ABSTRACT
Introducción. Valorar en un grupo de pacientes con litiasis renal y alteraciones metabólicas (hipercalciuria, hiperuricosuria, hipocitraturia, hiperoxaluria), cómo influye el tratamiento médico en el balance metabólico, en el número de eventos clínicos y en la necesidad de procedimientos urológicos, en seguimiento a largo plazo. Material y métodos. Estudio observacional retrospectivo. Los datos se obtuvieron de la revisión de 93 historias clínicas de pacientes que acudieron a consultas externas de medicina interna del Hospital La Princesa, Madrid, entre enero y junio de 2008. Los criterios de inclusión fueron: enfermedad litiásica renal recurrente, alteración metabólica y un mínimo de seguimiento de tres años. Se seleccionaron 68 pacientes. Resultados. Presentan hipercalciuria sola o asociada a otras alteraciones metabólicas 51/68 (75%) pacientes. Nunca habían recibido tratamiento farmacológico 57/68 (83,8%) pacientes. La necesidad de tratamiento instrumental disminuye de forma estadísticamente significativa. Se reduce el número de eventos clínicos y el balance metabólico mejora. Discusión. El tratamiento médico y el seguimiento a largo plazo favorecen la buena evolución clínica y analítica, y disminuyen la necesidad de procedimientos instrumentales (AU)
Introduction. Observational study on a group of patients with renal lithiasis and metabolic changes e.g: hypercalciuria, hyperuricosuria, hyperoxaluria, hypocitraturia. How the medical treatment would influence the restoration of the metabolic balance, the number of symptomatic events; the need for urological surgical procedures; and their long-term follow-up. Material and methods. This observational study was carried out on the data obtained from 93 medical records of patients who attended General Medicine outpatient clinics at La Princesa Hospital in Madrid between January and June 2008. The inclusion criteria were: (1) patient suffering from recurrent renal lithiasis; (2) showing metabolic changes; and (3) under survelliance for 3 or more years. Material and methods. Only 68 patients out of 93 were included in this study. Results. A total of 48/68 (70.6%) patients had hypercalciuria alone or in association with other metabolics changes. 57/68 (83.8%) patients never had appropriate pharmacological treatment. There is a statistically significant reduction in the number of cases treated by surgical procedures. There is also a reduction of clinical events and an improvement in the metabolic balance. Discussion. The medical treatment and long-term survelliance favour the good clinical and biochemical progress, and reduces the need for surgical procedures (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Nephrolithiasis/complications , Nephrolithiasis/diagnosis , Nephrolithiasis/metabolism , Metabolic Diseases/complications , Metabolic Diseases/physiopathology , Hypercalciuria/complications , Osteoporosis/complications , Risk Factors , Thiazides/therapeutic use , Retrospective Studies , Signs and Symptoms , Data Collection , Potassium Citrate/therapeutic use , Allopurinol/therapeutic use , Magnesium/therapeutic useABSTRACT
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Subject(s)
Humans , Hyperparathyroidism/therapy , Endocrine Surgical Procedures , Parathyroid Hormone/antagonists & inhibitorsABSTRACT
We describe the case of a 44-years-old female patient with a panarteritis nodosa preceded by a rapid progressive bilateral deafness after an acute otitis media. Once on treatment with steroids and cyclophosphamide, she developed a disseminated intravascular coagulation, with a fatal evolution not justifiable by a different cause apart from her main disease.
Subject(s)
Disseminated Intravascular Coagulation/etiology , Hearing Loss, Bilateral/etiology , Polyarteritis Nodosa/complications , Acute Disease , Adult , Disseminated Intravascular Coagulation/diagnosis , Disseminated Intravascular Coagulation/pathology , Fatal Outcome , Female , Hearing Loss, Bilateral/diagnosis , Hearing Loss, Bilateral/pathology , Humans , Otitis Media/complications , Otitis Media/diagnosis , Otitis Media/pathology , Polyarteritis Nodosa/diagnosis , Polyarteritis Nodosa/pathologyABSTRACT
Presentamos el caso de una paciente de 44 años con una panarteritis nodosa que vino precedida de una sordera bilateral de rápida instauración tras otitis media. Al iniciarse tratamiento con esteroides y ciclofosfamida, desarrolló un cuadro de CID de evolución fatal no justificable por otra causa diferente a su enfermedad de base (AU)
