Refluxo vesicoureteral primário e infecçao urinária: uma revisao / Vesoureteral primary reflux and urinary infection: a review

Apesar da infeccçao do trato urinário (ITU) ser a complicaçao mais frecüente em pacientes com refluxo vesicoureteral primário (RVU), há importantes questonamentos sobre essa ássociaçáo. Na faixa etária pediátrica, a prevalência estimada de IYU é 8 por cento no sexo feminino e 2 por cento no masculino. Durante investigaçao de ITU, o RVU é diagnosticado em até 40 por cento das crianças. A presença de episódios infecciosos está associada à formaçao de cicatrizes renais, que aumentam os riscos de herpertensao arterial sistêmica, insuficiência renal crônica e complicaçóes gestacionais futuras. Atualmente, é consenso que seja instituída a antibioticoprofilaxia por tempo prolongado para a maioria destes pacientes, com a finalidade de prevenir novos episódios de ITU. Entretanto, segundo pesquisas recentes nem todas as crianças co RVU parecem se beneficiar dessa abordagem terpêutica. O objetivo deste estudo foi discutir os principais aspectos, echados recentes e controvérsias da ssociaçao RVU e ITU.

Refluxo vesicoureteral primário e infecþao urinária: uma revisao / Vesoureteral primary reflux and urinary infection: a review

Apesar da infeccþao do trato urinário (ITU) ser a complicaþao mais frec³ente em pacientes com refluxo vesicoureteral primário (RVU), há importantes questonamentos sobre essa ássociaþáo. Na faixa etária pediátrica, a prevalÛncia estimada de IYU é 8 por cento no sexo feminino e 2 por cento no masculino. Durante investigaþao de ITU, o RVU é diagnosticado em até 40 por cento das crianþas. A presenþa de episódios infecciosos está associada O formaþao de cicatrizes renais, que aumentam os riscos de herpertensao arterial sistÛmica, insuficiÛncia renal cr¶nica e complicaþóes gestacionais futuras. Atualmente, é consenso que seja instituída a antibioticoprofilaxia por tempo prolongado para a maioria destes pacientes, com a finalidade de prevenir novos episódios de ITU. Entretanto, segundo pesquisas recentes nem todas as crianþas co RVU parecem se beneficiar dessa abordagem terpÛutica. O objetivo deste estudo foi discutir os principais aspectos, echados recentes e controvérsias da ssociaþao RVU e ITU.(AU)

Giovanni Battista Morgagni and his contribution to pediatric surgery.

Pediatric surgery is a less than a century old surgical specialty. However, early knowledge of human malformations and pediatric surgical conditions dates back to centuries before. One of the main contributors to progress in these fields was Giovanni Battista Morgagni (1682-1771), who also had a substantial weight in the development of future pediatric surgery. With his masterpiece De Sedibus et Causis Morborum per Anatomen Indagatis (On the Seats and Causes of Diseases Investigated by Anatomy) (1761), he set the basis for modern pathology. In this textbook, Morgagni was the first to describe anatomical elements like the trigonum sternocostale dextrum (the Morgagni's foramen), the appendix testis (the Morgagni's hydatid), and the vertical folds of distal rectum (the Morgagni's columns). He was also the first to describe pediatric pathological conditions like epispadia, meconium peritonitis, Crohn's disease, and coarctation of the aorta. Finally, he substantially contributed to the understanding of the pathophysiology of conditions like the vesico-ureteral reflux, the anterior wall defects (gastroschisis/omphalocele), and the spina bifida. For this, it was said of him: "If all the anatomical findings made by Morgagni should bear his name, probably one third of human body would be called Morgagni's."

Hojas urológicas del Dr. Narciso Serrallach Mauri, escritas hace casi 100 años / No disponible

Se expone un resumen de los trabajos y comentarios más interesantes del Dr. Narciso Serrallach Mauri, presentados en Hojas Urológicas, revista que bajo su propia dirección editó de forma continuada desde 1913 hasta 1935, anual o semestralmente. En ella pueden encontrarse los temas urológicos que en aquel entonces eran de mayor actualidad y despertaban el mayor interés así como las publicaciones y actividades de las sociedades médicas donde desarrolló su actividad profesional urológica. Se hace hincapié también en la valoración de su actividad en relación al estado de la ciencia y de la sociedad en el periodo estudiado (AU)

We present a summary of the most interesting works and commentaries by Dr. Narciso Serrallach Mauri, presented in Urological Records, a journal edited under his direction continuously from 1913 to 1935, annually or every six months. The state-of-the-art urological topics of the time rising the highest interest can be found in the journal, as well as in the publications and activities of the medical societies where he carried out his professional urological activity. We also emphasize the evaluation of his activity in relation to the estate of science and society at his time (AU)

Robert Lich, Jr., M.D.: innovator in pediatric and adult urology.

PURPOSE: Dr. Robert Lich, Jr. (1909 to 1987) advanced the foundation of knowledge in many areas in the field of urology. He is best known for his contributions to our understanding and management of vesicoureteral reflux. MATERIALS AND METHODS: We reviewed the many articles published by Dr. Robert Lich, Jr., focusing on his work with vesicoureteral reflux. We describe the contributions made by a pioneering urologist who helped advance the foundation of knowledge concerning the etiology of vesicoureteral reflux and its surgical management. We discuss his novel ideas within the framework of surgical techniques of his time, and relate personal experiences from his colleagues and his wife. RESULTS: Doctor Lich was a pioneer in adult and pediatric urology. He is remembered most for his innovative ureteral reimplant technique for the surgical management of vesicoureteral reflux. CONCLUSIONS: Doctor Lich enriched the fields of adult and pediatric urology through a lifelong pursuit of scientific investigation and refinement of surgical practice. It is appropriate to review his innovative contributions to the management of vesicoureteral reflux as we experience yet another paradigm shift in our understanding and management of this condition.

Treatment of vesicoureteric reflux by endoscopic injection of Teflon. 1984.

Thirteen girls with grade III-V vesicoureteric reflux were treated by endoscopic injection of Teflon paste behind the intravesical ureter. Fourteen of the 18 treated ureters showed complete absence of reflux after one injection of Teflon. Three ureters required a second injection of Teflon for successful treatment of the reflux. One ureter with grade IV reflux was converted to grade II reflux. Properly carried out, this procedure corrects reflux. It takes less than 15 minutes, may be done as a day procedure, and avoids open surgery. There have been no complications. (Reprinted with permission from Br Med J, 289: 7-9, 1984)