RESUMO
Los quistes del rafe medio representan defectos del desarrollo embriológico de la zona genitc cuentran tapizados por diferentes epitelios según su ubicación. Estas lesiones, que son más comúnmente hall ca del meato uretral, pueden localizarse en cualquier lugar del rafe medio genitoperineal, desde el glandi ano. El tratamiento de elección es la escisión quirúrgica. Presentamos tres nuevos casos y revisamos la literatura. (AU)
Assuntos
Humanos , Masculino , Adolescente , Adulto , Criança , Cistos/cirurgia , Cistos/embriologia , Cistos/terapia , Genitália Masculina/anormalidades , Genitália Masculina/cirurgia , Diagnóstico DiferencialRESUMO
Los quistes del rafe medio representan defectos del desarrollo embriológico de la zona genitc cuentran tapizados por diferentes epitelios según su ubicación. Estas lesiones, que son más comúnmente hall ca del meato uretral, pueden localizarse en cualquier lugar del rafe medio genitoperineal, desde el glandi ano. El tratamiento de elección es la escisión quirúrgica. Presentamos tres nuevos casos y revisamos la literatura.
Assuntos
Humanos , Masculino , Adolescente , Adulto , Criança , Cistos , Genitália Masculina , Diagnóstico DiferencialRESUMO
Forty-nine normoalbuminuric diabetic patients were studied: 22 males and 27 females, in whom urinary heparan sulphate (HS), albuminuria, creatininemia, creatininuria, creatinine clearance, HbA1c and arterial pressure (AP) were determined. Two groups were discerned: group 1, Type 1 DM, diabetic cases (n = 16); and group 2, Type 2 DM diabetic cases (n = 33). Patients were compared with 24 healthy controls: 12 men and 12 women, who showed a mean value +/- SD of 0.36 +/- 0.18 mg/24 h HS with significant differences between males and females (0.43 +/- 0.15 versus 0.28 +/- 0.17, respectively; p = 0.02). The total population of diabetic cases rendered a mean of 0.68 +/- 0.44 and comparison with controls proved highly significant (p < 0.001). Globally, male patients had a mean of 0.82 +/- 0.48 and females 0.54 +/- 0.35, with p < 0.02. Group 1 and 2 values of HS were not significantly different. HS levels failed to correlate either with age, body mass index (BMI), time since onset of diabetes, albuminuria, creatininemia, creatininuria, creatinine clearance, HbA1c or arterial hypertension. To conclude: both normal and diabetic males eliminate a greater quantity of HS than females. Normoalbuminuric diabetic patients of both types eliminate a greater quantity of HS regardless of arterial pressure and time since onset of diabetes.
Assuntos
Albuminúria , Diabetes Mellitus Tipo 1/urina , Heparitina Sulfato/urina , Adolescente , Adulto , Idoso , Albuminúria/urina , Pressão Sanguínea , Estudos de Casos e Controles , Diabetes Mellitus Tipo 1/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores SexuaisRESUMO
OBJECTIVE: To report a case of renal cell carcinoma associated with renal angiomyolipoma and renal cortical adenoma and discuss the possibility of a hereditary etiology. METHODS: A 64-year-old patient with a tumor in the right kidney underwent right renal nephrectomy. The pathological findings revealed a clear cell renal carcinoma, two cortical angiomyolipoma and a renal cortical adenoma. The literature on these three coincident renal tumors is reviewed. RESULTS: The association of these three renal tumors is rare and is usually seen in patients with tuberous sclerosis. CONCLUSIONS: Renal angiomyolipoma is a benign tumor frequently associated with Bourneville's disease or tuberous sclerosis, a disorder of autosomal dominant transmission. Familial evidence of renal cell carcinoma has been previously reported, as in von Hippel-Lindau disease. It has been suggested that heredity may play an important role in the association of renal cell carcinoma and other renal tumors.
Assuntos
Neoplasias do Córtex Suprarrenal/patologia , Adenoma Adrenocortical/patologia , Angiomiolipoma/patologia , Carcinoma de Células Renais/patologia , Neoplasias Renais/patologia , Neoplasias Primárias Múltiplas/patologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Los pólipos fibroepiteliales son tumores benignos que se pueden manifestar a lo largo de todo el tracto urinario. Se presenta un caso de pólipo fibroepitelial en uréter. Revisamos la literatura y discutimos las características clínicas, diagnósticas y terapéuticas de esta rara entidad(AU)
Assuntos
Humanos , Feminino , Adulto , Pólipos/diagnóstico , Pólipos/terapia , Doenças Ureterais/diagnóstico , Doenças Ureterais/terapiaRESUMO
Los pólipos fibroepiteliales son tumores benignos que se pueden manifestar a lo largo de todo el tracto urinario. Se presenta un caso de pólipo fibroepitelial en uréter. Revisamos la literatura y discutimos las características clínicas, diagnósticas y terapéuticas de esta rara entidad
Assuntos
Humanos , Feminino , Adulto , Doenças Ureterais/diagnóstico , Doenças Ureterais/terapia , Pólipos/diagnóstico , Pólipos/terapiaRESUMO
Forty-nine normoalbuminuric diabetic patients were studied: 22 males and 27 females, in whom urinary heparan sulphate (HS), albuminuria, creatininemia, creatininuria, creatinine clearance, HbA1c and arterial pressure (AP) were determined. Two groups were discerned: group 1, Type 1 DM, diabetic cases (n = 16); and group 2, Type 2 DM diabetic cases (n = 33). Patients were compared with 24 healthy controls: 12 men and 12 women, who showed a mean value +/- SD of 0.36 +/- 0.18 mg/24 h HS with significant differences between males and females (0.43 +/- 0.15 versus 0.28 +/- 0.17, respectively; p = 0.02). The total population of diabetic cases rendered a mean of 0.68 +/- 0.44 and comparison with controls proved highly significant (p < 0.001). Globally, male patients had a mean of 0.82 +/- 0.48 and females 0.54 +/- 0.35, with p < 0.02. Group 1 and 2 values of HS were not significantly different. HS levels failed to correlate either with age, body mass index (BMI), time since onset of diabetes, albuminuria, creatininemia, creatininuria, creatinine clearance, HbA1c or arterial hypertension. To conclude: both normal and diabetic males eliminate a greater quantity of HS than females. Normoalbuminuric diabetic patients of both types eliminate a greater quantity of HS regardless of arterial pressure and time since onset of diabetes.
RESUMO
OBJECTIVE: To report our experience over the last 10 years with Fournier's gangrene, an extensive fulminant infection of the perineoscrotal region, and to review the literature. METHODS: The medical records of 9 patients with Fournier's gangrene that had been diagnosed from January 1988 to December 1997 were reviewed. Patient age, etiology and predisposing factors, microbiological findings, duration of hospital stay, treatment and outcome were analyzed. RESULTS: The mean age of the patients was 53.8 years (range 43-71). The source of the gangrene was perirectal (22.22%), urinary (66.66%) and cutaneous (11.11%). Predisposing factors included diabetes mellitus, alcoholism, malnutrition and low socio-economic status. All patients were treated with surgical debridement and broad-spectrum antimicrobial therapy. Two patients underwent delayed reconstructive surgery. Cystostomy was performed in 100% of the cases. Two patients died from severe sepsis. CONCLUSIONS: Necrotizing fasciitis of the perineum and genitalia is a severe condition with a high morbidity and mortality. Good management is based on aggressive debridement, broad-spectrum antibiotics and intensive supportive care.