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1.
J Okla State Med Assoc ; 106(12): 477-9, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24620413

RESUMO

Today the classic triad of flank pain, hematuria and a palpable abdominal mass is rarely present at initial diagnosis of renal cell carcinoma due to the growing number of cases diagnosed incidentally on imaging studies. We report a case of a 58-year-old female who presented with melena where a subsequent esophagogastroduodenoscopy demonstrated a bleeding duodenal lesion. Pathologic study of a biopsy revealed Clear Cell RCC and an ensuing abdominal CT revealed the direct duodenal invasion of a primary renal mass. We also provide a brief review of nephrectomy in the face of metastatic renal cell carcinoma.


Assuntos
Carcinoma de Células Renais/patologia , Duodeno/patologia , Neoplasias Renais/patologia , Melena/patologia , Biópsia , Carcinoma de Células Renais/diagnóstico por imagem , Carcinoma de Células Renais/terapia , Duodeno/diagnóstico por imagem , Duodeno/cirurgia , Feminino , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/terapia , Melena/diagnóstico por imagem , Melena/cirurgia , Pessoa de Meia-Idade , Invasividade Neoplásica/diagnóstico por imagem , Invasividade Neoplásica/patologia , Nefrectomia/métodos , Tomografia Computadorizada por Raios X/métodos
2.
Int Urogynecol J ; 23(11): 1625-30, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22569690

RESUMO

INTRODUCTION AND HYPOTHESIS: The objective of the study was to compare office rigid cystoscopy (RC) versus flexible cystoscopy (FC) in women. METHODS: This was a prospective randomized trial comparing FC to RC. Aims were to assess 1-week post-procedural complications, compare procedure pain scores, and to assess physician perception of patient discomfort. Pain scores were assessed by visual analogue scale (VAS) and 5-point verbal descriptor scale (VDS). Chi-square was used for categorical comparison and t tests or Wilcoxon test for continuous variables. RESULTS: One hundred women were enrolled. The mean age of participants was 59.7 years (± SD 14.6), and 91 % were Caucasian. This was the first cystoscopy for 86 % of participants. On the 1-week post-procedure questionnaire (85 % response rate), participants in the FC group reported urinary frequency more often than in the RC group (p = 0.041). The FC group reported urgency with urination lasting 1-2 days (p = 0.030) and burning with urination lasting >3 days (p = 0.026), more than the RC group. These symptoms did not persist at 7 days. The duration of the procedure was slightly faster for the FC group (4.6 ± 1.8 min vs 5.7 ± 3.4 min, p = 0.046). Median VAS scores were 0.9 (0.1-2.72) for the FC group and 0.5 (0-2.4) for the RC group (p = 0.505). There were no significant differences between patient or physician perception of pain in either group. CONCLUSIONS: Urinary frequency and duration of urinary burning post procedure occurred more frequently in the FC group, although these symptoms were transient. Both office FC and RC are generally well tolerated in women with overall low morbidity.


Assuntos
Cistoscopia/efeitos adversos , Cistoscopia/classificação , Cistoscopia/instrumentação , Dor/etiologia , Maleabilidade , Transtornos Urinários/etiologia , Idoso , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Dor/epidemiologia , Medição da Dor , Relações Médico-Paciente , Estudos Prospectivos , Inquéritos e Questionários , Fatores de Tempo , Transtornos Urinários/epidemiologia
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