Impact of ureteral stenting on urological complications after kidney transplantation surgery: a single-center experience.

BACKGROUND: Urological complications such as ureteral strictures and ureteral leakage can affect the outcome of kidney transplantation by increasing morbidity and mortality, including graft loss. Controversy still exists regarding the role of stents in renal transplantation. The aim of this study was to evaluate the role of ureteral stenting in kidney transplantation. METHODS: We performed a retrospective study on a series of 798 consecutive renal transplants performed in our center between January 1, 2004, and December 31, 2011. Ureteral stents were used in 152 cases (19.1%) of the total (stent group) and were removed 2 weeks postoperatively. Donor and recipient age, sex, type of ureteroneocystostomy, stent and non-stent patients, cold and warm ischemia time, and urological complications were analyzed. RESULTS: The overall incidence of urological complications was 7.8% (62 cases). Ureteral stenosis (3.1%) and ureteral leakage (2.4%) were the most common complications; 39.7% (25 cases) of complications were recorded in the first month after transplantation. Major urological complication rate was 3.3% in the stent group compared with 8.8% in the non-stent group (P = .04). However, stent use was associated with the increase of urinary tract infections rate in the stent group (51.3%) compared with the non-stent group (17.9%) (P = .03). CONCLUSIONS: In our study, the use of ureteral stents significantly decreased urological complications in kidney transplant recipients but increased the risk for development of urinary tract infections.

[Epidemiological evaluations of the incidence of posttransfusion hepatitis in Iasi County in 1985-1995]. / Unele evaluari epidemiologice asupra incidentei hepatitei posttransfuzionale în judetul Iasi, în perioada 1985-1995.

In the interval 1985-1995 the morbidity rate of viral hepatitis of various causes showed yearly variations, an average of 181 cases being recorded. The performed investigations revealed markers for viral hepatitis B in an yearly average of 154 cases for the 11 years under study. Posttransfusion hepatitis had an average incidence of 43 cases per year, in 59.1% the markers for viral hepatitis B being absent. 93.3% of the cases with posttransfusion hepatitis belonged to the age groups over 20 years and workers presented a mean yearly incidence of 28.3% of all cases. In 1995 the blood donors with viral hepatitis C antibodies represented 4.05% and 75% of them belonged to the age groups 21-60 years, 50% of them being industrial workers and 40% having the A II blood group. Of the 321 admitted cases, 26.7% presented AgHBs, 8.4% AcVHC, in 2.3% markers for both viruses were evidenced and in 62.8% of the cases the diagnosis was made on epidemiological criteria and serologic exclusion (non A, B, C) without excluding the possible intervention of other hepatitic viruses.

[An epidemiological assessment of acute diarrheal diseases in Iasi city and County (1985-1994)]. / Evaluari epidemiologice asupra bolii diareice acute în municipiul si judetul Iasi (1985-1994).

Acute diarrhoea, with a remarkable etiologic, clinic and epidemiologic polymorphism represents, for various reasons, an important concern for health preservation both in industrialised countries and, mainly, in the developing ones. It is that, at world level, 1.2-1.5 milliards of diarrhoea episodes, of which 750-950 millions in children, causing death in over 4 millions aged 0-5 years, are recorded. In Romania, although the real data of morbidity by acute diarrhoea are not known, the reports show a significant decrease in the past 10 years. In 1993, 420.2 cases at 100,000 inhabitants were reported, the most commonly affected being the children age 0-4 years. In Moldavia (Romania), numerous extensive studies on the epidemiology of acute diarrhoea have been carried out. This paper present and aims rendering evident some epidemiological aspects of acute diarrhoea cases reported in the interval 1985-1994 in Iasi County and town.

[Seroepidemiological considerations of the incidence of viral hepatitis C in some population groups]. / Consideratii sero-epidemiologice privind incidenta hepatitei virale C în unele grupuri populationale.

In the interval 1985-1994, in the Iasi district, the reported cases of viral hepatitis (VH) have recorded annual morbidity rates ranging between 67/100,000 inhabitants in 1993 and 373/100,000 in 1990. VH attributed to HAV and HBV has represented, with yearly differences, 62% to 94% of all cases. Posttransfusion viral hepatitis (PTVH) has determined a morbidity of 0.51/100,000 inhabitants in 1986 and 8.34/100,000 in 1994. PTVH without AgHBs ranged from 16.3% in 1993 to 94.0% in 1987, as compared to 6.0% in 1987 and 1988 and 75.0% in 1985 for PTVH with AgHBs. In the interval under study 70.9% of the PTVH cases were most likely determined by HCV and 28.9% by HBV (AgHBs+). From all PTVH cases, 64.0% were from urban areas, 59.3% were females, 92.5% belonged to over 20 years age groups, and 31.3% were industrial workers, the remainder belonging to other 5 occupational groups. In 241 patients (18.2%) admitted for liver disorders, posttransfusion hepatitis included, AcHCV was present in 39.4%, of which 45.2% belonged to the age groups 20-60 years. The results of some investigations carried out on 4471 blood donors (72.4% males, 85.4% aged between 21 ad 50 years, 86.4% from urban areas, 62.1% workers in industry and building) are presented. Out of these, 217 (4.9%) presented to hepatitis C virus (AcHCV). Occupational distribution of AcHCV possessors shows that 44.2% are workers in the heavy industry, 14.8% in the light industry and 12.9% unemployed. Sera were tested by Monolisa New Antigens, and those with AcHCV were reassessed with Monolisa, Murex anti HCV, ORTO-HCV 3.0 and confirmed by Immunoblot DECISCAN, with 5 antigens.

Multiple false-positive reactions in anti-CD4 ELISA testing of dystrophic children.

BACKGROUND: Anti-CD4 autoantibodies are present in up to 10% of HIV infected patients and, until present, they were not recorded in other pathological circumstances. AIM: To test the presence of anti-CD4 autoantibodies in HIV-infected children, using an indirect ELISA test. DESIGN: Cross-sectional controlled study. PATIENTS AND METHODS: The study group: 9 HIV infected dystrophic children--3 AIDS (P2A), 6 P1C. Control groups: 9 HIV seronegative dystrophic children; 14 HIV seronegative eutrophic patients presenting chronic hepatopathies, or dialysed patients. METHODS: 1. Indirect ELISA using as antigen sCD4 molecules; 2. Western blot (sCD4); 3. "Antigenic displacement": sera preincubation with sCD4, followed by indirect ELISA. RESULTS: Indirect ELISA revealed anti-CD4 reactivities in all the dystrophic patients (9 HIV+ and 9 HIV-). WB sCD4 did not confirmed none of these reactivities. Sera preincubation with sCD4 did not significantly modified ELISA CD4 reactivities. CONCLUSIONS: False positive results (FPR) rate following testing of the presence of anti-CD4 in dystrophic children recommends prudence for the interpretation of such tests. "Antigenic displacement" could be an accessible and easy to perform method in order to eliminate the FPR.

[The clinical and immunological correlations between the p24 antigenemia levels and those of anti-p24 antibodies in HIV-seropositive children]. / Corelatii clinice si imunologice între nivelurile antigenemiei p24 si cele ale anticorpilor anti-p24 la copii HIV seropozitivi.

The influence of HIV I p24 antigen immune complexing with anti-p24 antibodies of the assessment of their respective levels in HIV-positive sera was studied. ELISA tests were used for evaluating anti-p24 and p24 antigenemia, with or without acid dissociation. We have observed that: 1. p24 antigenemia usually coexisted with low anti-p24 levels, an inverse correlation between these two parameters being traced; acid dissociation increased the percentage of p24 positive sera, especially when anti-p24 titers are low; 2. on contrary, after acid dissociation, p24 Ag remain undetectable in 55.56% of patients presenting high titers and 29.41% of those with low levels of anti-p24; acid dissociation do not increase anti-p24 titers. Whereas the first group of observations suggests that p24 Ag and anti-p24 Ab may be involved in immune complexes, the second set indicates that p24 Ag and Ab were not inevitably linked in such complexes. So, they may be indicative for two distinct biological phenomena.

[Epidemiological observations on the evolution of influenza in the city of Iasi in the epidemic season of 1993-1994]. / Observatii epidemiologice privind evolutia gripei în municipiul Iasi în sezonul epidemic 1993-1994.

The epidemiological, clinical and laboratory data of influenza and other respiratory diseases recorded during the epidemic season 1993-1994, as they resulted from the comparative analysis of the cases reported weekly and those recorded through the "sentinel" collectivities method, are presented. The findings at admissions to the Infectious Diseases Hospital, Military Hospital, Diagnosis and Treatment Centre for Pupils and Students and the solicitation for medical care at the Emergency Ambulance Service were also interpreted. The involvement of A/Beijing/32/92/(H3N2) influenza virus was confirmed by evidencing the seroconversion on two serum samples tested through RIH, while for others antigens anamnestic reactions were recorded. The influenza epidemic had affected all age groups, with horizontal extension, a first rise in December 1993 followed by the decline determined by winter vacation being notice. A second epidemic rise, much stronger, started beginning with the last month of January and reached a peak at mid February, followed by a marked decline.

[Two decades of epidemiologic surveillance of the evolution of viral hepatitis in Iasi County (1971-1990)]. / Doua decenii de supraveghere epidemiologica a evolutiei hepatitei virale în judetul Iasi (1971-1990).

The results of epidemiological observations on the evolution of viral hepatitis in the Iasi district in the interval 1971-1990 are presented. A mean morbidity of 251.2 cases/100,000 inhabitants, this being in most years under the national mean, was found. In 75.9% of all cases the infections caused by hepatitis viruses affected the age-groups 1-14 years, indicating a high incidence of hepatitis A... Hepatitis B had a more increased incidence in the children aged 0-1 year, then it decreased but was present in all age groups. Although recorded all year round, increases in the incidence of viral hepatitis A were noticed during fall and winter seasons, prevailing in the children and teenagers collectivities.

[Preliminary data on possibilities for the early detection of risk for primary liver carcinoma in chronic HBsAg carriers]. / Date preliminare asupra posibilitatilor depistarii precoce a riscului de carcinom hepatic primar la purtatorii cronici de AgHBs.

The investigations on the risk of hepatocarcinogenesis in the HBsAg chronic carriers have suggested that the early detection of primary liver carcinoma requires epidemiological and laboratory follow up of their state of health. The preliminary results of the comparative investigations of 103 HBsAg carriers detected among blood donors and 93 controls without HBsAg are presented. Epidemiological inquiries, clinical examinations and laboratory tests (HBsAg, serum alpha-fetoprotein, alkaline phosphatase, gamma-glutamyltranspeptidase, glutamic-pyruvic transaminase, proteinogram, siderophilin, immunoglobulins M, A, G) were carried out. Elevated levels of alpha-fetoprotein, alkaline phosphatase and gamma- glutamyltranspeptidase were recorded in carriers as compared to controls (38.8% and 86%, respectively). The elevation of the levels of liver damage markers was significantly correlated, in the HBsAg carriers, with the carrier state over 3 years and less with the age-group. In the case of two carriers with elevated levels of alpha-fetoprotein (> 600-> 1,000 ng/ml) ultrasonography confirmed the suspicion of primary liver carcinoma.

[A microepidemic of severe tuberculosis in a hospital for chronic neuropsychiatric patients]. / Consideratii asupra unei microepidemii de tuberculoza grava, într-un spital de neuropsihici cronici.

Details and considerations on a microepidemic of severe tuberculosis occurring in a hospital for chronic neuro-psychic patients are presented. This episode presents a practical interest by the knowledge of the circumstances of occurrence and progression, clinical-epidemiological features, associated favouring factors (immunodeficiency, absence of a sustained program for tuberculosis investigation) and biologic prophylaxis by BCG vaccinations and revaccinations. Several measures for avoiding such epidemics and, in prospect, of AIDS in the institutions at high risk are discussed.

[Epidemiological observations on alcohol consumption as a risk factor in essential arterial hypertension]. / Observatii epidemiologice asupra consumului de alcool ca factor de risc în hipertensiunea arteriala esentiala.

The results of the epidemiological investigations in industrial environment in view of demonstrating some relations between alcohol and salt consumption, tobacco smoking, over weight and prevalence of essential arterial hypertension are presented. The obtained data indicate that in 471 workers in smelting the prevalence of alcohol consumers (1-3 intakes/day of strong alcohol) was of 15% as compared to 28.4% in 559 workers in an unit for building equipment, 4% in the 1188 women, working in ready-made and knitted wear mills and 19.8 and 4.5% in men and women, respectively, working in administrative services. Both the prevalence of daily strong alcohol consumption and of the other considered factors are significantly increasing with age. An increased prevalence of alcohol consumption associated with tobacco smoking, salt consumption and over weight was found in the hypertensive subjects as compared to the controls. The obtained data are useful in elaborating primary prevention programs of essential arterial hypertension.

[Epidemiological and laboratory observations on viral hepatitis morbidity in child social welfare institutions]. / Observatii epidemiologice si de laborator asupra morbiditatii prin hepatita virala in institutii de asistenta sociala a copiilor.

The investigations revealed that in the interval 1978-1987 the mean incidence of viral hepatitis type B in children was 40 at 100,000 inhabitants as compared to 767 in the children from orphanages. In 27.5% of the cases, the children from orphanages, with or without HBs antigen, had viral hepatitis in their case history. The prevalence of AgHBs carriers was of 21.6%, the highest value (46.1%) being recorded in the children from orphanages in the age group 0-3 years. It was also found that 14.9% of the children had AgHBs when admitted to orphanage and 28.7% became carriers later on. It is suggested that in children homes there are conditions for an increased risk requiring special measures for viral hepatitis prophylaxis and control.

[Epidemiological observations on the significance of the relations between elevated values of essential arterial pressure in schoolchildren and their parents]. / Observatii epidemiologice asupra semnificatiei unor relatii între cresterea valorilor tensiunii arteriale esentiale la elevi si parintii acestora.

The results of an epidemiological screening of 1,228 parents and 614 children, pupils in the V-XII forms of 12 schools of different types, are presented. It is suggested that when parents present elevated blood pressure values their children, although normotensive, are at high risk, especially in case more risk factors are present. The relation hypertensive parents--hypertensive offsprings was strongly significant. In the hypertensive children with normotensive parents the high frequency of some life-style dependent risk factors is discussed. The relationship between risk factors and morbidity by essential hypertension both in parents and their offsprings and the need of primary and secondary prevention programs for pupils are underlined.

[Epidemiology of essential arterial hypertension in collectives of schoolchildren. The prevalence of blood pressure changes]. / Unele aspecte din epidemiologia hipertensiunii arteriale esentiale în colectivitati scolare. Prevalenta modificarilor tensiunii arteriale.

7,917 pupils in schools, between 10-19 years old, of both sexes, were investigated within an epidemiologic screening, performed in the school milieu, for detecting the prevalence of some risk factors (RF) and of the AT modifications with a view to work out the programmes for the essential arterial hypertension (EAHT) primary prevention. 84.4% of all the pupils in the Vth--VIIIth forms and 93.9 pupils in the IXth--XIIth forms were included in the screening. 422 cases of labile arterial hypertension (LAHT) (5.1%) and 457 of benign arterial hypertension (BATH) (54%) were found. In the children with normal arterial hypertension (NAHT) the following were recorded: 46.5% increases only of the diastolic tension: 44.0% of the systolic-diastolic and 7.1% of the systolic tension respectively. Although present, the differences between the LAHT and BAHT prevalence in the gymnasiums (4.3% and 5.4%) and lyceums (5.5% and 6.4%) are not significant and might be functions of: age, sex, psychomotor development, structure of the respective collectivities, the momentary psychoemotional reactions, lability of the blood pressure, specific to the childhood, several screening difficulties etc. The observations made on the prevalence of the growth of the AT values were correlated with the occurrence at some significant levels of the RF, suggesting the measures to be taken for the steady improvement of the primary and secondary prophylaxis of EAHT in schools.