Nefrolitotomía Endoscópica ex vivo del injerto renal de donante vivo con instrumento flexible

Introduction: The finding of an asymptomatic stone in the study of a living kidney donor does not necessarily contraindicate donation, however, there is no consensus on the management of these cases. The use of a graft with lithiasis may represent a risk of recurrence in the remaining kidney in the donor and eventual obstructive complications in the transplanted kidney. The objective of this work is to present the usefulness of ureteroscopy (URS) to resolve lithiasis ex vivo before transplantation. Material and Methods: Donors with a small, asymptomatic kidney stone and with an analysis of lithogenic factors without relevant findings were considered to continue in the donation process. The kidney unit with stone was selected for nephrectomy. Results: Four donor kidneys underwent flexible URS after nephrectomy under hypothermic preservation conditions during bench preparation. The average time of the procedure was 35 minutes and the stone was extracted in all cases without incident. The transplant was carried out in the usual way and the evolution of the recipients was without complications and with excellent renal function. During follow-up, no recurrence of lithiasis was observed in donors or recipients. Conclusions: In this experience, the URS of the donor kidney was a feasible procedure and was not associated with adverse consequences for the graft. The main advantage of this procedure is to avoid the potential risk to the recipient of an obstructive graft complication.

[Living-donor kidney graft ex vivo endoscopic nephrolithotomy with flexible instrument]. / Nefrolitotomía Endoscópica ex vivo del injerto renal de donante vivo con instrumento flexible.

INTRODUCTION: The finding of an asymptomatic stone in the study of a living kidney donor does not necessarily contraindicate donation, however, there is no consensus on the management of these cases. The use of a graft with lithiasis may represent a risk of recurrence in the remaining kidney in the donor and eventual obstructive complications in the transplanted kidney. The objective of this work is to present the usefulness of ureteroscopy (URS) to resolve lithiasis ex vivo before transplantation. MATERIAL AND METHODS: Donors with a small, asymptomatic kidney stone and with an analysis of lithogenic factors without relevant findings were considered to continue in the donation process. The kidney unit with stone was selected for nephrectomy. RESULTS: Four donor kidneys underwent flexible URS after nephrectomy under hypothermic preservation conditions during bench preparation. The average time of the procedure was 35 minutes and the stone was extracted in all cases without incident. The transplant was carried out in the usual way and the evolution of the recipients was without complications and with excellent renal function. During follow-up, no recurrence of lithiasis was observed in donors or recipients. CONCLUSIONS: In this experience, the URS of the donor kidney was a feasible procedure and was not associated with adverse consequences for the graft. The main advantage of this procedure is to avoid the potential risk to the recipient of an obstructive graft complication.

Evaluación del agua minero-medicinal de Presidencia Roque Sáenz Peña, provincia del Chaco, Argentina / Evaluation of the mineral-medicinal water of Presidencia Roque Sáenz Peña, Chaco province, Argentina / Avaliação da água mineral-medicinal da Presidência Roque Sáenz Peña, província de Chaco, Argentina

RESUMEN Introducción: El agua minero-medicinal estudiada procede del Complejo Termal de Presidencia Roque Sáenz Peña, provincia del Chaco, ubicado en el nordeste de Argentina. Las aguas de los acuíferos terciarios del norte argentino presentan un marcado gradiente de salinidad desde el sector oeste (subgrupo Jujuy) hasta el sector este (formación Chaco). Los acuíferos son procesos dinámicos y, en consecuencia, la composición del agua subterránea natural debe contemplarse con la perspectiva de su posible variación espacio-temporal. Objetivos: Analizar y comparar la composición química y la calidad microbiológica del agua de las termas de la ciudad de Sáenz Peña en el período 2016-2018 y evaluar sus principales características fisicoquímicas que definen sus potenciales aplicaciones terapéuticas. Resultados: El agua termal por su temperatura se clasifica como agua hipotermal, con pH cercano a la neutralidad, conductividad elevada mostrando su relación directa con la alta salinidad. Por su porcentual equivalente se define como agua clorurada, con alto contenido del anión sulfato y los cationes sodio, potasio, calcio y magnesio. De acuerdo con la composición mayoritaria de cloruros, el uso terapéutico vía tópica sería recomendado para afecciones óseas y musculares, así como problemas dermatológicos y circulatorios.

SUMMARY Introduction: The mineral-medicinal water studied comes from the Presidencia Roque Sáenz Peña Thermal Complex, Chaco province, located in the northeast of Argentina. The waters of the tertiary aquifers of northern Argentina present a marked salinity gradient from the western sector (Jujuy subgroup) to the eastern sector (Chaco formation). Aquifers are dynamic processes and consequently, the composition of natural groundwater must be viewed from the perspective of its possible spatial-temporal variation. Aims: To analyse and to compare the chemical composition and microbiological quality of thermal water of the city of Sáenz Peña in the 2016-2018 period and to evaluate its main physicochemical characteristics that define its potential therapeutic applications. Results: Due to its temperature, the thermal water is classified as hypothermal water, with a pH close to neutrality, high conductivity, showing its direct relationship with high salinity. Its equivalent percentage defined as chlorinated water, with high content of the sulphate anion and the cations sodium, potassium, calcium and magnesium. According to the majority composition of chlorides, topical use is recommended for bone and muscle ailments, as well as dermatological and circulatory problems.

RESUMO Introdução: A água mineral-medicinal estudada provém do Complexo Térmico Presidencia Roque Sáenz Peña, província de Chaco, localizada no nordeste da Argentina. As águas dos aquíferos terciários do norte da Argentina apresentam um acentuado gradiente de salinidade do setor ocidental (subgrupo Jujuy) ao setor oriental (formação Chaco). Os aquíferos são processos dinâmicos e, consequentemente, a composição da água subterrânea natural deve ser vista sob a perspectiva de sua possível variação espaço-temporal. Objetivos: Analisar e comparar a composição química e qualidade microbiológica das águas termais da cidade de Sáenz Peña no período 2016-2018 e avaliar suas principais características físico-químicas que definem seus potenciais aplicações terapêuticas. Resultados: Devido à sua temperatura, a água termal é classificada como água hipotérmica, com pH próximo da neutralidade, alta condutividade, mostrando sua relação direta com a alta salinidade. Seu percentual equivalente definido como água clorada, com alto teor do ânion sulfato e dos cátions sódio, potássio, cálcio e magnésio. De acordo com a composição majoritária dos cloretos, o uso tópico é recomendado para doenças ósseas e musculares, bem como para problemas dermatológicos e circulatórios.

Endoscopic Treatment of Fibroepithelial Polyp of the Ureter: Case Report.

Background: Fibroepithelial polyp of the ureter is a very rare benign tumor of the urinary tract that can present complications as urinary tract infection, hematuria, or urinary retention. Its incidence has increased in recent years. Its recognition and proper management are important to avoid invasive surgeries. Case Presentation: We present the case of a 24-year-old Latin pregnant woman with gross hematuria, right flank pain, and a bladder tumor as seen on a pelvic ultrasonography. Cystoscopy and MRI showed a right ureteral tumor that protruded through the ureteral meatus. Endoscopic resection using a holmium:YAG laser was performed during the second trimester of pregnancy. A ureteral tumor of 6.5 cm was completely resected. Histopathology showed morphological findings compatible with a fibroepithelial ureteral polyp. The postoperative evolution was satisfactory with no complications or recurrences to date. Conclusion: Fibroepithelial polyp of the ureter is a benign tumor that can be present in any of the ureter's segments. It usually affects people between 20 and 40 years. Endoscopic resection with holmium laser has become the preferred surgical treatment during the last time. It is associated with the advantages of a minimal invasive technique and a short period of convalescence.