Ingestión de sodio en pacientes litiásicos y su relación con variables demográficas y nutricionales / Sodium intake in lithiasic patients and its relationship to demographic and nutritional variables

Introducción: la medición de la excreción urinaria de sodio es importante en pacientes con litiasis urinaria, pues su excreción elevada predispone a hipercalciuria, el trastorno metabólico urinario más frecuente. Objetivo: determinar la ingestión (igual a excreción) de sodio e identificar su posible relación con variables demográficas y nutricionales, en pacientes con litiasis urinaria. Métodos: se desarrolló un estudio analítico, transversal, de los pacientes con litiasis urinaria que se hicieron estudio metabólico renal en el Instituto de Nefrología, entre enero 2011 y diciembre 2012. Se excluyeron los pacientes con factores que modifican la excreción de sodio. Las determinaciones de creatinina fueron realizadas por el método cinético de Jaffé, con espectrofotómetro Jenway®; las mediciones del sodio urinario, con analizador electrolítico marca Roche®. La información fue procesada de forma automatizada (SPSS versión 15.0). En cada categoría de las variables fueron calculadas media y desviación estándar de la excreción de sodio (mEq/d). Las comparaciones de los promedios se realizaron mediante la prueba t o mediante ANOVA. Resultados: de 1 985 pacientes estudiados, 1 363 fueron del sexo masculino (68,7 por ciento) y 622, del femenino (31,3 por ciento). La excreción urinaria media de sodio fue 235,29 mEq/d, globalmente, y resultó mayor en los hombres (252,69 mEq/d), al ser comparada con la de las mujeres (197,14 mEq/d) (p= 0,00). También se encontraron diferencias al comparar la excreción de sodio entre las categorías de valoración nutricional (p= 0,00) y de excreción de creatinina (p= 0,0). Conclusiones: la excreción urinaria de sodio es elevada en pacientes urolitiásicos, mayor en los hombres y en los sujetos con sobrepeso y obesidad...

Introduction: measurement of urinary sodium excretion is important in patients with urolithiasis, for a high level of excretion leads to hypercalciuria, the most common urinary metabolic disorder. Objective: to determine sodium intake (equal to excretion) and identify its possible relationship to demographic and nutritional variables in patients with urinary lithiasis. Methods: an analytical cross-sectional study was conducted in patientes with urinary lithiasis undergoing metabolic renal study at the Institute of Nephrology from January 2011 to December 2012. Patients with factors modifying sodium excretion were excluded. Creatinine determinations were made with Jaffé's kinetic method using a Jenway™ spectrophotometer. Urinary sodium was measured with a Roche™ electrolytic analyzer. Data was processed with the statistical software SPSS version 15.0. Variables for each category were estimated as mean and standard deviation of sodium excretion (mEq/d). Comparisons of averages were made with the t test or ANOVA. Results: of the 1 985 patients studied, 1 363 were male (68.7 percent) and 622 were female (31.3 percent). Global mean sodium urinary excretion was 235.29 mEq/d, greater in men (252.69 mEq/d) than in women (197.14 mEq/d) (p= 0.00). Differences were also found when sodium excretion was compared by nutritional assessment (p= 0.00) and creatinine excretion (p= 0.0). Conclusions: urinary sodium excretion is high in patients with urolithiasis. Values are higher in men, and in overweight and obese individuals...

Nocturnal Enuresis Is Associated with Attention Deficit Hyperactivity Disorder and Conduct Problems

OBJECTIVE: There are no published prevalence estimates of elimination disorders and their association with disruptive-behavior disorders among children in the Asian region using standardized diagnostic interviews. This study was conducted to determine the prevalence of elimination disorders and its association with disruptive-behavior disorders in a representative sample of children in Seoul, Korea. METHODS: The diagnosis of enuresis and encopresis was derived from parent-reported data for "enuresis and encopresis," collected using the Diagnostic Interview Schedule for Children, from a representative sample of 6- to 12-year-old children (n=1,645) who participated in the 2005 Seoul Child and Adolescent Mental Health Survey. Prevalence data for attention deficit and disruptive-behavior disorders were collected from the same sample. RESULTS: The overall 12-month prevalence of nocturnal enuresis and encopresis was 1.8% and 0.6%, respectively. Enuresis and encopresis prevalence in boys was significantly greater than that in girls. Enuresis and encopresis was most common at 7 to 9 years of age. Enuresis was significantly associated with ADHD (OR 2.6, 95% CI 1.0-6.9) and conduct disorder (CD; OR 4.7, 95% CI 1.0-22.4). CONCLUSION: Enuresis is significantly associated with ADHD and CD, so these conditions must be assessed together during the evaluation of children with enuresis.

Estudo do tempo de excreção renal pela cintilografia em felinos domésticos / Urinary excretion rate assessment by scintigraphy in domestic cats

Na rotina clínica de felinos domésticos, algumas modalidades de diagnóstico por imagem, como a ultrassonografia, radiografia simples e urografia excretora, já são amplamente utilizadas. A cintilografia é uma técnica não invasiva, capaz de oferecer informações funcionais de rins individualmente, porém é considerada uma modalidade menos usual. O objetivo deste estudo foi verificar o tempo de excreção renal de felinos domésticos através da cintilografia, em animais com parâmetros ultrassonográficos e radiográficos dentro dos limites da normalidade. Foram utilizados 15 animais, 9 machos e 6 fêmeas, e estes foram divididos em grupos de animais não submetidos à anestesia e anestesiados. Foi estabelecido o tempo para o radiofármaco obter acúmulo máximo em cada um dos rins e o tempo para este acúmulo máximo ser reduzido pela metade. Não houve diferença estatística entre os valores dos animais não-anestesiados e anestesiados, nem entre os rins esquerdo e direito, tampouco entre machos e fêmeas.

In internal medicine of domestic cats, some imaging diagnosis modalities, such as ultrasonography, radiography and intravenous pylogram are spreadly used. Scintigraphy is a non-invasive technique, which provides functional information of individual kidneys; however, it is regarded not ordinary nowadays. The aim of this study was to verify the time of excretion of each particular kidney in domestic cats by scintigraphy, and these animals were presented with normal ultrasonographic and radiographic parameters. We used 15 cats, 9 males and 6 females, and they were divided into awake and anesthetized cats. We calculated the time the radiopharmaceutical takes to reach the maximum activity in the kidneys (T max.) and the time it takes to decrease into half of this value (half-time). There was no difference between the awake and anesthetized cats, nor between the right and left kidneys, and no difference between male and female either.

Prevalence of elimination dysfunction, among primary school age children in Sari

Elimination dysfunction is referred to have various difficulties in urination and defecation, such as urinary frequency, delayed with difficulty in voiding or defecation. The prevalence of elimination dysfunction has been varied in different studies, as 21% of children experience elimination dysfunction during their childhood period. Presently, there are no studies pertaining to this difficulty in our country. Therefore, we carried out a descriptive study in primary schools from the Sari Township, regarding voiding and defecation dysfunction among children, and also we identified the epidemiology of the disease, in order to solve problems by implementing teaching programs and screening methods. This cross-sectional study was done on Primary school age students in the Sari Township, during 2007 through 2008. Considering the prevalence of elimination dysfunction [15-25%], confidence coefficient 95%, SE 10%, and the sample size of 2, 200 were randomly and equally selected from different parts of the township among the two-sex groups. A standard questionnaire including demographic characteristics and 10 questions on voiding status, in addition to 19 questions regarding defecation status was prepared. Questionnaires were distributed to the students by responsible school personnel and then referred to parents for completion. Data was analyzed by SPSS software and descriptive statistics [Frequency, Mean, and Standard Deviation]. Chi Square test [X[2]] and Student T-test were used to compare the Means. P < 0.05 was considered significant. Of 2201 primary school age students, 48.7% were girls. The mean age was 8.96 +/- 1.43 year. Voiding and defecation dysfunction was reported in 38.4% and 29% of the cases respectively. There was no significant relationship between prevalence of voiding dysfunction and other factors such as mean age, sex and level of education; however, there was a significant relationship between elimination dysfunction in other variables such as age, sex, level of education, family history, Soya and fiber diet in-take and environmental stressors. The mean age of children with voiding dysfunction was less than children without this problem. However, the prevalence of familial stress was higher than those involved children. Public Health Education is recommended to teach the different kinds of elimination dysfunction symptoms in urban and rural areas, in addition, to reduce the undesirable complications of the disease due to delay in referrals

Síndrome de mala eliminación / Dysfunctional elimination syndrome

El Síndrome de Mala Eliminación (SME) comprende la alteración en la evacuación a nivel intestinal y urinario, en distintos grados y formas de presentación clínica. Diversos estudios muestran el origen de esta patología en una alteración a nivel de la musculatura del piso pelviano. El objetivo de esta revisión es entregarle al pediatra una visión general de este concepto, usa cada vez más utilizado en la literatura internacional, destacando la importancia de la sospecha clínica, diagnóstico y manejo precoz. Los resultados de estudios internacionales avalan la necesidad del tratamiento conjunto de la afección urinaria y gastrointestinal, para lograr mayor porcentaje de mejoría. El enfoque conjunto de la incontinencia y la constipación, más la amplia gama de situaciones clínicas que cada uno de ellos conlleva, es el objetivo que persigue introducir este nuevo síndrome.

Psychiatric Comorbidity in Korean Children and Adolescents with Attention-Deficit Hyperactivity Disorder: Psychopathology According to Subtype

It is well-known that more than 50% of attention-deficit hyperactivity disorder (ADHD) cases also have comorbid psychiatric disorders. We evaluated the comorbid psychopathology of Korean children and adolescents with ADHD using a standardized diagnostic instrument. The Korean Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL-K) was administered and completed in 105 patients who had been referred to the outpatient and inpatient clinics at the Samsung Medical Center from March 2004 to May 2005. All of the cases were diagnosed as ADHD according to DSM-IV criteria. We analyzed their clinical characteristics and psychiatric comorbidities, and assessed the correlation of any comorbidity with gender, age and ADHD subtype. Among our 105 participants, 70 (66.7%) subjects were diagnosed with combined-type ADHD, 22 (21.0%) were the predominantly inattentive type, only 1 (1.0%) was determined to have the predominantly hyperactive-impulsive type of ADHD, and 12 (11.4%) were classified as not otherwise specified (NOS) ADHD. Eighty (76.2%) subjects had at least one comorbid disorder such as oppositional defiant disorder (n = 53, 50.5%), anxiety disorders (n = 35, 33.3%) and affective disorders (n = 15, 14.3%). Our patients ranged in age from five to 16 years. Among the factors including gender, age, and ADHD subtype, ADHD subtype was the only one significant to comorbidity in our study. The results of this study suggest that psychiatric comorbidity in Korean children with ADHD is similar to the results of previous studies in western countries. Out of all the ADHD subtypes, the combined-type group had a significantly higher ratio of comorbid disorders and psychopathologies.

Animus: um desafio diagnóstico e terapêutico / Animus: a diagnosis and therapeutic challenger

O animus tem sido implicado como o principal componente da evacuação obstruída. Além da constipação intestinal, a proctalgia crônica é outra manifestação freqüente deste distúrbio. O diagnóstico envolve medições laboratoriais do esforço evacuatório, sendo a proctografia dinâmica o exame padrão-ouro. O tratamento consiste, na maioria dos casos, de retreinamento com biofeedback (BF), associado a medidas dietoterápicas e uso de laxantes suaves.

Validation of the criteria used to determine protection at birth as applied to neonatal tetanus elimination in Vietnam

To determine the validity of the following simple criteria used to determine protection of the infant from neonatal tetanus, we carried out an analysis of 646 neonatal tetanus cases that were reported in Vietnam from 1994 to 1998. 93% (602) of the 646 cases did not fit the criteria set for “protection at birth”. It was concluded that the criteria used to define “protection at birth” are valid and reliable. It's enough to be used by health workers as a simple management tool to monitor the neonatal tetanus elimination program, and assess the eligibility of women for further tetanus toxoid doses, according to the EPI schedule.

Status of neonatal tetanus (NT) after 10 years of elimination program implementation in the Northern region, 1992-2001

After 10 years of implementing the program of neonatal tetanus elimination from 1992 to 2001 in the Northern region, the tetanus toxoid coverage for pregnant and for child bearing age women have always been maintained at greater than 84%. The incidence of NT per 1000 live births has decreased, from 0.23 in 1994 to 0.07 in 2001. The disease has been eliminated at provincial level since 1995 and at district level since 1999.

Efeitos da monensina em bezerros holandeses submetidos a estresse pelo calor / Monesin effects in dutch dairy cattle submitted to heat stress

Este trabalho teve como objetivo estudar a ação da monensina em animais em estresse térmico sobre o desempenho, digestibilidade do alimento, parâmetros ruminais, concentrações de Ca, P, Mg, Na, Zn e Cu no soro sangüíneo e retenção e absorção destes minerais. Foram utilizados 24 bezerros machos da raça Holandesa (peso médiio 82 kg), estrutua de tramentos de fatorial 2 x 2, dois níveis de suplemntaç+o: 0 mg de monensina e 85 mg de mononsina/animal/dia e duas temperaturas: temperatura ambiente (24,3 ºC) e de estresse térmico (33,2 ºC)...

Correlação entre parâmetros fisiológicos e função clínica nas anastomoses coloanais com e sem reservatório / Correlation between physiological parameters and clinical function in coloanal anastomosis withand without colonic pouch

As cirurgias de preservação esfincteriana no tratamento do câncer de reto têm significado importante progresso na manutenção da qualidade de vida dos pacientes após a ressecção retal completa, sem comprometer significativamente o seu prognóstico. O presente estudo tem como objetivos comparar as técnicas cirúrgicas de anastomose coloanal manual com e sem reservatório avaliando-se os resultados funcionais e análise dos parâmetros fisiológicos na medição do mecanismo de continência fecal envolvido. As hipóteses levantadas para este estudo são: 1) a anastomose coloanal com reservatório apresentaria melhores resultados do que a anastomose coloanal sem reservatório, 2) a medição de parâmetros fisiológicos estaria correlacionada ao índice funcional e poderia predizer os resultados funcionais. Foram estudados 42 pacientes operados pelo Grupo de Coloproctologia da Disciplina de Moléstias do Aparelho Digestivo da Faculdade De Ciências Médicas da Universidade Estadual de Campinas, no período de 1979 a 1995. Os pacientes responderam a questionário específico sobre função esfincteriana (índice funcional) para posterior quantificação dessa função. Os parâmetros fisiológicos estudados foram: pressão anal média de repouso, pressão anal máxima de contração voluntária, pesquisa do reflexo inibitório anoneorretal, valor médio de pressão anal de repouso na zona de mais alta pressão, índice de assimetria da zona de mais alta pressão em repouso, localização da zona de mais alta pressão em repouso em relação ao comprimento do canal anal, volume correspondente a primeira sensação anoneorretal, ao desejo de evacuar e à capacidade máxima neorretal, além da medida de complacência neorretal. Para a análise da ocorrência de evacuações fragmentadas e reflexo anoneorretal, utilizou-se a tabela de contigência, sendo o valor de significação estabelecido pelo teste exato de Fischer. Para calcular a existência de correlação entre o índice funcional e os parâmetros fisiológicos, foi utilizado o cálculo do coeficiente de correlação, sendo considerado estatisticamente significante valores de p<0,05. Os demais parâmetros fisiológicos (pressão anal média de repouso, pressão anal máxima de contração voluntária, índice de assimetria e localização da zona de mais alta pressão em repouso, volume de insuflação do balão intra-neorretal correspondente a primeira sensação anoneorretal e capacidade máxima neorretal) não apresentaram significância estatística entre os dois grupos.

Disturbances in water metabolism in parkinsonism

Sixteen patients suffering from parkinsonism due to paralysis agitans and post-encephalitis were studied. Eleven patients showed a defective elimination of water after a water load. In the two patients who showed the most marked diminution in water elimination, hypertonic saline failed to inhibit the urinary output after a water load, and produced an osmotic diuresis. The osmoreceptor hypothalamic pituitary mechanism is sluggish, both to the stimulus of hyper as well as hypoosmolarity, and the fault is most probably in the hypothalamic pituitary apparatus. 1] 16 patients suffering from parkin-sonism due to paralysis agitans and post-encephalitis were studied, 2] Eleven patients showed a defective elimination of water after a water load. 3] In the two patients who showed the most marked diminution in water elimination, hypertonic saline failed to inhibit the urinary output after a water load, and produced an osmotic diuresis. 4] The osmoreceptor hypothalamic pituitary mechanism is sluggish, both to the stimulus of hyper-, as well as hypo-osmolarity, and the fault is most probably in the hypothalamic pituitary apparatus