Assuntos
Doença de Crohn/cirurgia , Neoplasias do Íleo/cirurgia , Tumores Neuroendócrinos/cirurgia , Idoso , Doença de Crohn/complicações , Doença de Crohn/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Neoplasias do Íleo/complicações , Neoplasias do Íleo/diagnóstico por imagem , Masculino , Tumores Neuroendócrinos/complicações , Tumores Neuroendócrinos/diagnóstico por imagemRESUMO
INTRODUCTION: This study aims to compare outcomes of percutaneous nephrolithotomy (PCNL) performed with a nephrostomy tube placed prior to surgery versus access at the time of surgery. MATERIALS AND METHODS: Between March 2005 and August 2014, 233 PCNLs were performed. One hundred and nine of those cases underwent placement of nephrostomy tubes at least 1 day prior to surgery (Group A), and the remaining 124 cases were performed in which access was obtained at the time of PCNL (Group B). Patient demographics, comorbidities, stone size, sepsis rates, and additional complication rates including bleeding and inability to access stone were compared. RESULTS: There were no significant differences in patient demographics, stone size, or comorbidities when comparing the two groups. Success rates were not significantly different, 92.7% in Group A compared to 94.4% in Group B. Similarly, there was no significant difference in complication rates or ICU admissions. The rate of sepsis in Group A was 1.83% compared to 2.42% in Group B, which showed no statistical significance. Notably, there were more patients with neurogenic bladders in the pre-placement group (p = 0.05). CONCLUSION: Pre-placement of a nephrostomy tube prior to PCNL did not result in a decreased incidence of complications or sepsis and did not demonstrate increased success rates. Patients with neurogenic bladders may be more vulnerable to suffering from sepsis and therefore role of timing of nephrostomy tube placement must be further studied.
Assuntos
Cálculos Renais/cirurgia , Nefrolitotomia Percutânea/métodos , Nefrostomia Percutânea , Complicações Pós-Operatórias/etiologia , Feminino , Humanos , Unidades de Terapia Intensiva , Cálculos Renais/complicações , Masculino , Pessoa de Meia-Idade , Nefrolitotomia Percutânea/efeitos adversos , Nefrostomia Percutânea/efeitos adversos , Admissão do Paciente , Estudos Retrospectivos , Sepse/etiologia , Fatores de Tempo , Resultado do Tratamento , Bexiga Urinaria Neurogênica/complicaçõesRESUMO
Neurodegenerative diseases are caused by aggregation of specific proteins that catalyze a cascade of changes that ultimately lead to neurodegeneration. This concept guides current diagnostic approaches, as well as clinical trials, that focus on detecting or removing amyloid or tau from the brain. The semantic variant of primary progressive aphasia (svPPA), a clinical syndrome associated with frontotemporal lobar degeneration (FTLD) pathology, is usually associated with the molecular pathology TDP-C, but there are cases with TDP-B and Pick's disease. The existing literature on the clinical differentiation of these pathologies is limited. Here, we present a case study, in conjunction with a cross-sectional voxel-based morphometry (VBM), to elucidate the clinical and imaging features of a patient with svPPA due to Pick's disease.
