medio / alto (53%, p = 0.05) o bajo (74%, p = 0.0006). La diferencia fue más evidente en niños menores de 5 años (0%, 53% y 75% respectivamente). La serología para hidatidosis fue positiva en 3/4 individuos con quistes, 2/5 con microcalcificaciones y 17/85 (20%) con ecografía normal, lo que sugiere que la técnica de Elisa utilizada se asocia a frecuentes resultados falsos positivos. El estudio poblacional de Lara demostró una elevada prevalencia de esteatosis, litiasis vesicular e hidatidosis en adultos, ausencia de infección por HBV y HCV, y una baja exposición al HAV en niños, especialmente en menores de 5 años.

The goal of this population-based clinical, biochemical and ultrasonographic study was to assess the prevalence of liver diseases in Lara, a small rural community isolated in the mountain heights of Tucumán, a Province of Argentina with the highest reported rates of HAV infection in children. Inhabitants of Lara lack electricity, potable water and a sewer system. The study included 102 individuals representing 41% of the total population. Anti-HBc and anti-HCV were negative in all cases. No children showed clinical, biochemical or ecographic abnormalities. Among adults, 41% referred alcohol consumption and 12% blood transfusions. Only 3 adults (6%) had mildly elevated ALT. Ultrasound showed steatosis in 8 individuals (16%), gallstones in 7 (14%), parenchymal micro-calcifications in 5 (10%) and parasitic cysts in 4 (8%). Prevalence of HAV infection in Lara was 89% in adults and 35% in children, being significantly lower than that of children of medium/high (53%, p=0.05) and low (74%, p=0.0006) socioeconomic level from the city of Tucumán (control groups). These differences were more marked in children aged <5 years (anti-HAV in 0%, 53% y 75% respectively). Serologic tests for echinoccocal disease were positive in 3/4 individuals with parasitic cysts, 2/5 with micro-calcifications and 17/85 (20%) with normal ultrasound, thus suggesting a high rate of false-positive results of the Elisa test utilized. This study showed that in Lara there is a high prevalence of steatosis, gallstones and equinoccocal disease in adults, absenceof HBV and HCV infection and low exposure to HAV in children especially in those aged <5 years.

Association between testicular microlithiasis, testicular cancer, cryptorchidism and history of ascending testis

OBJECTIVE: To prospectively determine the prevalence of testicular microlithiasis in symptomatic patients who were referred for scrotal ultrasound examination and to evaluate the possible association of testicular microlithiasis with testicular cancer and other conditions such as cryptorchidism or history of ascending testis. MATERIALS AND METHODS: 391 men who were referred to our institutions between July 2002 and May 2005 for any type of symptoms from the testicles, underwent physical and scrotal ultrasound examination. The presence of testicular microlithiasis, the number of lesions and the involvement of both testicles in relation to the symptoms as well as the coexistence of other lesions were studied. RESULTS: Eighteen (4.6 percent) of 391 men enrolled into the study had testicular microlithiasis. Two out of the eighteen patients (11 percent) had concomitant testicular cancer, which was confirmed by pathological evaluation of the orchidectomy specimen. One of the patients with testicular microlithiasis presented a rising in biochemical tumor markers (LDH, and HCG) and underwent orchidectomy one year later. Five of the remaining 373 (1.3 percent) patients without microlithiasis were diagnosed with testicular cancer. Thirty six men reported having a history of ascending testis, but none of them was found with testicular cancer. Two cases of testicular torsion in a cryptorchid position had testicular microlithiasis, but the orchidectomy specimen (after surgery) was negative for testicular cancer. The correlation between testicular cancer and testicular microlithiasis found in our study was statistically significant (p < 0.05). CONCLUSION: There seems to be an association between testicular microlithiasis and testicular cancer.

Lithiase du haut appareil urinaire au Centre Hospitalier Universitaire Sanou Souro de Bobo-Dioulasso (Burkina Faso) : aspects epidemiologiques; cliniques et therapeutiques: A propos de 110

Objective: To study the epidemiological; clinical and therapeutic aspects of upper urinary tract lithiasis at our department. Material and Methods: This is a retrospective study based on the patients' records and covering the period from January 1; 1992 to December 31; 2002. Results: During a period of 10 years; 110 cases of upper urinary tract calculi out of a total number of 7128 hospitalized patients were seen at our institution; thus constituting 1;54of all hospital admissions. The patients' mean age was 35;49 years (range: one to 75 years); the male to female ratio was 7:1. The main presenting symptom was renal colic followed by lower back pain. Treatment was mainly by open surgery (108 of 109 cases were managed by conventional surgery). Follow-up was uneventful in all cases with a mean hospital stay of 13;5 days. Conclusion: Upper urinary tract lithiasis is rarely encountered in our region; but it seems to be in constant progression. We are still obliged to resort to open surgery in most cases; although this method is not the treatment of choice in developed countries any more

Sinais de uretelolitíase na tomografia computadorizada helicoidal sem contraste: ensaio iconográfico e revisão de literatura / Ureterolithiasis signs on unenhanced helical computed tomography: iconographic essay and literature review

O principal sinal diagnóstico de ureterolitíase na tomografia computadorizada é a visualização direta do cálculo no interior do ureter. Todavia, a sua caracterização pode ser prejudicada devido a suas pequenas dimensões, variação da respiração entre a aquisição dos cortes tomográficos, escassez de gordura retroperitoneal ou eliminação recente do cálculo. Neste contexto, foram descritos diversos sinais secundários de obstrução ureteral, observados na tomografia computadorizada, que podem auxiliar no diagnóstico de casos duvidosos, além de quantificar o grau de obstrução urinária.

La litiasis biliar y el cáncer de la vesícula y vías biliares en Chile: dos estrategias / Gallstone disease and gallbladder cancer in Chile: two strategies

En Chile, el tumor maligno de la vesícula y vías biliares es la principal causa de muerte por cáncer en el sexo femenino. En este artículo se analiza el comportamiento epidemiológico de esta enfermedad y el de su condicionante principal: la litiasis biliar sintomática. Sobre la base de la abundante bibliografía nacional, se acepta que la colecistectomía oportuna es la única medida actualmente efectiva para prevenir el cáncer vesicular y las otras graves complicaciones de la litiasis biliar. Se propone ejecutar un programa de control de los problemas mencionados, consistente en llevar la frecuencia de las colecistectomías a un nivel suficiente en las edades adecuadas. Se presentan distintas opciones para el diseño de tal programa, así como los resultados que se pueden esperar. Sobre la base de las diferencias de incidencia observadas entre las regiones norte y sur de Chile, se propone una investigación de los factores causales de la litiasis biliar, cuyos resultados servirían de base para la prevención primaria de dicha condición y de sus complicaciones.

Avaliaçäo de pacientes com litíase renal em regiäo de clima quente / Assessment of kidney stone patients in hot regions

O objetivo deste estudo é desenvolver um serviço de litíase renal e detectar as alteraçöes metabólicas associadas a essa doença em pacientes da cidade de Catanduva, Säo Paulo. Foram estudados 65 pacientes (40 mulheres e 25 homens), entre 1996 e 1999, com idade variando entre 18 e 67 anos. O protocolo utilizado consistiu de avaliaçäo clínica e exames complementares (bioquímica de imagem e dos principais elementos litogênicos plasmáticos e urinários). Para a análise dos resultados, foi utilizado o teste "t" de Student para amostras independentes e consideradas insignificantes quando p é menor que 0,05. Pelo menos, uma alteraçäo metabólica foi encontrada em 98,5 porcento dos casos avaliados.A reduçäo do volume urinário (77 porcento) foi a alteraçäo metabólica mais frequente, seguida pela hipocitratúria (62 porcento), hiperexcreçäo de ácido úrico (32 porcento), hipercalciúria (27 porcento), outras alteraçöes (8 porcento),e sem alteraçäo detectada (1,5 porcento). A detecçäo de, pelo menos, uma alteraçäo metabólica encontrada na grande maioria dos pacientes avaliados comprova a eficácia do protocolo aplicado nesse trabalho. O estudo sugere que a elevada prevalência de alteraçöes metabólicas associadas à litíase renal justifica a investigaçäo sistemática dos pacientes litiásicos. O estabelecimento de centros regionais com serviço de litíase renal deverá näo só favorecer aos pacientes dessas regiöes, bem como contribuir, no sentido epidemiológico, para um maior conhecimento dessa doença no Brasil.(au)

Hepatolitiasis y enfermedad de Caroli en Argentina: resultados de un estudio multicéntrico / Hepatolithiasis and Caroli's disease in Argentina: results of a multicenter study

A fin de determinar la prevalencia epidemiología y comportamiento clínico-terapêutico de la hepatolitiasis (HL) en el país se envió un cuestionario a 10 centros de referencia, en Radiología invasiva de vía biliar. De 10 centros encuestados, 7 (70 por ciento) contestaron en tiempo y forma. Reuniéndose un total de 8.736 colangiografías (C) en los últimos 5 años: 5.920 (68 por ciento) fueron litiasis biliares y 53 de estas resultaron HL (0.9 por ciento, rango 0,5-2.6 por ciento). El método diagnóstico fue la C. retrógrada en el 36 (68 por ciento) y en el 17 (32 por ciento) la C. transhepática. De 53 pacientes con HL (53 por ciento, x de edad 52, rango 23-85); el 79 por ciento (42/53) se presentó clínicamente con una colangitis; un 6 por ciento 3/53) padeció una pancreatitis aguda y un 9.4 por ciento (5/53), evolucionó a una cirrosis biliar. Las enfermedades predisponentes a HL fueron: en el 28 por ciento (15/53) estenosis postquirúrgica de la via biliar (EPQ); en el 20 por ciento (11/53) Enfermedad de Carolí en otro 28 por ciento (15/53) panlitiasiscoledociana. Mientras que un 9,4 por ciento (5/53) presentó una "historia biliar" (dos o más intervenciones sobre la via biliar) y en un 5,7 por ciento (3/53) no se hallaron factores predisponentes. En un 77 por ciento se observó un follow-up de 38 meses (rango 8-60), con una mortalidad de 4,8 por ciento (2/41): siendo tratados con cirurgía en el 58 por ciento de los casos (31/53); papilotomía en el 17 por ciento (9/53) y tratamiento combinados en el 15 por ciento (8/53) que incluían a litotripsia extracorpórea y Ac. Ursodesoxicólico(AUDC). Cuatro de 53 (7.5 por ciento) recibieron AUDC como única terapéutica. Se concluye que la HL es una entidad con alta morbilidad biliar (85 por ciento) y heoática (cirrosis en el 9.4 por ciento). Cuando se diagnostica en Occidente, debe buscarse EPQ o un Carolí. Siendo los tratamientos combinados o el AUDC como única alternativa, una nueva modalidad terapéutica del mundo occidental.