Causas de fallo en la implantación del TPM y modelo de puesta en marcha integrador

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Rafael Mateo Martínez

2010-02-01

Full Text Available Las empresas modernas precisan ser competitivas para sobrevivir en el mercado, por este motivo muchas compañías se plantean estrategias como el TPM (Total Productive Maintenance para la obtención de mejoras tangibles e intangibles en la organización que les ayuden a afrontar las dificultades del negocio. La gran mayoría de las organizaciones no son capaces de acometer con éxito la implantación del TPM, por no considerar las causas de fallo que se pueden presentar durante las diferentes etapas de desarrollo del modelo de implantación. El presente trabajo de investigación define, mediante un análisis de las publicaciones y estudios de caso existentes, un modelo genérico de implantación del TPM, y recopila las barreras, facilitadores y causas más comunes de fallo que se deben de tener en cuenta en cada etapa de su desarrollo y que pueden afectar al éxito de la implementación

Efecto diurético agudo de los extractos etanólico y acuoso de Ceratopteris pteridoides (Hook en ratas normales

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Antistio Aníbal Alviz

2013-03-01

Full Text Available Introducción. Ceratopteris pteridoides es un helecho semiacuático de la familia Parkeriacea, ampliamente utilizado en la medicina popular colombiana como diurético y colelitiásico, sobre el cual no existen reportes científicos que avalen su uso popular como diurético. Objetivo. Evaluar el efecto diurético agudo en dosis única y dosis repetidas a corto plazo, de los extractos etanólico y acuoso de C. pteridoides en un modelo in vivo. Materiales y métodos. El extracto etanólico total fue obtenido por maceración de la planta entera de C. pteridoides con etanol y el extracto acuoso fue obtenido por decocción a 60 °C por 15 minutos. Ambos extractos se sometieron a análisis fitoquímico preliminar y estudio histológico posterior a la administración de los extractos durante ocho días consecutivos (1.000 mg/kg. El efecto diurético se evaluó en ratas Wistar, tratadas con los extractos (500 mg/kg, en forma aguda y en dosis repetidas a corto plazo, cuantificando la eliminación de agua y la excreción renal de sodio y potasio por espectrofotometría de absorción atómica y, de cloruros, por titulación mercurimétrica. Resultados. En el modelo agudo, ambos extractos mostraron un significativo efecto diurético y de excreción renal de sodio y potasio en comparación con el control, mientras que con la administración en dosis repetidas a corto plazo mostraron efecto diurético sin eliminación de electrolitos. El estudio histopatológico no sugirió efectos tóxicos hepáticos o renales. Conclusión. Los resultados demuestran la actividad diurética de C. pteridoides y sustentan el uso popular dado a esta planta como diurético en la costa norte colombiana. Se requieren estudios posteriores que permitan aislar e identificar los compuestos responsables de la actividad y los mecanismos de acción involucrados.   doi: http://dx.doi.org/10.7705/biomedica.v33i1.611

Síndromes coronarios agudos: epidemiología y diagnóstico

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Carlos A. Cassiani M.

2009-01-01

Full Text Available Los síndromes coronarios agudos son un problema mayor de salud pública en todo el mundo. El síndrome coronario agudo (SCA incluye infarto agudo de miocardio (IAM, con o sin elevación del ST y la angina inestable. La incidencia anual de IAM es 565.000 nuevos eventos y 300.000 ataques recurrentes cada año. Los factores de riesgo para enfermedad cardíaca isquémica (ECI incluyen: tabaquismo, niveles elevados de lípidos séricos, hipertensión arterial, diabetes mellitus, obesidad mórbida, sedentarismo, bajo consumo diario de frutas y vegetales, consumo problemático de alcohol e índice psicosocial. La evaluación inicial de un SCA debe enfocarse en el disconfort toráxico, signos y síntomas asociados y factores de riesgo para SCA. Los marcadores biológicos de lesión miocárdica hoy no son fundamentales para decidir el manejo inicial, aunque han contribuido a una mayor sensibilidad del abordaje diagnóstico y aportan datos para el pronóstico de los pacientes.

Síndrome coronario agudo con supradesnivel del ST asociado al feocromocitoma con las catecolaminas inicialmente normales

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Jorge M. Pacheco

2016-01-01

Full Text Available Los feocromocitomas son tumores secretores de catecolaminas que cursan con paroxismos de hipertensión o hipotensión arterial y palpitaciones. Son una causa rara del síndrome coronario agudo. Presentamos el caso de una paciente con síndrome coronario agudo secundario a feocromocitoma que inicialmente tenía valores normales de catecolaminas.

Síndrome coronario agudo con supradesnivel del ST asociado al feocromocitoma con las catecolaminas inicialmente normales

OpenAIRE

Pacheco, Jorge M.; Pérez Baztarrica, Gabriel; Díaz Bozio, Fernando; Jiménez, Andrés; Porcile, Rafael

2016-01-01

Los feocromocitomas son tumores secretores de catecolaminas que cursan con paroxismos de hipertensión o hipotensión arterial y palpitaciones. Son una causa rara del síndrome coronario agudo. Presentamos el caso de una paciente con síndrome coronario agudo secundario a feocromocitoma que inicialmente tenía valores normales de catecolaminas.

Comunicación interventricular post infarto agudo del miocardio

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Fabián A. Ruiz, MD

2013-11-01

En este artículo se expone el caso de un paciente con síndrome coronario agudo sin terapia de reperfusión inicial, con posterior ruptura del septum interventricular, en quien se evidenció la utilidad de la ecocardiografía en el diagnóstico de dicha entidad.

Oxcarbazepina para los episodios afectivos agudos en el trastorno bipolar

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Akshya Vasudev

2012-09-01

Se necesitan ensayos controlados con asignación aleatoria con adecuado poder estadístico y de buena calidad metodológica para informar el potencial terapéutico de la oxcarbazepina a través del espectro de episodios agudos en el trastorno bipolar.

Complicaciones mecánicas del infarto agudo de miocardio: aunque infrecuentes, potencialmente letales

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Jerson Quitian Moreno

2017-09-01

Full Text Available Aunque la incidencia de complicaciones mecánicas en el infarto agudo de miocardio ha descendido después de la era de la intervención coronaria percutánea, la mortalidad sigue siendo significativa. La ruptura septal ventricular, la regurgitación mitral aguda y la ruptura de la pared libre del ventrículo izquierdo conforman el espectro de complicaciones mecánicas posteriores al infarto agudo de miocardio. La reparación quirúrgica es el pilar del tratamiento; sin embargo, como puente para la cirugía, el manejo médico permite estabilizar al paciente.

Las dosis recomendadas de β-lactámicos en el paciente séptico con técnicas continuas de reemplazo renal son insuficientes

OpenAIRE

Paz Martín, Daniel

2012-01-01

La sepsis es una causa importante de morbi-mortalidad entre los pacientes ingresados en Unidades de Cuidados Intensivos (UCI). En estos pacientes es prioritario tanto el control de la causa como el inicio temprano de la antibioterapia. De hecho, el retraso en el adecuado tratamiento antibiótico empeora el pronóstico de los pacientes sépticos. El fracaso renal agudo es una complicación frecuente de la sepsis que a menudo  precisa de técnicas continuas de reemplazo renal (TCRR). A pe...

Debido proceso probatorio y derecho de contradicción probatoria en el trámite de revisión de fallos de tutela

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Martha María Zapata González

2014-05-01

Full Text Available El debido proceso probatorio, en su aspecto de contradicción probatoria, es un derecho fundamental exigible en el procedimiento de revisión de los fallos de tutela por la Corte Constitucional de Colombia, a pesar de la celeridad propia de la acción constitucional. En la investigación de la cual deriva este artículo se estableció que en cinco expedientes de revisión de fallos de tutela relacionados con el derecho al mínimo vital de agua potable para sujetos de especial protección constitucional, la Corte Constitucional restringió gravemente el derecho de contradicción de la prueba sin justificación alguna, lo cual puede constituir una inobservancia de las garantías probatorias del derecho fundamental al debido proceso, y en especial al derecho de contradicción probatoria.

Factores relacionados con la mortalidad intrahospitalaria en el infarto agudo del miocardio

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Yanier Coll Muñoz

2012-09-01

Full Text Available Fundamento: la identificación de los factores relacionados con la mortalidad en el infarto agudo del miocardio representa un eslabón primordial en la evaluación inicial de los pacientes. Objetivo: identificar los factores relacionados con la mortalidad intrahospitalaria de los pacientes con infarto agudo del miocardio, ingresados en la Unidad de Cuidados Intensivos Coronarios de Cienfuegos durante el año 2010. Método: se realizó un estudio de serie de casos, que incluyó 241 pacientes con diagnóstico de infarto agudo del miocardio, ingresados en la Unidad de Cuidados Intensivos Coronarios del Hospital General Universitario Dr. Gustavo Aldereguía Lima de Cienfuegos, en el año 2010. Las variables que se analizaron fueron: edad, sexo, antecedentes patológicos personales, tipo de infarto agudo del miocardio (según electrocardiograma y localización topográfica, frecuencia cardiaca y tensión arterial al ingreso, clasificación de la insuficiencia cardiaca según Killip Kimball, creatinina, glicemia, colesterol total, triglicéridos, CPK-MB, y eventos adversos cardiovasculares durante su estadía hospitalaria. Resultados: la edad media de los pacientes estudiados fue de 65,6 años, con predominio del sexo masculino. La hipertensión arterial, el tabaquismo y el infarto miocárdico previo fueron los antecedentes de mayor interés, predominan los pacientes sin insuficiencia cardiaca y fracción de eyección conservada. Los eventos adversos cardiovasculares más frecuentes fueron: la angina post-infarto, arritmias ventriculares malignas y el choque cardiogénico. Conclusiones: se encontró relación significativa con la mortalidad para la edad avanzada (>70 años, taquicardia, glicemia ≥7 mmol/l al ingreso, y la presentación de arritmias ventriculares y choque cardiogénico durante la evolución intrahospitalaria.

Una propuesta para el diagnóstico de fallos en sistemas industriales mediante el uso de estrategias bioinspiradas A proposal to fault diagnosis in industrial systems using bio-inspired strategies

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Lídice Camps Echevarría

2011-08-01

Full Text Available In this work a study on the application of bio-inspired strategies for optimization to Fault Diagnosis in industrial systems is presented. The principal aim is to establish a basis for the development of new and viable model-based Fault Diagnosis Methods which improve some difficulties that the current methods cannot avoid. These difficulties are related mainly with fault sensitivity and robustness to external disturbances. In this study, there have been considered the Differential Evolution and the Ant Colony Optimization algorithms. This application is illustrated using simulated data of the Two tanks system benchmark. In order to analyze the advantages of these algorithms to obtain a diagnosis which needs to be sensitive to faults and robust to external disturbances, some experiments with incipient faults and noisy data have been simulated. The results indicate that the proposed approach, basically the combination of the two algorithms, characterizes a promising methodology for Fault Diagnosis.En el presente trabajo se presenta un estudio sobre la aplicación de estrategias bioinspiradas para la optimización al diagnóstico de fallos en sistemas industriales. El objetivo principal es establecer una base para el desarrollo de nuevos y viables métodos de diagnóstico de fallos basados en modelos que permitan mejorar las dificultades de los métodos actuales. Estas dificultades están relacionadas, fundamentalmente, con la sensibilidad ante la presencia de fallos y la robustez ante perturbaciones externas. En el estudio se consideraron los algoritmos Evolución Diferencial y Optimización por Colonia de Hormigas. La efectividad de la propuesta es analizada mediante experimentos con el conocido problema de prueba de los dos tanques. Los experimentos consideraron presencia de ruido en la información y fallos incipientes de manera que fuera posible analizar las ventajas de la propuesta en cuanto a diagnóstico robusto y sensible. Los resultados

[Anorexia nervosa as a cause of acute liver failure. Report of a case].

Science.gov (United States)

Voltas-Arribas, Beatriz; Artero-Fullana, Ana; Ferrer-García, Juan Carlos; Sánchez-Juan, Carlos; Marco-Alacid, Cristian; Sanz-Revert, Pablo; García-Blasco, Lourdes

2018-01-10

Caso clínico: presentamos una paciente de 33 años con anorexia nerviosa de 15 años de evolución con uno de los pocos casos reportados de fallo hepático agudo severo secundario a la desnutrición.Discusión: tras el soporte nutricional protocolizado para evitar el síndrome de realimentación y un adecuado manejo multidisciplinar, la paciente evoluciona favorablemente logrando normalizar los electrolitos, la función hepática y las alteraciones en la coagulación.

Tratamiento del dolor agudo en el paciente dependiente de sustancias

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DR. B. Juan Pablo Acuña

2014-07-01

Full Text Available El manejo del dolor agudo del paciente dependiente de sustancias, es un desafío para el profesional encargado de otorgar alivio a su síntoma. La dependencia de sustancias es reconocida como una enfermedad cerebral primaria crónica y recurrente. Su neurobiología y mecanismos fisiopatológicos de adaptación a la sustancia generan cambios en la percepción del dolor, en la respuesta a analgésicos opioides y cambios conductuales que interfieren con el tratamiento del dolor. Un conocimiento básico y claro respecto de lo descrito permite diseñar estrategias seguras y eficaces de alivio del dolor, sin interferir el curso de la enfermedad adictiva. Artículos de revisión, recomendaciones y guías elaboradas por expertos coinciden en que el tratamiento más eficaz del dolor incluye un manejo multimodal, un enfoque multidisciplinario, mantención de la terapia de sustitución y una estrecha vigilancia durante el episodio agudo de dolor y su seguimiento posterior.

Nuevos antiagregantes plaquetarios en síndrome coronario agudo

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Andrés F Buitrago

2013-06-01

Full Text Available En la actualidad las enfermedades cardiovasculares son la principal causa de muerte en los países industrializados y para 2020, lo serán en países en vía de desarrollo. El síndrome coronario agudo se caracteriza por la ruptura o erosión de una placa aterosclerótica que trae consigo grados variables de trombosis y embolización distal, que llevan a una disminución en la perfusión miocárdica. Posterior a la disrupción vascular, empieza un proceso de agregación, activación y adhesión plaquetaria que inicia la formación del trombo mural. Dado que el primer paso en la formación del trombo coronario involucra la activación y la agregación plaquetaria, el tratamiento con medicamentos antiplaquetarios es una de las piedras angulares del síndrome coronario agudo. La antiagregación dual con ácido acetil salicílico y un inhibidor del receptor P2Y12, hacen parte del manejo actual de los pacientes con síndrome coronario agudo y de aquellos sometidos a intervención coronaria percutánea. El clopidogrel es el inhibidor del receptor P2Y12 más utilizado; sin embargo, sus beneficios clínicos se ven limitados por varios factores que interfieren con la conversión del medicamento a su metabolito activo. Es por esto que recientemente se han desarrollado nuevos inhibidores del receptor P2Y12, como prasugrel y ticagrelor, con un efecto antiplaquetario más potente y mayores beneficios clínicos. Las actualizaciones recientes de las guías de manejo basadas en la evidencia los han incluido como parte del tratamiento de esta patología con un grado de recomendación incluso mayor que el de clopidogrel.

El sólido hiperbólico agudo

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Rosa María Herrera

2012-04-01

Full Text Available Torricelli consideró el cálculo del volumen de sólido hiperbólico agudo como el mejor logro en sus trabajos con ‘indivisibles curvos’. Fue publicado en la Opera geometrica. Aquí se presenta como muestra del estilo de las demostraciones matemáticas (geométricas que se efectuaban en el siglo XVII, y por su valor precursor del cálculo infinitesimal. Es un ejemplo significativo para aproximarse al pensamiento torricelliano.

Trasplante renal con HLA idéntico de donante vivo y cadavérico: experiencia de la Fundación Valle de Lili, Cali, Colombia

OpenAIRE

Caicedo, Luis Armando; Gómez-Vega, Juan Carlos; Duque, Mauricio Francisco; Serrano, Óscar Javier; Manzi, Eliana; Arrunátegui, Ana María; Posada, Juan Guillermo; Mesa, Liliana; Schweineberg, Johanna; Durán, Carlos Eduardo; Villegas, Jorge Iván; Dávalos, Diana María; Echeverri, Gabriel Jaime

2016-01-01

Introducción: En el trasplante renal con HLA idéntico los episodios de rechazo agudo son menores y tienen mejores tasas de supervivencia del injerto, comparado con los receptores con HLA no idéntico; a pesar de esto, persiste el dilema en cuanto al retiro o la disminución de la dosis de inmunosupresión. El objetivo de este trabajo es describir la experiencia de los trasplantes renales con HLA idéntico de donante vivo y cadavérico que se han realizado en la Fundación Valle del Lili desde 1995 ...

Insuficiência renal aguda secundária a acidentes ofídicos botrópico e crotálico. Análise de 63 casos

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Carlos Faria Santos Amaral

1986-08-01

Full Text Available Sessenta e três pacientes com insuficiência renal aguda secundária a acidente ofídico foram tratados no CTI do Hospital das Clínicas da UFMG. Em 32 pacientes (51% o acidente foi produzido por serpentes do gênero Bothrops (grupo bio-trópico e em 32 pacientes (49% pela cascavel sul-americana (grupo crotálico. As principais complicações apresentadas pelos pacientes foram a uremia (100% dos casos, hiperpotassemia (89% dos casos, anemia (78% dos casos, infecção urinária (37% dos casos, hiper-hidratação (17% dos casos, parada cardíaca (14% dos casos e edema agudo dos pulmões (11% dos casos. Cinco pacientes do grupo crotálico (16% tiveram insuficiência respiratória aguda atribuída à ação neurotóxica do veneno, quatro dos quais se recuperaram completamente. Sete pacientes do grupo botrópico (22% tiveram necrose cortical renal diagnosticada em cinco através da biópsia renal e em dois na necropsia. Quarenta e cinco pacientes (71% foram tratados com diálise peritoneal e a hemodiálise foi necessária em dois pacientes, um dos quais havia sido submetido a diálise peritoneal. Em 17 pacientes (27% o tratamento foi conservador. Cinqüenta e cinco pacientes receberam alta hospitalar, quatro dos quais com insuficiência renal crônica secundária a necrose cortical renal e oito (13% faleceram. Os óbitos foram atribuídos a edema pulmonar agudo em quatro pacientes, a estado de choque em dois pacientes e a coma e infecção respiratória após parada cardíaca em dois pacientes.

Eficacia de la asociación paracetamol-metamizol vs. paracetamol-dexketoprofeno en manejo de dolor agudo postoperatorio

OpenAIRE

García Ramiro, M.; Alonso Guardo, L.; Matilla Álvarez, A.; Bartol Sevillano, R.; Vaquero Roncero, L. M.; Muriel Villoria, C.

2013-01-01

Objetivo: El uso de fármacos con mecanismos diferentes combinados entre sí para el tratamiento del dolor, en concreto del dolor agudo postoperatorio, forma parte fundamental de un tipo de analgesia llamada multimodal. El objetivo de este trabajo es evaluar la eficacia de la asociación de paracetamol más metamizol y compararla con la asociación de paracetamol más dexketoprofeno en dolor agudo postoperatorio. Métodos: Diseñamos un estudio prospectivo de intervención en el que se incluyeron 42 p...

Aplicación de las escalas de estratificación del riesgo en el diagnóstico de los síndromes coronarios agudos

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John Jaime Sprockel Díaz

2017-09-01

Conclusiones: En una población de pacientes con alta probabilidad para el síndrome coronario agudo, las escalas HEART y TIMI mostraron una mayor capacidad para discriminar el diagnóstico del síndrome coronario agudo.

Efeitos do exercicio agudo sobre biomarcadores sericos de ratos diabeticos

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Fabio Milioni

2014-01-01

Full Text Available INTRODUÇÃO: As respostas ao exercício agudo dos biomarcadores, como a fosfatase alcalina (FA e a creatina quinase (CK séricas têm sido pouco investigadas em ratos diabéticos. OBJETIVOS: Verificar os efeitos do exercício físico aeróbio agudo sobre as concentrações de CK e FA, bem como, avaliar o estado hídrico em ratos diabéticos experimentais. MATERIAIS E MÉTODOS Foram utilizados ratos Wistar machos, adultos jovens, distribuídos em dois grupos: diabéticos (DA e controles (CA. O diabetes foi induzido por meio da administração de aloxana monoidratado Sigma(r (32 mg/kg de peso corporal. Duas semanas após confirmação do diabetes, ambos os grupos foram submetidos a uma sessão aguda de natação por 30 min, com carga aeróbia (4,5 % do peso corporal. Foram avaliados: glicose, hematócrito, CK, FA, albumina e a cinética de lactato durante o exercício por meio de coletas 25 µL de sangue da cauda dos animais, nos minutos 0, 10, 20 e 30 de exercício. RESULTADOS: ANOVA de dois fatores para medidas repetidas e o teste post hoc de Tukey apontaram diminuição significativa dos valores de glicemia após o exercício para o grupo DA, aumento significativo de CK pós-exercício para o grupo DA, aumento significativo de hematócrito para ambos os grupos após exercício e manutenção da FA após exercício para o grupo DA. CONCLUSÃO: O exercício agudo aeróbio foi eficiente no controle dos níveis glicêmicos de ratos diabéticos. Entretanto, deve ser aplicado com cautela, pois induziu altos valores de CK, sugerindo possíveis lesões teciduais.

Infarto Miocárdico Agudo: una perspectiva desde la Atención Primaria de Salud

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Lianne Ramos Marrero

Full Text Available Introducción: las enfermedades del corazón constituyen la primera causa de muerte a nivel mundial. Durante más de cuatro décadas, Cuba comportó similar estadística hasta el año 2012, a partir del cual el cáncer se situó como la primera causa de muerte; no obstante la enfermedades cardiovasculares constituyen un problema de salud de segundo orden para Cuba y dentro de este ítem el infarto miocárdico agudo como la principal causa de muerte. Objetivo: profundizar en el conocimiento sobre los elementos diagnósticos y de la conducta ante un infarto miocárdico agudo en el nivel primario de atención. Desarrollo: se hace especial énfasis en los elementos diagnósticos y la conducta recomendada ajustada a las posibilidades del nivel primario de atención. Conclusiones: el Infarto miocárdico agudo aporta la mayor mortalidad dentro de las enfermedades cardiacas, de causa multifactorial, su diagnóstico en la atención primaria de salud se basa en el cuadro clínico y cambios electrocardiográficos. La trombólisis es piedra angular en el tratamiento temprano de reperfusión.

Diagnóstico por imagem do tromboembolismo pulmonar agudo Imaging of acute pulmonary thromboembolism

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C. Isabela S. Silva

2004-10-01

Full Text Available O diagnóstico do tromboembolismo pulmonar agudo é baseado na probabilidade clínica, uso do dímero D (quando disponível e na avaliação por imagem. Os principais métodos de imagem utilizados no diagnóstico são representados por cintilografia ventilação-perfusão, angiografia pulmonar e tomografia computadorizada (TC. Na última década vários estudos têm demonstrado que a TC espiral apresenta elevada sensibilidade e especificidade no diagnóstico de tromboembolismo pulmonar agudo. Uma melhor avaliação das artérias pulmonares tornou-se possível com a recente introdução dos equipamentos de TC espirais com multidetectores. Vários pesquisadores têm sugerido que a angiografia pulmonar por TC espiral deve substituir a cintilografia na avaliação de pacientes com suspeita clinica de tromboembolismo pulmonar agudo. Os autores discutem os principais métodos de imagem utilizados no diagnóstico de tromboembolismo pulmonar agudo enfatizando o papel da TC espiral.The diagnosis of acute pulmonary thromboembolism is based on the clinical probability, use of D-dimer (when available and imaging. The main imaging modalities used in the diagnosis are ventilation-perfusion (V/Q, scintigraphy, angiography, and computed tomography (CT. In the last decade several studies have demonstrated that spiral CT has a high sensitivity and specificity in the diagnosis of acute pulmonary thromboembolism. The evaluation of the pulmonary arteries has further improved with the recent introduction of multidetector spiral CT scanners. Various investigators have suggested that spiral CT pulmonary angiography should replace scintigraphy in the assessment of patients whose symptoms are suggestive of acute PE. This article discusses the role of the various imaging modalities in the diagnosis of acute pulmonary thromboembolism with emphasis on the role of spiral CT.

Hematoma subdural agudo espontâneo e hemorragia intracerebral em paciente com microangiopatia trombótica gestacional

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Sâmia Yasin Wayhs

2013-06-01

Full Text Available Pré-eclâmpsia, síndrome HELLP (hemólise, elevação de enzimas hepáticas e plaquetopenia e fígado gorduroso agudo da gestação são as principais causas de microangiopatia trombótica e disfunção hepática grave durante a gestação, representando um spectrum do mesmo processo patológico. Relatou-se aqui o caso de uma gestante com 35 semanas internada em unidade de terapia intensiva no pós-operatório imediato de cesariana por morte fetal, com náuseas, vômitos e icterícia. Diagnosticaram-se pré-eclâmpsia pós-parto e fígado gorduroso agudo da gestação. Houve evolução tardia com hematoma subdural agudo e hemorragia intracerebral, sendo realizado tratamento neurocirúrgico. A paciente foi a óbito por anemia hemolítica refratária, com sangramento espontâneo em múltiplos órgãos. Pré-eclâmpsia, síndrome HELLP e fígado gorduroso agudo da gestação são processos patológicos que podem se sobrepor e se associar a complicações potencialmente fatais, como a hemorragia intracraniana aqui descrita. Sua detecção e diagnóstico precoces são fundamentais para a instituição de manejo adequado e sucesso do tratamento.

Infarto renal agudo: características clínicas y factores pronósticos

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Fernando Caravaca-Fontán

2016-03-01

Conclusiones: El INRA es una patología infrecuente, con manifestaciones clínicas poco específicas y, en más de la mitad de los casos, no asociada a enfermedad cardiaca o arritmias. Una alta proporción de pacientes evoluciona desfavorablemente. La función renal al diagnóstico es uno de los principales factores pronósticos.

Inestabilidad en múltiples placas ateroescleróticas en pacientes fallecidos por infarto agudo de miocardio

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Ricardo A. Sarmiento

2011-08-01

Full Text Available Los procesos inflamatorios en los síndromes coronarios agudos juegan un rol importante en la inestabilidad de la placa ateroesclerótica. Nuestro objetivo fue evaluar la presencia y distribución de placas vulnerables e infiltrados inflamatorios en pacientes fallecidos por infarto agudo de miocardio y su comparación con los hallazgos en pacientes fallecidos por cuadros no coronarios. Se analizaron los estudios anatomopatológicos de corazón de 68 pacientes fallecidos por infarto agudo de miocardio y 15 fallecidos por causa no coronaria. Se registró la presencia de trombo, hemorragia intraplaca, ruptura endotelial e infiltrado inflamatorio. Al evaluar los pacientes fallecidos por IAM, encontramos trombo en 73.5% de las arterias responsables del IAM y en 28.7% de las no responsables (p < 0.0001. La hemorragia intraplaca se halló en el 70.5% de las arterias responsables y en 39.7% de las no responsables, p < 0.0001; ruptura endotelial en el 29.4% de las arterias responsables y en 3.7% de las no responsables, p < 0.0001. No encontramos diferencias en la presencia de infiltrado inflamatorio (76.5% versus 68.4%. Comparando con los fallecidos por causas no coronarias, la presencia de trombo fue significativamente superior (73.5% vs. 13.3%; p < 0.0001, así como la de hemorragia intraplaca (70.5% vs. 0%; p < 0.0001 y de infiltrado inflamatorio en las placas ateroescleroticas (76.5% vs. 46.6%; p = 0.021. En los pacientes fallecidos por infarto agudo de miocardio se observa inestabilidad de placa y actividad inflamatoria, no sólo en la arteria responsable del infarto sino también en las arterias no responsables del infarto.

Estado Confusional Agudo nas Unidades de Cuidados Intensivos

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Santos, L; Alcântara, J

1996-01-01

As alterações do comportamento frequentemente observadas em doentes internados nas unidades de cuidados intensivos (UCI), podem ser adequadamente designadas, na maioria das vezes, por estado confusional agudo, o qual se caracteriza por: flutuação do estado de vigília, distúrbio do ciclo vigília-sono, défice de atenção e concentração, desorganização do pensamento, manifestado entre outras formas por discurso incoerente, distúrbios da percepção sob a forma de ilusões e/ou alucinações, desorient...

Actividad inflamatoria en múltiples placas ateroscleróticas en pacientes fallecidos por infarto agudo de miocardio

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Alejandro García Escudero

2009-01-01

Full Text Available IntroducciónEstudios clínicos y anatomopatológicos sugieren que los procesos inflamatorios tienen un papel importante en la inestabilidad de la placa aterosclerótica, dado que en pacientes con síndromes coronarios agudos se observan infiltrados inflamatorios difusos en las arterias coronarias.ObjetivosEvaluar y localizar la distribución de placas vulnerables e infiltrados inflamatorios en pacientes fallecidos por infarto agudo de miocardio.Material y métodosMediante microscopia óptica se estudiaron las arterias coronarias de 58 pacientes fallecidos por infarto de miocardio. En las arterias coronarias relacionadas con el infarto y en las no relacionadas se registraron las siguientes variables: presencia de trombo, rotura de placa, hemorragia intraplaca y presencia de infiltrado inflamatorio.ResultadosAl analizar las diferencias existentes entre las arterias responsables del infarto y en las no responsables se encontraron diferencias significativas con respecto a la presencia de trombo (69% versus 38%; p < 0,008 y de hemorragia intraplaca (69% versus 50%; p < 0,03. No se encontró una diferencia significativa entre la arteria responsable y la no responsable al evaluar la presencia de infiltrado inflamatorio en las placas ateroscleróticas (77% versus 71%; p = ns.ConclusiónEn el infarto agudo de miocardio se comprobó la presencia de actividad inflamatoria que afectaba a más de un vaso, con compromiso de otras arterias además de la responsable del infarto. Se detectó también accidente agudo de placa en más de una arteria coronaria.REV ARGENT CARDIOL 2009;77:81-87.

Nefropatía por contraste en el síndrome coronario agudo

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Mariana Carnevalini

2011-10-01

Full Text Available La nefropatía inducida por contraste (NIC es una de las causas más frecuentes de insuficiencia renal en pacientes internados. En el síndrome coronario agudo (SCA, la presencia de NIC aumenta la morbimortalidad. Las medidas de profilaxis y los factores de riesgo intervinientes de NIC en SCA no han sido determinados con exactitud. El objetivo de este estudio fue evaluar la incidencia de NIC y los factores asociados a su desarrollo en pacientes ingresados en unidad coronaria con requerimiento de cinecoronariografía (CCG. Se realizó un estudio de cohorte retrospectivo. Se incluyeron pacientes consecutivos cursando SCA estudiados con CCG dentro de las 72 horas de su admisión. Se definió NIC al aumento del 25% del valor de creatinina a las 48 h sobre el nivel basal de ingreso. El período de inclusión fue entre el 1° de enero de 2004 hasta el 30 de junio de 2010. Se analizaron 125 casos. La incidencia de NIC fue del 10.4% (n = 13. En el análisis multivariado, los factores asociados independientemente a su desarrollo fueron la edad [OR 1.05 (IC 95% 1.004 - 1.11 p = 0.034], la angioplastia a múltiple vaso [OR 2.2 (IC 95% 1.07 - 4.8, p = 0.03] y el volumen de contraste utilizado [OR 1.007 (IC 95% 1.001 - 1.01, p = 0.014].

Rotura de la pared libre del ventrículo izquierdo secundaria a infarto agudo de miocardio

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Claudio Solís

2009-01-01

Full Text Available RESUMENAunque la terapia trombolítica y la angioplastia primaria han cambiado radicalmente elmanejo, la evolución y el pronóstico del infarto agudo de miocardio, la rotura de la paredlibre del ventrículo izquierdo todavía implica una tasa elevada de mortalidad.Si bien la mayoría de los pacientes con esta complicación presentan un cuadro agudo ycatastrófico, que se caracteriza por taponamiento cardíaco, disociación electromecánica ymuerte en pocos minutos, aproximadamente un tercio de ellos tienen una evolución subagudacon hipotensión sostenida y diversos grados de derrame pericárdico, lo que posibilita laimplementación de medidas terapéuticas necesarias como puente al tratamiento quirúrgicoresolutivo.En este trabajo se presenta una revisión actualizada de las características clínicas yecocardiográficas de los pacientes con rotura de la pared libre del ventrículo izquierdo asociadacon infarto agudo de miocardio, con el objetivo de destacar los puntos clave del diagnóstico e incrementar la sospecha clínica de una entidad grave, no siempre fatal.REV ARGENT CARDIOL 2009;77:395-404.

COMPARTIMENTAÇÃO DE UNIDADES GEOMORFOLÓGICAS DO MUNICÍPIO DE AGUDO-RS

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Gerson Jonas Schirmer

2013-12-01

Full Text Available Este artigo apresenta um mapeamento geomorfológico do município de Agudo-RS, onde as unidades geomorfológicas representam a integração dos elementos físicos da área de estudo, frente aos processos envolvidos na organização da paisagem local. A metodologia é fundamentada nas contribuições da ciência geográfica, utilizando como ferramenta SIGs (Sistemas de Informação Geográfica.  Através de uma representação de síntese, foram definidos cinco unidades geomorfológicas, Rampas deColúvio-Aluvio do Rio Jacuí, Rampas de Colúvio-Alúvio de Arroios, Colinas Alúvio-Coluvionar, Colinas Vulcânicas do Planalto Serra Geral e Associação de Morros e Morrotes do Rebordo do Planalto, que caracterizam a paisagem do município de Agudo.

Infección por Polyoma virus en un paciente con transplante renal: A propósito de un caso

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Reyner Loza Munarriz

2008-07-01

Full Text Available La nefropatia por polyoma virus (NVBK esta siendo reconocida como causa importante de falla del injerto, usualmente confundido con rechazo agudo. A la fecha, no se han reportado casos en el Perú. Se presenta el caso de un niño trasplantado, 17 años de edad, quien presentó elevación persistente de la creatinina sérica en el primer mes postrasplante. Fue tratado como rechazo agudo. Al no presentar mejoría se realizó biopsia renal que mostró marcado daño del epitelio tubular con necrosis parcial y desprendimiento hacia la luz tubular y la presencia de células atípicas con escaso citoplasma e inclusiones intranucleares basofilicas, hallazgos compatibles con infección por virus BK. No se evidenció signos de rechazo. Además, en el papanicolao de orina, se encontró Decoy cells. La carga viral de virus BK fue elevada en sangre y en orina. Se suspendió el tratamiento con mofetil micofenolato, se redujo la dosis de tacrolimus y se inició el tratamiento con leflunomide 40 mg/dia. Seis meses después la función renal del paciente se estabilizó, pero sin mejoría completa quedando con una depuración de creatinina de 30 ml/min/1,73 m² SC. (Rev Med Hered 2008;19:123-127

Validez y confiabilidad de un instrumento de satisfacción del usuario con síndrome febril agudo

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Tiga-Loza, Diana C; Villar-Centeno, Luis á; Güiza-Sanabria, Diana R; Martínez-Vega, Ruth A

2010-01-01

Objetivo Determinar la validez y la confiabilidad de un instrumento de satisfacción del paciente con Síndrome Febril Agudo en urgencias y consulta oportuna de la Red Pública de Bucaramanga. Métodos Estudio de evaluación de tecnologías diagnósticas en personas con Síndrome Febril Agudo entre el 2008 y 2009. Se diseñó un cuestionario telefónico a partir de 3 instrumentos en español. Se evaluó validez de contenido mediante sometimiento a expertos y a profesionales de salud y validez facial en un...

Modelos de serviços hospitalares para casos agudos em idosos

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Coelho Filho João Macedo

2000-01-01

Full Text Available Embora a atenção ao idoso seja uma prioridade emergente no Brasil, pouca ênfase tem sido dada a modelos de organização de serviços hospitalares para pacientes geriátricos. São revisados modelos de serviços hospitalares para admissão e manuseio de casos agudos em idosos, com ênfase na discussão sobre o papel e o posicionamento da medicina geriátrica (incluindo sua interface com especialidades e com a clínica médica no âmbito da atenção hospitalar. Foi realizada pesquisa na base de dados Medline (1989-1999, bem como nos principais livros-texto de geriatria e de gerontologia, buscando identificar descrições de serviços hospitalares para cuidado agudo de pacientes idosos. As características dos modelos identificados foram compiladas e descritas à luz de sua adequação à realidade dos serviços de saúde no Brasil. Exemplos de intervenções em geriatria, com efetividade demonstrada através de revisões sistemáticas, foram também citadas. Os modelos mais freqüentemente relatados foram cuidado prolongado, tradicional, baseado na idade cronológica, não especializado e integrado. Adaptações e variantes de alguns desses modelos foram freqüentemente relatadas, assim como seu impacto potencial na efetividade do cuidado geriátrico. Evidências sobre o melhor modelo a seguir não foram identificadas, mas aqueles modelos favorecendo a integração da geriatria com a clínica geral pareceram mais adequados à nossa realidade. Ressalta a necessidade de reestruturação de serviços de saúde para responder às novas demandas que surgem com o envelhecimento da população, bem como do delineamento de serviços hospitalares para casos agudos, importantes para a efetividade do cuidado geriátrico e que devem ser objeto de maior debate e pesquisa no Brasil.

Efeitos do exercício físico durante a hemodiálise em indivíduos com insuficiência renal crônica: uma revisão

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Moura,Regina Márcia Faria de; Silva,Fernanda Camila Ribeiro; Ribeiro,Gláucia Marise; Sousa,Lidiane Aparecida de

2008-01-01

As principais alterações observadas em indivíduos com insuficiência renal crônica são anemia, hipertensão arterial sistêmica e atrofia muscular, que levam à baixa capacidade aeróbica e perda de força muscular. Assim, parte do tratamento desses indivíduos consiste em programas de exercício físico. O objetivo desta revisão da literatura foi documentar os efeitos agudos e as adaptações crônicas, cardiovasculares e musculares em indivíduos no estágio final da doença renal, submetidos a programas ...

Análisis de la incidencia de los factores militares y los factores políticos en el fallo del proceso de paz del Caguán entre el gobierno colombiano y las Farc-Ep, periodo 1998-2002

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López Narváez, Yeinner Andrés

2013-01-01

Esta monografía ofrece un análisis encaminado a revisar la incidencia de factores militares y políticos en el fallo del proceso de negociación del Caguán. Considera que la relación entre estos dos elementos y el fallo del proceso no han sido suficientemente estudiados por los analistas, ya que el examen de otros fenómenos ha desviado la atención de los analistas acerca de la importancia de estos elementos contextuales en la respuesta positiva o negativa de un proceso de paz. La primera part...

Presencia y severidad de calcio coronario: su relación con la aparición de eventos coronarios agudos

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Lázaro E. de la Cruz Avilés

2012-03-01

Full Text Available Fundamento: la detección de calcio en las arterias coronarias confirma la presencia de aterosclerosis y ha demostrado ser una herramienta útil para estratificar el riesgo cardiovascular. Objetivo: determinar la relación entre la presencia y severidad de calcio coronario con la aparición de eventos coronarios agudos. Métodos: se realizó un estudio observacional, descriptivo, prospectivo, tipo serie de casos, en el Hospital Universitario Dr. Gustavo Aldereguía Lima de Cienfuegos, entre enero y diciembre de 2008. La serie estuvo conformada por 137 pacientes, en los que se estudió: sexo, antecedentes patológicos personales, cifras de glucemia en ayunas, creatinina, colesterol total y triglicéridos. Los pacientes fueron seguidos durante dos años para evaluar la aparición de eventos coronarios agudos. Resultados: La edad media fue de 53,2±7,4 años, con predominio del sexo masculino (52,5 %. El mayor porciento de pacientes clasificados como de alto riesgo, según la cuantificación del calcio coronario (16,8 % perteneció al sexo masculino, predominando en los mayores de 70 años. La diabetes se relacionó de forma significativa con la severidad del puntaje de calcio. El infarto agudo del miocardio fue más frecuente en pacientes con puntaje de calcio mayor de 400 unidades Agatston. Conclusiones: la aparición de eventos coronarios agudos fue más frecuente en los pacientes de alto riesgo según cuantificación del calcio coronario.

Acute clinical events in patients with sickle cell disease: epidemiology and treatment Eventos agudos em doença falciforme: epidemiologia e tratamento

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Monique M. Loureiro

2008-04-01

Full Text Available Sickle cell disease is a hereditary illness of high prevalence in black population, and involved patients frequently have multiple hospitalizations. Our objective was to describe and to analyze the clinical course of hospitalizations in patients with sickle cell disease. Cross-sectional study of 78 patients submitted to 230 hospital admissions due to acute complications of sickle cell disease, from 2000 to 2004 in a public teaching hospital in Rio de Janeiro city, RJ, Brazil. Outcomes variables were length of hospital stay and death. Main covariables were age, gender, chronic renal failure, causes of hospitalization and use of medicines. Proportions were compared using the chi-square or the Fischer test, and for the continuous variables, Mann-Whitney test was used. The median age in years was 20.3 (15-53 and the most frequent clinical event was acute painful episode (73.5%. Mean length of stay was significantly higher in admissions caused by different reasons than acute painful episode (p A doença falciforme é uma doença hereditária, de alta prevalência na população negra, que leva a múltiplas internações hospitalares. Nosso objetivo foi descrever e analisar o curso clínico de pacientes com doença falciforme hospitalizados.Realizou-se estudo transversal de 78 pacientes submetidos a 230 internações hospitalares devido a complicações agudas da doença falciforme, de 2000 a 2004, em um hospital universitário no Rio de Janeiro-RJ, Brasil. Os desfechos estudados foram tempo de permanência hospitalar e óbito. As principais co-variáveis foram idade, sexo, presença de insuficiência renal crônica, causas de hospitalização e uso de medicamentos. Proporções foram comparadas utilizando-se o teste qui-quadrado ou teste de Fischer, e, para as variáveis contínuas, o teste de Mann-Whitney foi utilizado. A mediana da idade foi 20,3 anos (15-23 e o evento clínico mais freqüente foi o episódio doloroso agudo (73,5%. O tempo m

O que todo intensivista deve saber a respeito da síndrome do desconforto respiratório agudo e dano alveolar difuso?

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Fernando Rios

2017-09-01

Full Text Available RESUMO A síndrome do desconforto respiratório agudo é um desafio para o intensivista. A característica principal desta doença aguda é o dano alveolar difuso, presente em cerca de metade dos pacientes com a síndrome. É claro que o suporte respiratório à síndrome do desconforto respiratório agudo tem melhorado gradualmente nas últimas décadas. É também evidente que todos estes procedimentos são benéficos, já que reduzem a lesão pulmonar e mantêm o paciente vivo. Isto deve ser interpretado como uma estratégia de ganho de tempo, até que o fator desencadeante ou de risco causal melhore, assim como a tempestade inflamatória diminua e o pulmão se cure. Por outro lado, todos - exceto dois tratamentos farmacológicos (bloqueadores neuromusculares e esteroides - são incapazes de melhorar o desfecho da síndrome do desconforto respiratório agudo. A hipótese de que os resultados farmacológicos negativos podem ser explicados pela heterogeneidade histológica da síndrome do desconforto respiratório agudo tem sido apoiada pelas recentes demonstrações de que a síndrome com dano alveolar difuso tem característica clínico-patológica específica. O dano alveolar difuso é um diagnóstico patológico, e a biópsia pulmonar a céu aberto (a técnica mais comum para obtenção de tecido pulmonar tem efeitos colaterais graves, sendo necessário que se desenvolvam biomarcadores substitutos para o dano alveolar difuso. O objetivo desta revisão é discutir três tópicos relacionados à síndrome do desconforto respiratório agudo: o relacionamento entre a síndrome do desconforto respiratório agudo e o dano alveolar difuso; como o dano alveolar difuso pode ser representado no quadro clínico; e como o enriquecimento pode melhorar os resultados de estudos clínicos farmacológicos realizados com pacientes com a síndrome e com dano alveolar difuso.

Doença periodontal e infarto agudo do miocardio

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Coelho, Julita Maria Freitas

2010-01-01

p. 1-98 Dados epidemiológicos, experimentais e clínicos têm sugerido que a doença periodontal, especialmente a periodontite crônica, pode constituir um fator de risco para doenças cardiovasculares isquêmicas. A proposta deste estudo foi investigar a associação entre a doença periodontal e o infarto agudo do miocárdio (IAM) em indivíduos adultos. Uma revisão de literatura de estudos de caso-controle que estudaram essa associação foi sumarizada em uma meta-análise que demonstrou uma chance e...

Efeitos agudos da corrente interferencial ganglionar em mulheres sadias

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Nakata, Cláudio Hiroshi

2014-01-01

OBJETIVO: Analisar os efeitos agudos da corrente interferencial ganglionar em mulheres sadias. MATERIAIS E MÉTODOS: Estudo do tipo experimental aleatorizado e transversal. Vinte e uma mulheres militares do Exército Brasileiro divididas em dois grupos, conforme IPAQ, em ativas (média de idade de 32,80 ± 3,011 anos, massa 56,50 ± 5,523 Kg, estatura de 164,30 ± 6,993 cm e IMC de 20,90 ± 1,729 kg/m2 e 80% com conceito excelente no teste de aptidão física) e irregularmente ativas (média de idade d...

Troponina T vs Troponina I como Valor Predictivo para Síndrome Coronario Agudo en menores de 80 Años

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PE Pla Cala

2015-07-01

Full Text Available Resumen – Actualmente en la injuria miocárdica, ha tenido gran relevancia clínica la utilidad de las troponinas como método diagnóstico, repercutiendo en el manejo del síndrome coronario agudo. Objetivo: Analizar la importancia de los biomarcadores troponina T e I y otros elementos adyuvantes que cumplen un papel trascendental como es el electrocardiograma y los diferentes métodos invasivos, el cual brinda una orientación para la concepción de un diagnóstico oportuno que permita tomar las acciones pertinentes en un paciente con síndrome coronario agudo. Materiales y Métodos: Estudio descriptivo comparativo en 35 pacientes, adultos mayores de 21 años y menores 80 años, que se encontraban hospitalizados en la Empresa Social del Estado Centro de Atención y Rehabilitación Integral - E.S.E CARI de Alta complejidad, en el periodo comprendido entre el año 2012 a 2014. Resultados: Los pacientes presentaron síndrome coronario agudo (infarto agudo de miocardio con o sin elevación del ST, con factores de riesgo cardiovascular tales como: sedentarismo, tabaquismo, hipertensión arterial, diabetes, valvulopatías, dislipidemia y antecedentes de cardiopatía isquémica. El punto a analizar fue la elevación de los biomarcadores troponina T y troponina I en un periodo menor y mayor a 3 horas, desde el inicio de los síntomas (dolor torácico, criodiaforesis, disnea hasta el ingreso a la institución hospitalaria. Se compararon los resultados obtenidos de cada uno de estos biomarcadores en el diagnóstico precoz y oportuno del síndrome coronario agudo. De las muestra analizada (n=35 pacientes se obtuvo que la troponina T< 3 horas se elevó un 76.4% en rangos de edad entre los 60-80 años en contraste con troponina I < 3 horas en ese mismo grupo etario que fue de 70.5%. Conclusiones: se evidenció que ambos biomarcadores son equiparables con una ligera ventaja de la troponina T con respecto a la I.

Perfil etiológico del síndrome febril icterohemorrágico agudo y síndrome febril ictérico agudo en los valles del Apurímac, Quillabamba, Chanchamayo y Alto Huallaga, Perú, 1999-2000.

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2003-07-01

Full Text Available Objetivos: Conocer el perfil etiológico del síndrome febril hemorrágico agudo (SFHA y del síndrome febril ictérico agudo (SFIA en los valles del Río Apurímac (Ayacucho, Quillabamba (Cusco, Chanchamayo (Junín y Alto Huallaga (Huánuco. Materiales y métodos: Estudio longitudinal descriptivo realizado entre junio de 1999 y mayo de 2000, en 146 establecimientos de salud de los cuatro valles involucrados. Fueron incluidos pacientes que cumplieron con las definiciones de caso para la vigilancia del síndrome febril hemorrágico agudo y el síndrome febril ictérico agudo. Las muestras obtenidas se procesaron por ELISA IgM de captura para fiebre amarilla; IgM anti-HBc ELISA y HBsAg ELISA para hepatitis B; Ig anti-VHD ELISA para hepatitis D; e IgM ELISA para leptospirosis. Resultados: Fueron incluidos 63 casos: 98,4% con SFIA y 1,6% con SFHA. La letalidad fue de 16% y el tiempo entre inicio de síntomas y la obtención de la muestra de 7,2 ±5,1 días. Los casos que tuvieron confirmación diagnóstica fueron 31 (49,2%, hepatitis B (23,8%, hepatitis D (15,6%, fiebre amarilla (4,8% y leptospirosis (4,8%. Cusco tuvo el mayor porcentaje de casos confirmados por laboratorio, siendo la mayoría hepatitis B y D. Conclusiones: El estudio de la etiología de SFIA y SFHA ha permitido identificar tres brotes de fiebre amarilla en Cusco, Junín y Huánuco, y conocer la importancia de la hepatitis B, D y leptospirosis en el diagnóstico diferencial de estos síndromes. Si bien las definiciones usadas apuntan a detectar enfermedades severas, la vigilancia de ambos síndromes es complementaria y totalmente compatible con los sistemas de enfermedad específica y por el laboratorio.

Sistema informático para la gestión de la información hospitalaria del infarto agudo de miocardio (RHIMA)

OpenAIRE

Yanier Coll Muñoz; Francisco Valladares Carvajal; Jorge L. Fernández Curbelo; Ing. Luis E. Fernández Curbelo

2015-01-01

Introducción: La difícil recopilación de información sobre la prevalencia y desarrollo del infarto agudo de miocardio imposibilita medir la calidad del tratamiento durante la evolución de la enfermedad en un determinado grupo de pacientes.Objetivo: Desarrollar un sistema informático que permita la gestión de la información hospitalaria del infarto agudo de miocardio en el Servicio de Cardiología.Método: Se identificaron las variables necesarias para la confección del registro, divididas por b...

Agentes trombolíticos en el infarto agudo del miocardio

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Manuel Cué Brugueras

1995-01-01

Se presenta un revisión bibliográfica sobre los agentes trombolíticos y su uso en el infarto agudo del miocardio con el objetivo de actualizar a los farmacéuticos y otros profesionales de la salud en la terapéutica de este importante problema de salud a nivel internacional. Se revisaron las bases de datos MEDLINE (1985-9/1994), Excerpta Medica (1985-1993), Internacional Pharmaceutical Abstracts (1970-9/1993) y Predicast (1992-11/1993). En la revisión se abordan los beneficios y riesgos de la ...

Estudio y propuestas de solución para fallos recurrentes en bombas centrífugas horizontales // Study and proposal of solutions to recurrent failures in horizontal centrifugal pumps.

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Jesús Cabrera - Gómez

2010-05-01

Full Text Available ResumenLa necesidad de ejecutar la investigación está dada por los fallos recurrentes que están presentandolas bombas centrífugas horizontales que interrumpen el proceso de la planta de alquilación y alimpacto económico asociado a los fallos que han tenido un elevado costo por acciones demantenimiento preventivas y reactivas, en adición a los costos asociados por pérdida deoportunidad. Se llevó a cabo un estudio para establecer las causas que originan los reiterados fallosocurridos en el sistema de bombeo. Como resultado del trabajo realizado, se identificaronoportunidades de mejora de la disponibilidad de los activos estudiados por la vía del incremento de lavida útil del los sellos mecánicos y finalmente se propuso un programa de acciones correctivas alque debe darse seguimiento y que debe tributar a la solución permanente de los problemasidentificados.Palabras claves: mantenimiento de equipos rotatorios, fallos recurrentes, confiabilidad operacional,_________________________________________________________AbstractThe necessity of making the research outlined in this paper is given by recurrent failures in a set ofhorizontal centrifugal pumps. These failures interrupt the operating process in an alkylation plant andgenerate a great negative economic impact because of incrementing maintenance costs andopportunity losses. A study was carried out in order to establish the main causes of repeated failuresin the pumping system. As a result, several improvement opportunities of availability of pumps wereidentified by increasing the useful life of their mechanical seals. Finally, a corrective action programwas proposed in order to provide permanent solutions to identified problems.Key words: maintenance of rotating equipment, recurrent failures, operational reliability, root causeanalysis, horizontal centrifugal pumps.análisis de causa raíz, bombas centrífugas horizontales

Ubicación óptima de reserva en un sistema serie con respecto al orden de tasa de fallo Ubicación óptima de reserva en un sistema serie con respecto al orden de tasa de fallo

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Henry Laniado

2005-04-01

Full Text Available En este trabajo se estudia el problema de ubicar K reservas activas, cuyos tiempos de vida son variables aleatorias independientes e idénticamente distribuidas a las componentes de un sistema serie; con el objetivo de optimizar la función de tasa de fallo del sistema. A diferencia del trabajo de Singh y Singh, esta presentación obtiene los mismos resultados a partir de técnicas más elementalesIn this paper, we consider the problem of alocating K active reserves, whose lifetimes are independent identically distributed random variables, equal to the system series components; with the purpose of optimizing system failure rate function. As opposed to the work by Sing and Singh, our discussion yields the same results using more elementary methods.

ANESTESIA PARA AMPUTACIÓN SUPRACONDÍLEA EN PACIENTE CON SÍNDROME CORONARIO AGUDO / Anesthesia for supracondylar amputation in patient with acute coronary syndrome

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Marilyn Ramírez Méndez

2012-03-01

Full Text Available Resumen La insuficiencia arterial periférica es una enfermedad que se asocia a factores de riesgo aterogénico reconocidos, y es más frecuente en personas con hiperlipidemia, diabetes mellitus y hábito de fumar. Se presenta el caso de una mujer de 67 años de edad, con antecedentes de hipertensión arterial, diabetes mellitus e infarto de miocardio antiguo, que ingresa por signos de inflamación aguda del miembro inferior derecho como consecuencia de una insuficiencia arterial periférica. A los 8 días del ingreso presentó un síndrome coronario agudo sin elevación del segmento ST, con fallo de bomba Killip II, y una vez compensada fue anunciada para amputación supracondílea de urgencia, debido a una gangrena isquémica. Se decidió utilizar anestesia espinal subaracnoidea selectiva del miembro inferior derecho, a cual se aplicó sin complicaciones y favoreció el adecuado desarrollo de la cirugía planificada. A las 72 horas la paciente fue egresada de la UCI, sin síntomas cardiovasculares y compensación metabólica. / Abstract Peripheral arterial insufficiency is a disease that is associated with known atherogenic risk factors, and is more common in people with hyperlipidemia, diabetes mellitus and smoking habit. A case of a 67-year-old woman with a history of hypertension, diabetes mellitus and old myocardial infarction is presented. She was admitted for signs of acute inflammation of the right leg due to peripheral arterial insufficiency. 8 days after admission she presented an acute coronary syndrome without ST segment elevation with pump failure (Killip class II, and once compensated she was scheduled for emergency supracondylar amputation due to ischemic gangrene. It was decided to use selective spinal subarachnoid from the right leg, which was applied without complications and favored the proper development of the planned surgery. At 72 hours, the patient was discharged from the ICU, with metabolic compensation and without

El infarto agudo de miocardio, un problema de salud pública

OpenAIRE

Alberto Caccavo

2010-01-01

RESUMENEl infarto agudo de miocardio (IAM) es una causa importante de muerte en la Argentina. Lamortalidad intrahospitalaria del IAM en la actualidad es de aproximadamente el 10%, almenos en los centros que participan en registros.Su tratamiento está orientado a la reperfusión de la arteria ocluida con angioplastia primariao trombolíticos. Sin embargo, sólo un pequeño número de hospitales disponen deangioplastia primaria y reciben trombolíticos muchos menos pacientes que los que los requieren...

Estrategias para aumentar la seguridad del paciente en hemodiálisis: Aplicación del sistema de análisis modal de fallos y efectos (sistema AMFE

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María Dolores Arenas Jiménez

2017-11-01

Conclusiones: Las complicaciones en HD son frecuentes y la consideración de algunas de ellas como EA podría mejorar la seguridad en la asistencia, al poner en marcha medidas preventivas. La implementación del sistema AMFE permite estratificar y priorizar los posibles fallos de las unidades de diálisis, y actuar con mayor o menor premura, desarrollando las acciones de mejora necesarias.

El infarto agudo de miocardio, un problema de salud pública

OpenAIRE

Caccavo, Alberto

2010-01-01

El infarto agudo de miocardio (IAM) es una causa importante de muerte en la Argentina. La mortalidad intrahospitalaria del IAM en la actualidad es de aproximadamente el 10%, al menos en los centros que participan en registros. Su tratamiento está orientado a la reperfusión de la arteria ocluida con angioplastia primaria o trombolíticos. Sin embargo, sólo un pequeño número de hospitales disponen de angioplastia primaria y reciben trombolíticos muchos menos pacientes que los que los requieren. ...

Frecuencia de infección por VIH en pacientes con episodio agudo de herpes zoster

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Susana Lazarte Heraud

2005-01-01

Full Text Available Objetivo: Evaluar la frecuencia de infección por VIH en pacientes que consultan por episodio agudo de herpes zoster. Material y Métodos: Se incluyeron a todos los pacientes entre 18 y 49 años, atendidos entre setiembre del 2001 y enero del 2003 en el Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas del Hospital Nacional Cayetano Heredia, por un cuadro agudo de herpes zoster, diagnosticado clínicamente. Los criterios de inclusión fueron: status VIH desconocido tanto del paciente como de su pareja; que no presentaran alguna complicación neurológica o presentación atípica de zoster y que no tuvieran signos ni síntomas compatibles con infección por VIH (muguet oral, diarrea crónica, síndrome de desgaste, etc.. Previa firma de consentimiento informado, se tomó muestra de sangre para prueba de ELISA para VIH1. A todos los pacientes con resultado positivo se les realizó western blot. Resultados: Veintiún pacientes cumplieron los criterios del estudio, 14 varones y 7 mujeres. Cinco pacientes (23,8% fueron VIH positivos. De éstos, 4 fueron varones (4/14 y 1 mujer (1/7. No se encontró diferencias significativas en cuanto a la conducta sexual de riesgo. Conclusiones: Se encuentra un porcentaje elevado de infección por VIH en adultos jóvenes que consultan en un hospital general por un cuadro agudo de herpes zoster, sin ningún otro signo ni síntoma de inmunosupresión, independientemente de conductas sexuales de riesgo. Nuestro hallazgo justifica un despistaje de VIH en adultos jóvenes con herpes zoster.

Occurrence of uranium in the itabiritic iron ore of Morro Agudo on the NE border of the iron Quadrangle/Minas Gerais, Brasilien

International Nuclear Information System (INIS)

Guba, I.

1982-01-01

The precambrian itabirites and hematite ores of the Morro Agudo iron ore mine on the NE border of the Quadrilatero Ferrifero in Minas Gerais/Brazil contain uranium-bearing minerals and rare-earth elements. In association with phosphates they occupy planes of joints, fractures and cleavage in the area of amphibolitic schist which is intercalated in the s 1 -planes of the itabirites and hematite ores. Preliminary analyses of the uranium-bearing minerals were made by energy dispersive X-ray spectrometry and electron microscopy. The results are presented in connection with the lithologic and tectonic features of the Morro Agudo mine. (orig.) [de

Hiperglucemia en el síndrome coronario agudo: informe científico multidisciplinario

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Patricia Blanco

2012-04-01

Full Text Available La hiperglucemia con o sin diabetes preexistente es un hallazgo frecuente en pacientes que cursan un síndrome coronario agudo. Estudios previos han demostrado que la hiperglucemia es altamente prevalente y se asocia a un mayor riesgo de muerte y complicaciones hospitalarias. Los mecanismos fisiopatológicos mediante los cuales la hiperglucemia provoca resultados adversos no son claros, y se desconoce si es un marcador de eventos o su causa. Los efectos perjudiciales de la hiperglucemia en el sistema cardiovascular son múltiples, y el control de los niveles de glucosa con insulina parece mejorar el pronóstico en estos pacientes. Se han desarrollado numerosos protocolos para el control de glucemia que demostraron ser seguros y efectivos. En una iniciativa originada en el Consejo de Emergencias de la Sociedad Argentina de Cardiología, se convocó a expertos de nuestro medio con el propósito de debatir estrategias para el control de la glucemia en pacientes que cursan un síndrome coronario agudo. Este documento refleja lo discutido en este evento académico con la intención de resumir los principales aspectos del control de la glucemia y ofrecer recomendaciones generales de tratamiento en la Unidad Coronaria.

Efectos adversos de la acumulación renal de hemoproteínas. Nuevas herramientas terapéuticas

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Melania Guerrero-Hue

2018-01-01

Full Text Available La hemoglobina y la mioglobina son hemoproteínas que juegan un papel fundamental en el organismo ya que participan en el transporte de oxígeno. Sin embargo, debido a su estructura química, estas moléculas pueden ejercer efectos deletéreos cuando se liberan al torrente sanguíneo de forma masiva, como sucede en determinadas condiciones patológicas asociadas a rabdomiólisis o hemólisis intravascular. Una vez en el plasma, estas hemoproteínas se pueden filtrar y acumular en el riñón, donde resultan citotóxicas, principalmente para el epitelio tubular, e inducen fracaso renal agudo y enfermedad renal crónica. En la presente revisión analizaremos los distintos contextos patológicos que provocan la acumulación renal de estas hemoproteínas, su relación con la pérdida de función renal a corto y largo plazo, los mecanismos fisiopatólogicos responsables de sus efectos adversos y los sistemas de defensa que contrarrestan tales acciones. Por último, describiremos los distintos tratamientos utilizados actualmente y mostraremos nuevas opciones terapéuticas basadas en la identificación de nuevas dianas celulares y moleculares, prestando especial atención a los diversos ensayos clínicos que se encuentran en marcha en la actualidad.

Sistema de diagnóstico para la estimación de secciones en fallo en sistemas eléctricos de potencia; A Diagnostic Systems to Estimate Faulty Sections in Power Electric Systems

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Marta Bravo de las Casas

2011-02-01

Full Text Available El sistema de diagnóstico para la estimación de secciones en fallo (SDESF para sistemas eléctricos depotencia (SEP expuesto en el trabajo, usa la información procedente de los relés operados e interruptoresdisparados. Está escrito en Prolog, lenguaje de inteligencia artificial e implementado en una computadorapersonal. La tarea básica de este sistema es entrenar a los despachadores y utilizarlo como una herramientade apoyo a la toma de decisiones del despachador ante situaciones de emergencias complejas con unambiente computacional de usuario amigable. Este sistema ha sido verificado prácticamente por pruebasrealizadas en el SEP del territorio central de Cuba y los resultados preliminares de las pruebas sugieren quepuede ser implementado para el entrenamiento de despachadores. Se ha demostrado la efectividad delsistema para identificar la localización del fallo muy eficientemente, por lo tanto, puede servir como uninstrumento valioso de ayuda para la localización de fallos, y puede ser usado en las universidades comomedio de enseñanza. El sistema en un futuro pudiera ser ampliado para conectarse al sistema Scada(Sircre-2 a tiempo real para la estimación de secciones en fallo on-line.  The diagnostic system to estimate faulty sections (DSEFS in power electric systems (PES shown in thework it uses the information coming from the relays and breakers operated. It is written in Prolog Language ofartificial Intelligence and implemented in a personal computer. The basic task of this system is to train thedispatchers and to use it like a support tool to the taking of the dispatcher's decisions before situations ofcomplex emergencies with an ambient computacional of friendly user. This system has been verified practicallyby tests carried out in the PES of the central territory of Cuba and the preliminary results of the tests suggestthat  it  can  be  implemented  for  the  training  of  dispatchers.  The  effectiveness  of  the

Estudio comparativo de clasificadores empleados en el diagnóstico de fallos de sistemas industriales // A comparative study of clasification methods used in the fault diagnosis of industrial systems

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José Bernal-de Lázaro

2011-05-01

Full Text Available En este artículo se presenta un estudio comparativo del desempeño de cuatro de las técnicas declasificación más usadas para el diagnóstico de fallos en procesos industriales. Dentro de lastécnicas seleccionadas se encuentran los clasificadores Vecinos más Cercanos (VMC, MínimosCuadrados Parciales (MCP, Redes Neuronales Artificiales (RNA y Máquinas de Soporte Vectorial(MSV. El estudio comparativo se realiza con el objetivo de determinar las técnicas con mayorcapacidad para clasificar de forma correcta los patrones que identifican fallos en procesosindustriales a partir de los datos históricos provenientes de los mismos. Para el estudio se utilizaronlos datos obtenidos de la simulación del modelo del proceso industrial Tennessee Eastman. Lacomparación permitió comprobar cómo la capacidad de generalización de las técnicas declasificación se incrementa con el aumento de la complejidad en los clasificadores sin que estoimplique necesariamente un mayor esfuerzo computacional en el diagnóstico.Palabras claves: procesos industriales, diagnóstico de fallos, mantenimiento industrial, máquinas desoporte vectorial, redes neuronales artificiales, mínimos cuadrados parciales, vecinos más cercanos._________________________________________________________________________This paper, presents a comparative study of the performance of four classification techniques veryused in fault diagnosis of industrial processes. The selected techniques were: k-Nearest neighbor (k-NN, Partial least-squares (PLS, Artificial Neuronal Networks (ANN and Support Vector Machines(SVM. The comparison is based in the classification capacity of the historical data and thegeneralization using new observations. The four techniques are applied to historical data of theknown benchmark Tennessee Eastman industrial process. The comparison permitted to prove as thegeneralization capacity of the classification techniques grow with the complexity of classifiers withoutto

Fisiopatología, evaluación y manejo del dolor agudo en pediatría

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Tatiana Pabón-Henao

2015-12-01

Full Text Available El manejo del dolor agudo en los niños es deficiente, como lo afirma en el 2013 un estudio de la AMA (American Medical Association: la población pediátrica recibe entre 50% y 90% menos analgésicos que los adultos, es decir, no se tiene claridad en la fisiopatología, abordaje y manejo del dolor en los niños. El dolor puede clasificarse según su tiempo de duración, intensidad y mecanismo fisiopatoló-gico que lo desencadena (nociceptivo y neuropático. Teniendo en cuenta que la fisiopatología del dolor no varía con la edad pero sí como el paciente pediátrico lo manifieste, se requiere conocer el abordaje y manejo según su intensidad. Por lo tanto, el objetivo de esta revisión se enfoca en el estado del arte y en generar claridad de los aspectos críticos como son el conocimiento de la fisiopatología, valoración adecuada y el manejo no farmacológico y farmacológico del dolor agudo en pediatría.

Hematologia de tilápia-do-nilo alimentada com suplemento à base de algas frente a desafios de estresse agudo e crônico

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F. Garcia

2012-02-01

Full Text Available Avaliou-se o efeito da suplementação com produto à base de algas, ergosan, em dietas para tilápias Oreochromis niloticus, submetidas ao desafio de estresse agudo e crônico sobre as características hematológicas. O ensaio foi realizado com tilápias jovens (15g em caixas de 500L de capacidade de estocagem, em sistema com recirculação da água, com fluxo constante, na densidade de 35 peixes por caixa. Os peixes foram alimentados com as dietas-teste durante 10 dias e, ao final deste período, voltaram a receber dieta isenta de ergosan, quando foram submetidos aos desafios de estresses agudo e crônico. Utilizou-se o delineamento inteiramente ao acaso (DIC, em esquema fatorial 4x2, sendo testados: quatro porcentagens do suplemento 0; 0,25; 0,5 e 1% de ergosan na ração em dois tipos de estresse, agudo e crônico. Os resultados permitem concluir que os estímulos de estresse aplicados foram capazes de provocar alterações fisiológicas nos peixes, incluindo redução no número de eritrócitos, eritroblastos e leucócitos e aumento do volume corpuscular médio dos eritrócitos. A administração oral de 1% de suplemento durante 10 dias para juvenis de tilápia-do-nilo, em condição de estresse agudo, induz o incremento de 69% no número de trombócitos circulantes.

Evaluación de resistencia genotípica del VIH-1 en pacientes con fallo virológico de GuatemalaEvaluation of genotypic resistance of HIV-1 in patients with virologic failure Guatemala

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Blanca Samayoa

2014-10-01

Full Text Available La resistencia a la terapia antirretroviral (TARV es un factor determinante para el fallo virológico en pacientes con VIH. El objetivo de este estudio fue identificar los patrones genotípicos de resistencia en pacientes con fallo virológico. Fueron incluidos pacientes de las diferentes unidades de atención integral de VIH en Guatemala, de quienes se sospechaba resistencia y que necesitaban cambios en la TARV por fallo virológico, se requirió haber evaluado la adherencia y una carga viral ≥1,000 copias/ml. La información clínica y demográfica fue recolectada a través de la forma de solicitud. El análisis de resistencia se realizó a través de la metodología TRUGENE® HIV-1. La muestra se restringió a 25 pacientes por motivos de accesibilidad. El 68% de las muestras analizadas presentaron resistencia; por familia de ARV la resistencia fue de 88.2% para ITINN, 70.5% para ITIAN y 17.6% para IP. Se identificaron 79 mutaciones entre el grupo de estudio, el 46.8% de fueron asociadas a ITINN, 76.6% a ITIAN y 26.6% a IP. Para ITIAN las mutaciones más frecuentes fueron la M184V 43%, M184I 14% y K219E 10%; el 23.8% fueron mutaciones TAMs. Para ITINN fueron la V179D 16%, K103N 14%, G190A 14% y Y181C 14%. Para los IP la mutación más frecuente fue la M36I con 29%. La resistencia identificada en este grupo, fue menor a lo reportado en otros países latinoamericanos; sin embargo es similar a lo reportado por OMS en países con bajo o medio ingreso económico.

Diagnósticos de enfermería al alta hospitalaria en personas con Síndrome Coronario Agudo

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Clara Inés Padilla García

2017-04-01

Full Text Available Introducción: Enfermería juega un rol fundamental en las diferentes etapas de la atención de las personas con síndrome coronario agudo, entre ellas el egreso hospitalario. Brindar cuidado acorde a las necesidades propias de estas personas, requiere de la identificación de los principales diagnósticos de enfermería. Objetivo: Determinar la prevalencia de diagnósticos de Enfermería de las personas con síndrome coronario agudo al momento del alta hospitalaria. Metodología: Estudio de corte transversal en 196 personas hospitalizadas por el evento de interés, se utilizó instrumento de valoración focalizada que evaluaba las características definitorias de los diagnósticos de enfermería: ansiedad, afrontamiento ineficaz, disposición para mejorar la religiosidad, disposición para mejorar los conocimientos, intolerancia a la actividad; los cuales fueron identificados como prioritarios según la literatura científica y por consenso de expertos. Para determinar la prevalencia de los diagnósticos se realizó análisis de definición y características definitorias. Resultados: Se evidenció como principal problema de la población de estudio los conocimientos deficientes, seguido de la intolerancia a la actividad y la ansiedad. De igual forma se logró identificar diagnósticos positivos como la disposición para mejorar los conocimientos y la religiosidad. Conclusiones: El presente trabajo nos permitió identificar necesidades reales y reconocer factores protectores al momento del alta hospitalaria en personas que han vivido un evento coronario agudo, lo cual constituye un punto de partida para el diseño de planes de cuidado y la puesta en marcha de intervenciones que conduzcan a mejorar la situación de salud de este grupo de personas.

Terapia com células-tronco na síndrome do desconforto respiratório agudo Stem cell therapy in acute respiratory distress syndrome

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Tatiana Maron-Gutierrez

2009-03-01

Full Text Available A síndrome do desconforto respiratório agudo é caracterizada por uma reação inflamatória difusa do parênquima pulmonar, podendo ser induzida por um insulto direto ao epitélio alveolar (síndrome do desconforto respiratório agudo pulmonar ou indireto através do endotélio vascular (síndrome do desconforto respiratório agudo extrapulmonar. Acredita-se que uma terapia eficaz para o tratamento da síndrome do desconforto respiratório agudo deva atenuar a resposta inflamatória e promover adequado reparo da lesão pulmonar. O presente artigo apresenta uma breve revisão acerca do potencial terapêutico das células-tronco na síndrome do desconforto respiratório agudo. Essa revisão bibliográfica baseou-se em uma pesquisa sistemática de artigos experimentais e clínicos sobre terapia celular na síndrome do desconforto respiratório agudo incluídos nas bases de dados MedLine e SciELO nos últimos 10 anos. O transplante de células-tronco promove melhora da lesão inflamatória pulmonar e do conseqüente processo fibrótico, induzindo adequado reparo tecidual. Dentre os mecanismos envolvidos, podemos citar: diferenciação em células do epitélio alveolar e redução na liberação de mediadores inflamatórios e sistêmicos e fatores de crescimento. A terapia com células-tronco derivadas da medula óssea pode vir a ser uma opção eficaz e segura no tratamento da síndrome do desconforto respiratório agudo por acelerar o processo de reparo e atenuar a resposta inflamatória. Entretanto, os mecanismos relacionados à atividade antiinflamatória e antifibrogênica de tais células necessitam ser mais bem elucidados, limitando, assim, o seu uso clínico imediato.Acute respiratory distress syndrome is characterized by an acute pulmonary inflammatory process induced by the presence of a direct (pulmonary insult that affects lung parenchyma, or an indirect (extrapulmonary insult that results from an acute systemic inflammatory response

Sistema informático para la gestión de la información hospitalaria del infarto agudo de miocardio (RHIMA

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Yanier Coll Muñoz

2015-10-01

Full Text Available Introducción: La difícil recopilación de información sobre la prevalencia y desarrollo del infarto agudo de miocardio imposibilita medir la calidad del tratamiento durante la evolución de la enfermedad en un determinado grupo de pacientes.Objetivo: Desarrollar un sistema informático que permita la gestión de la información hospitalaria del infarto agudo de miocardio en el Servicio de Cardiología.Método: Se identificaron las variables necesarias para la confección del registro, divididas por bloques relacionados con la atención prehospitalaria, el síndrome coronario agudo, la atención en Unidades de Cuidados Coronarios y el egreso. Se creó un sistema informático que utiliza NetBeans como IDE de programación, Apache como servidor web y la base de datos en MySQL; como lenguaje de programación se utilizó PHP con la infraestructura digital (framework Yii del lado del servidor y JavaScript con el framework ExtJs 4.1.1 del lado del cliente. Como modelador de base de datos se utilizó ER/Studio.Resultados: Se conformó el Registro Hospitalario de Infarto Agudo de Miocardio (RHIMA para su aplicación en el Hospital Gustavo Aldereguía Lima de Cienfuegos, Cuba; se lograron obtener datos estadísticos inmediatos que permitieron realizar un análisis de la atención a los pacientes con esta enfermedad.Conclusiones: Se desarrolló un sistema informático web capaz de gestionar la información del IAM. Su diseño, acorde al Sistema Nacional de Salud de Cuba, tiene en cuenta las características epidemiológicas y demográficas de la población cubana y brindan indicadores de calidad en la terapéutica para el registro de la información del IAM, ajustadas a las recomendaciones de las principales Guías de Práctica Clínica.

Caracterización del infarto agudo del miocardio en mujeres atendidas en el hospital Ernesto Guevara

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Zailit González Cruz

2014-08-01

Full Text Available En Las Tunas han aumentado las cifras de mujeres afectadas por infarto agudo del miocardio (IMA, con una tasa de mortalidad superior a la media nacional. A pesar de ello, no existen estudios publicados que describan el comportamiento de esta entidad en las mujeres tuneras. Se realizó un estudio transversal descriptivo en el servicio de cardiología del hospital provincial de Las Tunas, “Dr. Ernesto Guevara de la Serna”, entre los años 2009 al 2011, con el objetivo de caracterizar el infarto agudo del miocardio en el sexo femenino. La muestra estuvo constituida por 181 mujeres admitidas en el servicio por esta entidad, diagnosticadas según los criterios establecidos. Para el análisis de los resultados se utilizó la estadística descriptiva, con valores absolutos y porcientos. En la muestra de estudio prevaleció el IMA CEST, de topografía anterior y no trombolizado. La disfunción ventricular izquierda constituyó la complicación más frecuente. Predominaron como factores de riesgo asociados la hipertensión arterial, las dislipidemias, el hábito de fumar y la diabetes mellitus.

Qualidade de vida de clientes pós-infarto agudo do miocárdio Calidad de vida de los clientes pós-infarto agudo del miocardio Client's quality of life after myocardial infarction

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Joselany Afio Caetano

2007-03-01

Full Text Available Objetivou-se neste estudo avaliar a qualidade de vida de clientes que sofreram infarto agudo do miocárdio. A amostra constou de 30 clientes selecionados pela busca em prontuários de uma unidade cardiológica, que nos permitiu a identificação e localização desses clientes, internados no ano de 2004. Para coleta de dados utilizamos a Escala de Qualidade de Vida de Flanagan e o tratamento estatístico com desvio-padrão. Os resultados mostraram maior índice de respostas nos níveis "indiferentes" a "pouco satisfeitos" em suas qualidades de vida. A relação interpessoal apresentou o mais alto índice de satisfação, contrariando o bem-estar físico e material, com o mais baixo índice de satisfação. Concluiu-se que a avaliação da qualidade de vida de clientes que sofreram infarto agudo do miocárdio se mostra comprometida, o que vem corroborar outros estudos anteriormente realizados.El objetivo del estudio fue evaluar la calidad de vida de los clientes que han sufrido infarto agudo del miocardio. La muestra ha consistido de 30 pacientes escogidos por la búsqueda en historias clínicas de una unidad cardiológica, que nos permitió la identificación y localización de estos clientes, internados en el año 2004. Para la colecta de los datos utilizamos la Escala de Calidad de Vida de Flanagan y el tratamiento estadístico con desvío medio. Los resultados muestran mayor índice de respuestas en los niveles "indiferentes" a "poco satisfechos" en sus calidades de vida. La relación interpersonal presentó el más alto índice de satisfacción, contrariando el bienestar físico y material, con el más bajo índice de satisfacción. Ha concluído que la evaluación de la calidad de vida de clientes que sufrieron infarto agudo del miocardio muéstrase comprometida, lo que viene a confirmar otros estudios anteriormente realizados.This study evaluates the quality of life of clients who suffered myocardial infarction. The sample consisted of 30

INFARTO AGUDO DO MIOCÁRDIO: MANUAL DE ORIENTAÇÃO PARA O PACIENTE

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Fernanda Carneiro Mussi

Full Text Available Baseado em pesquisa das expectativas de 30 pacientes internados em unidade coronária, os autores apresentam um manual de orientação para o paciente com diagnóstico de Infarto Agudo do Miocárdio. O objetivo do manual é ser um complemento do tratamento dos pacientes com Infarto do Miocárdio, a principal causa de morte em nosso pais. É composto por informações sobre o que é a doença, os fatores de risco a ela associados, retorno as atividades e tratamento.

Falhas na anestesia subaracnóidea Fallos en la anestesia subaracnoide Failure of subarachnoid blocks

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Hugo Praxedes

2010-02-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: Desde Bier, é descrita falha de anestesia subaracnóidea que causa desconforto ao paciente e que ocorre, eventualmente, mesmo diante de profissionais hábeis que a tenham conduzido de forma tecnicamente correta. Há variação, no entanto, de conceito de falha e, principalmente, de identificação precisa de causas. O objetivo do trabalho é identificar melhor as causas deste desconforto por meio de revisão sistemática de publicações com casuística significativa. CONTEÚDO: Dividiu-se a análise em três tópicos: anatomia e suas variações; o agente anestésico, que trata da seleção do agente, suas soluções e adições, de forma a atingir o resultado mais apropriado à intervenção cirúrgica proposta; e a dose, discutindo-se concentração, volume ou dose gravimétrica, no sentido de obter resultado mais adequado tanto no que diz respeito à intensidade do bloqueio quanto à sua duração. CONCLUSÕES: As falhas são mais afeitas a fatores técnicos: avaliação anatômica adequada, escolha criteriosa da agulha e do local da punção, cuidados no armazenamento dos agentes, adequação de dose, baricidade, além de posicionamento correto do paciente durante e após punção, tudo adequado ao objetivo cirúrgico.JUSTIFICATIVA Y OBJETIVOS: Bier ya describía los fallos en la anestesia subaracnoidea que causa la incomodidad al paciente, y que se da, eventualmente, incluso con la presencia de profesionales hábiles que la hayan conducido de forma técnicamente correcta. Existe una variación, sin embargo, del concepto de fallo y principalmente, de la identificación precisa de las causas. El objetivo del trabajo es identificar mejor las causas de esa incomodidad a través de la revisión sistemática de publicaciones con casuística significativa. CONTENIDO: El análisis se dividió en tres tópicos: la anatomía y sus variaciones; el agente anestésico, que trata sobre la selección del agente, sus soluciones

Controvérsias acerca da acidose hipercápnica na síndrome do desconforto respiratório agudo Controversies involving hypercapnic acidosis in acute respiratory distress syndrome

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Liliane Nardelli

2009-12-01

Full Text Available A síndrome do desconforto respiratório agudo é caracterizada por uma reação inflamatória difusa do parênquima pulmonar induzida por um insulto direto ao epitélio alveolar (síndrome do desconforto respiratório agudo pulmonar ou indireto por meio do endotélio vascular (síndrome do desconforto respiratório agudo extrapulmonar. A principal estratégia terapêutica da síndrome do desconforto respiratório agudo é o suporte ventilatório. Entretanto, a ventilação mecânica pode agravar a lesão pulmonar. Nesse contexto, uma estratégia ventilatória protetora com baixo volume corrente foi proposta. Tal estratégia reduziu a taxa de mortalidade dos pacientes com síndrome do desconforto respiratório agudo, porém acarretou acidose hipercápnica. O presente artigo apresenta uma revisão da literatura acerca dos efeitos da acidose hipercápnica na síndrome do desconforto respiratório agudo. Para tal, realizou-se uma revisão sistemática da literatura científica conforme critérios já estabelecidos para análise documental incluindo artigos experimentais e clínicos sobre o tema, usando-se como bases de dados MedLine, LILACS, SciElo, PubMed, Cochrane. A acidose hipercápnica é defendida por alguns autores como moduladora do processo inflamatório da síndrome do desconforto respiratório agudo. Entretanto, estudos clínicos e experimentais acerca dos efeitos da acidose hipercápnica têm demonstrado resultados controversos. Logo, é fundamental a realização de mais pesquisas para elucidar o papel da acidose hipercápnica na síndrome do desconforto respiratório agudo.Acute respiratory distress syndrome is characterized by a diffuse inflammatory reaction of lung parenchyma induced by a direct insult to the alveolar epithelium (pulmonary acute respiratory distress syndrome or an indirect lesion through the vascular endothelium (extrapulmonary acute respiratory distress syndrome. The main therapeutic strategy for acute respiratory

Algunas consideraciones respecto del fallo del tribunal constitucional chileno relativo a la distribución de la “píldora del día después”

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Juan Pablo Beca Frei

2009-06-01

Full Text Available En este artículo damos los fundamentos jurídicos de por qué resulta plenamente legítimo que el Tribunal Constitucional chileno se pronuncie sobre algunos aspectos de las Normas Chilenas sobre Fertilidad, en lo que concierne a la entrega de anticonceptivos de emergencia. En este fallo, el Tribunal Constitucional determinó que las normas contenidas en el Decreto Supremo Nº 48, de 26 de enero de 2007, del Ministerio de Salud son –desde el punto de vista jurídico– incompatibles con nuestras normas constitucionales. El segundo aspecto que analizamos desde el punto de vista jurídico es a quién corresponde el peso de la prueba. A nuestro parecer, lo que se prueba en cualquier juicio son hechos positivos, no hechos negativos, y quien debe probar es quien alega la ocurrencia de estos hechos. En consecuencia, consideramos que el Tribunal Constitucional debió haber exigido que los recurrentes probaran que el levonorgestrel impide el implante o anidación de un óvulo fecundado y no exigir al recurrido probar un hecho negativo, cual es que el mencionado producto no impide esta anidación. Reflexionamos además sobre ciertas imprecisiones del fallo, como aquellas relacionadas con el comienzo de la vida humana y la constitucionalidad de la consejería a menores.

Diagnóstico de fallos en el generador de vapor BKZ-340-140-29M

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Alberto Prieto Moreno

2011-09-01

Full Text Available Normal 0 21 false false false st1:*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Este trabajo presenta el diseño de un sistema de diagnóstico de fallos para un generador de vapor BKZ-340-140-29M, ubicado en la Central Termoeléctrica (CTE Máximo Gómez de Mariel, Cuba. El diagnosticador diseñado utiliza un árbol de decisión, que permite el diagnóstico de los poros en el sobrecalentador y el economizador. Estos equipos fueron seleccionados partiendo de un estudio estadístico, que demuestra su gran incidencia en la disponibilidad de los bloques de la CTE Máximo Gómez

Decúbito prono en pacientes con síndrome de distrés respiratorio agudo

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Mariano Setten

Full Text Available RESUMEN El síndrome de distrés respiratorio agudo ocupa gran atención en la unidad de cuidados intensivos. A pesar del amplio conocimiento alcanzado sobre la fisiopatología de éste síndrome, el enfoque en la unidad de cuidados intensivos consiste, en gran parte, en un tratamiento de soporte vital y en evitar los efectos secundarios de las terapéuticas invasivas. Si bien, durante los últimos 20 años, se generaron grandes avances en ventilación mecánica con un impacto importante sobre la mortalidad, ésta continúa siendo elevada. Una característica de los pacientes con síndrome de distrés respiratorio agudo, sobre todo los más severos, es la presencia de hipoxemia refractaria debido a la existencia de shunt, pudiendo requerir tratamientos adicionales a la ventilación mecánica, entre ellos la ventilación mecánica en decúbito prono. Este método, recomendado para mejorar la oxigenación por primera vez en 1974, puede ser implementado fácilmente en cualquier unidad de cuidados intensivos con personal entrenado. El decúbito prono tiene un sustento bibliográfico sumamente robusto. Varios ensayos clínicos randomizados han demostrado el efecto del decúbito prono sobre la oxigenación en pacientes con síndrome de distrés respiratorio agudo medida a través de la relación PaO2/FiO2 e incluso su impacto en el aumento de la sobrevida de estos pacientes. Los integrantes del Comité de Kinesiología Intensivista de la Sociedad Argentina de Terapia Intensiva realizaron una revisión narrativa con el objetivo de exponer la evidencia disponible en relación a la implementación del decúbito prono, los cambios producidos en el sistema respiratorio por la aplicación de la maniobra y su impacto sobre la mortalidad. Por último, se sugerirán lineamientos para la toma de decisiones.

Tomografia computadorizada sem contraste intravenoso no abdome agudo: quando e por que usar When and why use unenhanced computed tomography in patients with acute abdomen

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Edison de Oliveira Freire Filho

2006-02-01

Full Text Available A tomografia computadorizada sem contraste intravenoso tem sido freqüentemente proposta na avaliação inicial de pacientes com suspeita de abdome agudo, ocupando o espaço de outros métodos diagnósticos. Os autores apresentam uma revisão bibliográfica dos principais aspectos e eficácia da tomografia computadorizada sem contraste intravenoso no diagnóstico de apendicite aguda, cólica nefrética, diverticulite, pancreatite aguda, apendicite epiplóica, pneumoperitônio e obstrução intestinal. Discutem quais as vantagens e limitações desta técnica de exame, bem como seus aspectos práticos.The use of unenhanced computed tomography has been frequently recommended for the initial assessment of patients with clinical suspicion of acute abdomen instead of other diagnostic methods. The authors present a review of the literature on the main aspects, advantages, limitations and efficacy of unenhanced computed tomography for the diagnosis of acute appendicitis, renal colic, diverticulitis, acute pancreatitis, primary epiploic appendicitis, pneumoperitoneum and small bowel obstruction. The advantages and limitations of this technique are also discussed.

Estreptoquinasa recombinante en pacientes con infarto agudo del miocardio. Cardiocentro de Camaguey, 2008

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Héctor Mariño Cano

2015-12-01

Full Text Available Se realizó un estudio descriptivo longitudinal, con el objetivo de valorar la eficacia de la utilización de la Estreptoquinasa Recombinante en pacientes con Infarto Agudo de Miocardio (IMA en el Cardiocentro del Hospital Provincial Docente “Manuel Ascunce Doménech” en la provincia de Camagüey, en el período comprendido de enero a diciembre del 2008. El universo estuvo constituido por 200 pacientes, a los que se les diagnosticó Infarto Agudo de Miocardio y la muestra quedó formada por 80 pacientes que recibieron tratamiento trombolítico, las historias clínicas de los pacientes fueron la principal fuente de obtención de la información, utilizando  las  siguientes  variables: resultados criterio de perfusión, evolución clínica, criterio de reacciones adversas y la influencia que ejerce el tiempo puerta-aguja,  así como los cuidados de enfermería. Al terminar se observó que  el criterio de repercusión de mayor incidencia fue el eléctrico; la mayor cantidad de pacientes tuvieron buena evolución clínica; la hipotensión fue la reacción adversa más frecuente; el tiempo de puerta-aguja  que más incidió  fue el menor, de 3h; a todos los pacientes diagnosticados con infarto, que recibieron tratamiento trombolítico, se les  brindaron  cuidados de enfermería.

Comportamiento del infarto agudo del miocardio en personas con diabetes mellitus de la provincia Granma Situation of the acute myocardial infarction in persons with diabetes mellitus in Granma province

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Eduardo René Valdés Ramos; Marjoris Rivera Chávez; Niurka Bencosme Rodríguez

2012-01-01

Antecedentes: la diabetes mellitus, además de ser un factor de riesgo para el infarto agudo del miocardio, parece conferir per se un peor pronóstico en los pacientes con esta entidad. Objetivo: evaluar el comportamiento del infarto agudo del miocardio en personas con diabetes mellitus de la provincia de Granma. Métodos: se realizó un estudio transversal y descriptivo con 159 pacientes que ingresaron en la Unidad de Cuidados Intensivos Coronarios del Hospital "Carlos Manuel de Céspedes", de Ba...

Implementación y resultados de un nuevo programa de ECMO para trasplante de pulmón y distrés respiratorio agudo

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Eduardo San Roman

2015-06-01

Full Text Available RESUMEN Objetivo: El desarrollo de la membrana de oxigenación extracorpórea en América Latina representa un desafío para la especialidad. El objetivo de este artículo fue describir los resultados de un nuevo programa de membrana de oxigenación extracorpórea en una unidad de cuidados intensivos. Métodos: Estudio de cohorte retrospectivo. Incluye 22 pacientes que requirieron membrana de oxigenación extracorpórea desde Enero de 2011 hasta Junio de 2014. Se evaluaron características basales, indicaciones, duración de la corrida, días de ventilación mecánica, días de unidad de cuidados intensivos, complicaciones y mortalidad hospitalaria. Resultados: Quince pacientes requirieron membrana de oxigenación extracorpórea post-trasplante pulmonar y 7 pacientes por distrés respiratorio agudo. Todos los pacientes trasplantados fueron destetados de membrana de oxigenación extracorpórea, con una duración mediana de 3 días (Rango intercuantil - IQR: 2 - 5, de ventilación mecánica 15,5 días (IQR: 3 - 35, de estadía unidad de cuidados intensivos 31,5 días (IQR: 19 - 53 y de estadía hospitalaria 60 días (IQR: 36 - 89, con una mortalidad de 20%. Los pacientes con distrés respiratorio agudo tuvieron una mediana de duración de membrana de oxigenación extracorpórea de 9 días (IQR: 3 - 14, mediana de ventilación mecánica 25 días (IQR: 13 - 37, de estadía en terapia 31 días (IQR: 11 - 38, y hospitalaria 32 días (IQR: 11 - 41, y 57% de mortalidad. Las principales complicaciones fueron infecciones (80%, insuficiencia renal aguda (43%, sangrados en sitio quirúrgico y de inserción de cánulas (22%, plaquetopenia (60% y coagulopatía (30%. Conclusión: A pesar de encontrarnos transitando una curva de aprendizaje, consideramos la experiencia satisfactoria, con resultados y complicaciones comparables a las reportadas en la literatura.

Hepatocarcinoma como causa de abdome agudo em adolescente: relato de caso

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João Augusto dos Santos Martines

2012-08-01

Full Text Available O carcinoma hepatocelular (CHC é pouco prevalente nos países ocidentais, porém é um dos tumores mais freqüentes na Ásia e a quinta causa de câncer no mundo.É relatado um caso de adolescente do sexo feminino sem fatores de risco para um tumor extremamente agressivo, internada no Hospital Universitário da Universidade de São Paulo. A apresentação clínica foi de abdome agudo secundário a sangramento para cavidade peritoneal por ruptura do tumor evidenciado através de tomografia computorizada multidetectores (TCMD confirmado por laparotomia exploradora e biópsia hepática e tratada com rafia hemostática do parênquima hepático.

Características clínico epidemiológicas de pacientes con infarto miocárdico agudo

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Omar Lóriga García

2013-12-01

Full Text Available Introducción: la cardiopatía isquémica, y entre estas el Infarto Agudo del Miocardio con elevación del segmento ST, es la primera causa de muerte a nivel mundial. Objetivo: describir las características clínico epidemiológicas de pacientes con infarto agudo del miocardio de la unidad de cuidados coronarios del Hospital General Docente Abel Santamaría Cuadrado de Pinar del Río, en 2011 y 2012. Material y Método: estudio observacional, descriptivo, retrospectivo transversal; universo 644 pacientes ingresados con elevación del ST. Los datos se tomaron de las historias clínicas. Resultados: 62% tenían entre 60- 79 años. 84.5% de los pacientes entre 30 y 49 años eran hombres. 81,6% fumaba y el 45,5% era diabético. La localización topográfica del infarto fue: inferior el 70,8%, anterior el 22,9% y anterior extensa el 6,2% de los pacientes. Como complicación, la arritmia se presentó en el 34% de los pacientes, la insuficiencia cardiaca en el 14,9% y la muerte en 7,7%. El 68,5% de los pacientes con arritmias tuvo fibrilación auricular. La trombolisis se empleó en el 55,2% de los pacientes apareciendo, entre las complicaciones, la hipotensión en el 30,7%. Conclusiones: el infarto miocárdico agudo fue más frecuente en pacientes de mayor edad, siendo antes de los 50 años cinco veces más frecuente entre los hombres. Los factores de riesgo más representados fueron el hábito de fumar y la diabetes mellitus. La localización más frecuente fue la inferior y la complicación las arritmias y dentro de estas la fibrilación auricular. La trombolisis se complica principalmente con hipotensión, pudiendo ser más empleada.

Abdomen agudo ocasionado por apendicitis aguda de probable origen tuberculoso. Informe de un caso

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Montiel-Jarquín, Álvaro José; Alvarado-Ortega, Iván; Romero-Figueroa, María del Socorro; Rodríguez-Pérez, Fabiola; Rodríguez-Lima, Felipe; Loria-Castellanos, Jorge

2017-01-01

RESUMEN Antecedentes: la apendicitis aguda tuberculosa es una enfermedad rara, constituye de 0,001 % a 0,01 % de las formas clínicas de tuberculosis. Se presenta un caso de apendicitis aguda probablemente tuberculosa como causa de abdomen agudo quirúrgico. Caso clínico: hombre de 29 años con cuadro de dolor abdominal leve a moderado que se intensificó y localizó en el hemiabdomen derecho, claudicación, febrícula, vómito, mal estado general, leucocitosis de 11 300/µL y neutrofilia de 91 %....

Infarto agudo de miocardio inducido por heroína

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Beatriz Wills

2014-09-01

Full Text Available El uso mundial de drogas recreativas ha alcanzado proporciones preocupantes, al punto de amenazar la estabilidad socioeconómica de los países. Se estima que en los países desarrollados una de cada 4 personas ha utilizado drogas recreativas en algún momento de su vida. Por tanto, es frecuente que los médicos se enfrenten a cuadros de intoxicación secundaria al abuso de estas drogas. Además de sus efectos en el sistema nervioso central, también producen cambios significativos a nivel cardiovascular, responsables de una cantidad no despreciable de morbimortalidad relacionada con estas. En este artículo se expone un caso de infarto agudo de miocardio secundario al consumo de heroína, se revisan los efectos sistémicos de esta droga y se examinan el manejo y los mecanismos estudiados que explican esta relación.

Daño renal cortical en niños con primera infección del tracto urinario alto

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Tulio Antonio Amaya Sorto

2012-03-01

Full Text Available Introducción: entre el 5 y 22 % de los niños que padecen pielonefritis aguda desarrollarán cicatriz renal. Objetivo: describir los aspectos clínico-epidemiológicos del daño renal cortical en niños con la primera infección del tracto urinario alto. Métodos: estudio observacional prospectivo y longitudinal sobre el daño renal cicatricial en niños con la primera infección urinaria alta, ingresados en el servicio de nefrología del Hospital Pediátrico Universitario "William Soler", entre el 1º de enero de 2008 y diciembre 31 de 2009. Se diagnosticaron 50 pacientes, y 38 reunieron criterios para incluirlos en el estudio. Los pacientes tenían una edad media de 18 meses. A los 38 pacientes se les realizó ultrasonido renal durante la fase aguda de la enfermedad, y gammagrafía renal estática entre 6 y 12 meses después del cuadro agudo, para precisar la lesión renal cortical. En los casos con cicatriz renal, ausencia o disminución de captación del radiofármaco (99mTc-DMSA, se les realizó uretrocistografía miccional para precisar la existencia de reflujo vesicoureteral. Resultados: 28 pacientes (73,7 % son del sexo femenino, 17 (44,7 % menores de 6 meses, 17 (44,7 % tienen entre 6 y 36 meses, y 4 (10,6 % > 3 años. La infección urinaria fue atípica en 23 (60,5 %, y el germen aislado, la Escherichia coli en 33 (86,8 %. El ultrasonido de la fase aguda demostró dilatación pélvica renal en 3 (7,9 % y asimetría renal en 1 (2,6 %. En 2 pacientes (5,2 % se demostró cicatriz renal y en 11 (28,4 % hipofunción de la corteza renal. La uretrocistografía miccional demostró reflujo vesicoureteral grado III en una niña, que además, tenía cicatriz renal. No existió relación entre el inicio de los síntomas, comienzo de la terapeútica y lesión cortical. Conclusiones: los factores de riesgo para desarrollar cicatriz renal pospielonefrítica fueron: sexo femenino, edad menor de 3 años y reflujo vesicoureteral grado III.

Algunas consideraciones respecto del fallo del tribunal constitucional chileno relativo a la distribución de la “píldora del día después”

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Juan Pablo Beca Frei

2009-01-01

En este artículo damos los fundamentos jurídicos de por qué resulta plenamente legítimo que el Tribunal Constitucional chileno se pronuncie sobre algunos aspectos de las Normas Chilenas sobre Fertilidad, en lo que concierne a la entrega de anticonceptivos de emergencia. En este fallo, el Tribunal Constitucional determinó que las normas contenidas en el Decreto Supremo Nº 48, de 26 de enero de 2007, del Ministerio de Salud son –desde el punto de vista jurídico– incompatibles con nuestras norma...

Abscesso renal em recém-nascidos: um relato de caso

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Izilda das Eiras Tamega

2016-10-01

Full Text Available Introdução: O abscesso renal se caracteriza pela coleção de material purulento dentro do parênquima e pode ser causado por disseminação hematogênica, ascensão pelo trato urinário e infecção de área adjacente. Sua clínica na infância é inespecífica, e pode envolver dor abdominal ou lombar, febre e calafrios, mal- estar, anorexia e perda de peso. Sua ocorrência na infância é rara, mas o diagnóstico e tratamento precoces são fundamentais para a reduzir a mortalidade. Objetivo: Relatar caso de RN admitida no CHS com abdome agudo devido a um abscesso renal. Metodologia: Informações obtidas por meio de revisão de prontuário e literatura. Relato de caso: RN de EPB, sexo feminino, 13 dias de vida, encaminhada de Tietê com queixa de irritabilidade e distensão abdominal iniciadas no primeiro dia de vida, 2 episódios de hematêmese e 4 episódios de melena. Medicada na origem com ampicilina e gentamicina e transferida para o CHS. RN de parto normal, IG =39 semanas, peso ao nascimento=3750g, sem intercorrências relatadas no pré-natal e parto. Ao exame, apresentava-se em REG, descorada 2+/4, com abdome globoso, distendido, RHA +, flácido, doloroso à palpação, fígado a 2cm RCD, baço não palpável, sem demais alterações. Foi introduzida antibioticoterapia e realizado transfusão de concentrado de hemácias, mas a paciente evoluiu com instabilidade hemodinâmica e indicada laparotomia de urgência. No intra- operatório, foi identificado abscesso renal à direita, submetido à drenagem. A paciente evoluiu bem, com boa aceitação do leite materno e sem distensão abdominal e recebeu alta. Conclusão: O abscesso renal em recém-nascido é uma doença rara de difícil diagnóstico, cujo manejo adequado é imprescindível a fim de evitar lesão renal.

Los efectos jurídicos del fallo del Excelentísimo Tribunal Constitucional sobre la llamada “píldora del día después”

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Ángela Vivanco M.

2008-01-01

El tema de la llamada “píldora del día después” o “píldora del día siguiente” se inició en Chile con una serie de acciones ante los tribunales ordinarios con resultados muy contradictorios, tras lo cual el fallo del Tribunal Constitucional de abril de 2008 resultó una importante definición acerca del estatuto del embrión humano, la protección de la vida y el principio precautorio aplicado a ella, aunque no pudo extenderse a todas las materias relacionadas con la PDD por ser la competencia del...

Establecimiento de una base de datos de señales de vibraciones acústicas e imágenes termográficas infrarrojas para un sistema mecánico rotativo con la combinación de diferentes tipos de fallos y elaboración de guías de prácticas para detección de fallos en engranajes

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Guiracocha Guiracocha, Rómulo Andrés

2015-01-01

El proyecto genera bases de datos de señales de emisión acústica, señales de vibración mecánicas e imágenes termográficas sobre un sistema mecánico rotativo que servirán en el diagnóstico de fallos aplicado al monitoreo de la condición y se generan guías de práctica para el análisis de vibraciones mecánicas en caja de engranajes y evaluación térmica de rodamientos. This project generates databases of acoustic emission signals, mechanical vibration signals and thermal images on a rotating m...

Variabilidad geográfica de las hospitalizaciones por infarto agudo al miocardio en Costa Rica

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Melvin Morera Salas

2014-01-01

Full Text Available La presente investigación muestra los patrones geográficos de las hospitalizaciones por infarto agudo al miocardio en el seguro público de salud de Costa Rica en el trienio 2010-2012. Para el análisis geográfico por área de salud se utiliza un modelo bayesiano jerárquico espacial. Se estiman razones estandarizadas suavizadas y, como medida de precisión, la probabilidad de que cada área de salud registre un riesgo de hospitalización estadísticamente diferente al promedio nacional. En la determinación de presencia de autocorrelación espacial se utiliza el indicador de la I de Moran. La amplitud entre las variaciones observadas se estima mediante la razón interpercentil (percentil 95/percentil 5 y el coeficiente de variación. La tasa bruta de hospitalizaciones es de 5,8 por 10 mil habitantes en hombres y 2,6 / 10 mil en mujeres. Se registra un rango de variación de más de dos veces en las hospitalizaciones entre las áreas con mayores y menores egresos. Se presenta un patrón de bajas tasas de hospitalizaciones por infarto agudo al miocardio en áreas de salud fuera del Área Metropolitana, donde se encuentran los hospitales nacionales de mayor complejidad. Este elemento podría estar asociado a dificultades en el acceso de los servicios de hospitalización.

Tratamiento del adulto mayor con síndrome coronario agudo

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Carolina Pemberthy-López

2016-11-01

Full Text Available El adulto mayor se encuentra en una etapa de la vida con cambios fisiológicos importantes que posee repercusiones directas e indirectas sobre su estado clínico, es así como el enfoque diagnóstico y terapéutico de sus patologías debe ser abordado desde una perspectiva diferente, con consideraciones especiales para este grupo poblacional. Lamentablemente, este grupo no ha sido bien representado en los diferentes estudios y por tanto, es mucho lo que desconocemos; su comportamiento y la eficacia de las distintas terapias no están bien establecidos. Teniendo de referencia el síndrome coronario agudo como principal causa de mortalidad en pacientes mayores de 65 años de edad, abordaremos esta entidad desde la evidencia que nos aportan algunos de los registros más importantes al respecto en adultos mayores.

Sistema de diagnóstico para la estimación de secciones en fallo en sistemas eléctricos de potencia; A Diagnostic Systems to Estimate Faulty Sections in Power Electric Systems

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Marta Bravo de las Casas; Humberto Machado Fernández; Zenaida García Valdivia; Alain Álvarez Chávez; Isis Bonet Cruz; Norma E Cabrera González

2011-01-01

El sistema de diagnóstico para la estimación de secciones en fallo (SDESF) para sistemas eléctricos depotencia (SEP) expuesto en el trabajo, usa la información procedente de los relés operados e interruptoresdisparados. Está escrito en Prolog, lenguaje de inteligencia artificial e implementado en una computadorapersonal. La tarea básica de este sistema es entrenar a los despachadores y utilizarlo como una herramientade apoyo a la toma de decisi...

O problema do trabalho infantil na agricultura familiar: o caso da produção de tabaco em Agudo-RS

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Joel Orlando Bevilaqua Marin

2012-12-01

Full Text Available O objetivo do artigo é analisar a emergência do problema do trabalho infantil no cultivo de tabaco em Agudo, desencadeado pela promulgação do Decreto n. 6.481/2008, que trata das piores formas de trabalho infantil. Os procedimentos metodológicos utilizados foram a revisão bibliográfica, pesquisa documental e um estudo de caso, realizado no município de Agudo, Rio Grande do Sul. No estudo de caso, procurou-se obter dados quantitativos e qualitativos, por meio de questionários e entrevistas abertas, dirigidos para 27 agricultores familiares fumicultores, com filhos com menos de 18 anos de idade. Os resultados da pesquisa indicam a existência de um confronto entre diferentes concepções sobre o trabalho da criança no âmbito da agricultura familiar. Os dispositivos legais, os termos de compromissos e os contratos de integração na cadeia produtiva do fumo proíbem o trabalho de menores de 18 anos, fundamentando-se nos princípios internacionais da garantia do pleno desenvolvimento das crianças. Na perspectiva das famílias, o trabalho das crianças é entendido como "ajuda", forma de socialização e formação dos herdeiros. Portanto, os pais não concordam que se trata de uma forma perversa de exploração do trabalho dos próprios filhos.The aim of this paper is to analyze the emergence of the child labor problem in tobacco growing in Agudo (Rio Grande do Sul state, triggered by the promulgation of Act 6.481/2008, which addresses the worst child labor conditions. The methodological procedures used were the literature review, desk research and a case study, conducted in the municipality of Agudo. In the case study, we have tried to obtain quantitative and qualitative data through questionnaires and open interviews directed to 27 tobacco growers, and with teenagers and children under 18 years old. The survey results indicate the existence of a clash between different conceptions of child labor in small scale family farmers. The legal

ANALISIS COSTE-EFECTIVIDAD DE DISTINTOS MÉTODOS DE DIAGNÓSTICO POR IMAGEN DEL TROMBOEMBOLISMO PULMONAR AGUDO

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Stella Maris Batallés

2009-01-01

Full Text Available La técnica diagnóstica óptima para detectar tromboembolismo pulmonar agudo (TEP continúa en discusión. La gammagrafía pulmonar de ventilación/perfusión ha sido el examen preferido durante décadas, pero con el advenimiento de nuevas pruebas de imágenes las posibilidades diagnósticas se ampliaron, siendo necesario evaluarlas desde la perspectiva del coste y de la efectividad. El objetivo de este trabajo fue evaluar distintos métodos de diagnóstico por imagen para detectar TEP agudo para determinar el más coste-efectivo. Métodos. Análisis de coste-efectividad (CE empleando un árbol de decisiones para modelar distintas pruebas (centellograma V/Q, TC helicoidal, angiografía por tomografía computada multidetector (TCMD, resonancia magnética por imágenes (RMI y arteriografía convencional. Se obtuvieron valores de sensibilidad, especificidad, valor predictivo positivo (VPP y negativo (VPN de las pruebas diagnósticas. Resultado medido: "caso detectado de TEP". Los costes evaluados fueron los directos, expresados en euros (t, incluyendo los secundarios a las complicaciones de los métodos diagnósticos. Se realizó un análisis de sensibilidad de una vía para evaluar la robustez de las conclusiones. Resultados. No se eliminaron pruebas por dominancia extendida. La tasa cruda de CE para TCMD fue de 486 t por cada caso de TEP detectado. El coste marginal entre la TC helicoidal y el centellograma V/Q fue de 103 t para detectar 8 casos adicionales de TEP, mientras que el coste marginal entre la TCMD y la TC helicoidal fue de 229 t para detectar un caso adicional de TEP. Conclusiones. La prueba diagnóstica más coste-efectiva fue la TCMD, hallazgo que mostró robustez en el análisis de sensibilidad. Sin embargo, el análisis de C-E incremental nos mostró que la TCMD costó 229 t más respeto a la TC helicoidal para lograr una mínima mejora en la efectividad de la prueba (detección de TEP agudo. El alto valor predictivo negativo de

Fisiopatología del dolor agudo: alteraciones cardiovasculares, respiratorias y de otros sistemas y órganos

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Pérez-Castañeda Jorge, Tania

2012-01-01

Introducción: El dolor agudo constituye una compleja constelación de experiencias sensoriales y emocionales, relacionadas con respuestas autónomas producidas por daño a estructuras somáticas o viscerales. Las vías del dolor transmiten la información nociceptiva a través del sistema nervioso periférico y central y están plenamente integradas con el sistema motor y simpático a nivel medular y de los centros nerviosos superiores y dan lugar a actividad motora refleja, hiperactividad simpática y ...

Diagnóstico automático del síndrome coronario agudo utilizando un sistema multiagente basado en redes neuronales

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John Jaime Sprockel Díaz

2017-05-01

Conclusiones: Es posible desarrollar una herramienta para el diagnóstico automático del síndrome coronario agudo a partir de un sistema multiagente que ensamble la disposición tomada por un conjunto de redes neuronales artificiales, cuyo rendimiento permite su consideración para su implementación dentro de un sistema de soporte a las decisiones clínicas.

ESTRUTURA E VÍNCULOS DE UMA FAMÍLIA APÓS INFARTO AGUDO DO MIOCÁRDIO

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Garcia, Raquel Pötter; Budó, Maria de Lourdes Denardin; Viegas, Aline da Costa; Cardoso, Daniela Habekost; Schwartz, Eda; Muniz, Rosani Manfrin

2015-01-01

Introdução: Conhecer os vínculos e a estrutura de uma família após episódio de Infarto Agudo do Miocárdio. Materiais e Métodos: Pesquisa qualitativa e exploratória que representa um estudo de caso desenvolvido com uma das famílias participantes. A coleta de dados ocorreu no período de fevereiro a maio de 2012, por meio de observação no domicílio e entrevista com construção do genograma e ecomapa. A intensidade dos vínculos foi definida pela família conforme legenda do ecomapa. Resultados e Di...

Manejo do paciente com infarto agudo do miocárdio atendido no SUS

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Emerson de Albuquerque Seixas

2016-10-01

Full Text Available Introdução: O Infarto Agudo do Miocárdio (IAM é causado pela interrupção do fluxo sanguíneo nas artérias coronárias que irrigam o miocárdio. Trata-se de um evento com alta prevalência, que necessita de internação hospitalar e rápido tratamento. Objetivos: Descrever um caso de IAM que recebeu terapia trombolítica incompleta e realizou angioplastia parcial; Metodologia: Relato de caso de paciente internado no Conjunto Hospitalar de Sorocaba; Relato de Caso: SSA, 74anos, masculino, hipertenso e diabético há 20 anos, procurou o Pronto-Socorro na origem no dia 01/09/2015 com quadro de dor precordial intensa, após realização de esforço físico. Ao exame físico, apresentava-se taquicárdico (FC:150bpm e hipertenso (PA:230X120mmHg.Foi realizado ECG, que evidenciou supradesnivelamento do segmento ST em parede anterior extensa (de V1 a V5,DI e aVL. Foi optado pelo tratamento com agente trombolítico, porém o local só dispunha de metade da dose recomendada. Então foi transferido para o Conjunto Hospitalar de Sorocaba, onde foi optado por não realizar o restante da medicação. Cateterismo cardíaco realizado somente 14 dias depois, evidenciando 4 lesões. Realizada uma angioplastia com implante de apenas 2 stents. Foi solicitado nova angioplastia, que foi negada. Recebeu alta e atualmente aguarda a liberação do procedimento via ambulatorial, com quadro de angina estável. Conclusões: O relato reforça a necessidade da melhoria das condições de atendimento e tratamento de pacientes vítimas de infarto agudo do miocárdio no SUS.

Tratamiento del episodio agudo de asma bronquial en los servicios de urgencias pediátricos: Guía clínica práctica Treatment of the acute episode of bronchial asthma at the pediatric emergency services: Practical clinical guide

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Roberto Razón Behar

2005-12-01

Full Text Available Por lo general, no existe una sistematización para clasificar y tratar el episodio agudo de asma bronquial ni para evaluar la evolución de los pacientes. Se realizó un estudio en 142 pacientes de 6 a 15 años de edad, que presentaron episodios agudos de asma bronquial y acudieron a los servicios de urgencias de los Hospitales Pediátricos «William Soler» y «Leonor Pérez», y del Policlínico «Federico Capdevila». A estos pacientes se les aplicó una guía clínica práctica, que incluyó la clasificación de la severidad del episodio agudo y un esquema de tratamiento, basado en la utilización de oxígeno, broncodilatadores inhalados y esteroides orales. Durante el tratamiento, los pacientes se evaluaron con periodicidad. La respuesta al tratamiento fue buena en la mayoría de los casos y el resultado final fue el egreso domiciliario. Ocho de los pacientes requirieron ingreso hospitalario por respuestas al tratamiento incompletas o pobres. La atención del episodio agudo de asma bronquial puede mejorarse con el uso de guías clínicas prácticas de diagnóstico y tratamiento.

Investigación de vectores y reservorios en brote de Chagas agudo por posible transmisión oral en Aguachica, Cesar, Colombia

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Hugo Soto

2014-04-01

Full Text Available Colombia tiene un registro de 11 casos de Chagas agudo y 80 casos por contaminación oral con Trypanosoma cruzi. Este trabajo analiza los hallazgos entomológicos y parasitológicos del brote de Aguachica, Cesar, en 2010. Un grupo interdisciplinario de profesionales de la salud y de universidades regionales realizó las pruebas de laboratorio a los pacientes y el estudio del foco de transmisión. Se detectaron 11 casos agudos de enfermedad de Chagas en una sola familia con vivienda sin triatominos domiciliados y, Rhodnius pallescens, Pantrongylus geniculatus, Eratyrus cuspidatus y dos Didelphis marsupialis infectados con T. cruzi en palmas de Attalea butyracea y Elaeis oleifera del área urbana de Aguachica. Se analiza la participación del R. pallescens y el rol de las palmas en el ciclo silvestre de T. cruzi y para la transmisión oral de la enfermedad de Chagas. Incursiones esporádicas de R. pallescens, P. geniculatus y E. cuspidatus silvestres desde palmas cercanas al domicilio humano pueden provocar brotes cada vez más frecuentes de Chagas oral.

Daño renal cortical en niños con primera infección del tracto urinario alto Cortical renal damage in children with a first infection of the high urinary tract

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Tulio Antonio Amaya Sorto

2012-03-01

Full Text Available Introducción: entre el 5 y 22 % de los niños que padecen pielonefritis aguda desarrollarán cicatriz renal. Objetivo: describir los aspectos clínico-epidemiológicos del daño renal cortical en niños con la primera infección del tracto urinario alto. Métodos: estudio observacional prospectivo y longitudinal sobre el daño renal cicatricial en niños con la primera infección urinaria alta, ingresados en el servicio de nefrología del Hospital Pediátrico Universitario "William Soler", entre el 1º de enero de 2008 y diciembre 31 de 2009. Se diagnosticaron 50 pacientes, y 38 reunieron criterios para incluirlos en el estudio. Los pacientes tenían una edad media de 18 meses. A los 38 pacientes se les realizó ultrasonido renal durante la fase aguda de la enfermedad, y gammagrafía renal estática entre 6 y 12 meses después del cuadro agudo, para precisar la lesión renal cortical. En los casos con cicatriz renal, ausencia o disminución de captación del radiofármaco (99mTc-DMSA, se les realizó uretrocistografía miccional para precisar la existencia de reflujo vesicoureteral. Resultados: 28 pacientes (73,7 % son del sexo femenino, 17 (44,7 % menores de 6 meses, 17 (44,7 % tienen entre 6 y 36 meses, y 4 (10,6 % > 3 años. La infección urinaria fue atípica en 23 (60,5 %, y el germen aislado, la Escherichia coli en 33 (86,8 %. El ultrasonido de la fase aguda demostró dilatación pélvica renal en 3 (7,9 % y asimetría renal en 1 (2,6 %. En 2 pacientes (5,2 % se demostró cicatriz renal y en 11 (28,4 % hipofunción de la corteza renal. La uretrocistografía miccional demostró reflujo vesicoureteral grado III en una niña, que además, tenía cicatriz renal. No existió relación entre el inicio de los síntomas, comienzo de la terapeútica y lesión cortical. Conclusiones: los factores de riesgo para desarrollar cicatriz renal pospielonefrítica fueron: sexo femenino, edad menor de 3 años y reflujo vesicoureteral grado III

Clasificador neuronal de fallos en rodamientos utilizando entradas basadas en transformadas wavelet packet y de Fourier

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Víctor Gómez

2013-01-01

Full Text Available En este artículo se propone y se evalúa experimentalmente un método de diagnóstico de fallas en rodamientos utilizando la clasificación de patrones provenientes de las señales de las vibraciones mecánicas. El método utiliza pre-procesamientos con las transformadas de Fourier y wavelet packet para luego alimentar una red neuronal clasificadora que determina el tipo de fallo. Para evaluar las variables de entrada se realiza un análisis de varianza ANOVA comparando el efecto que tienen los factores: velocidad, carga, falla en pista externa y falla en elemento rodante sobre cada uno de los parámetros propuestos como entradas para las redes neuronales artificiales (RNA. Una vez seleccionadas las variables de entrada más adecuadas, se realiza la búsqueda del clasificador más apropiado explorando diversas configuraciones de red neuronal. Se han entrenado alrededor de 2000 RNA con el propósito de encontrar el clasificador más adecuado. Los resultados de validación muestran que para el algoritmo de entrenamiento tipo gradiente conjugado escalado (trainscg se alcanza un porcentaje de éxito en la clasificación del 88,5 %, mientras que para el algoritmo de entrenamiento de Levenberg-Marquardt (trainlm se logra un 91,8 %. Adicionalmente, se resalta que en 7 ocasiones se logró el 100 % de aciertos en la clasificación.

Descripción de un brote de enfisema y edema pulmonar agudo del bovino (EPAB) en Parral (Chile)

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H. URRUTIA; C. BREVIS; M. QUEZADA; S. DONOSO

1997-01-01

Se describe un brote de enfisema y edema alveolar agudo del bovino (EPAB) ocurrido en la zona centro-sur a fines del verano de 1995. Los animales Frisón negro, de aproximadamente 2 años de edad, fueron afectados después de cambiarse de una pradera fibrosa a una suculenta de alfalfa. La mortalidad por esta causa fue de un 23%. Las principales lesiones encontradas en la necropsia fueron enfisema y edema intersticial intenso del pulmón, lo cual fue corroborado histopatológicamente, encontrándose...

Descripción de un brote de enfisema y edema pulmonar agudo del bovino (EPAB) en Parral (Chile)

OpenAIRE

URRUTIA, H.; BREVIS, C.; QUEZADA, M.; DONOSO, S.

1997-01-01

Se describe un brote de enfisema y edema alveolar agudo del bovino (EPAB) ocurrido en la zona centro-sur a fines del verano de 1995. Los animales Frisón negro, de aproximadamente 2 años de edad, fueron afectados después de cambiarse de una pradera fibrosa a una suculenta de alfalfa. La mortalidad por esta causa fue de un 23%. Las principales lesiones encontradas en la necropsia fueron enfisema y edema intersticial intenso del pulmón, lo cual fue corroborado histopatológicamente, encontrándos...

Apendicitis epiploica. Causa poco común de abdomen agudo en niños. Presentación de un caso y revisión de la literatura

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SA Solórzano-Morales

2016-04-01

requiere tratamiento con analgésicos. La mayoría de los casos han sido descritos en pacientes adultos; sin embargo, el caso que presentamos es el segundo diagnosticado en el Instituto Nacional de Pediatría.   CASO CLÍNICO: niño de 9 años con diagnóstico clínico presuntivo de apendicitis, se diagnosticó por ultrasonido y tomografía computada como apendicitis epiploica, lo que se corroboró en la pieza anatomopatológica.   CONCLUSIONES: nuestro propósito es describir la apendicitis epiploica en niños como causa de abdomen agudo, así como los hallazgos clínicos, ultrasonográficos, de tomografía computada e histopatológicos de esta patología como causa rara de abdomen agudo. Es importante que se conozca el valor de los estudios de imagen de esta entidad a fin de evitar tratamientos invasivos innecesarios.

Hiperalimentação enteral em traumatismos crânio-encefálicos agudos reposição ou dietoterapia?

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Arthur Schelp

1992-06-01

Full Text Available Os autores apresentam revisão geral sobre a fisiopatogenia do trauma, ressaltando os estados de hipereatabolismo e hipermetabolismo, suas consequências nutricionais, com as particularidades do trauma encefálico. São feitas, também, considerações sobre as vias, composição e volumes das dietas enterais a serem administradas a pacientes com trauma agudo encefálico, assim como são apontadas questões a serem melhor elucidadas.

Mapping of micro and Small branch of industrial enterprises located in the cities of Agudo and Silveira Martins – RS

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Carla Hartmann Sturm

2016-06-01

Full Text Available In the development of a country are the companies responsible for creating jobs, pay taxes and thus cause the economic and regional development. In Brazil, most of these institutions is made up of micro enterprises and small that often struggling to survive in the market. Therefore, it is necessary investments and public incentives to encourage their development making them competitive. In this sense, this article aims to develop a mapping of micro and small enterprises in the industrial sector in the cities of Agudo and Silveira Martins – Rio Grande do Sul (RS. For this, we used a descriptive research on the purposes and literature as to the means being prepared a questionnaire for collecting data from the sample studied. As results obtained ten micro companies and three small businesses were found in Agudo – RS, and the main industries are the timber industry and the manufacture of bakery products, influenced 65.5% of the employees of micro and small companies analyzed in the municipality. Already in Silveira Martins – RS were found seven micro and small enterprises, where six are classified as micro company and only one as small business. It was found also that the main industrial branch is the timber sector (six companies, in which 96% of employees work in any activity related to wood processing.

SÍNDROME CORONARIO AGUDO DE CAUSA NO ATEROESCLERÓTICA / Acute coronary syndrome of non-atherosclerotic origin

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Yuri Medrano Plana

2013-10-01

Full Text Available Resumen La embolia coronaria es una causa poco frecuente de síndrome coronario agudo. Dentro de los varios tipos de material embólico se encuentra el de origen tumoral. Estos émbolos pueden ocasionar isquemia miocárdica de intensidad variable, desde angina de pecho hasta infarto agudo de miocardio o incluso, muerte súbita. Se presenta una mujer de 58 años de edad, que presentó episodios de angina inestable con cambios eléctricos sin factores de riesgo y sin antecedentes de cardiopatía isquémica, que en la coronariografía se demostró la presencia de arterias coronarias normales. El ecocardiograma transesofágico informó imagen ecogénica polilobulada y pediculada hacia la superficie septal de la aurícula izquierda (posible mixoma, sin observarse trombos en las cavidades cardíacas. La paciente fue operada (exéresis quirúrgica del tumor, evolucionó favorablemente y fue trasladada a su hospital de origen 72 horas después. / Abstract Coronary embolism is a rare cause of acute coronary syndrome. Among the various types of embolic material is that of tumoral origin. These emboli can cause myocardial ischemia of varying intensity, from angina to acute myocardial infarction or even sudden death. The case of a 58-year-old woman who presented unstable angina episodes with electrical changes with no risk factors and no history of ischemic heart disease is presented. By means of coronary angiography, the presence of normal coronary arteries was showed. Transesophageal echocardiography showed the echogenic polylobulated and pedicled image towards the septal surface of the left atrium (possible myxoma; thrombi in the cardiac chambers were not observed. The patient underwent surgery (surgical removal of the tumor, had a good progress and was transferred to her hospital of origin 72 hours later.

Edema agudo pulmonar associado à obstrução das vias aéreas: relato de caso Edema agudo pulmonar asociado a la obstrucción de las vías aéreas: relato de caso Acute pulmonary edema associated with obstruction of the airways: case report

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Flora Margarida Barra Bisinotto

2008-04-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: O edema pulmonar por pressão negativa tem sido definido como edema não-cardiogênico, com transudação de líquido para o interstício pulmonar, por aumento na pressão negativa intratorácica, ocasionado pela obstrução das vias aéreas superiores. Descreveu-se o caso de paciente hígida, submetida à anestesia geral, que apresentou edema agudo pulmonar após a extubação traqueal. RELATO DO CASO: Paciente de 23 anos, sexo feminino, estado físico ASA II, submetida à anestesia geral para videolaparoscopia ginecológica. O procedimento durou 3 horas, sem intercorrências. Após a extubação, a paciente apresentou laringoespasmo e diminuição da saturação de oxigênio. Houve melhora após colocação de cânula oral e administração de oxigênio, sob pressão positiva, com máscara facial. Estabilizado o quadro, foi encaminhada à sala de recuperação pós-anestésica, onde, logo após a admissão, apresentou edema agudo de pulmão com eliminação de secreção serossanguinolenta. O tratamento constou de elevação do dorso, oxigênio sob máscara, furosemida e restrição hídrica. A radiografia torácica mostrou imagem compatível com edema agudo pulmonar e área cardíaca normal. O eletrocardiograma (ECG, ecocardiografia e enzimas cardíacas estavam normais. A paciente apresentou boa evolução, recebendo alta hospitalar no dia seguinte, assintomática. CONCLUSÕES: O edema agudo de pulmão associado à obstrução das vias aéreas superiores é condição clínica que pode agravar procedimentos cirúrgicos de baixa morbidade e que aparece sobretudo em pacientes jovens. O tratamento deve ser instituído precocemente, pois a resolução também é rápida e, na maioria das vezes, sem seqüelas.JUSTIFICATIVA Y OBJETIVOS: El edema pulmonar por presión negativa ha sido definido como edema no cardiogénico, con transudación de líquido para el intersticio pulmonar, por aumento en la presión negativa

Efeitos agudos do exercício resistido sobre marcadores da resposta inflamatória e imune

OpenAIRE

Guilherme Borges Pereira

2012-01-01

O objetivo dos pesquisadores do presente estudo foi examinar os efeitos agudos do Exercício Resistido (ER) sobre a apoptose (Anexina V+) e a migração (CX3CR1) de linfócitos T CD4+ e CD8+. 12 sujeitos adultos realizaram duas sessões de ER (3 séries em 9 exercícios) com 1 minuto (Hiper-1) e 3 minutos (Hiper-3) de intervalo entre as séries e exercícios. Não foi observada alteração significativa na contagem celular de linfócitos CD4+ e CD8+ após os protocolos Hiper-1 e Hiper-3 (p > 0,05). Foi obs...

Fallos del mercado y regulación económica en los servicios públicos domiciliarios. Aproximaciones a una disciplina poco entendida por los juristas

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David de la Torre Vargas

2014-12-01

Full Text Available Derecho y Economía encuentran su más alto punto de interdependencia en materia de regulación económica, disciplina estudiada de antaño por los economistas, frente a la cual los juristas nos hemos ocupado principalmente a resolver los problemas frente a su ubicación en el sistema de fuentes del Derecho, o del análisis de las competencias de las autoridades encargadas de materializarla sin ir al fondo de su esencia: los fallos del mercado. Conceptos como la libre competencia, el monopolio natural, la demanda inelástica y la eficiencia económica que, entre otros, hacen parte de la cotidianidad del sector de los servicios públicos domiciliarios, son un buen contexto para profundizar sobre el conocimiento de la esencia de la regulación económica, un aspecto inexplorado hasta ahora por los juristas.

Agentes calciomiméticos en el tratamiento del hiperparatiroidismo secundario a la insuficiencia renal crónica Calcimimetic agents in the treatment of hyperparathyroidism secondary to chronic renal failure

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A. L. Negri

2003-04-01

Full Text Available La reciente identificación y clonación del receptor sensor de calcio (RSCa ha permitido tener una mejor comprensión de la regulación normal del metabolismo del calcio y entender un número de trastornos relativamente poco frecuentes del metabolismo mineral. En la glándula paratiroides el RSCa es el mecanismo responsable de modular la liberación de la hormona paratiroidea en función del nivel de calcio extracelular. Este descubrimiento también ha permitido desarrollar drogas que imitan o potencian las acciones del calcio extracelular sobre el RSCa (llamadas calciomiméticos que disminuyen la secreción de paratohormona sin incrementar el calcio sérico. Los calciomiméticos de última generación son pequeñas moléculas orgánicas que actúan como moduladores alostéricos del RSCa y se encuentran en su fase inicial de desarrollo clínico. A pesar de que la experiencia obtenida con estas drogas hasta ahora es limitada, ellas han mostrado ser efectivas para reducir los niveles de paratohormona en pacientes con hiperparatiroidismo secundario a fallo renal terminal sin inducir efectos secundarios de importancia. Es por ello que los compuestos calciomiméticos tienen un considerable potencial como nuevas drogas para el tratamiento del hiperparatiroidismo secundario y de la enfermedad ósea secundaria a la insuficiencia renal.The recent discovery and cloning of the extra cellular calcium sensing receptor (CaSR has allowed a better understanding of the regulation of normal calcium metabolism and of rare disturbances in mineral metabolism. In the parathyroid glands the CaSR is responsable for modulating parathyroid hormone release as a function of the extra cellular calcium level. This discovery has allowed the development of drugs that mimics or potentiates the actions of extra cellular calcium on the CaSR, called calcimimetics that decrease parathyroid hormone secretion without increasing serum calcium. The new calcimimetics are small organic

Prevalência de fatores de risco em pacientes com infarto agudo do miocárdio

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Simone Mathioni Mertins

2016-01-01

Full Text Available Objetivo: Identificar a prevalência de fatores de risco em pacientes com infarto agudo do miocárdio, internados em uma Unidade de Terapia Intensiva Coronariana de um hospital da região noroeste do estado do Rio Grande do Sul ̸ Brasil. Metodologia: Estudo quantitativo, descritivo e transversal, realizado no período compreendido entre 25 de abril a 25 de junho de 2012, com 48 pacientes. As variáveis de interesse para este estudo foram as condições sociodemográficas, dados antropométricos, hábitos alimentares e fatores de risco cardiovascular. Resultados: A idade média foi de 59,9 ± 11,55 anos, com predominância do sexo masculino (81,3%, de cor branca (83,3%, casados (70,8%, ensino fundamental incompleto (72,9%, aposentados (37,5%, renda menor que três salários mínimos (58,3% e procedentes da região urbana (72,9%. A prevalência dos fatores de risco se distribuiu da seguinte forma: sedentarismo (91,7%, hipertensão arterial sistêmica (63,8%, estresse (50%, circunferência abdominal alterada (50%, história familiar (43,7%, tabagismo (41,7%, sobrepeso (35,5%, obesidade (33,4%, dislipidemia (23%, diabetes mellitus (20,8% e consumo de álcool (12,5%. Conclusão: Os dados apresentados mostram a elevada prevalência de fatores de risco em pacientes que tiveram infarto agudo do miocárdio e nos direcionam a entender o papel da educação em saúde como estratégia para reduzir as causas de morbimortalidade, além de propor ações de cuidado e autocuidado e mudanças nos hábitos de vida.  Descritores: Fatores de Risco; Infarto do Miocárdio; Educação em Saúde (Fontes: DeCS e BIREME.

Efecto de un tratamiento intensivo con insulina sobre la reactividad plaquetaria en pacientes con hiperglucemia que ingresan con un síndrome coronario agudo

OpenAIRE

Vivas Balcones, Luis David

2011-01-01

El objetivo primario de este trabajo ha sido la valoración del efecto que produce el control estricto de la glucemia mediante un tratamiento intensivo y precoz con insulina sobre la reactividad plaquetaria durante la fase hospitalaria en pacientes que ingresan en una unidad de cuidados intensivos cardiológicos con un síndrome coronario agudo e hiperglucemia, respecto a un tratamiento convencional.

Abdomen agudo quirúrgico en el anciano

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Jesús M Valdés Jiménez

2002-04-01

Full Text Available Se presenta un estudio descriptivo retrospectivo de 156 enfermos mayores de 65 años, con diagnóstico de abdomen agudo quirúrgico (AAQ, operados en el Hospital Clinicoquirúrgico «Manuel Fajardo» e ingresados en la Unidad de Cuidados Intermedios Polivalente, durante el trienio comprendido entre 1995 y 1998. Las causas más frecuentes del síndrome fueron la oclusión intestinal (58,9 %, la colecistitis aguda (13,5 % y la úlcera péptica gastroduodenal perforada (10,9 %. Las enfermedades asociadas de mayor prevalencia eran la cardiopatía isquémica (62,2 % y la hipertensión arterial (48,7 %. La mortalidad aumentó con el avance de la edad, y alcanzó el 70,4 % en los mayores de 85 años. Entre las complicaciones predominaron la infección de la herida quirúrgica (12,8 % y la bronconeumonía (5,8 %. La principal causa de muerte fue la sepsis (10,3 %A descriptive and retrospective study of 156 patients over 65 with diagnosis of acute surgical abdomen (ASA that were operated on at "Manuel Fajardo" Clinical and Surgical Hospital and admitted at the Polyvalent Intermediate Care Unit, from 1995 to 1998, was conducted. The most common causes of the syndrome were intestinal occlusion (58.9 %, acute cholecystitis (13.5 % and the gastroduodenal perforated peptic ulcer (10.9 %. The associated diseases of highest prevalence were ischemic heart disease (62.2 % and arterial hypertension (48.7 %. Mortality increased with age and amounted to 70.4 % in patients over 85. The infection of the surgical wound (12.8 % and bronchopneumonia (5.8% prevailed among the complications. Sepsis (10.3 % was the main cause of death

El fallo “Smith” de la Corte Suprema de Justicia de Canadá y el análisis sobre el uso de cannabis y sus derivados para uso medicinal en la actualidad en la Argentina

OpenAIRE

Torti Iermini, Marcos Antonio

2017-01-01

El presente trabajo tiene como objetivo estudiar la problemática sobre la regulación del uso de la marihuana y sus productos derivados para uso medicinal. Para ello, se presenta el fallo “Smith” de la Corte Suprema de Justicia de Canadá del año 2015. En el mismo, se analizó la cuestión a la luz de las normas que regulan la producción de la marihuana seca como único medio para poder utilizarse en tratamientos médicos, en pacientes que contaran con la autorización pertinente. Esto llevó a que s...

sup(99m)Tc-DMSA renal scintigraphy in renal failure due to various renal diseases

Energy Technology Data Exchange (ETDEWEB)

Hosokawa, S; Daijo, K; Okabe, T; Kawamura, J; Hara, A [Kyoto Univ. (Japan). Hospital

1979-08-01

Renal contours in renal failure were studied by means of sup(99m)Tc-dimercaptosuccinic acid (DMSA) renoscintigraphy. Renal cortical images were obtained even in renal failure cases. Causes of renal failure were chronic glomerulonephritis in 7, bilateral renal tuberculosis in 2, chronic pyelonephritis in 3, bilateral renal calculi in 3, diabetic nephropathy in 2, polycystic kidney disease in 2 and stomach cancer in 1.

sup(99m)Tc-DMSA renal scintigraphy in renal failure due to various renal diseases

International Nuclear Information System (INIS)

Hosokawa, Shin-ichi; Daijo, Kazuyuki; Okabe, Tatsushiro; Kawamura, Juichi; Hara, Akira

1979-01-01

Renal contours in renal failure were studied by means of sup(99m)Tc-dimercaptosuccinic acid (DMSA) renoscintigraphy. Renal cortical images were obtained even in renal failure cases. Causes of renal failure were chronic glomerulonephritis in 7, bilateral renal tuberculosis in 2, chronic pyelonephritis in 3, bilateral renal calculi in 3, diabetic nephropathy in 2, polycystic kidney disease in 2 and stomach cancer in 1. (author)

Edema agudo hemorrágico da infância: relato de três casos Acute hemorrhagic edema of infancy: report of three cases

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Paulo Sergio Emerich

2011-12-01

Full Text Available O Edema Agudo Hemorrágico da Infância é uma vasculite leucocitoclástica pouco frequente, que ocorre, quase exclusivamente, em crianças entre 4 meses e 2 anos de idade. Caracteriza-se, clinicamente, pela tríade febre, lesões purpúricas na face, pavilhões auriculares e extremidades e edema. Embora os achados cutâneos sejam dramáticos e de surgimento rápido, o prognóstico é favorável, com resolução espontânea dentro de 1 a 3 semanas. Descrevem-se três casos cujos achados clínicos e histopatológicos são característicos de edema agudo hemorrágico da infância.Acute Hemorrhagic Edema of Infancy is an infrequent leukocytoclastic vasculitis which occurs almost exclusively in children between 4 months and 2 years of age. It is clinically characterized by the triad fever, purpuric lesions on the face, auricular pinna and extremities, and edema. Although the cutaneous findings are dramatic and of rapid onset, the prognosis is favorable, with spontaneous resolution within 1 to 3 weeks. Three cases are described in which clinical and histopathological findings are characteristic of acute hemorrhagic edema of infancy.

Fluidoterapia entérica versus fluidoterapia endovenosa em casos de síndrome de abdómen agudo em equinos

OpenAIRE

Mancha, Dora Alexandra Inácio

2009-01-01

Dissertação de Mestrado Integrado em Medicina Veterinária O Síndrome de Abdómen Agudo é uma patologia muito frequentemente encontrada na prática clínica de equinos. A hidratação dos cavalos com dor abdominal aguda é extremamente importante. Por este motivo, a abordagem terapêutica médica destes animais inclui quase invariavelmente a administração de fluidos. O médico veterinário pode recorrer à fluidoterapia entérica e à fluidoterapia endovenosa para o tratamento destes animais...

Prevalencia y curso clínico de la infección por dengue en adultos mayores con cuadro febril agudo en un hospital de alta complejidad en Cali, Colombia

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Fernando Rosso

2016-08-01

Conclusión. La infección por dengue fue frecuente en adultos mayores como causa de síndrome febril agudo. Una importante proporción requirió hospitalización y presentó complicaciones, sin embargo, el manejo adecuado evitó los casos fatales.

Determinación de las Prioridades de Mantenimiento en Turbogeneradores “Elektrosila TBФ-100-3600-T3” a partir del Comportamiento de sus Fallos; Determination of Maintenance Priorities in Turbogenerators “Elektrosila TBФ- 100-3600-T3” Based on their Failure

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Odalys Martínez Rodríguez

2012-11-01

Full Text Available Los generadores de potencia son de gran importancia para la producción de electricidad. Un fallo en un generador ocasiona la interrupción de su servicio, limitaciones o pérdida total de la energía generada, tiene efectos negativos sobre la economía y afecta la calidad de la vida de la sociedad. Ello conduce a la necesidad un control estricto de los generadores y sus sistemas, tal que faciliten la detección temprana de desviaciones en sus parámetros de operación e intervenir apropiadamente para impedir la ocurrencia de una avería. Este trabajo tiene como objetivo presentar los resultados de tres variantes empleadas en la determinación de las prioridades de mantenimiento de los turbogeneradores “ELEKTROSILA TBФ-100-3600-T3”, las variantes estudiadas fueron: el comportamiento histórico de los fallos, el comportamiento histórico de la energía indisponible debido a los fallos y el análisis de criticidad; los resultados, sustentados en seis años de estudio, descartaron la utilización del criterio de energía indisponible.  The power generators are very important for the electricity production. A failure in a generator causes the interruption of service, limitations or the complete loss of the generated energy, has negative effects on theeconomy and it harms quality of life of the society. This leads to the necessity of a strict control of the generators as in their systems, such that facilitates the early detection of any deviation on their operationparameters to intervene appropriately and avoid the occurrence of a failure. This paper has the objective to present the results of three variants used in the determination of the priorities of maintenance of theturbogenerators "ELEKTROSILA TBФ-100-3600-T3", the analyzed variants were: the historical behavior of failures, the historical behavior of the unavailable energy due to failures and the analysis of criticality; theobtained results, supported in six years of study, discard

Sindrome confusional agudo por abstinencia aguda de nicotina Delirium due to acute nicotine withdrawal

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Manuel Klein

2002-08-01

Full Text Available El síndrome confusional agudo (SCA o delirium en pacientes hospitalizados es un problema frecuente y grave. Se caracteriza por síntomas de comienzo agudo y curso fluctuante con inatención, pensamiento desorganizado, y con distintos niveles de alteración de la conciencia.En la bibliografía consultada, el SCA como manifestación de un síndrome de abstinencia aguda nicotínica fue descripto en solo ocho casos. Presentamos el caso de un tabaquista grave que, internado por una reagudización de su enfermedad pulmonar obstructiva crónica (EPOC, presentó un cuadro de SCA al tercer día de abstinencia tabacal, cediendo los síntomas tras la administración de un parche de nicotina. Lo descripto sugiere que en pacientes internados que presentan SCA y agitación, con fuertes antecedentes de tabaquismo, un simple ensayo con un parche de nicotina puede ofrecer en pocas horas una notable respuesta terapéutica y a su vez un test confirmatorio. El reconocimiento del SCA como forma de presentación de la abstinencia nicotínica permitirá identificar casos habitualmente complejos en los que se podrá implementar una sencilla y eficaz alternativa terapéutica.Delirium or acute confusional state among hospitalized patients is a frequent and serious problem. It is characterized by acute onset symptoms, fluctuating course, impaired attention, unorganized thinking, and altered level of conciousness. Delirium, as a manifestation of acute nicotine withdrawal syndrome has been reported in the reviewed literature only in eight cases. We report the case of a heavy smoker admitted because of a reagudization of his chronic obstructive pulmonary disease. At the third day of nicotine abstinence, he developed delirium with a rapid improvement of his symptoms after treatment with a transdermal nicotine patch. This description suggests that in hospitalized heavy smokers who develop delirium with agitation, a simple trial with a nicotine patch can offer a dramatic

Renal computed angiography. Part I: Renal CT phlebography. Renal veins variants

International Nuclear Information System (INIS)

Al-Amin, M.; Krupev, M.; Hadjidekov, V.; Plachkov, I.

2012-01-01

The changing trend in renal surgery, transplantation and minimal invasive urology implies preprocedure evaluation of renal veins. Development of imaging methods offers new possibilities for venographic visualization. The goal of this study is to present authors experience in visualization of renal veins using 64 MDCT and to evaluate the utility in assessments of their variants. 128 patients (68 females and 60 males, mean age 53,3) with urological complaints underwent 64MDCT examination including CT angiography. Contrast enhancement includes 3-4ml/sec injection flow of 90 ml contrast medium followed by 20 ml saline at the same rate. In 23 out of 128 examined patients some of the common variants of the renal vein is found. 64 MDCT angiography visualize very well renal veins and becomes method of choice in preoperative assessment of renal vein anatomy. (authors)

Impacto Pronóstico de los Síndromes Geriátricos en Pacientes Ancianos con Síndrome Coronario Agudo

OpenAIRE

Bonanad Lozano, Clara

2015-01-01

Los síndromes geriátricos pueden predecir eventos adversos en el contexto del síndrome coronario agudo más allá de la propia edad y de los clásicos factores de riesgo cardiovascular. El objetivo de la presente tesis doctoral fue cuantificar y evaluar un amplio espectro de síndromes geriátricos en pacientes supervivientes a la fase aguda de un síndrome coronario. Se incluyeron un total de 342 pacientes mayores de 65 años que ingresaron de forma consecutiva en el servicio de Cardiología de un ú...

Correlación clínica, laparoscópica e histológica en el abdomen agudo

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María Elena Trujillo Toledo

1995-12-01

Full Text Available Se presentan 132 pacientes con diagnóstico clínico de abdomen agudo durante 1991 a 1993, a quienes se les realizó laparoscopia de urgencia. Las afecciones más frecuentes en que se realizó laparoscopia fueron: apendicitis aguda y las enfermedades ginecológicas. La efectividad de la laparoscopia en relación con el resultado histológico fue del 97,1 %, y no coincidió en 3 pacientes con diagnóstico laparoscópico de apendicitis aguda, hematosalpinx derecho y peritonitis pélvica, sin especificar factor causal. En el 19,6 % la conclusión laparoscópica evitó una intervención quirúrgica

Evaluación económica del stent medicado vs. convencional para pacientes con infarto agudo de miocardio con elevación del ST en Colombia

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Mateo Ceballos

2014-11-01

Conclusiones: El stent medicado con sirolimus no es costo-efectivo para pacientes con infarto agudo de miocardio con elevación del ST en Colombia. Se recomienda mayor investigación futura sobre la probabilidad de muerte y trombosis muy tardía del stent, así como en subgrupos específicos de pacientes y stents medicados de segunda generación.

123. Intervención quirúrgica urgente en paciente varón joven con angiosarcoma primario cardíaco con diagnóstico de tromboembolismo pulmonar agudo

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N. Miranda

2012-04-01

Conclusiones: Son infrecuentes los casos de sarcoma cardíaco primario publicados en la bibliografía y muy pocos los que han cursado como tromboembolismo pulmonar agudo. Este caso ilustra la enorme dificultad que presentan para un diagnóstico y tratamiento precoz que ofrezca unas mínimas expectativas de vida a medio plazo.

Comportamiento del infarto agudo del miocardio en personas con diabetes mellitus de la provincia Granma Situation of the acute myocardial infarction in persons with diabetes mellitus in Granma province

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Eduardo René Valdés Ramos

2012-08-01

Full Text Available Antecedentes: la diabetes mellitus, además de ser un factor de riesgo para el infarto agudo del miocardio, parece conferir per se un peor pronóstico en los pacientes con esta entidad. Objetivo: evaluar el comportamiento del infarto agudo del miocardio en personas con diabetes mellitus de la provincia de Granma. Métodos: se realizó un estudio transversal y descriptivo con 159 pacientes que ingresaron en la Unidad de Cuidados Intensivos Coronarios del Hospital "Carlos Manuel de Céspedes", de Bayamo, Granma, con diagnóstico de infarto agudo del miocardio, en el período comprendido entre enero de 2010 y junio de 2011. De ellos, 39 con diabetes mellitus y 120 sin ella. De las historias clínicas se extrajeron los datos de las variables demográficas, clínicas y metabólicas estudiadas. Resultados: en los casos con diabetes mellitus el porcentaje de infartos extensos y sin dolor precordial fue superior a los no diabéticos, sin llegar a ser estadísticamente significativo (p= 0,3283 y p= 0,1066. Los pacientes diabéticos presentaron 2,8 veces más posibilidad de sufrir una complicación eléctrica que aquellos sin diabetes mellitus (p= 0,0121. No hubo relación significativa entre las complicaciones mecánicas del infarto agudo del miocardio y la presencia de diabetes mellitus (p= 0,4104. El número de defunciones fue significativamente mayor en los casos con diabetes mellitus, que en los no diabéticos (p= 0,0124. Los niveles de glucemia al ingreso estuvieron significativamente más elevados en los casos complicados y fallecidos, tanto en los diabéticos como en los no diabéticos. Conclusiones: el infarto agudo del miocardio, en los pacientes diabéticos de nuestro medio, con frecuencia se presenta sin dolor precordial, extenso, con complicaciones eléctricas y asociado con una elevada mortalidad. La hiperglucemia al ingreso está relacionada con un incremento de la morbilidad y la mortalidad del infarto agudo del miocardio

Neumonía eosinofílica: presentación de dos casos, agudo y crónico

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Oscar Pamo Reyna

2007-01-01

Full Text Available Se presenta dos casos de neumonía eosinofílica idiopática, uno crónico y otro agudo. En el caso clínico 1 se realizó una confirmación anatomopatológica de neumonía eosinofílica idiopática y en el caso clínico 2 se tuvo una neumonia eosinofílica aguda probable. Ambos presentaron tos, fiebre y disnea. El estudio radiográfico reveló lesiones alveolares bilaterales con tendencia a la consolidación. La marcada eosinofilia en sangre periférica fue un dato resaltante que facilitó el diagnóstico. Ambos casos tuvieron muy buena respuesta a la corticoterapia.(Rev Med Hered 2007;18:39-44.

Continuous renal replacement therapy improves renal recovery from acute renal failure.

Science.gov (United States)

Jacka, Michael J; Ivancinova, Xenia; Gibney, R T Noel

2005-03-01

Acute renal failure (ARF) occurs in up to 10% of critically ill patients, with significant associated morbidity and mortality. The optimal mode of renal replacement therapy (RRT) remains controversial. This retrospective study compared continuous renal replacement therapy (CRRT) and intermittent hemodialysis (IHD) for RRT in terms of intensive care unit (ICU) and hospital mortality, and renal recovery. We reviewed the records of all patients undergoing RRT for the treatment of ARF over a 12-month period. Patients were compared according to mode of RRT, demographics, physiologic characteristics, and outcomes of ICU and hospital mortality and renal recovery using the Chi square, Student's t test, and multiple logistic regression as appropriate. 116 patients with renal insufficiency underwent RRT during the study period. Of these, 93 had ARF. The severity of illness of CRRT patients was similar to that of IHD patients using APACHE II (25.1 vs 23.5, P = 0.37), but they required significantly more intensive nursing (therapeutic intervention scale 47.8 vs 37.6, P = 0.0001). Mortality was associated with lower pH at presentation (P = 0.003) and increasing age (P = 0.03). Renal recovery was significantly more frequent among patients initially treated with CRRT (21/24 vs 5/14, P = 0.0003). Further investigation to define optimal timing, dose, and duration of RRT may be beneficial. Although further study is needed, this study suggests that renal recovery may be better after CRRT than IHD for ARF. Mortality was not affected significantly by RRT mode.

Renal cell carcinoma in patient with crossed fused renal ectopia

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Ozgur Cakmak

2016-01-01

Full Text Available Primary renal cell carcinomas have rarely been reported in patients with crossed fused renal ectopia. We presented a patient with right to left crossed fused kidney harbouring renal tumor. The most frequent tumor encountered in crossed fused renal ectopia is renal cell carcinoma. In this case, partial nephrectomy was performed which pave way to preservation of the uninvolved both renal units. Due to unpredictable anatomy, careful preoperative planning and meticulous delineation of renal vasculature is essential for preservation of the uninvolved renal units.

Infarto agudo do miocárdio na 31ª semana de gravidez: relato de caso

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Filipa Pires Duarte

2011-04-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: A ocorrência de infarto agudo do miocárdio (IAM durante a gravidez é rara. Os autores descrevem o caso de IAM numa grávida de 31 semanas e a importância da existência de uma equipe multidisciplinar para sua abordagem. RELATO DO CASO: Grávida de 31 semanas, com antecedentes de tabagismo, alcoolismo e hipertensão, internada após um episódio de síncope. Na admissão, encontrava-se consciente e assintomática, embora hipotensa. O eletrocardiograma evidenciou marcada elevação do segmento ST em DI, AVL, V1-V6. Pesquisa de enzimas cardíacas foi positiva. O ecocardiograma transtorácico demonstrou redução da contratilidade ventricular esquerda e septal e uma fração de ejeção de 30%. A angiografia revelou oclusão proximal da artéria descendente anterior. Por insucesso da angioplastia por balão, foi colocado um stent metálico. A paciente iniciou terapêutica com b-bloqueadores, aspirina e clopidogrel. Em relação ao parto, optou-se por realizar cesariana eletiva, quatro semanas após o IAM. Suspendeu-se o clopidogrel sete dias antes do parto. A função cardíaca pré-operatória foi otimizada com infusão de levosimendana iniciada no dia anterior. A cesariana decorreu sob bloqueio peridural. O período intraoperatório decorreu sem complicações, à exceção de moderada hipotensão facilmente corrigida com fenilefrina. O índice de Apgar do recém-nascido foi de 9/10. CONCLUSÕES: Este é um dos poucos casos de infarto agudo do miocárdio e angioplastia descritos durante a gravidez. Os autores discutem as decisões tomadas pela equipe multidisciplinar, constituída por anestesiologistas, obstetras, cardiologistas e neonatologistas, notadamente no que se refere à dupla antiagregação plaquetária, ao tipo de parto e à anestesia.

Chronic renal failure due to unilateral renal agenesis and total renal dysplasia (=aplasia)

International Nuclear Information System (INIS)

Kroepelin, T.; Ziupa, J.; Wimmer, B.

1983-01-01

Three adult patients with unilateral renal agenesis/total dysplasia (= aplasia) and with an early chronic renal failure are presented. One patient had renal agenesis without ureter bud and ureteric ostium on one side, and reflux pyelonephritis on the other; one had small compact total renal dysplasia (= aplasia) on one side, while chronic uric acid nephropathy (chronic renal disease as a cause of gout) was diagnosed on the other; the third patient had a total large multicystic dysplasia on one side, and on the other a segmental large multicystic dysplasia. Radiological steps and radiodiagnostic criteria are discussed and the combination of urogenital and extraurogenital anomalies is referred to. (orig.)

Efficacy of ultrasonography-guided renal biopsy for the evaluation of renal dysfunction following renal transplantation

International Nuclear Information System (INIS)

Kim, Young Jae; Choi, Chul Soon; Min, Seon Jeong; Lee, Gyung Kyu; Lee, Eil Seong; Kang, Ik Won; Bae, Sang Hoon

2003-01-01

To evaluate the usefulness and complications of renal biopsy under ultrasonography-guidance in renal dysfunction after renal transplantation. Ultrasonography-guided renal biopsy was done in 47 patients with the transplanted kidney. The subjects consisted of 30 males and 17 females, age ranged from 16 to 66 years (average age=38 years). Biopsies were done once in 27 patients, twice in 17 patients, three times in 3 patients, a total of 70 biopsies. The success rate of renal biopsy for the accurate pathologic diagnosis and the incidence and types of complications following biopsy were evaluated. The success rate of renal biopsy for the accurate pathologic diagnosis was 96%(67/70). Pathologic diagnosis included 27 cases of acute rejection (39%), 8 cases of acute tubular necrosis (11%), 4 cases of acute rejection and acute tubular necrosis (6%), 4 cases of cyclosporin toxicity (6%), 4 cases of primary disease recurrence (6%), 4 cases of infection (6%) and others. Complications after renal biopsy included 15 cases of microscopic hematuria (21%), 1 case of gross hematuria with spontaneous cessation and 1 case of life threatening hemorrhage. Ultrasonography-guided renal biopsy is a safe and effective diagnostic method for the evaluation of renal dysfunction following renal transplantation.

Rol del fallo mecánico en la optimización del mantenimiento en una central nuclear//Role of the mechanical failure during the maintenance optimization in the nuclear power plant

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Antonio Torres-Valle

2012-05-01

Full Text Available Entre las más recientes aplicaciones del Análisis Probabilista de Seguridad (1997 – 2003 de la Central Nuclear Embalse en Argentina, está el Programa de Mantenimiento Orientado a la Seguridad (2006– 2009 el cual se ha desarrollado con el empleo de la metodología de Mantenimiento Centrado en la Confiabilidad (RCM en inglés. El objetivo general del artículo es demostrar la alta contribución de los fallos mecánicos en el diseño de las políticas de mantenimiento de varios sistemas de la instalación a través del empleo de la metodología RCM. La composición, estructura y políticas de explotación de los sistemas tecnológicos de muchas instalaciones con riesgo asociado, similares a las de los sistemas analizados en este estudio, permite inferir que los resultados que se obtendrán serán equivalentes de aplicarse la metodología RCM en dichas instalaciones. Palabras claves: mantenimiento centrado en la confiabilidad, mantenimiento predictivo, mantenimiento preventivo, fallo mecánico, seguridad, confiabilidad, riesgo.______________________________________________________________________________ Abstract One of the most recent applications of Probabilistic Safety Analysis (1997 – 2003 to Embalse Nuclear Power Plant in Argentina, is the Safety Oriented Maintenance Program (2006 – 2009 developed with employment of the Reliability Centered Maintenance (RCM methodology. The general objective of the paper is to demonstrate the high contribution of the mechanical failures in the maintenance program design through the RCM methodology. The composition, structure and operation strategies of the technological systems of many risk associated facilities, similar to the analysed systems included in this study, allow deduce that the results will equivalent in case of application of RCM methodology in such facilities. Key words: reliability centered maintenance (RCM, predictive maintenance, preventive maintenance, mechanical failure, safety

“Transcollateral” Renal Angioplasty for a Completely Occluded Renal Artery

International Nuclear Information System (INIS)

Chandra, Subash; Chadha, Davinder S.; Swamy, Ajay

2011-01-01

Percutaneous transluminal renal angioplasty with stenting has been effective in the control of hypertension, renal function, and pulmonary edema caused by atherosclerotic renal artery stenosis. However, the role of the procedure has not been fully established in the context of chronic total occlusion of renal artery. We report the successful use of this procedure in 57-year-old male patient who reported for evaluation of a recent episode of accelerated hypertension. A renal angiogram in this patient showed ostial stenosis of the right renal artery, which was filling by way of the collateral artery. Renal angioplasty for chronic total occlusion of right renal artery was successfully performed in a retrograde fashion through a collateral artery, thereby leading to improvement of renal function and blood pressure control.

Fibrilação atrial, infarto agudo do miocárdio e oclusão arterial aguda em paciente jovem com hipertireoidismo

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Fabrício Thebit Bortolon

2009-09-01

Full Text Available Relato de caso de paciente jovem com hipertireoidismo não diagnosticado, apresentando quadro de fibrilação atrial, infarto agudo do miocárdio e oclusão arterial aguda de perna direita. Submetido à trombólise, embolectomia e iniciado tratamento para hipertireoidismo com tapazol. A evolução foi satisfatória, com reversão da alteração eletrocardiográfica isquêmica, melhora dos sintomas de oclusão arterial, controle do ritmo cardíaco e da função tireoidiana.

ESTUDIO CUALITATIVO DEL DUELO TRAUMÁTICO DE FAMILIARES DE VÍCTIMAS DE HOMICIDIO SEGÚN LA PRESENCIA O AUSENCIA DE CASTIGO LEGAL

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Ana María Corredor

2002-07-01

Full Text Available Para estudiar el duelo traumático en familiares de víctimas de homicidio considerando el efecto de la ausencia o presencia de castigo penal para el homicida, se elaboró un estudio exploratorio de seis casos. En tres de ellos, la investigación penal iniciada por homicidio culminó en sentencia condenatoria, en otros tres no se conoció la identidad de los homicidas. Se analizaron las narraciones acerca del homicidio y sus implicaciones desde una perspectiva cognitivo emocional, y se evaluaron los síntomas del duelo traumático a través de la versión en español del Grief Experience Inventory. Se esperaba que las personas que no obtuvieron castigo para los homicidas tuvieran mayores síntomas de duelo o síntomas más agudos. Esta hipótesis fue rechazada. Las dinámicas cognitivo emocionales relacionadas con el fallo penal difirieron de los prototipos propuestos por Spungen (1998, National Organization for Victims Assistance (1985, Thompson Norris y Ruback (1996.

Nefrotoxicidad por uso recreacional de drogas psicoactivas. Reporte de un caso

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Gustavo Aroca

2015-01-01

Full Text Available El uso recreacional de drogas psicoactivas es una prácticageneralizada en población de adultos jóvenes en el mundo. Existe evidencia de que los opioides y la cocaína producen toxicidad renal. La necrosis tubular aguda, rabdomiolisis y la glomerulonefritis focal segmentaria son las presentaciones más comunes. Reportamos un caso de daño renal agudo en un joven después del uso recreacional de alcohol, cocaína y opioides, cuyos hallazgos patológicos son descritos brevemente en la literatura.

Trastornos psiquiátricos frecuentes post infarto agudo al miocardio y su relación pronóstica. Revisión de la literatura.

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Manuel Mallol Simmonds

2017-07-01

Full Text Available La enfermedad cardiovascular es la principal causa de muerte a nivel mundial. De ella, el Infarto Agudo al Miocardio (IAM y el Accidente Cerebrovascular (AVC se encuentran fuertemente asociados a los cambios ambientales y sociales del último tiempo, tales como aumento de ingesta de comida rápida, sedentarismo, tabaquismo, entre otros. Algunos trastornos psiquiátricos que aparecen a corto y largo plazo posterior al evento coronario agudo tienen una implicancia directa en la morbimortalidad cardiovascular y global. De ellos, la depresión representa el trastorno psiquiátrico más frecuente, pudiendo encontrarse en 3 de cada 10 pacientes que tuvieron un IAM. La depresión aumenta las hospitalizaciones, disminuye la adherencia terapéutica y empeora el pronóstico cardiovascular a largo plazo.  La fisiopatología en lo anterior es explicada en parte por alteraciones en el eje neuroendocrino y la respuesta al estrés, mientras que otros fenómenos permanecen aún desconocidos. Dentro de otros trastornos psiquiátricos asociados a un IAM se encuentran el delirium, ansiedad y trastornos de la personalidad. En función de lo anterior, se hace necesaria la incorporación de un sistema continuo de monitoreo y apoyo en salud mental en este grupo de pacientes para mejorar tanto su pronóstico como la calidad de vida.

Efectos agudos de la actividad física y los videojuegos activos sobre las funciones cognitivas en jóvenes y adultos mayores

OpenAIRE

López García, Jesús

2017-01-01

La presente tesis doctoral consiste en intentar aportar nuevas evidencias científicas que traten de ampliar y clarificar el conocimiento existente referente a los efectos agudos de la actividad física aeróbica y los videojuegos activos sobre las funciones cognitivas en dos muestras poblacionales diferentes: los jóvenes adultos y los adultos mayores. Como síntesis general, podríamos indicar que el fin de las series experimentales desarrolladas en esta tesis tratan de estudiar si la práctic...

Influences of renal stone surgeries on renal function; Evaluation of renal function with sup 99m Tc-DMSA renal scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Katayama, Yasushi (Niigata Univ. (Japan). School of Medicine)

1991-10-01

From 1984 to 1990, {sup 99m}Tc-DMSA renal scintigraphy was performed before and after nephrolithotomy (15 cases), pyelolithotomy (15 cases), percutaneous nephrolithotripsy (PNL: 15 cases) and extracorporeal shock wave lithotripsy (ESWL: 16 cases, 17 kidneys) in order to evaluate of influences of renal stone surgeries on split renal function. DMSA renal uptake change ratio of treated kidneys of nephrolithotomy (-24.94{+-}5.60%) was significantly lower than that of PNL (-0.06{+-}3.92%), pyelolithotomy (-4.08{+-}4.79%) (p<0.01) and ESWL (-7.72{+-}3.87%) (p<0.05). The average change ratios of contralateral kidneys were as follows: PNL 4.80{+-}4.21% nephrolithotomy 4.67{+-}4.73%, pyelolithotomy -1.46{+-}5.39% and ESWL -2.02{+-}4.44%. One to 3 weeks after PNL, the cold area on the renal image was found in 10 (66.7%) of 15 cases. In cases of ESWL, DMSA renal uptake decreased even 4-10 weeks (mean 7 weeks) after treatment. In conclusion, possibility of deterioration of renal function after ESWL was suggested. (author).

Abdome agudo em pós-operatório tardio de apendicite aguda: pode não ser bridas

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Bruno Castro Fernandes

2014-10-01

Full Text Available As ressecções intestinais em países desenvolvidos ocorrem devido às malformações congênitas. Em países em desenvolvimento essas resseções ocorrem por causas potencialmente evitáveis, como invaginação intestinal irredutível, trauma abdominal fechado, volvo de jejuno-íleo, enterocolite necrosante, hérnia inguinal estrangulada e obstrução por bridas pós-operatórias. O volvo intestinal na infância é raro e geralmente de causas iatrogênicas causado, por exemplo, pela presença de grampos soltos a cavidade intestinal após apendicectomia laparoscópica. O volvo de jejuno-íleo pode ser secundário à isquemia nos casos de gastrosquise tratadas com silo ou mesmo pela colocação de banda gástrica pós-laparoscopia, ou ainda pela presença de lipoma mesentérico. Não foi identificado trabalho na literatura recente sobre volvo jejuno-íleo e isquemia e necrose de segmento de alça intestinal. O autores relatam um caso de abdome agudo obstrutivo em criança de 6 anos, em pós-operatório tardio (4 anos de apendicectomia aberta e cuja ressecção de segmento de Alça intestinal foi necessária nas duas oportunidades mas por motivos diferentes. Situações adversas em abdome agudo pós-operatório podem não ser por aderências intestinais, mas por situações mais graves e o cirurgião deve estar preparado para corrigir sua tática operatória.

Análise da tendência temporal de dano renal agudo entre pacientes graves conforme polimorfi smos I/D e -262A > T da enzima conversora da angiotensina Temporal trends in acute renal dysfunction among critically ill patients according to I/D and -262A > T ACE polymorphisms

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José Alberto Rodrigues Pedroso

2010-06-01

Full Text Available A síndrome de disfunção de múltiplos órgãos e sistemas (DMOS e a disfunção renal aguda compartilham muitos dos fatores fisiológicos envolvidos em seu desenvolvimento. Estudos recentes correlacionam suscetibilidades individuais, determinadas geneticamente, à disfunção de órgãos em pacientes criticamente enfermos, situação em que o gene da enzima conversora da angiotensina (ECA poderia ser um candidato para elucidar predisposição ou risco genético. Nosso objetivo foi examinar os efeitos da presença de dois polimorfismos, I/D e -262A > T, na disfunção renal em pacientes agudamente graves do Sul do Brasil. O escore SOFA (sequential organ failure assessment à admissão e a tendência da função renal (medida pelo escore renal diário do SOFA foram determinados em pacientes de unidade de terapia intensiva (UTI. Um total de 153 pacientes adultos (79 homens foi incluído no estudo. Houve monitoração diária da função renal durante toda a permanência na UTI e também pós-UTI. Observou-se a progressão para insuficiência renal (SOFA 3 e 4 nos primeiros sete dias de internação em UTI, bem como necessidade de diálise. As frequências genotípicas gerais em nossa amostra foram II = 0,17; ID = 0,46; DD = 0,37; e AA = 0,30; AT = 0,55; TT = 0,15; e as frequências alélicas foram I = 0,40, D = 0,60; e A = 0,56; T = 0,44. Este é o primeiro estudo para verificar a influência de polimorfismos I/D e -262A > T da ECA em disfunção renal aguda em pacientes críticos. Nenhuma associação significativa foi encontrada entre os genótipos ou as frequências alélicas e a evolução da função renal. Os polimorfismos I/D e -262A > T da ECA não têm impacto significativo sobre a evolução da função renal durante a primeira semana de internação na UTI nem exercem qualquer influência sobre a mortalidade em pacientes graves.Multiple organ failure syndrome and acute renal dysfunction share many of physiologic factors involved in

Renal Osteodystrophy

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Aynur Metin Terzibaşoğlu

2004-12-01

Full Text Available Chronic renal insufficiency is a functional definition which is characterized by irreversible and progressive decreasing in renal functions. This impairment is in collaboration with glomeruler filtration rate and serum creatinine levels. Besides this, different grades of bone metabolism disorders develop in chronic renal insufficiency. Pathologic changes in bone tissue due to loss of renal paranchyme is interrelated with calcium, phosphorus vitamine-D and parathyroid hormone. Clinically we can see high turnover bone disease, low turnover bone disease, osteomalacia, osteosclerosis and osteoporosis in renal osteodystropy. In this article we aimed to review pathology of bone metabolism disorders due to chronic renal insufficiency, clinic aspects and treatment approaches briefly.

Nefropatía por contraste en el síndrome coronario agudo Contrast induced nephropathy in acute coronary syndrome

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Mariana Carnevalini

2011-10-01

Full Text Available La nefropatía inducida por contraste (NIC es una de las causas más frecuentes de insuficiencia renal en pacientes internados. En el síndrome coronario agudo (SCA, la presencia de NIC aumenta la morbimortalidad. Las medidas de profilaxis y los factores de riesgo intervinientes de NIC en SCA no han sido determinados con exactitud. El objetivo de este estudio fue evaluar la incidencia de NIC y los factores asociados a su desarrollo en pacientes ingresados en unidad coronaria con requerimiento de cinecoronariografía (CCG. Se realizó un estudio de cohorte retrospectivo. Se incluyeron pacientes consecutivos cursando SCA estudiados con CCG dentro de las 72 horas de su admisión. Se definió NIC al aumento del 25% del valor de creatinina a las 48 h sobre el nivel basal de ingreso. El período de inclusión fue entre el 1° de enero de 2004 hasta el 30 de junio de 2010. Se analizaron 125 casos. La incidencia de NIC fue del 10.4% (n = 13. En el análisis multivariado, los factores asociados independientemente a su desarrollo fueron la edad [OR 1.05 (IC 95% 1.004 - 1.11 p = 0.034], la angioplastia a múltiple vaso [OR 2.2 (IC 95% 1.07 - 4.8, p = 0.03] y el volumen de contraste utilizado [OR 1.007 (IC 95% 1.001 - 1.01, p = 0.014].Contrast induced nephropathy (CIN is one of the most frequent causes of acute renal failure in hospitalized patients. It is associated with an increase in morbidity and mortality in patients hospitalized for acute coronary syndrome (ACS undergoing percutaneous coronary intervention (PCI. Risk factors and prevention strategies are not well defined. The aim of this study was to assess the incidence and clinical risk factors associated to the development of contrast induced nephropathy in patients hospitalized for ACS. In a retrospective cohort we analyzed consecutive patients hospitalized for ACS undergoing urgent PCI within 72 hours from the admission. CIN was defined as a 25% increase of creatinine levels from baseline at 48

CT differentiation of infiltrating renal cell carcinoma and renal urothelial tumor

International Nuclear Information System (INIS)

Choi, Hyo Kyeong; Goo, Dong Erk; Bang, Sun Woo; Lee, Moon Gyu; Cho, Kyoung Sik; Auh, Yong Ho

1994-01-01

It may be difficult to differentiate renal cell carcinoma involving collecting system from renal urothelial tumor invading into renal parenchyma. The purpose of this study was to assess the differences of CT findings between two conditions. CT findings of 5 cases of renal cell carcinoma involving the renal collecting systems and 10 cases of renal urothelial tumors invading the renal parenchyma were compared, and analyzed about the presence or absence of hydronephrosis, normal or abnormal CT nephrogram, renal contour changes due to mass and tentative diagnosis. The diagnoses were confirmed at surgery. Renal cell carcinoma showed hydronephrosis in only 20% and normal CT nephrogram and outward contour bulging in all cases. In contrast, renal urothelial tumor showed hydronephrosis(70%), abnormal CT nephrogram(60%), and preservation of reinform shape(100%). Renal contour changes and CT nephrogram may be useful in distinguishing both disease entities

Cuestionario de Fallos de Memoria de la Vida Cotidiana (MFE: análisis de factores con población española

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Pedro Montejo

2014-01-01

Full Text Available Uno de los instrumentos más utilizados para valorar los olvidos cotidianos es el Cuestionario de Fallos de Memoria de la Vida Cotidiana (MFE. Los objetivos del presente estudio fueron: a examinar la estructura factorial del MFE, b explorar las relaciones de los factores resultantes con el rendimiento objetivo de memoria (Listas de Palabras y Escenas de la Escala de Memoria de Wechsler - III, el estado de ánimo y la ansiedad (Escala de Depresión y Ansiedad de Goldberg y con dos preguntas generales sobre quejas de memoria. Los datos se recogieron de una muestra de 647 adultos jóvenes (19-64 años. Los resultados mostraron la existencia de una estructura de tres factores, que explicaban el 29.3 % de la varianza: Recuerdo de Actividades, Monitorización de la Comunicación y Reconocimiento. Los dos primeros factores mostraron una correlación positiva más alta entre ellos y una asociación mayor con el estado de ánimo y las quejas generales de memoria. Por el contrario, el factor Reconocimiento presentó una correlación positiva más alta con la edad y negativa con el rendimiento objetivo de memoria.

The renal scan in pregnant renal transplant patients

International Nuclear Information System (INIS)

Goldstein, H.A.; Ziessman, H.A.; Fahey, F.H.; Collea, J.V.; Alijani, M.R.; Helfrich, G.B.

1985-01-01

With the greater frequency of renal transplant surgery, more female pts are becoming pregnant and carrying to term. In the renal allograft blood vessels and ureter may be compressed resulting in impaired renal function and/or, hypertension. Toxemia of pregnancy is seen more frequently than normal. Radionuclide renal scan monitoring may be of significant value in this high risk obstetrical pt. After being maintained during the pregnancy, renal function may also deteriorate in the post partum period. 5 pregnant renal transplant pts who delivered live babies had renal studies with Tc-99m DTPA to assess allograft perfusion and function. No transplanted kidney was lost during or after pregnancy as a result of pregnancy. No congenital anomalies were associated with transplant management. 7 studies were performed on these 5 pts. The 7 scans all showed the uterus/placenta. The bladder was always distorted. The transplanted kidney was rotated to a more vertical position in 3 pts. The radiation dose to the fetus is calculated at 0.024 rad/mCi administered. This study demonstrates the anatomic and physiologic alterations expected in the transplanted kidney during pregnancy when evaluated by renal scan and that the radiation burden may be acceptable in management of these pts

Abdome agudo por obstrução por ileobiliar

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Márcia Cristina de Alencastro

Full Text Available OBJETIVO: descrever a experiência na abordagem dos doentes com abdome agudo por obstrução por IB, desde o diagnóstico até o tratamento definitivo. MÉTODOS: estudo retrospectivo incluindo todos os casos de IB tratados em um período de 23 anos. De acordo com a abordagem cirúrgica realizada, os pacientes foram divididos em dois grupos (1 enterolitotomia com colecistectomia no segundo momento; e (2 enterolitotomia, colecistectomia e abordagem da fístula. RESULTADOS: Doze pacientes foram incluídos, sendo 11 mulheres (91,6%, com média de idade de 72,2 anos. Todos os pacientes apresentavam doenças associadas, principalmente hipertensão arterial sistêmica (75%. Dois pacientes não apresentavam sintomas significativos de obstrução intestinal. O diagnóstico de IB foi realizado em seis pacientes (50% antes da laparotomia. O grupo 1 foi constituído de oito pacientes e o grupo 2 de quatro, e a morbidade foi, respectivamente, 33,3% e 8,3%. A mortalidade foi 16,6% (um paciente de cada grupo. CONCLUSÃO: O manejo do IB deve ser individualizado. O tratamento da obstrução mediante remoção do cálculo biliar por enterotomia proximal é a escolha inicial para o tratamento do IB. A colecistectomia e a correção da fístula bilioentérica podem ser realizadas juntamente com a remoção do cálculo, no entanto, em pacientes com comorbidades significativas, esses procedimentos devem ser realizados posteriormente.

Renal perfusion scintiscan

Science.gov (United States)

... Radionuclide renal perfusion scan; Perfusion scintiscan - renal; Scintiscan - renal perfusion Images Kidney anatomy Kidney - blood and urine flow Intravenous pyelogram References Rottenberg G, Andi AC. Renal ...

Análisis cualitativo y cuantitativo de los fallos de diseño y ejecución en los proyectos de cubiertas y fachadas y de su incidencia patológica en los edificios de España

OpenAIRE

Carretero Ayuso, Manuel Jesús

2017-01-01

La comprensión de las deficiencias y los fallos existentes en la construcción es clave para la mejora de la edificación en España, dado que es uno de los sectores donde se dan más problemáticas durante su proceso de producción, y en donde, además existe uno de los mayores grados de insatisfacción de los usuarios. Las fachadas y las cubiertas son una de las partes más significativas de los edificios, pues constituyen la piel que los separa del exterior, debiendo satisfacer simultáneamente dife...

Efectividad del modelo de cuidado de enfermería para la familia de paciente con infarto agudo al miocardio en la unidad de cuidados intensivos

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David Jahel Garcia Avendaño

2015-05-01

Full Text Available Introducción: Este protocolo de investigación tiene la finalidad de intervenir con la familia y determinar la efectividad del Modelo de Cuidado de Enfermería para la Familia de Paciente con Infarto Agudo al Miocardio (IAM en la Unidad de Cuidados Intensivos (UCI. Materiales y Métodos: Estudio descriptivo de intervención familiar. Resultados y Discusión: El 100% de las familias respondió afirmativamente que la enfermera familiar les informo sobre los cuidados a realizar en la familia según las necesidades detectadas, estableció un plan de intervención en la familia mismo que cumplió y se interesó para que dentro de lo posible la estancia en la familia sea agradable. Conclusiones: Los resultados de esta investigación de intervención a las familias de paciente con IAM en las UCI aporta resultados que apoyan la importancia de aplicar un Modelo de Cuidado de Enfermería Familiar en dichas unidades.Cómo citar este artículo: García DJ, Estrada MC, Gallegos M, Antuna AB. Efectividad del modelo de cuidado de enfermería para la familia de paciente con infarto agudo al miocardio en la unidad de cuidados intensivos. Rev Cuid. 2015; 6(1: 923-31. http://dx.doi.org/10.15649/cuidarte.v6i1.166

Study of acute renal insufficiency and chronic renal insufficiency using radioisotopes

International Nuclear Information System (INIS)

Raynaud, C.

1976-01-01

Radioisotopic renal function tests are of assistance to diagnose and follow-up the course of renal insufficiency. The radioisotopic renogram is useful in assessing the response to therapy of child obstructive uropathies and evaluating renal transplant function. The renal scan is helpful, in an emergency service, to differenciate chronic renal insufficiency from acute renal insufficiency. Hg renal uptake test provides informations on physiopathological problems. Among them, the following problems are emphasized: evolution of a nonfunctioning kidney, control of the success of a reparative surgery and of bilateral obstructive uropathies with unilateral symptoms [fr

Cardiomiopatia de Takotsubo: uma causa rara de choque cardiogênico simulando infarto agudo do miocárdio Takotsubo cardiomiopathy: a rare cause of cardiogenic shock simulating acute myocardial infarction

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Jayro Thadeu Paiva de Vasconcelos

2005-08-01

Full Text Available Cardiomiopatia de Takotsubo é uma causa rara de aneurisma ventricular esquerdo agudo, na ausência de coronariopatia, só recentemente descrita na literatura mundial. Os sintomas podem assemelhar-se aos do infarto agudo do miocárdio com dor torácica típica. A imagem do balonamento ventricular sugestivo de haltere ou "Takotsubo" (dispositivo utilizado no Japão para prender Octopus é característico desta nova síndrome e usualmente há desaparecimento do movimento discinético até o 18º dia do início dos sintomas, em média.Takotsubo Cardiomiopathy is a rare cause of acute left ventricular aneurysm, in the absence of coronariopathy, only recently described in world literature. Symptoms may be similar to those from acute myocardial infarction with typical thoracic pain. The image of dumbbell or Takotsubo (a device used in Japan to capture octopus suggestive ventricular ballooning is characteristic of that new syndrome and there is usually the disappearing of dyskinetic movement up to the 18th day from the beginning of the symptoms, in average.

Edema agudo do pulmão pós-extubação traqueal – Caso clínico

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Maria de Lurdes Castro

2009-05-01

Full Text Available Resumo: O edema agudo do pulmão pós-extubação traqueal é um acontecimento raro (≈ 0,1%1. A etiologia é multifactorial, sendo a obstrução da via aérea superior o factor desencadeante principal. O esforço inspiratório contra a glote encerrada causa pressões intratorácicas muito negativas, que se transmitem ao interstício pul-monar, condicionando uma transudação de fluidos a partir dos vasos capilares pulmonares1−5. Relatamos um caso de edema agudo do pulmão pós-extubação num doente de quinze anos, operado no serviço de urgência por amputação traumática da perna esquer-da. Revemos a fisiopatologia, o padrão radiológico, potenciais factores de risco e medidas preventivas des-ta complicação respiratória pós-anestésica.Rev Port Pneumol 2009; XV (3: 537-541 Abstract: Negative pressure pulmonary oedema is an uncommon complication of traqueal extubation (≈ 0,1% mostly caused by acute upper airway obstruction. Upper airway obstruction from glottis closure leads to marked inspiratory effort, which generates negative intrathoracic pressure transmitting to pulmonary interstitium, and inducing fluid transudation from pulmonary capillary bed1−5. We report a case of post-extubation pulmonary oedema in a fifteen years old patient, submitted to surgery following traumatic amputation of his left leg. We review the pathophysiology, radiological findings, potential risk factors and preventive measures of this post-anaesthetic respiratory complication.Rev Port Pneumol 2009; XV (3: 537-541 Palavras-chave: Edema agudo do pulmão pós-extubação traqueal, obstrução da via aérea superior, laringospasmo, pressão negativa intratorácica, Key-words: Post-extubation pulmonary oedema, upper airway obstruction, laryngospasm, intra-thoracic negative pressure

Etiología del síndrome febril agudo en la provincia de Jaén, Perú 2004-2005

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Lucinda Troyes R

2006-01-01

Full Text Available Objetivo: Conocer a tiología el Síndrome febril agudo en nacientes que acudieron a tres establecimientos de salud de la provincia de Jaén entre mayo de 2004 y abril de 2005. Materiales y métodos: Estudio descriptivo prospectivo realizado en tres establecimientos de salud: Hospital General de Jaén, Hospital de Apoyo Bellavista y Centro de Salud Morro Solar. Se incluyeron pacientes entre 5 y 65 años con fiebre de menos de ocho días de evolución y sin foco infeccioso aparente. Inicialmente se les realizó gota gruesa para malaria y frotis sanguíneo para Bartonelosis; de los casos negativos se obtuvo una segunda muestra de sangre para la búsqueda de ELISA IgM y microaglutinación para el diagnóstico de leptospirosis, ELISA IgM para dengue, Mayaro, Oropuche y encefalitis equina venezolana, e inmunofluorescencia indirecta para Rickettsiosis. Resultados: De 1039 febriles incluidos, se determinó la etiología en 680 (65,4%casos, malaria por P.falciparum 312 (30,0%, leptospirosis 115 (11,1%, dengue 105 (10,1%, malaria por P. vivax 76 (7,3%,leptospirosis más dengue 30 (2,9%, Rickettsiosis 15 (1,4%,Bartonelosis 17 (1,6%,leptospirosis más Rickettsiosis 7 (0,7%, y leptospirosis, dengue más Rickettsiosis 3 (0,3%. Los serovares de Leptospira más frecuentes fueron varilla (35,7%y bratislava (32,5%. Conclusión: La malaria es la principal causa de síndrome febril agudo en Jaén, se destaca la presencia de la leptospirosis como segunda causa,por delante del dengue; es necesario considerar dentro del diagnóstico diferencial Rickettsiosis y Bartonelosis.

Distal renal tubular acidosis in recurrent renal stone formers

DEFF Research Database (Denmark)

Osther, P J; Hansen, A B; Røhl, H F

1989-01-01

Renal acidification ability was examined in 90 recurrent renal stone formers, using fasting morning urinary pH levels followed by a short ammonium chloride loading test in subjects with pH levels above 6.0. Fifteen patients (16.6%) revealed a distal renal tubular acidification defect: one patient......, this has important therapeutic implications. The pathological sequence in renal stone formers with dRTA is discussed....

Screening renal stone formers for distal renal tubular acidosis

DEFF Research Database (Denmark)

Osther, P J; Hansen, A B; Røhl, H F

1989-01-01

A group of 110 consecutive renal stone formers were screened for distal renal tubular acidosis (RTA) using morning fasting urinary pH (mfUpH) levels followed by a short ammonium chloride loading test in patients with levels above 6.0. In 14 patients (12.7%) a renal acidification defect was noted...... RTA in renal stone formers. Regardless of whether the acidification defect is primary or secondary to stone formation, however, all renal stone formers with distal RTA can expect to benefit from prophylactic alkaline therapy and it is recommended that the screening procedure, which is easy to use...

Acute renal infarction Secondary to Atrial Fibrillation Mimicking Renal Stone Picture

International Nuclear Information System (INIS)

Salih, Salih Bin; Al-Durihim, H.; Al-Jizeeri, A.; Al-Maziad, G.

2006-01-01

Acute renal infarction presents in a similar clinical picture to that of a renal stone. We report a 55-year-old Saudi female, known to have atrial fibrillation secondary to mitral stenosis due to rheumatic heart disease. She presented with a two day history of right flank pain that was treated initially as renal stone. Further investigations confirmed her as a case of renal infarction. Renal infarction is under-diagnosed because the similarity of its presentation to renal stone. Renal infarction should be considered in the differential diagnosis of loin pain, particularly in a patient with atrial fibrillation. (author)

Identificación de síntomas relacionados al Síndrome de Apnea Obstructiva del sueño en historias clínicas de pacientes con eventos vasculares agudos.

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Darwin Roger VIZCARRA ESCOBAR

2006-07-01

Full Text Available El síndrome de apnea obstructiva del sueño (SAOS se caracteriza por ronquidos, pausas en la respiración y somnolencia diurna excesiva entre los síntomas más relevantes. Se ha demostrado una asociación con incremento de riesgo vascular en pacientes con SAOS. Objetivo: Evaluar si el personal médico busca síntomas relacionados al SAOS en pacientes con un cuadro cerebrovascular o síndrome coronario agudo, en los servicios de Medicina del Hospital Nacional Cayetano Heredia en Lima, Perú, desde septiembre del 2003 hasta septiembre del 2004. Materiales y métodos: Se planteó un estudio observacional retrospectivo. Se revisaron historias clínicas de 291 pacientes con diagnóstico al ingreso de accidente cerebrovascular, ataque isquémico transitorio o síndrome coronario agudo, buscando información sobre síntomas relacionados al SAOS, incluyendo evaluación por especialidades y epicrisis, detallando los evaluadores que recogieron los datos. Resultados: En la evaluación de 291 pacientes participaron 1122 evaluadores, 0,98 % de ellos consignó descartar el SAOS, que correspondió a 9 pacientes. En sólo 1 paciente se sugirió realizar un estudio de polisomnografía para corroborar el diagnóstico, sin ofrecerse ninguna opción terapéutica. Del total de pacientes, en el 6,87 % se indagó por ronquidos durante el sueño, 28,52 % por somnolencia y 0,68 % por episodios de apneas durante el sueño. Conclusiones: No se realiza una adecuada búsqueda del SAOS en pacientes con un evento cardiovascular o cerebrovascular agudo. En los pocos pacientes en los que se sospecha esta patología no existe seguimiento clínico ni tampoco se ofrece opción diagnóstica ni terapéutica alguna. (Rev Med Hered 2006;17:148-155.

The Effects of Renal Denervation on Renal Hemodynamics and Renal Vasculature in a Porcine Model.

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Willemien L Verloop

Full Text Available Recently, the efficacy of renal denervation (RDN has been debated. It is discussed whether RDN is able to adequately target the renal nerves.We aimed to investigate how effective RDN was by means of functional hemodynamic measurements and nerve damage on histology.We performed hemodynamic measurements in both renal arteries of healthy pigs using a Doppler flow and pressure wire. Subsequently unilateral denervation was performed, followed by repeated bilateral hemodynamic measurements. Pigs were terminated directly after RDN or were followed for 3 weeks or 3 months after the procedure. After termination, both treated and control arteries were prepared for histology to evaluate vascular damage and nerve damage. Directly after RDN, resting renal blood flow tended to increase by 29±67% (P = 0.01. In contrast, renal resistance reserve increased from 1.74 (1.28 to 1.88 (1.17 (P = 0.02 during follow-up. Vascular histopathology showed that most nerves around the treated arteries were located outside the lesion areas (8±7 out of 55±25 (14% nerves per pig were observed within a lesion area. Subsequently, a correlation was noted between a more impaired adventitia and a reduction in renal resistance reserve (β: -0.33; P = 0.05 at three weeks of follow-up.Only a small minority of renal nerves was targeted after RDN. Furthermore, more severe adventitial damage was related to a reduction in renal resistance in the treated arteries at follow-up. These hemodynamic and histological observations may indicate that RDN did not sufficiently target the renal nerves. Potentially, this may explain the significant spread in the response after RDN.

The Effects of Renal Denervation on Renal Hemodynamics and Renal Vasculature in a Porcine Model

Science.gov (United States)

Verloop, Willemien L.; Hubens, Lisette E. G.; Spiering, Wilko; Doevendans, Pieter A.; Goldschmeding, Roel; Bleys, Ronald L. A. W.; Voskuil, Michiel

2015-01-01

Rationale Recently, the efficacy of renal denervation (RDN) has been debated. It is discussed whether RDN is able to adequately target the renal nerves. Objective We aimed to investigate how effective RDN was by means of functional hemodynamic measurements and nerve damage on histology. Methods and Results We performed hemodynamic measurements in both renal arteries of healthy pigs using a Doppler flow and pressure wire. Subsequently unilateral denervation was performed, followed by repeated bilateral hemodynamic measurements. Pigs were terminated directly after RDN or were followed for 3 weeks or 3 months after the procedure. After termination, both treated and control arteries were prepared for histology to evaluate vascular damage and nerve damage. Directly after RDN, resting renal blood flow tended to increase by 29±67% (P = 0.01). In contrast, renal resistance reserve increased from 1.74 (1.28) to 1.88 (1.17) (P = 0.02) during follow-up. Vascular histopathology showed that most nerves around the treated arteries were located outside the lesion areas (8±7 out of 55±25 (14%) nerves per pig were observed within a lesion area). Subsequently, a correlation was noted between a more impaired adventitia and a reduction in renal resistance reserve (β: -0.33; P = 0.05) at three weeks of follow-up. Conclusion Only a small minority of renal nerves was targeted after RDN. Furthermore, more severe adventitial damage was related to a reduction in renal resistance in the treated arteries at follow-up. These hemodynamic and histological observations may indicate that RDN did not sufficiently target the renal nerves. Potentially, this may explain the significant spread in the response after RDN. PMID:26587981

Renal pathological implications in type 2 diabetes mellitus patients with renal involvement.

Science.gov (United States)

Li, Li; Zhang, Xiuhui; Li, Zhicheng; Zhang, Rui; Guo, Ruikun; Yin, Qinghua; Yang, Lichuan; Yue, Rongzheng; Su, Baihai; Huang, Songmin; Xu, Huan; He, Cijiang; Liu, Fang

2017-01-01

To investigate the renal pathological implications in type 2 diabetes mellitus patients with renal involvement. A total of 328 type 2 diabetes mellitus (T2DM) patients with renal involvement who underwent a renal biopsy and received follow-up for at least one year were recruited in our study. The patients were divided into the diabetic nephropathy (DN), non-diabetic renal disease (NDRD), and NDRD superimposed on DN groups based on the pathological diagnosis. Renal outcomes were defined by the initiation of renal replacement therapy or doubling of the serum creatinine. Kaplan-Meier analysis was used to compare renal survival, and Cox proportional hazard analysis was used to determine the predictors of renal outcomes in the DN group. Renal biopsy findings revealed that 188 patients (57.32%) had pure DN, 121 patients (36.89%) had NDRD alone, and 19 patients (5.79%) had NDRD superimposed on DN. The most frequent subclassification of NDRD was membranous nephropathy (MN). Compared with the NDRD and NDRD superimposed on DN groups, patients with pure DN had poorer renal function and lower renal survival rates. In the DN group, the five-year renal survival rates of glomerular classes of I, IIa, IIb, III and IV were 100%, 84.62%, 60%, 47.5% and 33.33%, respectively. Multivariate Cox proportional hazard analysis showed that the glomerular lesions, proteinuria and serum creatinine were independent risk factors for renal outcomes, while interstitial fibrosis/inflammation and arteriolar hyalinosis were not independently associated with renal outcomes in the DN group. Making an accurate pathologic diagnosis by renal biopsy is crucial for diabetes mellitus (DM) patients with renal involvement. The findings of our present study indicated that patients with pure DN had poorer renal outcomes than patients with NDRD or NDRD superimposed on DN. The classification of glomerular lesions, proteinuria and serum creatinine were independent risk factors for renal outcomes in the DN group

Detection of acute renal allograft rejection by analysis of renal tissue proteomics in rat models of renal transplantation

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Dai Yong

2008-01-01

Full Text Available At present, the diagnosis of renal allograft rejection requires a renal biopsy. Clinical management of renal transplant patients would be improved if rapid, noninvasive and reliable biomarkers of rejection were available. This study is designed to determine whether such protein biomarkers can be found in renal-graft tissue proteomic approach. Orthotopic kidney transplantations were performed using Fisher (F344 or Lewis rats as donors and Lewis rats as recipients. Hence, there were two groups of renal transplant models: one is allograft (from F344 to Lewis rats; another is syngrafts (from Lewis to Lewis rats serving as control. Renal tissues were collected 3, 7 and 14 days after transplantation. As many as 18 samples were analyzed by 2-D Electrophoresis and mass spectrometry (MALDI-TOF-TOF-MS. Eleven differentially expressed proteins were identified between groups. In conclusion, proteomic technology can detect renal tissue proteins associated with acute renal allograft rejection. Identification of these proteins as diagnostic markers for rejection in patients′ urine or sera may be useful and non-invasive, and these proteins might serve as novel therapeutic targets that also help to improve the understanding of mechanism of renal rejection.

Renal sympathetic denervation: MDCT evaluation of the renal arteries.

LENUS (Irish Health Repository)

Hutchinson, Barry D

2013-08-01

Percutaneous transluminal renal sympathetic denervation is a new treatment of refractory systemic hypertension. The purpose of this study was to assess the clinical utility of MDCT to evaluate the anatomic configuration of the renal arteries in the context of renal sympathetic denervation.

Infarto agudo del miocardio en los centros diagnósticos integrales de Vargas, Venezuela Myocardial acute infarction in integral diagnosis centers of Vargas, Venezuela

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Ana Rosa Jorna Calixto

2010-12-01

Full Text Available INTRODUCCIÓN: el infarto agudo del miocardio constituyó más del 12 % de los fallecimientos por cardiopatía isquémica en Venezuela en 2006, sin evidenciarse disminución en la mortalidad a pesar del mejoramiento tecnológico de los servicios de urgencias. OBJETIVO: caracterizar su comportamiento en los centros de diagnóstico integrales del Estado de Vargas, en el período comprendido de junio de 2006 a junio de 2009. MÉTODOS: se realizó un estudio descriptivo, retrospectivo para caracterizar el comportamiento del infarto agudo del miocardio en los servicios de urgencia y emergencia de los centros de diagnóstico integrales utilizando las estadísticas de la Misión Barrio Adentro. RESULTADOS: fueron atendidos 186 pacientes por infarto agudo del miocardio, predominaron los ingresos en la terapia intensiva (2,4 % sobre los servicios de hospitalización. Los fallecidos por esta causa fueron 35 personas, 17,1 % del total de fallecidos. Fueron trombolizados el 39,2 %, con el mayor número alcanzado en el 2008 con 51,2 %. La letalidad por infarto agudo del miocardio osciló entre tasas de 17,3 y 20 por cada 100 pacientes vistos. La tasa de mortalidad bruta fue de 9,58 x 100 000 habitantes. CONCLUSIONES: el número de casos atendidos por infarto tuvo un comportamiento ascendente de manera estable, representaron el 0,7 % del total de ingresos en estos centros, con predominio de los ingresos en la terapia intensiva sobre los servicios de hospitalización. Se le aplicó el tratamiento trombolítico con estreptoquinasa recombinante a un por ciento importante de enfermos. En los servicios de hospitalización fue superior la letalidad por esta causa. No disminuyó el riesgo de morir para los pacientes con esta enfermedad y la mortalidad general en el período estudiado fue de 35 pacientes para una tasa de 9,58 × 100 000 habitantes.INTRODUCTION: the acute myocardial infarction was over the 12 % of deceased from ischemic heart disease in Venezuela in

Relationship between renal cortex and parenchyma thickness and renal function: study with CT measurement

International Nuclear Information System (INIS)

Xu Yufeng; Tang Guangjian; Jiang Xuexiang

2006-01-01

Objective: To study the relationship between renal morphology and renal function, and to assess the value of CT as a criterion to grade renal function. Methods: Enhancement CT were performed in 89 patients with no local renal disease whose split renal glomerular filtration rates (GFR) were measured by renal dynamic imaging with 99 Tc m -DTPA. The 178 kidneys were divided into normal renal function, mild and severe renal impairment groups according to renal function. Differences between three groups respect to the mean thickness of renal cortex and parenchyma were assessed by ANOVA. Using Pearson's correlation test, the correlation between the renal cortex, parenchyma thicknesses and renal GFR were examined. The value of CT in predicting renal function was assessed by using ROC analysis. Results: The renal cortex thicknesses of normal renal function, mild and severe renal impairment groups were (5.9±1.1), (4.6± 1.1), and (3.3±1.0) mm respectively, and the renal parenchyma thicknesses were (26.3±4.2), (21.3±4.6), (16.2±4.6) mm. There were significant differences of renal cortex, parenchyma thicknesses between 3 groups (cortex F=54.78, P<0.01; parenehyma F=43.90, P<0.01). The thicknesses of renal cortex (r=0.752, P<0.01), parenchyma (r=0.738, P<0.01) had positive linear correlation with renal function. ROC analysis of the renal cortex thicknesses measured by CT in predicting mild and severe renal impairment showed that the Az was 0.860 and 0.905 respectively, whereas that of parenchyma was 0.868 and 0.884. Conclusion: The thicknesses of renal cortex, parenchyma measured by CT can reflect renal function. CT was a supplementary method to assess renal function. (authors)

Glomerular Filtration Rate Estimation in Renal and Non-Renal Solid Organ Transplantation

DEFF Research Database (Denmark)

Hornum, Mads; Feldt-Rasmussen, Bo

2017-01-01

Following transplantation (TX) of both renal and non-renal organs, a large proportion of patients have renal dysfunction. There are multiple causes for this. Chronic nephrotoxicity and high doses of calcineurin inhibitors are important factors. Preoperative and perioperative factors like...... or estimates of renal function in these patients, in order to accurately and safely dose immunosuppressive medication and perform and adjust the treatment and prophylaxis of renal dysfunction. This is a short overview and discussion of relevant studies and possible caveats of estimated glomerular filtration...... rate methods for use in renal and non-renal TX....

Superselective transcatheter renal arterial embolization for acute renal bleeding in patients with renal insufficiency: its clinical efficacy and safety

International Nuclear Information System (INIS)

Hu Tingyang; Zhou Bing; Yu Wenqiang; Luo Zuyan; Mao Yingmin; Chen Fanghong; Li Bo; Yuan Jianhua

2010-01-01

Objective: To discuss the clinical efficacy and complications of super selective renal arterial embolization in treating acute renal arterial bleeding in patients with renal insufficiency, and to evaluate the influence of the treatment on the renal function. Methods: During the period of January 2000 December 2009, super selective renal arterial embolization was performed in our institution for acute renal bleeding in 13 patients with renal insufficiency. The complete clinical and imaging materials of all patients were properly collected. The clinical effectiveness, the renal function, the extent of embolization and the complications were observed and the relationship between each other was analyzed. Results: The embolization procedure was successfully completed in all patients with a technical success rate of 100%. The mean embolized territory was 22% of a single kidney. Three days after the procedure, the hemoglobin level, hematocrit, blood pressure and heart rate were considerably improved in all patients. Compared to the corresponding preoperative data, all the differences were statistically significant (P 0.05), while the blood urea nitrogen was markedly decreased (P=0.011). Post embolization syndrome occurred in 5 patients and progressive aggravation of the renal function was observed in one patient, who had to receive hemodialysis finally. The embolized territory in patients occurring complications was larger than that in patients without occurring complications (U=1.500, P=0.006). Conclusion: Super selective renal arterial embolization is an effective and safe treatment for acute renal arterial bleeding in patients with renal insufficiency, the therapy will not significantly worsen the renal function. Appropriate and reasonable extent of embolization, as small as possible, is the key point for reducing the complications. (authors)

Mortalidad por enfermedad de Chagas: A propósito de los brotes de Chagas agudo como enfermedad reemergente de transmisión alimentaria

OpenAIRE

Rísquez, Alejandro

2009-01-01

Tras la ocurrencia de los primeros brotes de Chagas agudos en la capital (diciembre 2007) y Estado Vargas (marzo 2009) por trasmisión oral, se procedió a una revisión de la mortalidad por la enfermedad registrada entre 1997 y 2006, cuyos datos se analizaron de acuerdo a la edad, sexo y forma de presentación. El número absoluto de muertes sigue siendo elevado con promedio de 796 muertes anuales, de predominio en el sexo masculino, la mayoría en después de los 60 años de edad. Llama la atención...

Detection of acute renal allograft rejection by analysis of Renal TissueProteomics in rat models of renal transplantation

International Nuclear Information System (INIS)

Dai, Y.; Lv, T.; Wang, K.; Li, D.; Huang, Y.; Liu, J.

2008-01-01

At present, the diagnosis of renal allograft rejection requires a renalbiopsy. Clinical management of renal transplant patients would be improved ifrapid, noninvasive and reliable biomarkers of rejection were available. Thisstudy is designed to determine whether such protein biomarkers can be foundin renal graft tissue proteomic approach. Orthotopic kidney transplantationswere performed using Fisher (F344) or Lewis rats as donors and Lewis rats asrecipients. Hence, there were two groups of renal transplant models: one isallograft (from F344 to Lewis rats); another is syngrafts (from Lewis toLewis rats) serving as control. Renal tissues were collected 3, 7 and 14 daysafter transplantation. As many 18 samples were analyzed by 2-DElectrophoresis and mass spectrometry (MALDI-TOF-TOF-MS). Elevendifferentially expressed proteins were identified between groups. Inconclusion, proteomic technology can detect renal tissue proteins associatedwith acute renal allograft rejection. Identification of these proteins asdiagnostic markers for rejection in patient's urine or sera may be useful andnon-invasive, and these proteins might serve as novel therapeutic targetsthat also help to improve the understanding of mechanisms of renal rejection.(author)

Anatomic Patterns of Renal Arterial Sympathetic Innervation: New Aspects for Renal Denervation.

Science.gov (United States)

Imnadze, Guram; Balzer, Stefan; Meyer, Baerbel; Neumann, Joerg; Krech, Rainer Horst; Thale, Joachim; Franz, Norbert; Warnecke, Henning; Awad, Khaled; Hayek, Salim S; Devireddy, Chandan

2016-12-01

Initial studies of catheter-based renal arterial sympathetic denervation to lower blood pressure in resistant hypertensive patients renewed interest in the sympathetic nervous system's role in the pathogenesis of hypertension. However, the SYMPLICITY HTN-3 study failed to meet its prespecified blood pressure lowering efficacy endpoint. To date, only a limited number of studies have described the microanatomy of renal nerves, of which, only two involve humans. Renal arteries were harvested from 15 cadavers from the Klinikum Osnabruck and Schuchtermann Klinik, Bad Rothenfelde. Each artery was divided longitudinally in equal thirds (proximal, middle, and distal), with each section then divided into equal superior, inferior, anterior, and posterior quadrants, which were then stained. Segments containing no renal nerves were given a score value = 0, 1-2 nerves with diameter 4 nerves or nerve diameter ≥600 µm a score = 3. A total of 22 renal arteries (9 right-sided, 13 left-sided) were suitable for examination. Overall, 691 sections of 5 mm thickness were prepared. Right renal arteries had significantly higher mean innervation grade (1.56 ± 0.85) compared to left renal arteries (1.09 ± 0.87) (P renal artery has significantly higher innervation scores than the left. The anterior and superior quadrants of the renal arteries scored higher in innervation than the posterior and inferior quadrants did. The distal third of the renal arteries are more innervated than the more proximal segments. These findings warrant further evaluation of the spatial innervation patterns of the renal artery in order to understand how it may enhance catheter-based renal arterial denervation procedural strategy and outcomes. The SYMPLICITY HTN-3 study dealt a blow to the idea of the catheter-based renal arterial sympathetic denervation. We investigated the location and patterns of periarterial renal nerves in cadaveric human renal arteries. To quantify the density of the

Renal Blood Flow, Glomerular Filtration Rate, and Renal Oxygenation in Early Clinical Septic Shock.

Science.gov (United States)

Skytte Larsson, Jenny; Krumbholz, Vitus; Enskog, Anders; Bragadottir, Gudrun; Redfors, Bengt; Ricksten, Sven-Erik

2018-06-01

Data on renal hemodynamics, function, and oxygenation in early clinical septic shock are lacking. We therefore measured renal blood flow, glomerular filtration rate, renal oxygen consumption, and oxygenation in patients with early septic shock. Prospective comparative study. General and cardiothoracic ICUs. Patients with norepinephrine-dependent early septic shock (n = 8) were studied within 24 hours after arrival in the ICU and compared with postcardiac surgery patients without acute kidney injury (comparator group, n = 58). None. Data on systemic hemodynamics and renal variables were obtained during two 30-minute periods. Renal blood flow was measured by the infusion clearance of para-aminohippuric acid, corrected for renal extraction of para-aminohippuric acid. Renal filtration fraction was measured by renal extraction of chromium-51 labeled EDTA. Renal oxygenation was estimated from renal oxygen extraction. Renal oxygen delivery (-24%; p = 0.037) and the renal blood flow-to-cardiac index ratio (-21%; p = 0.018) were lower, renal vascular resistance was higher (26%; p = 0.027), whereas renal blood flow tended to be lower (-19%; p = 0.068) in the septic group. Glomerular filtration rate (-32%; p = 0.006) and renal sodium reabsorption (-29%; p = 0.014) were both lower in the septic group. Neither renal filtration fraction nor renal oxygen consumption differed significantly between groups. Renal oxygen extraction was significantly higher in the septic group (28%; p = 0.022). In the septic group, markers of tubular injury were elevated. In early clinical septic shock, renal function was lower, which was accompanied by renal vasoconstriction, a lower renal oxygen delivery, impaired renal oxygenation, and tubular sodium reabsorption at a high oxygen cost compared with controls.

Método de las invariantes en la conducta a seguir ante un paciente con abdomen agudo quirúrgico en el nivel primario de atención

Directory of Open Access Journals (Sweden)

Esteban Regalado García

2003-08-01

Full Text Available El médico que hoy formamos tiene una visión más integral de los problemas de salud del ser humano. En nuestro sistema de salud, el nivel primario constituye, en gran medida, su puerta de entrada. Los profesionales que laboran en este nivel deben estar preparados para resolver los problemas de salud propios de su especialidad e identificar aquellas entidades que deben ser resueltas en los otros niveles del sistema. El abdomen agudo quirúrgico es de los problemas de salud que deben ser atendidos oportunamente para evitar complicaciones, incluso fatales, en nuestros pacientes. Un método pedagógico para aprender los conocimientos necesarios, con calidad y que orienta la conducta correcta ante cada paciente, es el método de las invariantes. El concepto de invariante contempla la identificación de aquellas cuestiones fundamentales, esenciales y necesarias para poder sospechar un diagnóstico. Cuando el Médico General Integral conoce las invariantes de una entidad, puede tomar decisiones con un elevado margen de seguridad. Un abdomen agudo quirúrgico puede ser producido por cientos de enfermedades y estudiarlas una por una sería interminable; dada su gravedad, cualquier error que se cometa en su manejo puede ser fatal. Hemos identificado 7 signos invariantes en el abdomen agudo quirúrgico, estos signos que presentamos en este trabajo, pueden ser reconocidos en 9 de cada 10 pacientes que consultan con un dolor abdominal agudo. Existen dificultades para su identificación en un pequeño número de pacientes, a lo que hemos llamado "Situaciones Especiales".The physicians that we are preparing today have more comprehensive vision of the health problems of the human being. In our health care system, the primary health care level constitutes, in a greater extent, an entry door. Health professionals working at this level should be ready to solve health problems inherent to their specialty and to identify those entities that should be resolved at

The 64-MSCT study of relationship between renal corticomedullary differentiation, contrast between renal cortex and medulla, renal cortex and medulla CT peak value with the single renal function in hydronephrotic kidney

International Nuclear Information System (INIS)

Wang Yunhua; Hou Weiwei; Liu Ruihong; He Jianjun; Zhi Ke

2009-01-01

Objective: To study 64-MSCT perfusion imaging features about renal corticomedullary differentiation, contrast between renal cortex and medulla (CMC), renal cortex and medulla CT peak value in normal and hydronephrotic kidneys, and to explore the relationship between them and the unilateral renal function. Methods: Thirty-six patients with obstructive nephrohydrosis underwent 64-MSCT perfusion scanning. The split renal glomerular filtration rates (GFR) of their kidneys were measured by SPECT renal dynamic imaging. The 72 kidneys were divided into groups of normal renal function group, mild and severe renal impairment groups according to GFR. Renal corticomedullary differentiation on CT images was graded as clear, obscure, part clear. The CT intensity of cortex and medulla was measured in order to calculate contrast between renal cortex and medulla (CMC). Using Pearson correlation test, the correlation between them and renal GFR were examined. Results: (1) In the 24 kidneys of normal group, all kidneys showed clear CMD. In the 21 kidneys of mild renal impairment group, 14 kidneys showed clear CMD, 2 showed obscure CMD and 5 showed part clear of CMD. In the 27 kidneys of severe renal impairment group, 7 kidneys showed clear CMD, 5 showed obscure CMD and 15 showed part clear of CMD. (2)The CMC of normal group was 0.62 ± 0.20, while it was 0.52 ± 0.14 and 0.37 ± 0.11 for mild renal impairment group and severe renal impairment group CMC respectively. The CMC had positive linear correlation with GFR (r=0.536,P<0.05). (3) The renal cortex and medulla CT peak value of normal group were (133 ± 22) and (104 ± 16) HU; The renal cortex and medulla CT peak value of mild renal impairment group were (91 ± 29) and (76 ± 25) HU; The renal cortex and medulla CT peak value of severe renal impairment group were (68 ± 24) and (57 ± 21) HU(F=42.76 and 32.68,P<0.05). The renal cortex and medulla CT peak value had positive linear correlation with GFR (r=0.672 and 0.623, P<0

TÉCNICAS DE OFENSA Y DEFENSA A LOS FALLOS POR CORRUPCIÓN DE MEMORIA Memory Corruption Failures Attack and Defense Techniques

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David Mora Rodríguez

2011-12-01

Full Text Available Las técnicas de ataque a aplicaciones por corrupción de memoria aprovechan las debilidades de los programas para obtener ejecución de código arbitrario. Estos fallos de programación han sido utilizados por diferentes ataques desde la década de los ochenta. Este documento presenta las diferentes técnicas que puede utilizar un atacante para lograr su objetivo y las precauciones que debe tener un desarrollador de aplicaciones, para evitar que su programa esté expuesto a vulnerabilidades que permitan ejecutar ataques por corrupción de memoria. Los fabricantes de sistemas operativos y compiladores introdujeron diferentes mecanismos de defensa para proteger las aplicaciones. Estos mecanismos no son excluyentes y cada uno tiene sus propios objetivos de diseño para añadir nuevas capas de seguridad.Attack techniques against memory corruption applications take advantage of the programs weakness for obtaining execution of arbitrary code. These programming failures have been used for several attacks since the 80's. This document shows several techniques to be used by an attacker in order to achieve his objectives and the precautions an application developer should have for preventing the program to be exposed vulnerable situations which may allow having attacks for memory corruption. Manufacturers of operating systems and compilers introduced several defense mechanisms to protect applications. These are not excluding mechanisms and each one of them has its own design objectives for adding new security layers.

Multiple Renal Artery Pseudoaneurysms in Patients Undergoing Renal Artery Embolization Following Partial Nephrectomy: Correlation with RENAL Nephrometry Scores

International Nuclear Information System (INIS)

Gupta, Nakul; Patel, Anish; Ensor, Joe; Ahrar, Kamran; Ahrar, Judy; Tam, Alda; Odisio, Bruno; Huang, Stephen; Murthy, Ravi; Mahvash, Armeen; Avritscher, Rony; McRae, Stephen; Sabir, Sharjeel; Wallace, Michael; Matin, Surena; Gupta, Sanjay

2017-01-01

PurposeTo describe the incidence of multiple renal artery pseudoaneurysms (PSA) in patients referred for renal artery embolization following partial nephrectomy and to study its relationship to RENAL nephrometry scores.Materials and MethodsThe medical records of 25 patients referred for renal artery embolization after partial nephrectomy were retrospectively reviewed for the following parameters: size and number of tumors, RENAL nephrometry scores, angiographic abnormalities, technical and clinical outcomes, and estimated glomerular filtration rates (eGFRs) after embolization.ResultsTwenty-four patients had primary renal tumors, while 1 patient had a pancreatic tumor invading the kidney. Multiple tumors were resected in 4 patients. Most patients (92 %) were symptomatic, presenting with gross hematuria, flank pain, or both. Angiography revealed PSA with (n = 5) or without (n = 20) AV fistulae. Sixteen patients (64 %) had multiple PSA involving multiple renal vessels. Higher RENAL nephrometry scores were associated with an increasing likelihood of multiple PSA. Multiple vessels were embolized in 14 patients (56 %). Clinical success was achieved after one (n = 22) or two (n = 3) embolization sessions in all patients. Post-embolization eGFR values at different time points after embolization were not significantly different from the post-operative eGFR.ConclusionA majority of patients requiring renal artery embolization following partial nephrectomy have multiple pseudoaneurysms, often requiring selective embolization of multiple vessels. Higher RENAL nephrometry score is associated with an increasing likelihood of multiple pseudoaneurysms. We found transarterial embolization to be a safe and effective treatment option with no long-term adverse effect on renal function in all but one patient with a solitary kidney.

Multiple Renal Artery Pseudoaneurysms in Patients Undergoing Renal Artery Embolization Following Partial Nephrectomy: Correlation with RENAL Nephrometry Scores

Energy Technology Data Exchange (ETDEWEB)

Gupta, Nakul [Houston Methodist Hospital (United States); Patel, Anish [The University of Texas Southwestern Medical Center (United States); Ensor, Joe [Houston Methodist Research Institute, The Houston Methodist Cancer Center (United States); Ahrar, Kamran; Ahrar, Judy; Tam, Alda; Odisio, Bruno; Huang, Stephen; Murthy, Ravi; Mahvash, Armeen; Avritscher, Rony; McRae, Stephen; Sabir, Sharjeel; Wallace, Michael [The University of Texas MD Anderson Cancer Center, Department of Interventional Radiology (United States); Matin, Surena [The University of Texas MD Anderson Cancer Center, Department of Urology (United States); Gupta, Sanjay, E-mail: sgupta@mdanderson.org [The University of Texas MD Anderson Cancer Center, Department of Interventional Radiology (United States)

2017-02-15

PurposeTo describe the incidence of multiple renal artery pseudoaneurysms (PSA) in patients referred for renal artery embolization following partial nephrectomy and to study its relationship to RENAL nephrometry scores.Materials and MethodsThe medical records of 25 patients referred for renal artery embolization after partial nephrectomy were retrospectively reviewed for the following parameters: size and number of tumors, RENAL nephrometry scores, angiographic abnormalities, technical and clinical outcomes, and estimated glomerular filtration rates (eGFRs) after embolization.ResultsTwenty-four patients had primary renal tumors, while 1 patient had a pancreatic tumor invading the kidney. Multiple tumors were resected in 4 patients. Most patients (92 %) were symptomatic, presenting with gross hematuria, flank pain, or both. Angiography revealed PSA with (n = 5) or without (n = 20) AV fistulae. Sixteen patients (64 %) had multiple PSA involving multiple renal vessels. Higher RENAL nephrometry scores were associated with an increasing likelihood of multiple PSA. Multiple vessels were embolized in 14 patients (56 %). Clinical success was achieved after one (n = 22) or two (n = 3) embolization sessions in all patients. Post-embolization eGFR values at different time points after embolization were not significantly different from the post-operative eGFR.ConclusionA majority of patients requiring renal artery embolization following partial nephrectomy have multiple pseudoaneurysms, often requiring selective embolization of multiple vessels. Higher RENAL nephrometry score is associated with an increasing likelihood of multiple pseudoaneurysms. We found transarterial embolization to be a safe and effective treatment option with no long-term adverse effect on renal function in all but one patient with a solitary kidney.

Infarto agudo de miocardio. Guía de práctica clínica

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Yanier Coll Muñoz

2011-08-01

Full Text Available

La elaboración de esta Guía de Práctica Clínica se justifica, en primer lugar, por la elevada frecuencia de presentación y mortalidad del infarto agudo del miocardio en la población general. Las enfermedades cardiovasculares constituyen en la actualidad la principal causa de muerte en los países industrializados, y se espera que también lo sean en los países en vías de desarrollo en el año 2020.  La presente guía se refiere a los pacientes que presentan síntomas isquémicos o sus equivalentes, y una elevación persistente del segmento ST en el electrocardiograma, o cambios del electrocardiograma de infradesnivel del ST o de la onda T, compatibles con el diagnóstico de IAM sin elevación del ST. Esta Guía no aborda los elementos relacionados directamente con los procedimientos de intervencionismo coronario percutáneo ni la revascularización miocárdica quirúrgica.

The renal quantitative scintillation camera study for determination of renal function

International Nuclear Information System (INIS)

Thompson, I.M. Jr.; Boineau, F.G.; Evans, B.B.; Schlegel, J.U.

1983-01-01

The renal quantitative scintillation camera study assesses glomerular filtration rate and effective renal plasma flow based upon renal uptake of 99mtechnetium-iron ascorbate and 131iodine-hippuran, respectively. The method was compared to inulin, para-aminohippuric acid and creatinine clearance studies in 7 normal subjects and 9 patients with various degrees of reduced renal function. The reproducibility of the technique was determined in 15 randomly selected pediatric patients. The values of glomerular filtration rate and effective renal plasma flow were not significantly different from those of inulin and para-aminohippuric acid studies. The reproducibility of the technique was comparable to that of inulin and para-aminohippuric acid studies. Patient acceptance of the technique is excellent and the cost is minimal. Renal morphology and excretory dynamics also are demonstrated. The technique is advocated as a clinical measure of renal function

Inhibiting aerobic glycolysis suppresses renal interstitial fibroblast activation and renal fibrosis.

Science.gov (United States)

Ding, Hao; Jiang, Lei; Xu, Jing; Bai, Feng; Zhou, Yang; Yuan, Qi; Luo, Jing; Zen, Ke; Yang, Junwei

2017-09-01

Chronic kidney diseases generally lead to renal fibrosis. Despite great progress having been made in identifying molecular mediators of fibrosis, the mechanism that governs renal fibrosis remains unclear, and so far no effective therapeutic antifibrosis strategy is available. Here we demonstrated that a switch of metabolism from oxidative phosphorylation to aerobic glycolysis (Warburg effect) in renal fibroblasts was the primary feature of fibroblast activation during renal fibrosis and that suppressing renal fibroblast aerobic glycolysis could significantly reduce renal fibrosis. Both gene and protein assay showed that the expression of glycolysis enzymes was upregulated in mouse kidneys with unilateral ureter obstruction (UUO) surgery or in transforming growth factor-β1 (TGF-β1)-treated renal interstitial fibroblasts. Aerobic glycolysis flux, indicated by glucose uptake and lactate production, was increased in mouse kidney with UUO nephropathy or TGF-β1-treated renal interstitial fibroblasts and positively correlated with fibrosis process. In line with this, we found that increasing aerobic glycolysis can remarkably induce myofibroblast activation while aerobic glycolysis inhibitors shikonin and 2-deoxyglucose attenuate UUO-induced mouse renal fibrosis and TGF-β1-stimulated myofibroblast activation. Furthermore, mechanistic study indicated that shikonin inhibits renal aerobic glycolysis via reducing phosphorylation of pyruvate kinase type M2, a rate-limiting glycolytic enzyme associated with cell reliance on aerobic glycolysis. In conclusion, our findings demonstrate the critical role of aerobic glycolysis in renal fibrosis and support treatment with aerobic glycolysis inhibitors as a potential antifibrotic strategy. Copyright © 2017 the American Physiological Society.

RENAL CRYOABLATION

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A. V. Govorov

2012-01-01

Full Text Available Renal cryoablation is an alternative minimally-invasive method of treatment for localized renal cell carcinoma. The main advantages of this methodology include visualization of the tumor and the forming of "ice ball" in real time, fewer complications compared with other methods of treatment of renal cell carcinoma, as well as the possibility of conducting cryotherapy in patients with concomitant pathology. Compared with other ablative technologies cryoablation has a low rate of repeat sessions and good intermediate oncological results. The studies of long-term oncological and functional results of renal cryoablation are presently under way.

Radicales libres de oxígeno y distress respiratorio agudo

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Aracelis E. Dorado Lambert

2000-09-01

Full Text Available Se realizó una revisión acerca de la formación de radicales libres de oxígeno en el organismo, así como el aumento exagerado de su génesis durante la exposición a altas concentraciones de oxígeno y en el desarrollo de la explosión respiratoria que acompaña la fagocitosis. Se analiza además la formación de estos radicales en el pulmón durante la evolución del distress respiratorio agudo. Se abordó, posteriormente, el uso actual, sobre todo en el ámbito internacional, de los antioxidantes y bloqueadores de la lipoperoxidación para disminuir los efectos adversos de los radicales libres. A pesar de estas nuevas medidas, se corrobora que la disminución experimentada en la mortalidad por esta entidad, obedece a la optimización de los cuidados respiratorios, en especial la ventilación mecánica.The formation of free oxygen radicals in the body and the excessive increase of its genesis during exposure to high concentrations of oxygen and in the development of respiratory burst accompanying phagocytosis were reviewed. Also the formation of these radicals in lung during acute respiratory distress was analyzed. Similarly, the present use at the international level of antioxidants and lipoperoxidation blockers to diminish adverse effects of free radicals are addressed in this paper. In spite of these new measures, it was confirmed that the reduction of mortality rate from this disease was due to the improvement of respiratory care particularly the mechanical ventilation.

Renal artery pulsatility index and renal volume: Normal fetuses versus growth-retarded fetuses

International Nuclear Information System (INIS)

Lee, Kyung Soon; Woo, Bock Hi

2001-01-01

To evaluate the blood flow velocity waveform of the renal artery and renal volume of growth-retarded fetuses and to compare them with those of normal fetuses. Pulsatility index of the renal artery and renal volume measured by three-dimensional ultrasonography were obtained from seventy eight normal fetuses at the gestational age from twenty five to thirty nine weeks and eighteen intrauterine growth retarded fetuses whose weight was below ten percentile at birth. We studied changes of the pulsatility index of the renal artery and renal volume according to the gestational age and compared with those of growth-retarded fetuses. Pulsatility index (PI) of the fetal renal artery decreased throughout the gestational period (r=0.703, p<0.0001). In growth-retarded fetuses, despite of abnormal doppler velocity waveform of the middle cerebral artery, which was showing fetal hypoxia, the renal PI was not increased significantly. The fetal renal volume increased throughout the gestational period (r=0.834, p<0.0001) whereas in growth-retarded fetuses, all renal volume was below fifth percentile of normal fetuses. In growth-retarded fetuses, fetal renal volume was decreased significantly without change of the renal vascular flow. Therefore, the fetal renal volume measured by three-dimensional ultrasonography may be a helpful parameter in the diagnosis of growth-retarded fetuses.

Renal artery pulsatility index and renal volume: Normal fetuses versus growth-retarded fetuses

Energy Technology Data Exchange (ETDEWEB)

Lee, Kyung Soon; Woo, Bock Hi [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

2001-06-15

To evaluate the blood flow velocity waveform of the renal artery and renal volume of growth-retarded fetuses and to compare them with those of normal fetuses. Pulsatility index of the renal artery and renal volume measured by three-dimensional ultrasonography were obtained from seventy eight normal fetuses at the gestational age from twenty five to thirty nine weeks and eighteen intrauterine growth retarded fetuses whose weight was below ten percentile at birth. We studied changes of the pulsatility index of the renal artery and renal volume according to the gestational age and compared with those of growth-retarded fetuses. Pulsatility index (PI) of the fetal renal artery decreased throughout the gestational period (r=0.703, p<0.0001). In growth-retarded fetuses, despite of abnormal doppler velocity waveform of the middle cerebral artery, which was showing fetal hypoxia, the renal PI was not increased significantly. The fetal renal volume increased throughout the gestational period (r=0.834, p<0.0001) whereas in growth-retarded fetuses, all renal volume was below fifth percentile of normal fetuses. In growth-retarded fetuses, fetal renal volume was decreased significantly without change of the renal vascular flow. Therefore, the fetal renal volume measured by three-dimensional ultrasonography may be a helpful parameter in the diagnosis of growth-retarded fetuses.

Risk factors for maternal death in patients with severe preeclampsia and eclampsia Fatores de risco para morte materna em pacientes com pré-eclâmpsia grave/ eclâmpsia

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Melania Maria Ramos de Amorim

2001-12-01

agudo de pulmão, coagulopatia intravascular disseminada, choque hemorrágico, embolia pulmonar, insuficiência renal aguda, e septicemia e três casos por causas indeterminadas. Os principais fatores de risco foram: idade > 25 anos, multiparidade, idade gestacional 110mmHg, convulsões, hipertensão arterial sistêmica crônica, síndrome HELLP, edema agudo de pulmão, descolamento prematuro de placenta, coagulopatia intravascular disseminada e insuficiência renal aguda. As variáveis que persistiram associadas com morte materna foram: síndrome HELLP, eclâmpsia, edema agudo de pulmão, hipertensão crônica e falta de pré-natal. CONCLUSÕES: os principais fatores de risco para morte em mulheres com pré-eclâmpsia/eclâmpsia são falta de pré-natal associados com hipertensão crônica e complicações como síndrome HELLP, eclâmpsia e edema agudo de pulmão.

Obesity and renal hemodynamics

NARCIS (Netherlands)

Bosma, R. J.; Krikken, J. A.; van der Heide, J. J. Homan; de Jong, P. E.; Navis, G. J.

2006-01-01

Obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Obesity is associated with several renal risk factors such as hypertension and diabetes that may convey renal risk, but obesity is also associated with an unfavorable renal hemodynamic profile

Does the presence of accessory renal arteries affect the efficacy of renal denervation?

Science.gov (United States)

Id, Dani; Kaltenbach, Benjamin; Bertog, Stefan C; Hornung, Marius; Hofmann, Ilona; Vaskelyte, Laura; Sievert, Horst

2013-10-01

This study sought to assess the efficacy of catheter-based renal sympathetic denervation in patients with accessory renal arteries and to compare the blood pressure (BP)-lowering effect with that observed in patients with bilateral single renal arteries after renal denervation. Catheter-based renal sympathetic denervation causes significant BP reductions in patients with resistant hypertension. Seventy-four patients were included in this study. Patients were assigned to 2 main groups: a bilateral single renal arteries group I (n = 54) and an accessory renal arteries group II (n = 20). Group II consisted of 9 patients whose accessory renal arteries were all denervated (group IIa), and 11 patients whose accessory renal arteries were not, or only incompletely, denervated (group IIb). The primary endpoint was the change in office systolic BP after 6 months. The procedure was successful in all patients. Group I: mean BP at baseline was 166.2/89.4 ± 20.5/14.6 mm Hg and decreased by -16.6 (p renal denervation in patients with accessory renal arteries is less pronounced than in patients with bilateral single renal arteries. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Radiopharmaceuticals for renal studies

International Nuclear Information System (INIS)

Verdera, Silvia

1994-01-01

Between the diagnostic techniques using radiopharmaceuticals in nuclear medicine it find renal studies.A brief description about renal glomerular filtration(GFR) and reliability renal plasma flux (ERPF),renal blood flux measurement agents (RBF),renal scintillation agents and radiation dose estimates by organ physiology was given in this study.tabs

Glomerular Filtration Rate Estimation in Renal and Non-Renal Solid Organ Transplantation

DEFF Research Database (Denmark)

Hornum, Mads; Feldt-Rasmussen, Bo

2017-01-01

Following transplantation (TX) of both renal and non-renal organs, a large proportion of patients have renal dysfunction. There are multiple causes for this. Chronic nephrotoxicity and high doses of calcineurin inhibitors are important factors. Preoperative and perioperative factors like hyperten......Following transplantation (TX) of both renal and non-renal organs, a large proportion of patients have renal dysfunction. There are multiple causes for this. Chronic nephrotoxicity and high doses of calcineurin inhibitors are important factors. Preoperative and perioperative factors like...... hypertension, hypotension, drugs and infections may play a causative role as well. Organ-specific causes include hepatorenal syndrome, cirrhosis, low cardiac function, low respiratory function and diabetes developed both before and after TX. It is important to be able to perform precise and valid measurements...... rate methods for use in renal and non-renal TX....

Treatment of non-neoplastic renal hemorrhage with segmental embolization of renal artery

International Nuclear Information System (INIS)

Zhu Bing

2007-01-01

Objective: To explore the value of segmental embolization of renal artery in dealing with non- neoplastic renal hemorrhage. Methods: Four cases of non-neoplastic hemorrhage, including 2 with bleeding after renal acupuncture biopsy, 2 with bleeding after nephrolithotomy and 1 with congenital renal arteriovenous malformation, were treated with superselective segmental embolization of renal artery. 2 were embolized with coil, 1 with alcohol plus coil and 1 with PVA parcels. Results: Hematuria disappeared in 1-3 days. There was no recurrence in 7-45 months follow up and no complications induced by embolization. Conclusion: It is a safe and reliable therapy to treat non-neoplastic renal hemorrhage with segmental embolization of renal artery. (authors)

A diferenciação da dor do infarto agudo do miocárdio entre pacientes diabéticos e não-diabéticos Diferenciación del dolor del infarto agudo de miocardio entre pacientes diabéticos y no diabéticos The difference in acute myocardial infarction pain between diabetic and non diabetic patients

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Leandra de Gouveia Pacheco Gondim

2003-12-01

Full Text Available O estudo teve como objetivo comparar a dor do infarto agudo do miocárdio (IAM entre pacientes diabéticos e não-diabéticos. Uma amostra de 80 pacientes com IAM, divididos em 2 grupos com e sem diabetes mellitus (DM, sendo 29% diabéticos e 71% não-diabéticos. Os pacientes com DM referiram ausência de dor (pEl objetivo de este estudio fue comparar el dolor del infarto agudo de miocardio (IAM entre pacientes diabéticos y no diabéticos. La muestra la conformaron 80 pacientes con IAM divididos en dos grupos: con y sin diabetes mellitus (DM, siendo el 29% diabéticos y el 71% no diabéticos. Los pacientes con DM manifestaron ausencia de dolor (pThe goal of this study was to compare the acute myocardial infarction (AMI pain between diabetic and non diabetic patients. A sample of 80 AMI patients was divided in two groups, with and without diabetes mellitus (DM, being 29% diabetic and 71% non diabetic patients. The patients with DM said they had no pain (p<0.05 and gave lower scores for pain when compared with patients without DM. There was a significant difference between average scores for pain among diabetic and non diabetic patients (p<0.001. In conclusion, the diabetic patients presented no pain or diminished pain when compared with patients without diabetes.

Bilateral renal artery variation

OpenAIRE

Üçerler, Hülya; Üzüm, Yusuf; İkiz, Z. Aslı Aktan

2014-01-01

Each kidney is supplied by a single renal artery, although renal artery variations are common. Variations of the renal arteryhave become important with the increasing number of renal transplantations. Numerous studies describe variations in renalartery anatomy. Especially the left renal artery is among the most critical arterial variations, because it is the referred side forresecting the donor kidney. During routine dissection in a formalin fixed male cadaver, we have found a bilateral renal...

[Aortic dissection spread to the renal arteries: role of renal volumetry after angioplasty].

Science.gov (United States)

Vautrin, E; Thony, F; Chavanon, O; Hannachi, I; Barone-Rochette, G; Pierre, H; Baguet, J-P

2012-06-01

Type A or B aortic dissection can extend to renal arteries, causing a renal ischemia which treatment is usually endovascular. The aim of our study is to show the interest of the renal volumetry in the follow-up of these patients. Twenty-two patients (16 men, mean age 63.4±11.8years, BMI 25.2±3.4kg/m(2)) with a type A or B aortic dissection spread to one or to both renal arteries and followed at Grenoble university hospital were consecutively included. All patients underwent renal angiography with aorto-renal pressure gradients measurements and follow-up by renal volumetry (scanner Siemens(®)). A renal ischemia was defined by a decrease of 20% or more of the volumetry. Sixteen patients (73%) were hypertensive before the aortic dissection among which ten (62%) were treated. Eight patients (36%) have a significant renal pressure gradient among which five (62%) underwent renal endovascular therapy. The renal volumetry of these five patients remained unchanged while six of 17 patients (36%) without angioplasty have a decreasing volumetry. Renal volumetry appeared an effective and attractive option for the follow-up of the patients with aortic dissection spread to the renal arteries. These results should be taken into account to put the indication of an endovascular treatment. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

BILATERAL DUPLICATION OF RENAL ARTERIES

OpenAIRE

Prajkta A Thete; Mehera Bhoir; M.V.Ambiye

2014-01-01

Routine dissection of a male cadaver revealed the presence of bilateral double renal arteries. On the right side the accessory renal artery originated from the abdominal aorta just above the main renal artery. On the left side the accessory renal artery originated from the abdominal aorta about 1 cm above the main renal artery. Knowledge of the variations of renal vascular anatomy has importance in exploration and treatment of renal trauma, renal transplantation, renal artery embolization, su...

Computed tomography of renal cell carcinoma in patients with terminal renal impairment

International Nuclear Information System (INIS)

Ferda, Jiri; Hora, Milan; Hes, Ondrej; Reischig, Tomas; Kreuzberg, Boris; Mirka, Hynek; Ferdova, Eva; Ohlidalova, Kristyna; Baxa, Jan; Urge, Tomas

2007-01-01

Purpose: An increased incidence of renal tumors has been observed in patients with end-stage-renal-disease (ESRD). The very strong association with acquired renal cystic disease (ACRD) and increased incidence of the renal tumors (conventional renal cell carcinoma (CRCC), papillary renal cell carcinoma (PRCC) or papillary renal cell adenoma (PRCA)) was reported. This study discusses the role of computed tomography (CT) in detecting renal tumors in patients with renal impairment: pre-dialysis, those receiving dialysis or with renal allograft transplants. Materials and methods: Ten patients (nine male, one female) with renal cell tumors were enrolled into a retrospective study; two were new dialysis patients, three on long-term dialysis, and five were renal transplant recipients with history of dialysis. All patients underwent helical CT, a total of 11 procedures were performed. Sixteen-row detector system was used five times, and a 64-row detector system for the six examinations. All patients underwent nephrectomy of kidney with suspected tumor, 15 nephrectomies were performed, and 1 kidney was assessed during autopsy. CT findings were compared with macroscopic and microscopic assessments of the kidney specimen in 16 cases. Results: Very advanced renal parenchyma atrophy with small cysts corresponding to ESRD was found in nine patients, chronic pyelonephritis in remained one. A spontaneously ruptured tumor was detected incidentally in one case, patient died 2 years later. In the present study, 6.25% (1/16) were multiple PRCA, 12.5% (2/16) were solitary PRCC, 12.5% tumors (2/16) were solitary conventional renal cell carcinomas (CRCC's), 12.5% tumors (2/16) were multiple conventional renal cell carcinomas (CRCC's), 25% (4/16) were CRCC's combined with multiple papillary renal cell carcinomas with adenomas (PRCC's and PRCA's), and 25% (4/16) of the tumors were multiple PRCC's combined with PRCA's without coexisting CRCC's. Bilateral renal tumors were found in our study

Traumatic renal infarction

International Nuclear Information System (INIS)

Yashiro, Naobumi; Ohtomo, Kuni; Kokubo, Takashi; Itai, Yuji; Iio, Masahiro

1986-01-01

Four cases of traumatic renal artery occlusion were described and illustrated. In two cases, direct blows to the abdomen compressed the renal artery against the vertebral column. Clinically, they were severely injured with macroscopic hematuria. Aortograms showed abrupt truncation of renal arteries. In the other two, rapid deceleration caused sudden displacement of the kidney producing an intimal tear with resultant thrombosis. Although they showed little injury without macrohematuria, aortograms revealed tapered occlusion of renal arteries. One of them developed hypertension. ''Rim sign'' of post-contrast CT and hypertension resulted from traumatic renal artery occlusion were reviewed. (author)

Imaging chronic renal disease and renal transplant in children

International Nuclear Information System (INIS)

Carmichael, Jim; Easty, Marina

2010-01-01

At Great Ormond Street Hospital we have the highest number of paediatric renal transplant patients in Europe, taking cases from across the United Kingdom and abroad. Our caseload includes many children with rare complicating medical problems and chronic renal failure related morbidity. This review aims to provide an overview of our experience of imaging children with chronic renal failure and transplants. (orig.)

Síndrome coronario agudo y enfermedad de Erdheim-Chester. Patogénesis e implicaciones terapéuticas

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José Carlos Alarcón-García

2017-05-01

Full Text Available La enfermedad de Erdheim-Chester es una histiocitosis celular diferente a la histiocitosis de Langerhans, de origen incierto. Se caracteriza por una implicación multi-orgánica debida a la infiltración de los histiocitos CD68+/CD1a-, en forma de xantogranulomas, que afectan principal y comúnmente a la metáfisis y diáfisis de huesos largos. El diagnóstico se realiza mediante biopsia, donde se revelan histiocitos CD68+/CD1a-, carencia de proteína S, y presencia de gránulos de Birbeck. Se ha subestimado la implicación cardiovascular. Reportamos un caso de un varón de 67 años con la enfermedad de Erdheim-Chester e infarto de miocardio agudo, debido a implicación coronaria, además de enfermedad ósea, vascular, pituitaria y retroperitoneal. Revisamos la literatura relevante y describimos el tratamiento clínico de estos pacientes.

Radionuclide evaluation of renal transplants

International Nuclear Information System (INIS)

Yang Hong; Zhao Deshan

2000-01-01

Radionuclide renal imaging and plasma clearance methods can quickly quantitate renal blood flow and function in renal transplants. They can diagnose acute tubular necrosis and rejection, renal scar, surgical complications such as urine leaks, obstruction and renal artery stenosis after renal transplants. At the same time they can assess the therapy effect of renal transplant complications and can also predict renal transplant survival from early post-operative function studies

EFEITO AGUDO DO LASER DE BAIXA POTÊNCIA NA FADIGA DO BÍCEPS BRAQUIAL DE ATLETAS DE VOLEIBOL

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Juliana Lôbo Froio

Full Text Available RESUMO Introdução: A laserterapia de baixa potência tem entre seus propósitos auxiliar a recuperação de tecidos biológicos, atenuando os efeitos da fadiga muscular e contribuindo com a melhora do desempenho em atletas. Aspectos metodológicos ainda limitam as conclusões do efeito agudo da laserterapia sobre o desempenho muscular. Objetivo: Verificar o efeito agudo do laser terapêutico de baixa potência na fadiga induzida do bíceps braquial de atletas de voleibol. Métodos: Este foi um estudo randomizado e duplo-cego, aprovado pelo Comitê de Ética da UNESP de Marília. Participaram do estudo 19 atletas de voleibol de ambos os sexos. Realizou-se coleta de dados eletromiográficos do músculo bíceps braquial no exercício isométrico de flexão de cotovelo antes e após a aplicação do laser terapêutico. Um haltere com 75% do pico de força, obtido por uma célula de carga, foi utilizado para o protocolo de fadiga. Em seguida, os voluntários foram submetidos à aplicação do laser (ativo ou placebo em seis pontos do músculo bíceps braquial. Os dados eletromiográficos foram analisados no domínio da frequência, utilizando-se o software Myosystem®. Verificou-se a distribuição de normalidade dos dados pelo teste de Shapiro-Wilk, e utilizou-se Anova (split plot de medidas repetidas a fim de testar a interação entre tempo e grupo. Resultados: Para nenhuma das variáveis analisadas foi observada interação significativa entre grupo e tempo, indicando que o grupo irradiado não apresentou vantagens com relação ao grupo placebo. Conclusão: Após o protocolo de fadiga proposto, uma única aplicação de laser de baixa potência não foi suficiente para produzir efeitos positivos no desempenho de força e no sinal eletromiográfico do músculo bíceps braquial de atletas de voleibol.

Edema agudo hemorrágico da infância: relato de três casos Acute hemorrhagic edema of infancy: report of three cases

OpenAIRE

Paulo Sergio Emerich; Patricia Almeida Prebianchi; Luciene Lage da Motta; Elton Almeida Lucas; Leonardo Mello Ferreira

2011-01-01

O Edema Agudo Hemorrágico da Infância é uma vasculite leucocitoclástica pouco frequente, que ocorre, quase exclusivamente, em crianças entre 4 meses e 2 anos de idade. Caracteriza-se, clinicamente, pela tríade febre, lesões purpúricas na face, pavilhões auriculares e extremidades e edema. Embora os achados cutâneos sejam dramáticos e de surgimento rápido, o prognóstico é favorável, com resolução espontânea dentro de 1 a 3 semanas. Descrevem-se três casos cujos achados clínicos e histopatológi...

El estrés agudo modifica la recuperación y la extinción de la memoria espacial en función de su intensidad

OpenAIRE

Cuestas Diana Marcela; Troncoso Julieta

2007-01-01

Para evaluar los efectos del estrés agudo por restricción de movimientos sobre la recuperación y la extinción
de la memoria espacial sin sobreentrenamiento, se utilizaron tres grupos de ratas: control, estrés una hora
y estrés cuatro horas. Todos los animales fueron entrenados en el laberinto circular de Barnes. El protocolo
de entrenamiento constaba de ocho ensayos de adquisición (intervalo entre ensayos, IEE; 5 min). Los animales de todos los grupos experime...

Renal Replacement Therapy Modality in the ICU and Renal Recovery at Hospital Discharge.

Science.gov (United States)

Bonnassieux, Martin; Duclos, Antoine; Schneider, Antoine G; Schmidt, Aurélie; Bénard, Stève; Cancalon, Charlotte; Joannes-Boyau, Olivier; Ichai, Carole; Constantin, Jean-Michel; Lefrant, Jean-Yves; Kellum, John A; Rimmelé, Thomas

2018-02-01

Acute kidney injury requiring renal replacement therapy is a major concern in ICUs. Initial renal replacement therapy modality, continuous renal replacement therapy or intermittent hemodialysis, may impact renal recovery. The aim of this study was to assess the influence of initial renal replacement therapy modality on renal recovery at hospital discharge. Retrospective cohort study of all ICU stays from January 1, 2010, to December 31, 2013, with a "renal replacement therapy for acute kidney injury" code using the French hospital discharge database. Two hundred ninety-one ICUs in France. A total of 1,031,120 stays: 58,635 with renal replacement therapy for acute kidney injury and 25,750 included in the main analysis. None. PPatients alive at hospital discharge were grouped according to initial modality (continuous renal replacement therapy or intermittent hemodialysis) and included in the main analysis to identify predictors of renal recovery. Renal recovery was defined as greater than 3 days without renal replacement therapy before hospital discharge. The main analysis was a hierarchical logistic regression analysis including patient demographics, comorbidities, and severity variables, as well as center characteristics. Three sensitivity analyses were performed. Overall mortality was 56.1%, and overall renal recovery was 86.2%. Intermittent hemodialysis was associated with a lower likelihood of recovery at hospital discharge; odds ratio, 0.910 (95% CI, 0.834-0.992) p value equals to 0.0327. Results were consistent across all sensitivity analyses with odds/hazards ratios ranging from 0.883 to 0.958. In this large retrospective study, intermittent hemodialysis as an initial modality was associated with lower renal recovery at hospital discharge among patients with acute kidney injury, although the difference seems somewhat clinically limited.

Technical aspects of renal denervation in end-stage renal disease patients with challenging anatomy.

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Spinelli, Alessio; Da Ros, Valerio; Morosetti, Daniele; Onofrio, Silvia D; Rovella, Valentina; Di Daniele, Nicola; Simonetti, Giovanni

2014-01-01

We describe our preliminary experience with percutaneous renal denervation in end-stage renal disease patients with resistant hypertension and challenging anatomy, in terms of the feasibility, safety, and efficacy of this procedure. Four patients with end-stage renal disease patients with resistant hypertension (mean hemodialysis time, 2.3 years) who had been taking at least four antihypertensive medications underwent percutaneous renal denervation. Renal artery eligibility included the absence of prior renal artery interventions, vessel stenosis renal denervation is a feasible approach for end-stage renal disease patients with resistant hypertension with encouraging short-term preliminary results in terms of procedural efficacy and safety.

Injuria renal aguda en la sepsis grave Acute kidney injury in severe sepsis

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Hernán Trimarchi

2009-06-01

Full Text Available La sepsis afecta al 40% de los pacientes críticos, siendo su mortalidad de aproximadamente un 30% en el caso de la sepsis grave, y de 75% con injuria renal aguda, la cual sucede en el 20-51% de los casos. Se realizó un estudio prospectivo, observacional, longitudinal, en 80 pacientes sépticos graves en el lapso de 1 año para determinar el desarrollo de injuria renal aguda y su relación con la mortalidad; correlacionar antecedentes clínicos y variaciones del laboratorio con la mortalidad; determinar la tasa de mortalidad de la sepsis grave; relacionar óbito y foco séptico primario; evaluar la predictibilidad de mortalidad según niveles de creatinina de ingreso y sus variaciones finales. Se definieron dos grupos: Obito (n = 25 y No-óbito (n = 55. Analizados según la creatinina de ingreso, 39 tenían valores normales de creatinina (10 óbitos y 41 la presentaban elevada (15 óbitos; según la creatinina de egreso, 48 presentaron creatinina normal y fallecieron 7, mientras que 32 tenían daño renal agudo, de los cuales 18 fallecieron. De los 25 pacientes fallecidos, el 72% presentaron daño renal. De éstos, 7 pacientes vivos y 2 fallecidos requirieron hemodiálisis. El foco primario más frecuente fue el respiratorio (26.4%. El desarrollo de daño renal es un alto predictor de mortalidad en la sepsis, independientemente de los valores iniciales de creatinina. Edad más avanzada, hipertensión arterial, score APACHE más elevado, anemia más grave, hipoalbuminemia, hiperfosfatemia e hiperkalemia se asociaron a mayor mortalidad. La mortalidad global fue 31.3%. La imposibilidad de identificar el foco séptico primario se asoció a mayor mortalidad. El foco respiratorio se relacionó a mayor riesgo de requerir hemodiálisis.Sepsis affects 40% of critically ill patients, with a reported mortality of approximately 30% in severe sepsis, raising to 75% when acute kidney injury ensues, which occurs in about 20-51% of cases. The present study

Renal rescue of dopamine D2 receptor function reverses renal injury and high blood pressure

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Konkalmatt, Prasad R.; Asico, Laureano D.; Zhang, Yanrong; Yang, Yu; Drachenberg, Cinthia; Zheng, Xiaoxu; Han, Fei; Jose, Pedro A.; Armando, Ines

2016-01-01

Dopamine D2 receptor (DRD2) deficiency increases renal inflammation and blood pressure in mice. We show here that long-term renal-selective silencing of Drd2 using siRNA increases renal expression of proinflammatory and profibrotic factors and blood pressure in mice. To determine the effects of renal-selective rescue of Drd2 expression in mice, the renal expression of DRD2 was first silenced using siRNA and 14 days later rescued by retrograde renal infusion of adeno-associated virus (AAV) vector with DRD2. Renal Drd2 siRNA treatment decreased the renal expression of DRD2 protein by 55%, and DRD2 AAV treatment increased the renal expression of DRD2 protein by 7.5- to 10-fold. Renal-selective DRD2 rescue reduced the expression of proinflammatory factors and kidney injury, preserved renal function, and normalized systolic and diastolic blood pressure. These results demonstrate that the deleterious effects of renal-selective Drd2 silencing on renal function and blood pressure were rescued by renal-selective overexpression of DRD2. Moreover, the deleterious effects of 45-minute bilateral ischemia/reperfusion on renal function and blood pressure in mice were ameliorated by a renal-selective increase in DRD2 expression by the retrograde ureteral infusion of DRD2 AAV immediately after the induction of ischemia/reperfusion injury. Thus, 14 days after ischemia/reperfusion injury, the renal expression of profibrotic factors, serum creatinine, and blood pressure were lower in mice infused with DRD2 AAV than in those infused with control AAV. These results indicate an important role of renal DRD2 in limiting renal injury and preserving normal renal function and blood pressure. PMID:27358912

Tc-99m-DMSA renal uptake rate and renal volume of elderly persons

International Nuclear Information System (INIS)

Ohishi, Yukihiko; Machida, Toyohei; Kido, Akira

1987-01-01

Renal function of erderly persons was evaluated by the radionuclide renal function test based on the renal uptake rate and the renal volume determined by Tc-99m-DMSA transectional tomographic images using single photon emission computed tomography (SPECT). Forty-three erderly cases (13 healthy persons and 30 patients with various types of renal disorders) aged between 60 and 87 on an average of 70 were studied and compared with results obtained from 20 healthy adults (18 - 45 years old). Renal volume was calculated from the summation of voxels in the region districted by equi-count threshold level (percentage to maximum count) on each section of the SPECT image. Attenuation correction was made by GE-STAR protocol utilizing Sorrenson's precorrection method. The renal uptake rate was expressed as a percentage of the total radioactivity detected within the renal volume, against an amount of dose injected. In the 26 kidneys of 13 healthy elderly persons, Tc-99m-DMSA renal uptake was 23 ± 5 %, which was significantly lower (p < 0.01) than that of healthy adults being 27 ± 2 %. A correlation coefficient between renal volume and uptake of 79 kidneys of 43 elderly persons was 0.5081 (p < 0.01). Creatinine clearance (Ccr) was better correlated with the total renal uptake (r = 0.6471, p < 0.01) than with the total renal volume (r = 0.3592, p < 0.01). This method is considered to be useful for clinical purpose as a test of renal function for elderly persons since it requires neither blood nor urine samples. (author)

Edema agudo do pulmão pós-extubação traqueal - Caso clínico Post-tracheal extubation pulmonary oedema - Case report

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Maria de Lurdes Castro

2009-05-01

Full Text Available O edema agudo do pulmão pós-extubação traqueal é um acontecimento raro (≈ 0,1%¹. A etiologia e multifactorial, sendo a obstrução da via aérea superior o factor desencadeante principal. O esforço inspiratório contra a glote encerrada causa pressões intratorácicas muito negativas, que se transmitem ao interstício pulmonar, condicionando uma transudação de fluidos a partir dos vasos capilares pulmonares1-5. Relatamos um caso de edema agudo do pulmão pós-extubação num doente de quinze anos, operado no serviço de urgência por amputação traumática da perna esquerda. Revemos a fisiopatologia, o padrão radiológico, potenciais factores de risco e medidas preventivas desta complicação respiratória pós-anestésica.Negative pressure pulmonary oedema is an uncommon complication of traqueal extubation (≈ 0,1%¹ mostly caused by acute upper airway obs truction. Upper airway obstruction from glottis closure leads to marked inspiratory effort, which generates negative intrathoracic pressure transmitting to pulmonary interstitium, and inducing fluid transudation from pulmonary capillary bed1-5. We report a case of post-extubation pulmonary oedema in a fifteen years old patient, submitted to surgery following traumatic amputation of his left leg. We review the pathophysiology, radiological findings, potential risk factors and preventive measures of this post-anaesthetic respiratory complication.

Uso de alteplase no tratamento do acidente vascular encefálico isquêmico agudo: o que sabem os enfermeiros?

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Samia Jardelle Costa de Freitas Maniva

2012-06-01

Full Text Available O estudo objetivou analisar o conhecimento de enfermeiros acerca do uso de alteplase no tratamento do acidente vascular encefálico (AVE isquêmico agudo. Estudo descritivo-exploratório realizado em uma unidade de AVE de um hospital público localizado na cidade de Fortaleza-CE, durante o mês de outubro de 2010. Participaram do estudo dez enfermeiros, com idade média de 25 anos. Os benefícios da medicação foram apresentados em justaposição com as limitações do uso. Estratégias para ampliar a utilização de alteplase foram apontadas pelos enfermeiros. O conhecimento da realidade investigada contribui na construção do saber de enfermagem e pode auxiliar o enfermeiro que presta assistência direta ao paciente que se submete a este tratamento.

Efeitos da intoxicação por lítio sobre a locomoção de ratos em um modelo animal de insuficiência renal aguda cirurgicamente induzido

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Bittencourt José Augusto Ferreira

2001-01-01

Full Text Available INTRODUÇÃO: O lítio é um metal usado sob a forma de sal para tratamento de episódios agudos de mania e no controle profilático de desordens afetivas bipolares. Pacientes com algum grau de insuficiência renal podem rapidamente sofrer intoxicação por esse fármaco. Nosso objetivo foi verificar a influência da litemia na locomoção em um modelo animal cirurgicamente induzido de insuficiência renal aguda (IRA. MÉTODOS: Foram submetidos 61 ratos Wistar a tratamento com lítio por uma semana previamente a nefrectomia unilateral. Trinta ratos foram induzidos a IRA. Foi administrado lítio ou solução fisiológica aos ratos e após observada sua locomoção e concentração de creatinina sérica. Utilizou-se análise estatítica. RESULTADOS: A creatina apresentou-se elevada nos ratos com IRA. A locomoção foi menor nos ratos com IRA que receberam lítio, havendo relação inversa entre a litemia e a atividade locomotora. CONCLUSÕES: O modelo animal cirúrgico de IRA foi efetivo. Ratos insuficientes renais que receberam lítio apresentaram alterações locomotoras comparados aos demais. O aumento da litemia causa diminuição proporcional na locomoção dos ratos.

Blood Pressure Response to Main Renal Artery and Combined Main Renal Artery Plus Branch Renal Denervation in Patients With Resistant Hypertension.

Science.gov (United States)

Fengler, Karl; Ewen, Sebastian; Höllriegel, Robert; Rommel, Karl-Philipp; Kulenthiran, Saaraaken; Lauder, Lucas; Cremers, Bodo; Schuler, Gerhard; Linke, Axel; Böhm, Michael; Mahfoud, Felix; Lurz, Philipp

2017-08-10

Single-electrode ablation of the main renal artery for renal sympathetic denervation showed mixed blood pressure (BP)-lowering effects. Further improvement of the technique seems crucial to optimize effectiveness of the procedure. Because sympathetic nerve fibers are closer to the lumen in the distal part of the renal artery, treatment of the distal main artery and its branches has been shown to reduce variability in treatment effects in preclinical studies and a recent randomized trial. Whether this optimized technique improves clinical outcomes remains uncertain. We report a 2-center experience of main renal artery and combined main renal artery plus branches renal denervation in patients with resistant hypertension using a multielectrode catheter. Twenty-five patients with therapy-resistant hypertension underwent renal sympathetic denervation with combined main renal artery and renal branch ablation and were compared to matched controls undergoing an ablation of the main renal artery only. BP change was assessed by ambulatory measurement at baseline and after 3 months. At baseline, BP was balanced between the groups. After 3 months, BP changed significantly in the combined ablation group (systolic/diastolic 24-hour mean and daytime mean BP -8.5±9.8/-7.0±10.7 and -9.4±9.8/-7.1±13.5 mm Hg, P renal artery and branches appears to improve BP-lowering efficacy and should be further investigated. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Renal angiographic and computed tomographic evaluation of local extension of renal cell carcinoma

International Nuclear Information System (INIS)

Masuda, Fujio; Onishi, Tetsuro; Sasaki, Tadamasa; Arai, Yoshikazu; Shoji, Ryo

1981-01-01

In 23 cases of renal cell carcinoma, the degree of local invasion of carcinoma was diagnosed using renal angiography and CT, and compared with the findings obtained by operation or autopsy. Among 5 cases in which the tumor was confined to the renal capsule, accurate diagnosis could be established with renal angiography in 4 cases and with CT in all of 5 cases. Both renal angiography and CT provided correct diagnosis in 7 of 8 cases in which the tumor showed infiltration extending to the perinephric fat. Out of 5 cases with tumor invasion of renal vein or inferior vena cava, diagnosis could be established correctly by renal angiography and CT in 3 cases. Among the remaining 2 cases the diagnosis could be established by renal angiography and CT in one each case. Among 5 cases with metastases to the regional lymph nodes, diagnosis could be established by renal angiography in only 2 cases, while all of 5 cases could be diagnosed by CT. In 3 cases where the tumor invaded an ajacent organ beyond Gerota's fastia, renal angiography could diagnose in none of the 3 cases while with CT all of 3 cases could successfully be diagnosed. The consistency of degree of local invasion as revealed by renal angiography and CT was seen in 15 of 23 cases (65%) for renal agniography and 20 of 23 cases (87%) for CT, indicating superiority of CT in this respect. In particular, CT appears to be more superior to renal angiography for determining whether the tumor confined to Gerota's fastia or it infiltrated over it. Both combined use of renal angiography and CT, the degree of infiltration of tumor could be diagnosed correctly in 22 of 23 cases (96%). (author)

Participación de la respuesta inflamatoria en el desarrollo del Síndrome Urémico hemolítico

OpenAIRE

Fernández, Gabriela C.

2002-01-01

La forma típica del síndrome urémico hemolítico (D+SUH) es una microangiopatía trombótica caracterizada por anemia hemolítica con fragmentación de eritrocitos, trombocitopenia con agotamiento de la función plaquetaria y daño renal agudo. Esta enfermedad es la principal causa de daño renal en la población pediátrica y nuestro país presenta la mayor incidencia del mundo. Si bien la mortalidad es baja debido a las terapias de soporte empleadas en el tratamiento de los síntomas, existe una alta p...

Clinical application of calculated split renal volume using computed tomography-based renal volumetry after partial nephrectomy: Correlation with technetium-99m dimercaptosuccinic acid renal scan data.

Science.gov (United States)

Lee, Chan Ho; Park, Young Joo; Ku, Ja Yoon; Ha, Hong Koo

2017-06-01

To evaluate the clinical application of computed tomography-based measurement of renal cortical volume and split renal volume as a single tool to assess the anatomy and renal function in patients with renal tumors before and after partial nephrectomy, and to compare the findings with technetium-99m dimercaptosuccinic acid renal scan. The data of 51 patients with a unilateral renal tumor managed by partial nephrectomy were retrospectively analyzed. The renal cortical volume of tumor-bearing and contralateral kidneys was measured using ImageJ software. Split estimated glomerular filtration rate and split renal volume calculated using this renal cortical volume were compared with the split renal function measured with technetium-99m dimercaptosuccinic acid renal scan. A strong correlation between split renal function and split renal volume of the tumor-bearing kidney was observed before and after surgery (r = 0.89, P volumetry had a strong correlation with the split renal function measured using technetium-99m dimercaptosuccinic acid renal scan. Computed tomography-based split renal volume measurement before and after partial nephrectomy can be used as a single modality for anatomical and functional assessment of the tumor-bearing kidney. © 2017 The Japanese Urological Association.

Assessment of relative individual renal function based on DMSA uptake corrected for renal size

International Nuclear Information System (INIS)

Estorch, M.; Camacho, V.; Tembl, A.; Mena, I.; Hernandez, A.; Flotats, A.; Carrio, I.; Torres, G.; Prat, L.

2002-01-01

Decreased relative renal DMSA uptake can be a consequence of abnormal kidney size, associated with normal or impaired renal function. The quantification of relative renal function based on DMSA uptake in both kidneys is an established method for the assessment of individual renal function. Aim: To assess relative renal function by means of quantification of renal DMSA uptake corrected for kidney size. Results were compared with relative renal DMSA uptake without size correction, and were validated against the absolute renal DMSA uptake. Material and Methods: Four-hundred-forty-four consecutive patients (147 adults, mean age 14 years) underwent a DMSA study for several renal diseases. The relative renal function, based on the relative DMSA uptake uncorrected and corrected for renal size, and the absolute renal DMSA uptake were calculated. In order to relate the relative DMSA uptake uncorrected and corrected for renal size with the absolute DMSA uptake, subtraction of uncorrected (SU) and corrected (SC) relative uptake percentages of each pair of kidneys was obtained, and these values were correlated to the matched subtraction percentages of absolute uptake (SA). If the individual relative renal function is normal (45%-55%), the subtraction value is less or equal to 10%. Results: In 227 patients (51%) the relative renal DMSA uptake value was normal either uncorrected or corrected for renal size (A), and in 149 patients (34%) it was abnormal by both quantification methods (B). Seventy-seven patients (15%) had the relative renal DMSA uptake abnormal only by the uncorrected method (C). Subtraction value of absolute DMSA uptake percentages was not significantly different of subtraction value of relative DMSA uptake percentages corrected for renal size when relative uncorrected uptake was abnormal and corrected normal. where * p<0.0001, and p=NS. Conclusion: When uncorrected and corrected relative DMSA uptake are abnormal, the absolute uptake is also impaired, while when

Aplicación del análisis modal de fallos y efectos en el proceso de donación de sangre total Application of modal analysis of failures and effects in the process of total blood donation

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Tatiana Escoriza-Martínez

2010-12-01

Full Text Available La búsqueda constante de medidas para garantizar la calidad y seguridad de la sangre y hemocomponentes constituye una necesidad para el logro de la seguridad transfusional. Aunque las buenas prácticas de producción tienen el objetivo de disminuir los riesgos para obtener productos puros, seguros y eficaces, es necesario complementarlas con herramientas que permitan prevenir los posibles fallos y detectar dichos riesgos. Tal es el caso de la aplicación del Análisis Modal de Fallos y Efectos en el Banco de Sangre Provincial de Villa Clara, donde se identificaron y evaluaron las posibles fallas del proceso de donación de sangre total, lo que permitió caracterizar este proceso, identificar sus variables críticas, proporcionar las bases para proponer nuevos puntos críticos de control y establecer las acciones necesarias para la reducción o eliminación de las fallas detectadas. Esto contribuyó al aumento de la satisfacción de los servicios de transfusión hospitalarios y de los pacientes.The constant search of measures to guarantee the quality and the safe of blood and hemocomponents is a need to achieve the transfusion safe. Although the aim of the good practices of production was to decrease the risks to obtain pure, safe and effective products, it is necessary its fulfillment with tools allowing to prevent the potential failures and to detect such risks. That is the case of the application of the Modal Analysis of Failures and Effects in the Provincial Blood Bank of Villa Clara where the potential failures in the process of total blood donation were identified and assessed, allowing to characterize it, to identify its critical variables, to lay the foundations to propose new critical points of control and to establish the actions necessary to reduce or to eliminate the failures detected. All this contributed to the satisfaction of hospital transfusion services and of patients.

Alteraciones renales en la drepanocitosis Renal disorders in sickle cell disease

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Aramís Núñez-Quintana

2011-06-01

Full Text Available La drepanocitosis está asociada con un amplio espectro de alteraciones renales que tienen su base en la falciformación de los eritrocitos en los vasos de la médula renal, que conduce a fenómenos de isquemia, microinfartos y anomalías de la función tubular. Se producen también alteraciones glomerulares funcionales reversibles de la autorregulación renal (hiperfiltración, que pueden conducir a cambios anatómicos irreversibles con glomeruloesclerosis segmentaria focal. Estas anomalías se expresan tempranamente como microalbuminuria, proteinuria y de forma mas tardía, como síndrome nefrótico e insuficiencia renal crónica. Medidas terapéuticas como el uso de inhibidores de la enzima convertidora de la angiotensina II, de los bloqueadores del receptor de la angiotensina II, asociados o no con la hidroxiurea, pueden prevenir o retardar el daño glomerular. En el presente trabajo se exponen de forma resumida aspectos relacionados con la fisiopatología del daño renal en la drepanocitosis y su tratamiento.Sickle cell disease is associated with a wide range of renal disorders resulting from the falciformation of erythrocytes in vessels of the renal medulla, leading to ischemia, microinfarctions and tubular function abnormalities. Reversible glomerular functional renal self-regulation disorders (hyperfiltration also occur, which may lead to irreversible anatomical changes with focal segmental glomerular sclerosis. These anomalies are expressed at an early stage as microalbuminuria and proteinuria, and at a later stage as nephrotic syndrome and chronic renal failure. Therapeutic measures such as the use of angiotensin-II converting enzyme inhibitors and angiotensin-II receptor blockers, associated or not with hydroxyurea, may either prevent or delay glomerular damage. The paper succinctly presents the physiopathology of renal damage in drepanocytosis and its treatment.

Modelos de serviços hospitalares para casos agudos em idosos Hospital services for acute care of elderly people

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João Macedo Coelho Filho

2000-12-01

Full Text Available Embora a atenção ao idoso seja uma prioridade emergente no Brasil, pouca ênfase tem sido dada a modelos de organização de serviços hospitalares para pacientes geriátricos. São revisados modelos de serviços hospitalares para admissão e manuseio de casos agudos em idosos, com ênfase na discussão sobre o papel e o posicionamento da medicina geriátrica (incluindo sua interface com especialidades e com a clínica médica no âmbito da atenção hospitalar. Foi realizada pesquisa na base de dados Medline (1989-1999, bem como nos principais livros-texto de geriatria e de gerontologia, buscando identificar descrições de serviços hospitalares para cuidado agudo de pacientes idosos. As características dos modelos identificados foram compiladas e descritas à luz de sua adequação à realidade dos serviços de saúde no Brasil. Exemplos de intervenções em geriatria, com efetividade demonstrada através de revisões sistemáticas, foram também citadas. Os modelos mais freqüentemente relatados foram cuidado prolongado, tradicional, baseado na idade cronológica, não especializado e integrado. Adaptações e variantes de alguns desses modelos foram freqüentemente relatadas, assim como seu impacto potencial na efetividade do cuidado geriátrico. Evidências sobre o melhor modelo a seguir não foram identificadas, mas aqueles modelos favorecendo a integração da geriatria com a clínica geral pareceram mais adequados à nossa realidade. Ressalta a necessidade de reestruturação de serviços de saúde para responder às novas demandas que surgem com o envelhecimento da população, bem como do delineamento de serviços hospitalares para casos agudos, importantes para a efetividade do cuidado geriátrico e que devem ser objeto de maior debate e pesquisa no Brasil.Although the implementation of geriatric services is an emerging priority in Brazil, little emphasis has been put on the type of acute care that should be provided for elderly

A Renal Perforating Artery Mistaken for Arterial Bleeding after Percutaneous Renal Biopsy: A Case Report

International Nuclear Information System (INIS)

Kim, Ye Lim; Lee, Chang Hee; Kim, Kyeong Ah; Park, Cheol Min

2009-01-01

Perirenal hematoma after a renal biopsy is a common complication that usually resolves spontaneously, but this rarely requires transfusions or surgical/radiological intervention. We report here on a case of a renal perforating artery that was mistaken for renal arterial bleeding in a 53-year-old woman who was complicated with perirenal hematoma after undergoing a percutaneous renal biopsy. On the color and pulsed wave Doppler ultrasonography, linear blood flow was seen in the perirenal hematoma, which extended perpendicularly from the renal parenchyma into the perirenal space, and this linear blood flow exhibited an arterial pulse wave. On CT angiography, the renal perforating artery was demonstrated as a curvilinear vessel coursing tangentially to the renal margin and we decided that it was a pseudolesion caused by the renal perforating artery. A renal perforating artery may be mistaken for renal arterial bleeding after a percutaneous renal biopsy. A renal perforating artery and arterial bleeding can be differentiated by the location and shape seen on a color Doppler examination and the pulse waves characteristics

A Renal Perforating Artery Mistaken for Arterial Bleeding after Percutaneous Renal Biopsy: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Kim, Ye Lim; Lee, Chang Hee; Kim, Kyeong Ah; Park, Cheol Min [Korea University College of Medicine, Seoul (Korea, Republic of)

2009-12-15

Perirenal hematoma after a renal biopsy is a common complication that usually resolves spontaneously, but this rarely requires transfusions or surgical/radiological intervention. We report here on a case of a renal perforating artery that was mistaken for renal arterial bleeding in a 53-year-old woman who was complicated with perirenal hematoma after undergoing a percutaneous renal biopsy. On the color and pulsed wave Doppler ultrasonography, linear blood flow was seen in the perirenal hematoma, which extended perpendicularly from the renal parenchyma into the perirenal space, and this linear blood flow exhibited an arterial pulse wave. On CT angiography, the renal perforating artery was demonstrated as a curvilinear vessel coursing tangentially to the renal margin and we decided that it was a pseudolesion caused by the renal perforating artery. A renal perforating artery may be mistaken for renal arterial bleeding after a percutaneous renal biopsy. A renal perforating artery and arterial bleeding can be differentiated by the location and shape seen on a color Doppler examination and the pulse waves characteristics

Renal venogram

Science.gov (United States)

... be black. Other structures will be shades of gray. Veins are not normally seen in an x- ... Venogram - kidney; Renal vein thrombosis - venogram Images Kidney anatomy Kidney - blood and urine flow Renal veins References ...

[Anatomy character of renal artery and treatment of living-donor renal transplantation].

Science.gov (United States)

Zhang, Lei; Fei, Ji-guang; Chen, Li-zhong; Wang, Chang-xi; Deng, Su-xiong; Qiu, Jiang; Li, Jun; Chen, Guo-dong; Huang, Gang

2009-12-15

To study the anatomy characters of renal artery and the treatment of multiple arteries in living donor renal grafts. Records of 142 living donors were analyzed in our center. We analyzed the anatomic structure of renal arteries by DSA and CTA pre-transplantation. Thirty-one kidneys with multiple arteries were transplanted after reconstruction. Then clinical effects were compared between multiple-renal-arteries group (n=31) and single-renal-artery group (n=111). The incidence of multiple renal artery was 30.99%, and there was no difference between both sides (left kidney 22.54%, right kidney 22.13%). If the multiple artery occurred in left or right kidney, the incidence of the multiple artery occurred in the other side was 56.25% and 60.00%, respectively. The diameter of left main renal artery was more magnanimous (P=0.001) and the first branch was more closed to abdominal aorta (P=0.004). Operation time and warm/cool ischemia time were longer in the multiple-renal-arteries group. However, estimated blood loss, delayed graft function, acute rejection and flow rate of arcuate artery were similar in both groups, the same as serum creatinine and serum creatinine clearance rate on day 7, 1 month and 3 month post-operation. It was shown by repeated measures ANOVA that graft with multiple arteries didn't affect the tendency of renal function at early time post-operation. Comprehending the character of renal artery and accurate treatment of multiple artery anastomosis are critical for the effect of the living kidney transplantation.

Preemptive Renal Transplantation-The Best Treatment Option for Terminal Chronic Renal Failure.

Science.gov (United States)

Arze Aimaretti, L; Arze, S

2016-03-01

Renal transplantation is the best therapeutic option for end-stage chronic renal disease. Assuming that it is more advisable if performed early, we aimed to show the clinical, social, and economic advantages in 70% of our patients who were dialyzed only for a short period. For this purpose, we retrospectively collected data over 28 years in 142 kidney transplants performed in patients with renal transplantation with renal failure, especially in developing countries such as Bolivia, where until last year, full public support for renal replacement therapy was unavailable. Copyright © 2016 Elsevier Inc. All rights reserved.

Albumin uptake by renal lymphatics with and without obstruction of the renal vein

International Nuclear Information System (INIS)

Threefoot, S.A.; Pearson, J.E. Jr.; Georgiardis, A.

1989-01-01

Experiments involving injection of radio-iodinated albumin into the left renal arteries or left ureters of dogs indicate that the renal lymphatics are capable of a major contribution in returning to the circulation albumin (or other large molecules) escaping from renal capillaries. I-131-albumin was injected into the jugular vein of controls or into the left renal artery or in retrograde manner into the left ureter of female dogs. Experimental groups included those with no obstruction, occlusion of left renal veins or left renal lymphatics, or both. Collections were made from the right femoral artery, both renal veins, thoracic duct and both ureters at frequent intervals for 2 to 4 hours. Data analysis included I-131 concentration, specific activity, rate of recovery and selected ratios. After renal arterial injection, the percentage of I131 recovered in thoracic duct lymph of dogs without renal venous obstruction was 5 to 10 times that recovered in those that received injections into the jugular vein. In dogs with renal venous obstruction, recovery from the thoracic duct was 10 to 1,000 times that in control dogs. Most of the differences occurred during the first hour, after which time as recirculation and redistribution occurred the rates of appearance in thoracic duct lymph in each group were similar. The differences in the ratios of concentration in thoracic duct lymph to concentration in femoral arterial blood were also much greater when the renal vein was obstructed than in dogs with no obstruction. The greater return of albumin through the thoracic duct in those with impeded renal venous outflow was probably related to both sequestered concentration and increased intrarenal pressure

Incidental renal neoplasms

DEFF Research Database (Denmark)

Rabjerg, Maj; Mikkelsen, Minne Nedergaard; Walter, Steen

2014-01-01

On the basis of associations between tumor size, pathological stage, histological subtype and tumor grade in incidentally detected renal cell carcinoma vs symptomatic renal cell carcinoma, we discussed the need for a screening program of renal cell carcinoma in Denmark. We analyzed a consecutive...... series of 204 patients with renal tumors in 2011 and 2012. The tumors were classified according to detection mode: symptomatic and incidental and compared to pathological parameters. Eighty-nine patients (44%) were symptomatic, 113 (55%) were incidental. Information was not available in two patients...

Renal function study assessed by 99mTc-DMSA renal scintigraphy before and after PNL

International Nuclear Information System (INIS)

Sakurai, Masaki; Hioki, Takuichi; Okuno, Toshiyuki; Sugimura, Yoshiki; Yamakawa, Kensuke; Yanagawa, Makoto; Tajima, Kazuhiro; Tochigi, Hiromi; Kawamura, Juichi

1990-01-01

99m Tc-DMSA renal scintigraphy was carried out in 54 patients with unilateral renal stones before and after PNL. Four to 8 weeks after PNL the DMSA renal uptake significantly decreased to 17.2±6.0% from 18.2±6.7% before PNL. DMSA renal uptake did not change in the contralateral side. Since in some patients changes in the DMSA renal uptake of 5-7% were observed after PNL not only in the PNL side but also in the contralateral side, the renal function was assessed by the formula: DMSA renal uptake in the PNL side/DMSA renal uptake in the contralateral side, and the change of this ratio was evaluated in 44 patients, in whom the renal DMSA uptake in the PNL side was less than two times that in the contralateral side. The DMSA renal uptake ratio decreased to 95.6±8.7% from the base line 4-8 weeks after PNL. This change was statistically significant. Some functional risks such as massive bleeding with PNL, the fever after PNL and the number of nephrostomy tract did not affect the decrease in the renal function. In 29 patients in whom renal function was reevaluated one year after PNL, the DMSA renal uptake ratio significantly decreased to 94.2±9.6% from the base line 4-8 weeks after PNL. But the ratio significantly improved to 99.6±11.6% about one year after PNL. In two patients with a cold area on the renal image, the renal function of the operated side still remained at about 80% levels from the base line even one year after PNL. It is concluded that although renal function slightly decreased 4-8 weeks after PNL, it is expected to improve within one year after PNL. But in the case with a cold area on the renal image, the complete functional recovery would not be expected. 99m Tc-DMSA renal scintigraphy is a useful adjunct to evaluate the renal function before and after PNL. (author)

Renal artery and parenchymal changes after renal denervation: assessment by magnetic resonance angiography

Energy Technology Data Exchange (ETDEWEB)

Sanders, Margreet F.; Vink, Eva E.; Blankestijn, Peter J. [University Medical Center Utrecht, Department of Nephrology and Hypertension, PO Box 85500, Utrecht (Netherlands); Doormaal, Pieter Jan van; Habets, Jesse; Vonken, Evert-Jan; Leiner, Tim [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Beeftink, Martine M.A.; Verloop, Willemien L.; Voskuil, Michiel [University Medical Center Utrecht, Department of Cardiology, Utrecht (Netherlands); Bots, Michiel L. [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Fadl Elmula, Fadl Elmula M. [Oslo University Hospital, Department of Internal Medicine and Department of Cardiology, Ullevaal, Oslo (Norway); Hammer, Frank [Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, Department of Radiology, Brussels (Belgium); Hoffmann, Pavel [Oslo University Hospital, Section for Interventional Cardiology, Department of Cardiology, Ullevaal, Oslo (Norway); Jacobs, Lotte; Staessen, Jan A. [University of Leuven, Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, Leuven (Belgium); Mark, Patrick B.; Taylor, Alison H. [University of Glasgow, Institute of Cardiovascular and Medical Sciences, Glasgow, Scotland (United Kingdom); Persu, Alexandre; Renkin, Jean [Universite Catholique de Louvain, Pole of Cardiovascular Research, Institut de Recherche Experimentale et Clinique, Brussels (Belgium); Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, Cardiology Department, Brussels (Belgium); Roditi, Giles [Glasgow Royal Infirmary, Department of Radiology, Glasgow (United Kingdom); Spiering, Wilko [University Medical Centre Utrecht, Department of Vascular Medicine, Utrecht (Netherlands); Collaboration: on behalf of the European Network COordinating research on Renal Denervation (ENCOReD) Consortium

2017-09-15

Relatively little is known about the incidence of long-term renal damage after renal denervation (RDN), a potential new treatment for hypertension. In this study the incidence of renal artery and parenchymal changes, assessed with contrast-enhanced magnetic resonance angiography (MRA) after RDN, is investigated. This study is an initiative of ENCOReD, a collaboration of hypertension expert centres. Patients in whom an MRA was performed before and after RDN were included. Scans were evaluated by two independent, blinded radiologists. Primary outcome was the change in renal artery morphology and parenchyma. MRAs from 96 patients were analysed. Before RDN, 41 renal anomalies were observed, of which 29 mostly mild renal artery stenoses. After a median time of 366 days post RDN, MRA showed a new stenosis (25-49% lumen reduction) in two patients and progression of pre-existing lumen reduction in a single patient. No other renal changes were observed and renal function remained stable. We observed new or progressed renal artery stenosis in three out of 96 patients, after a median time of 12 months post RDN (3.1%). Procedural angiographies showed that ablations were applied near the observed stenosis in only one of the three patients. (orig.)

Atención farmacéutica en personas que han sufrido episodios coronarios agudos (estudio TOMCOR

Directory of Open Access Journals (Sweden)

Álvarez de Toledo Flor

2001-01-01

Full Text Available Fundamento: Este estudio valora los efectos de un nuevo modelo de trabajo en las farmacias, denominado Atención Farmacéutica, frente al modelo tradicional. Se pretende conocer su factibilidad y las diferencias, potencialmente debidas a la Atención Farmacéutica, respecto de los resultados de salud de la farmacoterapia usada, en una muestra de pacientes que han sufrido episodios coronarios agudos. Métodos: Es un estudio prospectivo con un grupo de intervención (330 personas y un grupo control (405 personas, realizado en 83 farmacias de Asturias, Barcelona, Madrid y Vizcaya, en las que se hizo seguimiento durante un año del uso de medicamentos en 735 personas, de las cuales finalizaron el estudio 600. Resultados: Hubo diferencias favorables al grupo intervención, respecto de: a uso de servicios sanitarios indicativos de mayor morbilidad, tales como la frecuencia de consultas hospitalarias urgentes por paciente 1,27Interv. (IC95 %:1,10 a 1,44 y 1,63Contr.(IC95 %:1,36 a 1,90 o los días promedio de UCI por paciente hospitalizado: 2,46Interv.(IC95 %:1,56 a 3,36 y 5,87Contr.(IC95 %: 3,57 a 8,17, por causa cardiológica; b calidad de vida con diferencia de 4,7 (p < 0,05 en la dimensión de función física; c conocimiento de factores de riesgo de enfermedad coronaria, promedio de +10 % (p < 0,02 - 0,07, según dimensión; d identificación nominal de los medicamentos usados +10 % (p < 0,01; importancia subjetiva otorgada a los antiagregantes + 12 % (p < 0,009, los beta-bloqueantes, así como sus efectos +25 % (p < 0,02; y e satisfacción con la AF y percepción de la competencia profesional, promedio de + 12 % (p < 0,000 - 0,05, según dimensión. Conclusiones: Los valores menores de: demanda individual urgente coronaria, frecuencia de hospitalizaciones y número de días de Unidad de Cuidados Intensivos coronaria por hospitalización, sugerirían que los pacientes que tras un episodio coronario agudo reciben Atención Farmacéutica tienden a

Atención farmacéutica en personas que han sufrido episodios coronarios agudos (estudio tomcor

Directory of Open Access Journals (Sweden)

Flor Álvarez de Toledo

2001-01-01

Full Text Available Fundamento: Este estudio valora los efectos de un nuevo modelo de trabajo en las farmacias, denominado Atención Farmacéutica, frente al modelo tradicional. Se pretende conocer su factibilidad y las diferencias, potencialmente debidas a la Atención Farmacéutica, respecto de los resultados de salud de la farmacoterapia usada, en una muestra de pacientes que han sufrido episodios coronarios agudos. Métodos: Es un estudio prospectivo con un grupo de intervención (330 personas y un grupo control (405 personas, realizado en 83 farmacias de Asturias, Barcelona, Madrid y Vizcaya, en las que se hizo seguimiento durante un año del uso de medicamentos en 735 personas, de las cuales finalizaron el estudio 600. Resultados: Hubo diferencias favorables al grupo intervención, respecto de: a uso de servicios sanitarios indicativos de mayor morbilidad, tales como la frecuencia de consultas hospitalarias urgentes por paciente 1,27Interv. (IC95 %:1,10 a 1,44 y 1,63Contr.(IC95 %:1,36 a 1,90 o los días promedio de UCI por paciente hospitalizado: 2,46Interv.(IC95 %:1,56 a 3,36 y 5,87Contr.(IC95 %: 3,57 a 8,17, por causa cardiológica; b calidad de vida con diferencia de 4,7 (p < 0,05 en la dimensión de función física; c conocimiento de factores de riesgo de enfermedad coronaria, promedio de +10 % (p < 0,02 - 0,07, según dimensión; d identificación nominal de los medicamentos usados +10 % (p < 0,01; importancia subjetiva otorgada a los antiagregantes + 12 % (p < 0,009, los beta-bloqueantes, así como sus efectos +25 % (p < 0,02; y e satisfacción con la AF y percepción de la competencia profesional, promedio de + 12 % (p < 0,000 – 0,05, según dimensión. Conclusiones: Los valores menores de: demanda individual urgente coronaria, frecuencia de hospitalizaciones y número de días de Unidad de Cuidados Intensivos coronaria por hospitalización, sugerirían que los pacientes que tras un episodio coronario agudo reciben Atención Farmacéutica tienden a

Grupos de utilizacion de recursos en unidades de agudos y media estancia de servicios de geriatria

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Solano Jaurrieta Juan José

2001-01-01

Full Text Available Fundamentos: En los últimos años se han implantado en nuestro país Sistemas de Clasificación de Pacientes (SCP con objeto de medir el «producto hospitalario». Sin embargo los sistemas más tradicionales resultan poco adecuados para la población anciana, en los que la incapacidad asociada a la enfermedad resulta determinante para explicar el consumo de recursos y los resultados asistenciales. Por ello, nos planteamos aplicar en servicios especializados de atención al anciano un sistema que contempla este parámetro, los Grupos de Utilización de Recursos (RUG, analizando las características y diferencias en la distribución en función de RUG en cuatro Servicios de Geriatría. Métodos: Se estudian transversalmente, mediante cortes sucesivos en períodos superiores a la estancia media en cada unidad, los pacientes ingresados en las unidades de agudos y media estancia de los Servicios de Geriatría del Hospital Monte Naranco (HMN (n=318, Hospital Central de la Cruz Roja (HCCR (n=384, Hospital General de Guadalajara (HG (n=272 y Hospital Virgen del Valle (HVV (n=390, en lo relativo a su distribución según la clasificación RUG-T18. Las posibles diferencias entre los centros se analizaron mediante el test estadístico chi-cuadrado (SPSS para windows Resultados: Para el conjunto de la muestra los pacientes se concentran en los grupos R, S y C de la clasificación, con muy escasa representación de los grupos P y B, detectándose diferencias entre los centros. Así, el HCCR es el que maneja una mayor proporción de pacientes del grupo R (47,64% vs. 23,66% en el HMN, 20,57% en el HG y 20,53% en el HVV y una menor proporción de pacientes del grupo S (3,12% vs 6,40% en el HMN, 9,92% en el HG y 9,76% en el HVV y C (48,94% vs 76,29% en el HMN, 66,89% en el HG y 68,36% en el HVV. Igualmente es posible detectar diferencias en el análisis individual para las unidades de agudos y media estancia. Conclusiones: Los grupos de utilización de recursos

GRUPOS DE UTILIZACION DE RECURSOS EN UNIDADES DE AGUDOS Y MEDIA ESTANCIA DE SERVICIOS DE GERIATRIA

Directory of Open Access Journals (Sweden)

Juan José Solano Jaurrieta

2001-01-01

Full Text Available Fundamentos: En los últimos años se han implantado en nuestro país Sistemas de Clasificación de Pacientes (SCP con objeto de medir el «producto hospitalario». Sin embargo los sistemas más tradicionales resultan poco adecuados para la población anciana, en los que la incapacidad asociada a la enfermedad resulta determinante para explicar el consumo de recursos y los resultados asistenciales. Por ello, nos planteamos aplicar en servicios especializados de atención al anciano un sistema que contempla este parámetro, los Grupos de Utilización de Recursos (RUG, analizando las características y diferencias en la distribución en función de RUG en cuatro Servicios de Geriatría. Métodos: Se estudian transversalmente, mediante cortes sucesivos en períodos superiores a la estancia media en cada unidad, los pacientes ingresados en las unidades de agudos y media estancia de los Servicios de Geriatría del Hospital Monte Naranco (HMN (n=318, Hospital Central de la Cruz Roja (HCCR (n=384, Hospital General de Guadalajara (HG (n=272 y Hospital Virgen del Valle (HVV (n=390, en lo relativo a su distribución según la clasificación RUG-T18. Las posibles diferencias entre los centros se analizaron mediante el test estadístico chi-cuadrado (SPSS para windows Resultados: Para el conjunto de la muestra los pacientes se concentran en los grupos R, S y C de la clasificación, con muy escasa representación de los grupos P y B, detectándose diferencias entre los centros. Así, el HCCR es el que maneja una mayor proporción de pacientes del grupo R (47,64% vs. 23,66% en el HMN, 20,57% en el HG y 20,53% en el HVV y una menor proporción de pacientes del grupo S (3,12% vs 6,40% en el HMN, 9,92% en el HG y 9,76% en el HVV y C (48,94% vs 76,29% en el HMN, 66,89% en el HG y 68,36% en el HVV. Igualmente es posible detectar diferencias en el análisis individual para las unidades de agudos y media estancia. Conclusiones: Los grupos de utilización de recursos

Renal Function in Hypothyroidism

International Nuclear Information System (INIS)

Khalid, S.; Khalid, M; Elfaki, M.; Hassan, N.; Suliman, S.M.

2007-01-01

Background Hypothyroidism induces significant changes in the function of organ systems such as the heart, muscles and brain. Renal function is also influenced by thyroid status. Physiological effects include changes in water and electrolyte metabolism, notably hyponatremia, and reliable alterations of renal hemodynamics, including decrements in renal blood flow, renal plasma flow, glomerular filtration rate (GFR). Objective Renal function is profoundly influenced by thyroid status; the purpose of the present study was to determine the relationship between renal function and thyroid status of patients with hypothyroidism. Design and Patients In 5 patients with primary hypothyroidism and control group renal functions are measured by serum creatinine and glomerular filtration rate (GFR) using modified in diet renal disease (MDRD) formula. Result In hypothyroidism, mean serum creatinine increased and mean estimated GFR decreased, compared to the control group mean serum creatinine decreased and mean estimated GFR Increased. The hypothyroid patients showed elevated serum creatinine levels (> 1.1mg/dl) compared to control group (p value .000). In patients mean estimated GFR decreased, compared to mean estimated GFR increased in the control group (p value= .002).

Renal Sinus Fat Invasion and Tumoral Thrombosis of the Inferior Vena Cava-Renal Vein: Only Confined to Renal Cell Carcinoma

OpenAIRE

Turker Acar; Mustafa Harman; Serkan Guneyli; Sait Sen; Nevra Elmas

2014-01-01

Epithelioid angiomyolipoma (E-AML), accounting for 8% of renal angiomyolipoma, is usually associated with tuberous sclerosis (TS) and demonstrates aggressive behavior. E-AML is macroscopically seen as a large infiltrative necrotic tumor with occasional extension into renal vein and/or inferior vena cava. However, without history of TS, renal sinus and venous invasion E-AML would be a challenging diagnosis, which may lead radiologists to misinterpret it as a renal cell carcinoma (RCC). In this...

Acute renal failure in children

International Nuclear Information System (INIS)

Vergesslich, K.A.; Balzar, E.; Weninger, M.; Ponhold, W.; Sommer, G.; Wittich, G.R.; Vienna Univ.

1987-01-01

Acute renal failure (ARF) may be due to obstructive uropathy or renal parenchymal disease. Twenty-five children with acute renal failure secondary to renal parenchymal disease underwent ultrasonographic examination of the kidneys. Changes of renal size and cortical echogenicity were correlated with renal function. All patients presented with bilaterally enlarged kidneys with the exception in renal function resulted in normalization of renal size. With regard to cortical echogenicity two groups were formed. Group A comprised 11 patients whose kidneys had the same echogenicity as the liver, while in group B the kidneys were more echogenic (14 patients). Cortical echogenicity was always increased. Determination of creatinine levels showed a statistically significant difference between group A (3.32 mg% ± 1.40 S.D.) and group B (5.95 mg% ± 1.96 S.D.), p < 0.001. Changes in renal function were paralleled by rapid changes in renal size and cortical echogenicity. (orig.)

Renal tolerance for iopromide (ultravist) in patients with chronic renal failure. Preliminary report

International Nuclear Information System (INIS)

Golebiowski, M.; Pruszynski, B.

1993-01-01

The authors present the renal tolerance for nonionic low-osmotic contrast agent iopromide (ultravist) on the ground of literature and of angiographic examinations in 10 patients with chronic renal failure. One patient only had significant temporary deterioration of renal function. The presented results showed that analyzed agent is less nephrotoxic than high osmolality contrast agents. The use of iopromide is strongly recommended in patients with chronic renal failure. The risk of depression of renal function after administration of contrast material is minimized. (author)

Effect of Shenkang injection combined with hemodialysis treatment on renal function, renal anemia and cytokine levels in patients with chronic renal failure

Directory of Open Access Journals (Sweden)

Rui Liu

2016-10-01

Full Text Available Objective: To study the effect of Shenkang injection combined with hemodialysis treatment on renal function, renal anemia and cytokine levels in patients with chronic renal failure. Methods: A total of 68 patients with chronic renal failure who received hemodialysis treatment in our hospital during between October 2013 and February 2016 were selected and randomly divided into two groups, the observation group received Shenkang injection treatment in the process of dialysis, and the control group only received conventional symptomatic and supportive treatment. 8 weeks after treatment, serum was collected to determine the levels of renal function indexes, nutritional status indexes, anemia indexes and cytokines, and urine was collected to determine renal function indexes. Results: β2-MG, UA, Cr, phosphorus, IL-17, IL-23, CTGF, TGF-β1, FGF-2 and FGF-23 levels in serum as well as NGAL, KIM-1 and RBP levels in urine of observation group were significantly lower than those of control group, and TP, Alb, PA, calcium, Hb, EPO, Fe, TRF and FER levels in serum were significantly higher than those of control group. Conclusion: Shenkang injection combined with hemodialysis treatment helps to improve renal function, nutritional status and renal anemia, and reduce the synthesis of inflammation and renal interstitial fibrosis-related cytokines in patients with chronic renal failure.

Anatomic variations of the renal vessels: focus on the precaval right renal artery.

Science.gov (United States)

Bouali, Ourdia; Labarre, David; Molinier, François; Lopez, Raphaël; Benouaich, Vincent; Lauwers, Frédéric; Moscovici, Jacques

2012-07-01

The aim of this study was to determine the prevalence of precaval right renal artery and to investigate the distribution of renal arteries and veins. We discuss a theory of development of renal vascular variants. We retrospectively reviewed 120 arterial phase contrast material-enhanced spiral computerized tomography scans of the abdomen (1- to 2-mm section thickness) performed during a two-month period. Forty percent of the study group (48 patients) had one artery and one vein on each side, with typical course. There was a 9.17% prevalence of precaval right renal artery: 10 patients had a lower pole accessory artery in precaval position and one patient had the main and the accessory arteries that pass anterior to the inferior vena cava. In these cases, associated variations of renal vessels were higher than in the patients without precaval artery variant. There were multiple arteries in 28.3% of the right kidneys and in 26.7% of the left ones. Variants of the right renal vein consisted in multiple veins in 20% (24 cases). We detected no case of multiple left renal veins, but we described variations of its course (circum- or retroaortic vein) in 9.17% (11 cases). Twenty-six patients (21.7%) had associated variations of the renal pedicle. The current technical support allows for a minimally invasive study of vessels anatomy. In our study the prevalence of a precaval right renal artery appears to be higher than previously reported (9.17%). Knowledge on anatomical variations of right renal artery and associated renal vessels variations has major clinical implications.

Renal shear wave velocity by acoustic radiation force impulse did not reflect advanced renal impairment.

Science.gov (United States)

Takata, Tomoaki; Koda, Masahiko; Sugihara, Takaaki; Sugihara, Shinobu; Okamoto, Toshiaki; Miyoshi, Kenichi; Matono, Tomomitsu; Hosho, Keiko; Mae, Yukari; Iyama, Takuji; Fukui, Takeaki; Fukuda, Satoko; Munemura, Chishio; Isomoto, Hajime

2016-12-01

Acoustic radiation force impulse is a noninvasive method for evaluating tissue elasticity on ultrasound. Renal shear wave velocity measured by this technique has not been fully investigated in patients with renal disease. The aim of the present study was to compare renal shear wave velocity in end-stage renal disease patients and that in patients without chronic kidney disease and to investigate influencing factors. Renal shear wave velocities were measured in 59 healthy young subjects (control group), 31 subjects without chronic kidney disease (non-CKD group), and 39 end-stage renal disease patients (ESRD group). Each measurement was performed 10 times at both kidneys, and the mean value of eight of 10 measurements, excluding the maximum and minimum values, was compared. Renal shear wave velocity could be measured in all subjects. Renal shear wave velocity in the control group was higher than in the non-CKD group and in the ESRD group, and no difference was found between the non-CKD group and the ESRD group. Age and depth were negatively correlated to the renal shear wave velocity. In multiple regression analysis, age and depth were independent factors for renal shear wave velocity, while renal impairment was not. There was no difference between the non-CKD group and the ESRD group, even when ages were matched and depth was adjusted. Renal shear wave velocity was not associated with advanced renal impairment. However, it reflected alteration of renal aging, and this technique may be useful to detect renal impairment in the earlier stages. © 2015 Asian Pacific Society of Nephrology.

Renal parenchyma thickness: a rapid estimation of renal function on computed tomography

International Nuclear Information System (INIS)

Kaplon, Daniel M.; Lasser, Michael S.; Sigman, Mark; Haleblian, George E.; Pareek, Gyan

2009-01-01

Purpose: To define the relationship between renal parenchyma thickness (RPT) on computed tomography and renal function on nuclear renography in chronically obstructed renal units (ORUs) and to define a minimal thickness ratio associated with adequate function. Materials and Methods: Twenty-eight consecutive patients undergoing both nuclear renography and CT during a six-month period between 2004 and 2006 were included. All patients that had a diagnosis of unilateral obstruction were included for analysis. RPT was measured in the following manner: The parenchyma thickness at three discrete levels of each kidney was measured using calipers on a CT workstation. The mean of these three measurements was defined as RPT. The renal parenchyma thickness ratio of the ORUs and non-obstructed renal unit (NORUs) was calculated and this was compared to the observed function on Mag-3 lasix Renogram. Results: A total of 28 patients were evaluated. Mean parenchyma thickness was 1.82 cm and 2.25 cm in the ORUs and NORUs, respectively. The mean relative renal function of ORUs was 39%. Linear regression analysis comparing renogram function to RPT ratio revealed a correlation coefficient of 0.48 (p * RPT ratio. A thickness ratio of 0.68 correlated with 20% renal function. Conclusion: RPT on computed tomography appears to be a powerful predictor of relative renal function in ORUs. Assessment of RPT is a useful and readily available clinical tool for surgical decision making (renal salvage therapy versus nephrectomy) in patients with ORUs. (author)

Renal ornithine decarboxylase activity, polyamines, and compensatory renal hypertrophy in the rat

International Nuclear Information System (INIS)

Humphreys, M.H.; Etheredge, S.B.; Lin, Shanyan; Ribstein, J.; Marton, L.J.

1988-01-01

The authors determined the role of ornithine decarboxylase (ODC) in compensatory renal hypertrophy (CRH) by relating renal ODC activity and polyamine content to kidney size, expressed as a percent of body weight, 1 wk after unilateral nephrectomy (UN). In normal rats, renal ODC activity increased after UN; 1 wk later the remaining kidney weight had increased. Renal concentration of putrescine, the product of ODC's decarboxylation of ornithine, was increased 3, 8, and 48 h after UN, but concentrations of polyamines synthesized later in the pathway, spermidine and spermine, were not appreciably affected. Pretreatment with difluoromethylornithine (DFMO), an irreversible inhibitor of ODC inhibited both base-line renal ODC activity and putrescine concentration as well as increases stimulated by UN, although concentrations of spermidine and spermine were not decreased. In hypophysectomized rats, both increased renal ODC activity and CRH occurred as well, indicating that these two consequences of UN do not require intact pituitary function. Thus stimulation of renal ODC activity and putrescine content do not appear critical to the process of CRH after UN

Renal pelvis urothelial carcinoma of the upper moiety in complete right renal duplex: a case report.

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Zhang, Yiran; Yu, Quanfeng; Zhang, Zhihong; Liu, Ranlu; Xu, Yong

2015-01-01

Urothelial carcinoma (UC) originated from renal pelvis is the common tumor of the urinary system, however, neoplasia of the renal pelvis in duplex kidneys is extremely rare, especially in the complete renal and ureteral duplex cases. We present the first case of renal pelvis UC of the upper moiety in a complete right renal duplex. This male patient has bilateral complete renal and ureteral duplex. To the best of our knowledge, this is the first reported case of renal pelvis UC in a complete renal duplex system. After this experience we feel that the diagnosis of renal pelvis UC in duplex kidneys is not so easy, and once the diagnosis is determined, the whole renal duplex units and bladder cuff or ectopic orifice should be excised radically.

OBSTETRIC RENAL FAILURE

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Rajeshwari

2015-11-01

Full Text Available Renal failure in obstetrics is rare but important complication, associated with significant mortality and long term morbidity.1,2 It includes acute renal failure due to obstetrical complications or due to deterioration of existing renal disease. AIMS AND OBJECTIVES: To evaluate the etiology and outcome of renal failure in obstetric patients. METHODS: We prospectively analyzed 30 pregnant and puerperal women with acute renal failure or pre-existing renal disease developing renal failure during pregnancy between November 2007 to sep-2009. Patients who presented/developed ARF during the hospital stay were included in this study. RESULTS: Among 30 patients, mean age was 23 years and 33 years age group. 12 cases (40% patients were primigravidae and 9(30% patients were multigravidae and 9 cases (30% presented in post-partum period. Eighteen cases (60% with ARF were seen in third trimester, followed by in postpartum period 9 cases (30%. Most common contributing factors to ARF were Pre-eclampsia, eclampsia and HELLP syndrome 60%, sepsis 56.6%, post abortal ARF 10%. DIC 40%. Haemorrhage as the aetiology for ARF was present 46%, APH in 20% and PPH in 26.6%. The type of ARF was renal in (63% and prerenal (36%; Oliguric seen in 10 patients (33% and high mortality (30%. Among the 20 pregnant patients with ARF, The average period of gestation was 33±2 weeks (30 -36 weeks, 5 cases (25% presented with intrauterine fetal demise and 18 cases (66% had preterm vaginal delivery and 2 cases (10% had induced abortion. And the average birth weight was 2±0.5 kg (1.5 kg. Eight cases (26% required dialysis. 80% of patients recovered completely of renal functions. 63% patients recovered without renal replacement therapy whereas 17% required dialysis. the maternal mortality was 20%, the main reason for mortality was septic shock and multi organ dysfunction (66%. CONCLUSION: ARF related pregnancy was seen commonly in the primigravidae and in the third trimester, the most

Renal nerves dynamically regulate renal blood flow in conscious, healthy rabbits.

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Schiller, Alicia M; Pellegrino, Peter R; Zucker, Irving H

2016-01-15

Despite significant clinical interest in renal denervation as a therapy, the role of the renal nerves in the physiological regulation of renal blood flow (RBF) remains debated. We hypothesized that the renal nerves physiologically regulate beat-to-beat RBF variability (RBFV). This was tested in chronically instrumented, healthy rabbits that underwent either bilateral surgical renal denervation (DDNx) or a sham denervation procedure (INV). Artifact-free segments of RBF and arterial pressure (AP) from calmly resting, conscious rabbits were used to extract RBFV and AP variability for time-domain, frequency-domain, and nonlinear analysis. Whereas steady-state measures of RBF, AP, and heart rate did not statistically differ between groups, DDNx rabbits had greater RBFV than INV rabbits. AP-RBF transfer function analysis showed greater admittance gain in DDNx rabbits than in INV rabbits, particularly in the low-frequency (LF) range where systemic sympathetic vasomotion gives rise to AP oscillations. In the LF range, INV rabbits exhibited a negative AP-RBF phase shift and low coherence, consistent with the presence of an active control system. Neither of these features were present in the LF range of DDNx rabbits, which showed no phase shift and high coherence, consistent with a passive, Ohm's law pressure-flow relationship. Renal denervation did not significantly affect nonlinear RBFV measures of chaos, self-affinity, or complexity, nor did it significantly affect glomerular filtration rate or extracellular fluid volume. Cumulatively, these data suggest that the renal nerves mediate LF renal sympathetic vasomotion, which buffers RBF from LF AP oscillations in conscious, healthy rabbits. Copyright © 2016 the American Physiological Society.

Cardio-renal syndrome

OpenAIRE

Gnanaraj, Joseph; Radhakrishnan, Jai

2016-01-01

Cardio-renal syndrome is a commonly encountered problem in clinical practice. Its pathogenesis is not fully understood. The purpose of this article is to highlight the interaction between the cardiovascular system and the renal system and how their interaction results in the complex syndrome of cardio-renal dysfunction. Additionally, we outline the available therapeutic strategies to manage this complex syndrome.

Renal hemodynamic effects of activation of specific renal sympathetic nerve fiber groups.

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DiBona, G F; Sawin, L L

1999-02-01

To examine the effect of activation of a unique population of renal sympathetic nerve fibers on renal blood flow (RBF) dynamics, anesthetized rats were instrumented with a renal sympathetic nerve activity (RSNA) recording electrode and an electromagnetic flow probe on the ipsilateral renal artery. Peripheral thermal receptor stimulation (external heat) was used to activate a unique population of renal sympathetic nerve fibers and to increase total RSNA. Total RSNA was reflexly increased to the same degree with somatic receptor stimulation (tail compression). Arterial pressure and heart rate were increased by both stimuli. Total RSNA was increased to the same degree by both stimuli but external heat produced a greater renal vasoconstrictor response than tail compression. Whereas both stimuli increased spectral density power of RSNA at both cardiac and respiratory frequencies, modulation of RBF variability by fluctuations of RSNA was small at these frequencies, with values for the normalized transfer gain being approximately 0.1 at >0.5 Hz. During tail compression coherent oscillations of RSNA and RBF were found at 0.3-0.4 Hz with normalized transfer gain of 0.33 +/- 0.02. During external heat coherent oscillations of RSNA and RBF were found at both 0.2 and 0.3-0.4 Hz with normalized transfer gains of 0. 63 +/- 0.05 at 0.2 Hz and 0.53 +/- 0.04 to 0.36 +/- 0.02 at 0.3-0.4 Hz. Renal denervation eliminated the oscillations in RBF at both 0.2 and 0.3-0.4 Hz. These findings indicate that despite similar increases in total RSNA, external heat results in a greater renal vasoconstrictor response than tail compression due to the activation of a unique population of renal sympathetic nerve fibers with different frequency-response characteristics of the renal vasculature.

Renal computed angiography. Part I: Renal CT arteriography in hypertension

International Nuclear Information System (INIS)

Al-Amin, M.; Hadjidekov, V.

2012-01-01

Visualization of renal vasculature is needed in several clinical condition among which hypertension is dominant. CT angiography now day replaces catheter angiography as non-invasive method. The goal of this study is to present initial authors experience in visualization of renal arteries using 64 MDCT and to evaluated the utility in hypertensive patients. MDCT assures excellent assessment of renal arteries conditions. Multiplanar reconstruction and allow better delineation in tortuous vessels course and anatomic variants. (authors)

Renal sympathetic nervous system and the effects of denervation on renal arteries.

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Kannan, Arun; Medina, Raul Ivan; Nagajothi, Nagapradeep; Balamuthusamy, Saravanan

2014-08-26

Resistant hypertension is associated with chronic activation of the sympathetic nervous system resulting in various comorbidities. The prevalence of resistant hypertension is often under estimated due to various reasons. Activation of sympathetic nervous system at the renal- as well as systemic- level contributes to the increased level of catecholamines and resulting increase in the blood pressure. This increased activity was demonstrated by increased muscle sympathetic nerve activity and renal and total body noradrenaline spillover. Apart from the hypertension, it is hypothesized to be associated with insulin resistance, congestive heart failure and obstructive sleep apnea. Renal denervation is a novel procedure where the sympathetic afferent and efferent activity is reduced by various techniques and has been used successfully to treat drug-resistant hypertension improvement of various metabolic derangements. Renal denervation has the unique advantage of offering the denervation at the renal level, thus mitigating the systemic side effects. Renal denervation can be done by various techniques including radiofrequency ablation, ultrasound guided ablation and chemical ablation. Various trials evaluated the role of renal denervation in the management of resistant hypertension and have found promising results. More studies are underway to evaluate the role of renal denervation in patients presenting with resistant hypertension in different scenarios. Appropriate patient selection might be the key in determining the effectiveness of the procedure.

ERK Regulates Renal Cell Proliferation and Renal Cyst Expansion in inv Mutant Mice

International Nuclear Information System (INIS)

Okumura, Yasuko; Sugiyama, Noriyuki; Tanimura, Susumu; Nishida, Masashi; Hamaoka, Kenji; Kohno, Michiaki; Yokoyama, Takahiko

2009-01-01

Nephronophthisis (NPHP) is the most frequent genetic cause of end-stage kidney disease in children and young adults. Inv mice are a model for human nephronophthisis type 2 (NPHP2) and characterized by multiple renal cysts and situs inversus. Renal epithelial cells in inv cystic kidneys show increased cell proliferation. We studied the ERK pathway to understand the mechanisms that induce cell proliferation and renal cyst progression in inv kidneys. We studied the effects of ERK suppression by administering PD184352, an oral mitogen-activated protein kinase kinase (MEK) inhibitor on renal cyst expansion, extracellular signal-regulated protein kinase (ERK) activity, bromo-deoxyuridine (BrdU) incorporation and expression of cell-cycle regulators in invΔC kidneys. Phosphorylated ERK (p-ERK) level increased along with renal cyst enlargement. Cell-cycle regulators showed a high level of expression in invΔC kidneys. PD184352 successfully decreased p-ERK level and inhibited renal cyst enlargement. The inhibitor also decreased expression of cell-cycle regulators and BrdU incorporation in renal epithelial cells. The present results showed that ERK regulated renal cell proliferation and cyst expansion in inv mutants

Renal artery stenosis

International Nuclear Information System (INIS)

Desberg, A.; Paushter, D.M.; Lammert, G.K.; Hale, J.; Troy, R.; Novic, A.; Nally, J. Jr.

1989-01-01

Renal artery disease is a potentially correctable cause of hypertension. Previous studies have suggested the utility of duplex sonography in accurately detecting and grading the severity of renal artery stenosis. The purpose of this paper is to evaluate color flow Doppler for this use. Forty-three kidneys were examined by color-flow Doppler and conventional duplex sampling in patients with suspected renovascular hypertension or those undergoing aortography for unrelated reasons. Doppler tracings were obtained from the renal arteries and aorta with calculation of the renal aortic ratio (RAR) and resistive index (RI). Results of Doppler sampling with color flow guidance were compared with aortograms in a blinded fashion

Predictors of renal recovery in patients with pre-orthotopic liver transplant (OLT) renal dysfunction.

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Iglesias, Jose; Frank, Elliot; Mehandru, Sushil; Davis, John M; Levine, Jerrold S

2013-07-13

Renal dysfunction occurs commonly in patients awaiting orthotopic liver transplantation (OLT) for end-stage liver disease. The use of simultaneous liver-kidney transplantation has increased in the MELD scoring era. As patients may recover renal function after OLT, identifying factors predictive of renal recovery is a critical issue, especially given the scarcity of available organs. Employing the UNOS database, we sought to identify donor- and patient-related predictors of renal recovery among 1720 patients with pre-OLT renal dysfunction and transplanted from 1989 to 2005. Recovery of renal function post-OLT was defined as a composite endpoint of serum creatinine (SCr) ≤1.5 mg/dL at discharge and survival ≥29 days. Pre-OLT renal dysfunction was defined as any of the following: SCr ≥2 mg/dL at any time while awaiting OLT or need for renal replacement therapy (RRT) at the time of registration and/or OLT. Independent predictors of recovery of renal function post-OLT were absence of hepatic allograft dysfunction, transplantation during MELD era, recipient female sex, decreased donor age, decreased recipient ALT at time of OLT, decreased recipient body mass index at registration, use of anti-thymocyte globulin as induction therapy, and longer wait time from registration. Contrary to popular belief, a requirement for RRT, even for prolonged periods in excess of 8 weeks, was not an independent predictor of failure to recover renal function post-OLT. These data indicate that the duration of renal dysfunction, even among those requiring RRT, is a poor way to discriminate reversible from irreversible renal dysfunction.

Dynamic renal scintigraphy in aortic disorders

International Nuclear Information System (INIS)

Terae, Satoshi; Itoh, Kazuo; Tsukamoto, Eriko; Nakada, Kunihiro; Fujimori, Kenji; Hashimoto, Masato; Tanabe, Tatsuzo; Furudate, Masayori; Irie, Goro

1986-01-01

Dynamic renal scintigraphy has been reviewed for evaluation of renal arterial involvement in aortic disorders such as arteriosclerosis obliterans, abdominal aortic aneurysm and dissecting aneurysm. As a diagnostic finding and parameters, we used blood perfusion images of both kidneys and relative split renal function index obtained with analysis of the time-activity curves which were generated using a renal region of interest. In the diagnosis of unilateral renal arterial involvement, sensitivity and specificity of blood perfusion images were 100 % (9/9) and 77 % (10/13) and those of relative split renal function index were 78 % (7/9) and 92 % (12/13), respectively. Dynamic renal scintigraphy was useful for evaluating unilateral renal arterial involvement in aortic diseases. However, scintigraphic diagnosis of bilateral renal arterial involvement were difficult. And in a severe case, we could not differentiate renal parenchymal damage due to renovascular involvement from senile renal dysfunction or hypertensive renal disease which is often a cause of aortic disorders. (author)

Renal Function in Hypothyroidism

International Nuclear Information System (INIS)

Khalid, A. S; Ahmed, M.I; Elfaki, H.M; Hassan, N.; Suliman, S. M.

2006-12-01

Background hypothyroidism induces significant changes in the function of organ systems such as the heart, muscles and brain. Renal function is also influenced by thyroid status. Physiological effects include changes in water and electrolyte metabolism, notably hyponatraemia, and reliable alterations of renal hemodynamics, including decrements in renal blood flow, renal plasma flow, glomerular filtration rate (GFR). Objective renal function is profoundly influenced by thyroid status, the purpose of the present study was to determine the relationship between renal function and thyroid status of patients with hypothyroidism. Design and patients in 5 patients with primary hypothyroidism and control group renal functions are measured by serum creatinine and glomerular filtration rate(GFR) using modified in diet renal disease (MDRD) formula. Result in hypothyroidism, mean serum creatinine increased and mean estimated GFR decreased, compared to the control group mean serum creatinine decreased and mean estimated GFR increased. The hypothyroid patients showed elevated serum creatinine levels(>1.1 mg/d1) compared to control group (p value= 000). In patients mean estimated GFR increased in the control group (p value=.002).Conclusion thus the kidney, in addition to the brain, heart and muscle, is an important target of the action of thyroid hormones.(Author)

Perioperative acute renal failure.

LENUS (Irish Health Repository)

Mahon, Padraig

2012-02-03

PURPOSE OF REVIEW: Recent biochemical evidence increasingly implicates inflammatory mechanisms as precipitants of acute renal failure. In this review, we detail some of these pathways together with potential new therapeutic targets. RECENT FINDINGS: Neutrophil gelatinase-associated lipocalin appears to be a sensitive, specific and reliable biomarker of renal injury, which may be predictive of renal outcome in the perioperative setting. For estimation of glomerular filtration rate, cystatin C is superior to creatinine. No drug is definitively effective at preventing postoperative renal failure. Clinical trials of fenoldopam and atrial natriuretic peptide are, at best, equivocal. As with pharmacological preconditioning of the heart, volatile anaesthetic agents appear to offer a protective effect to the subsequently ischaemic kidney. SUMMARY: Although a greatly improved understanding of the pathophysiology of acute renal failure has offered even more therapeutic targets, the maintenance of intravascular euvolaemia and perfusion pressure is most effective at preventing new postoperative acute renal failure. In the future, strategies targeting renal regeneration after injury will use bone marrow-derived stem cells and growth factors such as insulin-like growth factor-1.

Spiral CT in kidney: assumption of renal function by objective evaluation of renal cortical enhancement

International Nuclear Information System (INIS)

Choi, Bo Yoon; Lee, Jong Seok; Lee, Joon Woo; Myung, Jae Sung; Sim, Jung Suk; Seong, Chang Kyu; Kim, Seung Hyup; Choi, Guk Myeong; Chi, Seong Whi

2000-01-01

To correlate the degree of renal cortical enhancement, objectively evaluated by means of spiral CT with the serum level of creatinine, and to determine the extent to which this degree of enhancement may be used to detect renal parenchymal disease. Eighty patients (M:F = 50:30; age + 25-19, (mean 53) years) with available serum level of creatinine who underwent spiral CT between September and October 1999 were included in this study. In fifty patients the findings suggested hepatic or biliary diseases such as hepatoma, biliary cancer, or stone, while in thirty, renal diseases such as cyst, hematoma, or stone appeared to be present. Spiral CT imaging of the cortical phase was obtained at 30-40 seconds after the injection of 120 ml of non-ionic media at a rate of 3 ml/sec. The degree of renal cortical enhancement was calculated by dividing the CT attenuation number of renal cortex at the level of the renal hilum by the CT attenuation number of aorta at the same level. The degree of renal cortical enhancement was compared with the serum level of creatinine, and the degree of renal cortical enhancement in renal parenchymal disease with that of the normal group. Among eighty patients there were five with renal parenchymal disease and 75 with normal renal function. The ratio of the CT attenuation number of renal cortex to that of aorta at the level of the renal hilum ranged between 0.49 and 0.99 (mean, 0.79; standard deviation, 0.15). while the serum level of creatinine ranged between 0.6 and 3.2 mg/dl. There was significant correlation (coefficient of -0.346) and a statistically significant probability of 0.002 between the ratio of the CT attenuation numbers and the serum level of creatinine. There was a significant difference (statistically significant probability of less than 0.01) between those with renal parenchymal disease and the normal group. The use of spiral CT to measure the degree of renal cortical enhancement provides not only an effective index for

EL TAMAÑO DE GRANO FERRÍTICO: UN FACTOR IGNORADO, DE HECHO, EN EL ANÁLISIS DEL FALLO EN EL HUNDIMIENTO DE UN FAMOSO BARCO.

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JOSÉ ANTONIO PERO-SANZ ELORZ

2012-01-01

Full Text Available En la mucha literatura publicada sobre el hundimiento del famoso trasatlántico Titanic, el 15 de Abril de 1912 en las aguas del Atlántico Norte, tras chocar con un iceberg, no se ha hecho un análisis suficientemente riguroso de las causas de aquel, en relación al comportamiento de los materiales, dada la maniobra del buque y choque producidos. En las planchas de acero, material del casco, se abrió una tremenda grieta de varias decenas de metros y no existe una explicación suficientemente satisfactoria al día de hoy. El acero se calificó malo por exceso de azufre, dándole excesiva importancia a la presencia de inclusiones de sulfuro de manganeso o a su forma poco globular, habiendo también demasiada fijación en el fallo de los remaches. En realidad la causa primordial fue, en nuestra opinión, la ausencia en el acero de aleantes afinantes de grano y el correspondiente tratamiento de la chapa, que produjeron un tamaño de grano excesivo. En las condiciones de navegación, en aguas bajo 0ºC, el acero del Titanic había pasado con holgura la temperatura de transición dúctil-frágil, convirtiendo el casco en un recipiente de "cristal".

Síndrome do desconforto respiratório agudo relacionada à sepse em crianças com câncer: dinâmica respiratória de uma condição devastadora

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Rodrigo Genaro Arduini

Full Text Available RESUMO Objetivo: Avaliar a evolução clínica e os parâmetros respiratórios de crianças com câncer submetidas à ventilação mecânica que apresentavam síndrome do desconforto respiratório agudo relacionada à sepse. Métodos: Este estudo longitudinal, prospectivo e observacional de coorte com duração de 2 anos incluiu 29 crianças e adolescentes. Dados clínicos, avaliações de gasometria sanguínea e parâmetros ventilatórios foram coletados em quatro momentos diferentes. As flutuações entre as avaliações e as diferenças entre as médias estimadas foram analisadas por meio de modelos lineares mistos, tendo como parâmetro primário (endpoint a ocorrência de óbito dentro de 28 dias após o início da síndrome do desconforto respiratório agudo. Resultados: Ocorreram 17 óbitos dentro de 28 dias após o início da síndrome do desconforto respiratório agudo, e outros 7 entre 29 e 60 dias. Apenas cinco pacientes sobreviveram por mais de 60 dias. Nove (31% pacientes faleceram como consequência direta de hipoxemia refratária, e os demais em razão de falência de múltiplos órgãos e choque refratário a catecolaminas. Em 66% das avaliações, o volume corrente demandado para obter saturação de oxigênio igual ou acima de 90% foi superior a 7mL/kg. As médias estimadas de complacência dinâmica foram baixas e similares para sobreviventes e não sobreviventes, porém com inclinação negativa da reta entre a primeira e última avaliações, acompanhada por uma inclinação negativa da reta para volume corrente nos não sobreviventes. Os não sobreviventes tiveram significantemente mais hipoxemia, com relações PaO2/FiO2 que demonstravam médias mais baixas e inclinação negativa da reta nas quatro avaliações. As pressões pico, expiratória e média das vias aéreas demonstraram inclinações positivas na reta para os não sobreviventes, que também apresentaram mais acidose metabólica. Conclusões: Na maioria de

Studies on the evaluation of renal function in urological renal disorders with 99mTc-DMSA renal uptake, 1

International Nuclear Information System (INIS)

Takeda, Masayuki

1987-01-01

The change of normal value of 99m Tc-dimercaptosuccinic acid (DMSA) renal uptake with age was investigated, and the correlation between total renal uptake of 99m Tc-DMSA and 24-hour endogenous creatinine clearance was studied in each age group separately. (1) 99m Tc-DMSA renal uptake was measured in 107 normal controls without renal or urinary tract diseases between 0 and 67 years old and normal values were analyzed in each age group. The normal value was highest in the age group of 0 ∼ 9 years old and was gradually decreased with age. Over 20 years old, the normal value hardly changed. (2) The lower limit of normal values of 99m Tc-DMSA renal uptake in each kidney was 19.62, 13.89, 13.18, 11.58, 12.00, 10.24 % in the age groups of 0 ∼ 9, 10 ∼ 19, 20 ∼ 29, 30 ∼ 39, 40 ∼ 49, 50 ∼ 59 years old, respectively. (3) Correlations between total renal uptake and 24-hour endogenous creatinine clearance were investigated in each age group in 248 patients between 0 and 79 years old. Positive linear correlations were found in the age groups of 0 ∼ 9, 10 ∼ 19, 20 ∼ 29, 30 ∼ 39, 40 ∼ 49, 50 ∼ 59, 60 ∼ 69, 70 ∼ 79 years old, and especially above 50 years old closer correlations were found. It is concluded that although 99m Tc-DMSA renal uptake is a useful method for renal function test through life, the change with age must be considered in the evaluation of its value. (author)

Daño pulmonar agudo asociada a transfusión en el embarazo

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Silvia María Melians Abreu

2014-06-01

Full Text Available Introducción: el daño pulmonar agudo asociado a la transfusión es una reacción adversa a la transfusión poco frecuente, la mortalidad se ha estimado entre 1-10 %. Su diagnóstico es clínico e infrecuentemente sospechado, su incidencia es baja. Presentación del caso: se presentaron dos transfusión-related-acute-lunginjury en dos gestantes con 28,5 y 32 semanas de embarazo respectivamente, hospitalizadas en la salas de cuidados materno perinatales con enfermedades asociadas al embarazo, a quienes se le administraron componentes sanguíneos, ambas a las 5 horas de transfundidas; presentaron el síndrome clínico con hipoxemia moderada y necesitaron ventilación; con estos hallazgos y la relación temporal con la transfusión. Se realizó el diagnóstico de síndrome de dificultad respiratoria aguda moderada asociada a transfusión. Conclusiones: el resultado fue óptimo con resolución completa del evento respiratorio. Se considera importante reportar ambos casos dado su aparición en embarazadas, causa poco frecuente informada en la literatura y la importancia de conservar la salud de la madre del niño y la niña e incentivar la notificación de esta reacción adversa a la transfusión al banco de sangre para fortalecer el sistema de hemovigilancia.

Eppur Si Muove: The dynamic nature of physiological control of renal blood flow by the renal sympathetic nerves.

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Schiller, Alicia M; Pellegrino, Peter Ricci; Zucker, Irving H

2017-05-01

Tubuloglomerular feedback and the myogenic response are widely appreciated as important regulators of renal blood flow, but the role of the sympathetic nervous system in physiological renal blood flow control remains controversial. Where classic studies using static measures of renal blood flow failed, dynamic approaches have succeeded in demonstrating sympathetic control of renal blood flow under normal physiological conditions. This review focuses on transfer function analysis of renal pressure-flow, which leverages the physical relationship between blood pressure and flow to assess the underlying vascular control mechanisms. Studies using this approach indicate that the renal nerves are important in the rapid regulation of the renal vasculature. Animals with intact renal innervation show a sympathetic signature in the frequency range associated with sympathetic vasomotion that is eliminated by renal denervation. In conscious rabbits, this sympathetic signature exerts vasoconstrictive, baroreflex control of renal vascular conductance, matching well with the rhythmic, baroreflex-influenced control of renal sympathetic nerve activity and complementing findings from other studies employing dynamic approaches to study renal sympathetic vascular control. In this light, classic studies reporting that nerve stimulation and renal denervation do not affect static measures of renal blood flow provide evidence for the strength of renal autoregulation rather than evidence against physiological renal sympathetic control of renal blood flow. Thus, alongside tubuloglomerular feedback and the myogenic response, renal sympathetic outflow should be considered an important physiological regulator of renal blood flow. Clinically, renal sympathetic vasomotion may be important for solving the problems facing the field of therapeutic renal denervation. Copyright © 2016 Elsevier B.V. All rights reserved.

Leiomyosarcoma of the renal pelvis

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Dhamne Sagar

2009-10-01

Full Text Available Leiomyosarcomas are rare malignant tumors of the kidney. They may arise from the renal capsule, renal vein, renal pelvic musculature or renal parenchyma. Renal pelvis is an uncommon site of occurrence, with around 10 cases reported in the literature so far. Here we present a 60-year-old male who presented with increased urinary frequency, lower limb weakness, anorexia and weight loss. Imaging showed a right renal mass. A renal cell carcinoma was suspected clinically. A right nephrectomy was performed, which showed a large circumscribed mass in the hilar region. Histology revealed a tumor mass arising from the renal pelvis. The tumor was composed of spindle cells arranged in fascicles. Immunohistochemistry showed tumor cells to be positive for smooth muscle actin (SMA and desmin (Des and negative for cytokeratin (CK, HMB 45, CD117 (C-kit, and CD34. That confirmed the diagnosis of leiomyosarcoma.

Renal and post-renal causes of acute renal failure in children

International Nuclear Information System (INIS)

Jamal, A.; Ramzan, A.

2004-01-01

Objective: To identify the causes of acute renal failure (ARF) in pediatric population along with the identification of the age and gender most affected by the failure. Subjects and Methods: The study included children under the age of 12 years who presented with signs and symptoms suggestive of ARF (oliguria/anuria, vomiting, acidotic breathing etc.) along with raised blood urea nitrogen (BUN) serum creatinine and metabolic acidosis as shown by arterial blood gases (ABGs). Patients were divided into two group on the basis of age; group A consisting of 0-2 years and group B from >2 years. Patients presenting with transient pre-renal azotaemia were excluded from the study. After providing initial emergency cover, detailed history, physical examination and investigations were carried out according to a proforma specially designed to ascertain the cause of ARF. Patients were managed for ARF as per standard recommendations and investigations completed or repeated as and when required. Results: A total of 119 patients with ARF were admitted in the ward over a period of two years constituting 1.36% of the total admissions and 16.39% of the admissions due to renal pathology. Mean age of presentation was 4.5 years 16.7% of the patients under the age of 5 years. Male predominance was noted in all ages with an overall male to female ratio of 2.3:1. Most common cause leading to ARF in younger age group was found to be hemolytic uremic syndrome [25(54.34%)] followed by septicemia [7(15.21 %)]. In older patients renal calculus disease was the most common [22(30.13%)] underlying pathology followed by pre-existing, undiagnosed chronic renal failure [16(21.91 %)]. Conclusion: ARF is fairly cotton in children especially under the age of 5 years showing a male predominance. More than 90% of the cases can be prevented by improving primary health care and by early and prompt treatment of infections. (author)

Dependence of renal blood flow on renal artery stenosis measured using CT angiography

Energy Technology Data Exchange (ETDEWEB)

Luedemann, Lutz [Charite - Universitaetsmedizin Berlin (Germany). Dept. of Radiotherapy; Nafz, B.; Persson, P. [Charite - Universitaetsmedizin Berlin (Germany). Inst. for Vegetative Physiology; Elsner, F. [Krankenhaus am Urban, Berlin (Germany). Dept. of Anesthesiology; Grosse-Siestrup, C.; Meissler, M. [Charite - Universitaetsmedizin Berlin (Germany). Experimental Animal Unit; Gutberlet, M. [Charite - Universitaetsmedizin Berlin (Germany). Dept. of Diagnostic and Interventional Radiology; Univ. Leipzig/ Leipzig Heart Center (Germany). Dept. of Diagnostic and Interventional Radiology; Lengsfeld, P.; Voth, M. [Bayer-Schering Pharma AG, Berlin (Germany). Global Medical Affairs Diagnostic Imaging

2011-03-15

The present study investigates the suitability of computed tomography angiography (CTA) depicting the degree of renal artery stenosis for estimating renal blood flow (RBF) in a kidney. Materials and Methods: We investigated renal artery stenosis assessment by CTA in eight adult female hybrid pigs with an ultrasound probe implanted at the renal vein for RBF measurement. An inflatable metal-free cuff was placed around the renal artery to control the RBF. The RBF was then reduced in four steps. For each reduced RBF value and baseline RBF, CTA with a reconstructed slice thickness of 0.625 mm was performed in the arterial phase following injection of 80 ml of nonionic intravenous contrast medium. The radius of the stenotic and non-stenotic renal artery segment was measured in the reconstructed images. Results: A significant linear correlation (p < 0.0001) was found between the relative apparent stenosis (calculated as the ratio of the radii of the actual stenotic segment and a non-stenotic renal artery segment) and RBF. The linear regression yielded a slope of 0.57 and a y-axis of 24.1 %. A significant linear correlation (p < 0.0001) was also found between the relative true stenosis (the ratio of the radii of the actual stenotic segment and a non-stenotic renal artery segment at baseline) and the RBF. The linear regression yielded a slope of 0.67 and a y-axis of 13.8 %. Conclusion: The results show that the relative stenosis apparent on CTA differs from the true degree of renal artery stenosis. Nevertheless, the degree of renal artery stenosis determined by CTA provides a reliable estimate of the resulting RBF reduction. (orig.)

Dependence of renal blood flow on renal artery stenosis measured using CT angiography

International Nuclear Information System (INIS)

Luedemann, Lutz; Nafz, B.; Persson, P.; Elsner, F.; Grosse-Siestrup, C.; Meissler, M.; Gutberlet, M.; Univ. Leipzig/ Leipzig Heart Center; Lengsfeld, P.; Voth, M.

2011-01-01

The present study investigates the suitability of computed tomography angiography (CTA) depicting the degree of renal artery stenosis for estimating renal blood flow (RBF) in a kidney. Materials and Methods: We investigated renal artery stenosis assessment by CTA in eight adult female hybrid pigs with an ultrasound probe implanted at the renal vein for RBF measurement. An inflatable metal-free cuff was placed around the renal artery to control the RBF. The RBF was then reduced in four steps. For each reduced RBF value and baseline RBF, CTA with a reconstructed slice thickness of 0.625 mm was performed in the arterial phase following injection of 80 ml of nonionic intravenous contrast medium. The radius of the stenotic and non-stenotic renal artery segment was measured in the reconstructed images. Results: A significant linear correlation (p < 0.0001) was found between the relative apparent stenosis (calculated as the ratio of the radii of the actual stenotic segment and a non-stenotic renal artery segment) and RBF. The linear regression yielded a slope of 0.57 and a y-axis of 24.1 %. A significant linear correlation (p < 0.0001) was also found between the relative true stenosis (the ratio of the radii of the actual stenotic segment and a non-stenotic renal artery segment at baseline) and the RBF. The linear regression yielded a slope of 0.67 and a y-axis of 13.8 %. Conclusion: The results show that the relative stenosis apparent on CTA differs from the true degree of renal artery stenosis. Nevertheless, the degree of renal artery stenosis determined by CTA provides a reliable estimate of the resulting RBF reduction. (orig.)

Acute renal dysfunction in liver diseases

OpenAIRE

Betrosian, Alex P; Agarwal, Banwari; Douzinas, Emmanuel E

2007-01-01

Renal dysfunction is common in liver diseases, either as part of multiorgan involvement in acute illness or secondary to advanced liver disease. The presence of renal impairment in both groups is a poor prognostic indicator. Renal failure is often multifactorial and can present as pre-renal or intrinsic renal dysfunction. Obstructive or post renal dysfunction only rarely complicates liver disease. Hepatorenal syndrome (HRS) is a unique form of renal failure associated with advanced liver dise...

Assessment of renal function with 99Tcm-DTPA renal dynamic imaging in neonatal hydronephrosis

International Nuclear Information System (INIS)

Jiang Lixin; Guo Zongyuan; Wu Rongde; Yu Qihai; Liu Zhanfeng

2004-01-01

Objective: To assess the renal function in neonatal hydronephrosis with 99 Tc m -DTPA renal imaging. Methods: Eighteen unilateral hydronephrotic kidneys and 12 normal kidneys were studied by 99 Tc m -DTPA renal dynamic imaging , and glomerular filtration rate (GFR) quantitative analysis was also performed. Blood urea nitrogen (BUN), serum creatinine (SCr) and hemoglobin (Hb) were determined simultaneously and the correlations between GFR and each of these parameters were analyzed. Results: Positive correlation was discovered between GFR and Hb in neonates with moderate or severe hydronephrosis (r=0.414, 0.667, P 0.05). The renal function was decreased significantly in moderate and severe neonatal hydronephrosis (P 99 Tc m -DTPA renal dynamic imaging GFR is an ideal marker for estimating renal function in neonatal hydronephrosis; SCr could be a marker for renal damage especially in moderate and severe neonatal hydronephrosis; BUN could not be a marker for evaluating renal function in neonatal hydronephrosis. Neonates with hydronephrosis should be referred for surgical procedures as soon as possible in the early stage

Renal Function Outcomes for Multifocal Renal Neoplasms Managed by Radiofrequency Ablation

Energy Technology Data Exchange (ETDEWEB)

Gupta, Pushpender, E-mail: pugupta@wakehealth.edu; Allen, Brian C., E-mail: bcallen2@wakehealth.edu; Chen, Michael Y., E-mail: mchen@wakehealth.edu; Childs, David D., E-mail: dchilds@wakehealth.edu; Kota, Gopi, E-mail: gkota@wakehealth.edu; Zagoria, Ronald J., E-mail: rzagoria@wakehealth.edu [Wake Forest University School of Medicine, Department of Radiology (United States)

2013-10-15

Purpose: To evaluate renal function changes related to radiofrequency ablation (RFA) for the treatment of multifocal renal neoplasms. Methods: This is an institutional review board-approved, Health Insurance Portability and Accountability Act compliant retrospective study of all patients treated with computed tomography guided RFA for multifocal renal neoplasms at one institution. Fifty-seven subjects, mean age 70 (range 37-88) years, underwent RFA of 169 renal neoplasms (average size 2.0 cm). Subjects had between 2 and 8 (mean 2.96) neoplasms ablated. Estimated glomerular filtration rate (eGFR) was measured before and after RFA. Complications related to RFA were recorded. Results: eGFR decreased on average of 4.4 % per tumor treated and 6.7 % per ablation session (average 1.76 tumors treated per session). For subjects with the largest neoplasm measuring >3 cm, eGFR decreased an average of 14.5 % during the course of their treatment. If the largest neoplasm measured 2-3 cm, eGFR decreased an average of 7.7 %, and if the largest neoplasm measured <2 cm, eGFR decreased an average of 3.8 %. Subjects with reduced baseline renal function were more likely to have a greater decline in eGFR after RFA. There was a minor complication rate of 6.3 % (6 of 96 sessions), none of which required treatment, and a major complication rate of 4.2 % (4 of 96 sessions). Conclusion: RFA for the treatment of multifocal renal neoplasms results in mild decline of renal function.

Renal papillary necrosis

Science.gov (United States)

... asking your provider. Alternative Names Necrosis - renal papillae; Renal medullary necrosis Images Kidney anatomy Kidney - blood and urine flow References Bushinsky DA, Monk RD. Nephrolithiasis and nephrocalcinosis. ...

Current perspectives of acute pain treatment Perspectivas actuales de tratamiento del paciente con dolor agudo

Directory of Open Access Journals (Sweden)

Tiberio Alvarez Echeverri

1993-03-01

Full Text Available

In the last years opioids have become of great importance in the relief of postoperative and other forms of acute pain. Reasons for this trend have been the availability of agonist opioids like phentanyl. sulphentanyl and alphentanyl and the results of research on the physlology. The pharmacology and the chemistry of drug receptors and neurotransmitters. The studies on chemicals other than opioids that contribute to pain relief when administered through different ways. specially the spinal. Have also influenced such a trend.

En los últimos años los opiáceos han adquirido gran importancia en el alivio del dolor agudo especialmente del tipo postoperatorio. Una de las razones ha sido la disponibilidad de morfínicos agonistas como el fentanil, el sufentanil y el alfentanil; otra es la investigación de la fisiología, la farmacología y la química de los receptores y los neurotransmisores como de sustancias diferentes a los opláceos, aplicadas por diferentes vías en especial la espinal, que coadyuvan al alivio del dolor.

Imaging of renal osteodystrophy

Energy Technology Data Exchange (ETDEWEB)

Jevtic, V. E-mail: vladimir.jevtic@mf.uni-lj.si

2003-05-01

Chronic renal insufficiency, hemodialysis, peritoneal dialysis, renal transplantation and administration of different medications provoke complex biochemical disturbances of the calcium-phosphate metabolism with wide spectrum of bone and soft tissue abnormalities termed renal osteodystrophy. Clinically most important manifestation of renal bone disease includes secondary hyperparathyroidism, osteomalacia/rickets, osteoporosis, adynamic bone disease and soft tissue calcification. As a complication of long-term hemodialysis and renal transplantation amyloid deposition, destructive spondyloarthropathy, osteonecrosis, and musculoskeletal infections may occur. Due to more sophisticated diagnostic methods and more efficient treatment classical radiographic features of secondary hyperparathyroidism and osteomalacia/rickets are now less frequently seen. Radiological investigations play an important role in early diagnosis and follow-up of the renal bone disease. Although numerous new imaging modalities have been introduced in clinical practice (scintigraphy, CT, MRI, quantitative imaging), plain film radiography, especially fine quality hand radiograph, still represents most widely used examination.

Imaging of renal osteodystrophy

International Nuclear Information System (INIS)

Jevtic, V.

2003-01-01

Chronic renal insufficiency, hemodialysis, peritoneal dialysis, renal transplantation and administration of different medications provoke complex biochemical disturbances of the calcium-phosphate metabolism with wide spectrum of bone and soft tissue abnormalities termed renal osteodystrophy. Clinically most important manifestation of renal bone disease includes secondary hyperparathyroidism, osteomalacia/rickets, osteoporosis, adynamic bone disease and soft tissue calcification. As a complication of long-term hemodialysis and renal transplantation amyloid deposition, destructive spondyloarthropathy, osteonecrosis, and musculoskeletal infections may occur. Due to more sophisticated diagnostic methods and more efficient treatment classical radiographic features of secondary hyperparathyroidism and osteomalacia/rickets are now less frequently seen. Radiological investigations play an important role in early diagnosis and follow-up of the renal bone disease. Although numerous new imaging modalities have been introduced in clinical practice (scintigraphy, CT, MRI, quantitative imaging), plain film radiography, especially fine quality hand radiograph, still represents most widely used examination

CT findings of renal abscess

International Nuclear Information System (INIS)

Lee, Myung Jun; Kim, Mi Young; Woo, Jung Ju; Kim, Ho Kyun; Kim, Won Hong; Jeon, Jeong Dong; Jeon, Woo Ki; Han, Chang Yul

1996-01-01

The purpose of this study is to determine characteristic CT findings in renal abscess. Twenty cases of renal abscess were retrospectively analyzed for CT findings relating to the shape and extent of the abscess, change of nephrogram, peripheral rim enhancement, wedge-shaped enhancement on delayed scans, enlargement of the kidney involved and associated findings. Seven patients had a renal abscess at the right kidney, nine at the lift kidney and two bilaterally. The abscesses were round in 18 cases and finger-like in two. Rim enhancement around renal abscess was seen in four cases (20%). Changes in the nephrogram around the abscess were seen in 12 cases (60%). In all six patients who had undergone delayed postcontrast scans, wedge-shaped enhancement was shown around the abscess (100%). In the observation of the extent of renal abscesses, 14 cases were within the kidney, six cases extended the beyond renal capsule, and two were loculated in the renal fascia itself. Renal enlargement was seen in nine cases (45%). These results suggest that CT findings such as delayed wedge-shaped enhancement, change of nephrogram, peripheral rim enhancement, renal enlargement, and associated findings are valuable for diagnosis, and that CT also gives information concerning the extent, evolution and complication of a renal abscess

[Clinical study of influential factors on renal scarring after ESWL monotherapy for renal stone disease].

Science.gov (United States)

Ishito, Noritaka; Takamoto, Hitoshi; Kunitomi, Kimito; Satoh, Eiichi; Ishii, Ayano; Shiotuka, Youichi; Sako, Shinichi; Ohta, Naoki; Araki, Tohru

2002-11-01

ESWL is now widely used for the treatment of renal stone disease. Although ESWL has many advantages for patients' quality of life, few reports have demonstrated the long-term outcomes of the alterations of renal morphology after ESWL. We reported renal scarring after ESWL monotherapy in patients with renal calyceal stones. In this study, we evaluated a large series of patients' cohort treated at our institution, and assessed the causal effect of ESWL on the late occurrence of renal scar formation. ESWL was performed with EDAP (LT-01,02) that generates shock wave energy by piezoelectric discharge. We analyzed the records of 285 kidneys treated between Dec. 1986 and Nov. 1998. Renal scarring was noted in 44 kidneys and not in 241 kidneys with periodical ultrasonography. We compared the backgrounds of the two groups using chi-square or non-parametric analysis. The Kaplan-Meier method and Cox regression model determined the analysis of renal scar formation. Univariate and multiple regression analysis revealed that the total amount of ESWL emission and hyperuricemia independently affected the probability of renal scar formation. Over-emission of ESWL (over 10,000 shots) must be care for the prevention of renal scarring in patients with renal calyceal calculi, especially when associated with hyperuricemia. After ESWL, periodical checkups with ultrasonography will provide useful information for the clinical diagnosis of renal scarring.

Acute renal haemodynamic and renin-angiotensin system responses to graded renal artery stenosis in the dog.

Science.gov (United States)

Anderson, W P; Johnston, C I; Korner, P I

1979-01-01

1. The acute renal haemodynamic and renin-angiotensin system responses to graded renal artery stenosis were studied in chronically instrumented, unanaesthetized dogs. 2. Stenosis was induced over 30 sec by inflation of a cuff around the renal artery to lower distal pressure to 60, 40 or 20 mmHg, with stenosis maintained for 1 hr. This resulted in an immediate fall in renal vascular resistance, but over the next 5--30 min both resistance and renal artery pressure were restored back towards prestenosis values. Only transient increases in systemic arterial blood pressure and plasma renin and angiotensin levels were seen with the two milder stenoses. Despite restoration of renal artery pressure, renal blood flow remained reduced at all grades of stenosis. 3. Pre-treatment with angiotensin I converting enzyme inhibitor or sarosine1, isoleucone8 angiotensin II greatly attenuated or abolished the restoration of renal artery pressure and renal vascular resistance after stenosis, and plasma renin and angiotensin II levels remained high. Renal dilatation was indefinitely maintained, but the normal restoration of resistance and pressure could be simulated by infusing angiotensin II into the renal artery. 4. The effective resistance to blood flow by the stenosis did not remain constant but varied with changes in the renal vascular resistance. PMID:219182

Value of renal cortical thickness as a predictor of renal function impairment in chronic renal disease patients

Directory of Open Access Journals (Sweden)

Samia Rafael Yamashita

2015-02-01

Full Text Available Objective: To determine the presence of linear relationship between renal cortical thickness, bipolar length, and parenchymal thickness in chronic kidney disease patients presenting with different estimated glomerular filtration rates (GFRs and to assess the reproducibility of these measurements using ultrasonography. Materials and Methods: Ultrasonography was performed in 54 chronic renal failure patients. The scans were performed by two independent and blinded radiologists. The estimated GFR was calculated using the Cockcroft-Gault equation. Interobserver agreement was calculated and a linear correlation coefficient (r was determined in order to establish the relationship between the different renal measurements and estimated GFR. Results: The correlation between GFR and measurements of renal cortical thickness, bipolar length, and parenchymal thickness was, respectively, moderate (r = 0.478; p < 0.001, poor (r = 0.380; p = 0.004, and poor (r = 0.277; p = 0.116. The interobserver agreement was considered excellent (0.754 for measurements of cortical thickness and bipolar length (0.833, and satisfactory for parenchymal thickness (0.523. Conclusion: The interobserver reproducibility for renal measurements obtained was good. A moderate correlation was observed between estimated GFR and cortical thickness, but bipolar length and parenchymal thickness were poorly correlated.

Cadmium and renal cancer

International Nuclear Information System (INIS)

Il'yasova, Dora; Schwartz, Gary G.

2005-01-01

Background: Rates of renal cancer have increased steadily during the past two decades, and these increases are not explicable solely by advances in imaging modalities. Cadmium, a widespread environmental pollutant, is a carcinogen that accumulates in the kidney cortex and is a cause of end-stage renal disease. Several observations suggest that cadmium may be a cause of renal cancer. Methods: We performed a systematic review of the literature on cadmium and renal cancer using MEDLINE for the years 1966-2003. We reviewed seven epidemiological and eleven clinical studies. Results: Despite different methodologies, three large epidemiologic studies indicate that occupational exposure to cadmium is associated with increased risk renal cancer, with odds ratios varying from 1.2 to 5.0. Six of seven studies that compared the cadmium content of kidneys from patients with kidney cancer to that of patients without kidney cancer found lower concentrations of cadmium in renal cancer tissues. Conclusions: Exposure to cadmium appears to be associated with renal cancer, although this conclusion is tempered by the inability of studies to assess cumulative cadmium exposure from all sources including smoking and diet. The paradoxical findings of lower cadmium content in kidney tissues from patients with renal cancer may be caused by dilution of cadmium in rapidly dividing cells. This and other methodological problems limit the interpretation of studies of cadmium in clinical samples. Whether cadmium is a cause of renal cancer may be answered more definitively by future studies that employ biomarkers of cadmium exposure, such as cadmium levels in blood and urine

Sobrecarga en el cuidador de paciente con infarto agudo al miocardio

Directory of Open Access Journals (Sweden)

Norma Lizbeth Ávila Estrada

2012-12-01

Full Text Available Introducción: Las enfermedades cardiovasculares constituyen la primera causa de muerte en México, generando un impacto social persistente que involucra tanto a quien lo padece como a quienes lo rodean. Objetivo: Determinar el nivel de sobrecarga en el cuidador con pacientes de infarto agudo miocardio (IAM en el Hospital General de Durango. Materiales y Métodos: Estudio descriptivo no experimental, transversal; 54 familiares de pacientes hospitalizados con diagnóstico de IAM en el Hospital General Durango, no probabilístico por conveniencia. Resultados: La edad promedio en el estudio es de 18 a 25 años correspondiendo al 37%, de los cuales el 66.7% es femenino, 59.3% tiene escolaridad de medios superior, el 72.2% son de procedencia de la ciudad de Durango, con respecto al parentesco del cuidador con la persona que demanda cuidado esta es en su mayoría hijo con un porcentaje de 20.4%; también un alto porcentaje 81.5 % convive con el enfermo y un 63.0% trabaja fuera del hogar, y un 27.8% ha dejado el trabajo parcialmente; el resultado revelo que existe un nivel medio de sobrecarga del 44.2% en el cuidador primario. Discusión y Conclusiones: Son identificables los niveles de sobrecarga en cuidadores de pacientes con IAM generando una serie de variables que alteran la relación cuidador-paciente trayendo consigo una sobrecarga de tipo medio. (Rev Cuid 2012;3(3:342-8.Palabras clave: Cuidados Posteriores, Absentismo Familiar, Atención no Remunerada. (Fuente: DeCS BIREME.

EJERCICIO Y LA DETECCION DEL MAL AGUDO DE MONTAÑA GRAVE

Science.gov (United States)

Garófoli, Adrián; Montoya, Paola; Elías, Carlos; Benzo, Roberto

2012-01-01

El Mal Agudo de Montaña (MAM) es un conjunto de síntomas inespecíficos padecidos por sujetos que ascienden rápidamente desde baja a alta altura sin adecuada aclimatación. Usualmente es autolimitado, pero las formas graves (edema pulmonar y cerebral) pueden causar la muerte. La hipoxemia exagerada en reposo está relacionada con el desarrollo de MAM pero su valor predictivo es limitado. Dado que el ejercicio en altura se acompaña de mayor hipoxemia y síntomas, postulamos el valor predictivo de un simple test de ejercicio para pronosticar MAM grave. Se estudió el valor predictivo de la saturación de oxígeno en reposo y ejercicio submáximo a 2 700m y 4 300m en 63 sujetos que ascendían al cerro Aconcagua (6 962m). Se consideró desaturación de oxígeno con ejercicio a una disminución >=5% respecto al reposo. Se utilizó la escala de Lake-Louise para establecer la presencia de MAM grave. 6 sujetos presentaron MAM grave (9.5%) y requirieron evacuación. La saturación de oxígeno en reposo a 2 700m no fue significativa para clasificar sujetos que luego desarrollaron MAM grave. Por el contrario, la asociación de desaturación durante el ejercicio a 2 700m más la saturación inapropiada en reposo a 4 300m fue significativa para clasificar a los sujetos que desarrollaron MAM grave con un valor predictivo positivo de 80% y un valor predictivo negativo del 97%. Nuestros resultados son relevantes para el montañismo y sugieren la adición de un simple test de ejercicio en la predicción del MAM grave. PMID:20228017

Renal endothelial function and blood flow predict the individual susceptibility to adriamycin-induced renal damage

NARCIS (Netherlands)

Ochodnicky, Peter; Henning, Robert H.; Buikema, Hendrik; Kluppel, Alex C. A.; van Wattum, Marjolein; de Zeeuw, Dick; van Dokkum, Richard P. E.

2009-01-01

Susceptibility to renal injury varies among individuals. Previously, we found that individual endothelial function of healthy renal arteries in vitro predicted severity of renal damage after 5/6 nephrectomy. Here we hypothesized that individual differences in endothelial function in vitro and renal

[Hypertension and renal disease

DEFF Research Database (Denmark)

Kamper, A.L.; Pedersen, E.B.; Strandgaard, S.

2009-01-01

Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...... hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...... nephropathy, effective blood pressure lowering is of paramount importance, and angiotensin converting enzyme inhibitors and angiotensin receptor blockers are agents of choice Udgivelsesdato: 2009/6/15...

Bilateral triple renal arteries

International Nuclear Information System (INIS)

Pestemalci, Turan; Yildiz, Yusuf Zeki; Yildirim, Mehmet; Mavi, Ayfer; Gumusburun, Erdem

2009-01-01

Knowledge of the variations of the renal artery has grown in importance with increasing numbers of renal transplants, vascular reconstructions and various surgical and radio logic techniques being performed in recent years. We report the presence of bilateral triple renal arteries, discovered on routine dissection of a male cadaver. On the right side, one additional renal artery originated from the abdominal aorta (distributed to superior pole of the kidney) and one other originated from the right common iliac artery (distributed to lower pole of the kidney). On the left side, both additional renal arteries originated from the abdominal aorta. Our observation has been compared with variations described in the literature and their clinical importance has been emphasized. (author)

Radiology of renal failure

International Nuclear Information System (INIS)

Griffiths, H.J.

1990-01-01

This book covers most aspects of imaging studies in patients with renal failure. The initial chapter provides basic information on contrast agents, intravenous urography, and imaging findings in the urinary tract disorders responsible for renal failure and in patients who have undergone transplantation. It illustrates common gastro-intestinal abnormalities seen on barium studies in patients with renal failure. It illustrates the cardiopulmonary complications of renal failure and offers advice for radiologic differentiation. It details different aspects of skeletal changes in renal failure, including a basic description of the pathophysiology of the changes; many excellent illustrations of classic bone changes, arthritis, avascular necrosis, and soft-tissue calcifications; and details of bone mineral analysis

Renal sinus fat invasion and tumoral thrombosis of the inferior vena cava-renal vein: only confined to renal cell carcinoma.

Science.gov (United States)

Acar, Turker; Harman, Mustafa; Guneyli, Serkan; Sen, Sait; Elmas, Nevra

2014-01-01

Epithelioid angiomyolipoma (E-AML), accounting for 8% of renal angiomyolipoma, is usually associated with tuberous sclerosis (TS) and demonstrates aggressive behavior. E-AML is macroscopically seen as a large infiltrative necrotic tumor with occasional extension into renal vein and/or inferior vena cava. However, without history of TS, renal sinus and venous invasion E-AML would be a challenging diagnosis, which may lead radiologists to misinterpret it as a renal cell carcinoma (RCC). In this case presentation, we aimed to report cross-sectional imaging findings of two cases diagnosed as E-AML and pathological correlation of these aforementioned masses mimicking RCC.

Diagnostic use of angiotensin converting enzyme (ACE)-inhibited renal scintigraphy in the identification of selective renal artery stenosis in the presence of multiple renal arteries: A case report

International Nuclear Information System (INIS)

Morton, K.A.; Rose, S.C.; Haakenstad, A.O.; Handy, J.E.; Scuderi, A.J.; Datz, F.L.

1990-01-01

In patients with renovascular hypertension, it is unknown whether the angiotensin converting enzyme-(ACE) inhibited renal scan will identify stenosis of a segmental branch of a single renal artery or of an accessory artery where multiple renal arteries are present. Since multiple renal arteries may be present in approximately 25% of all individuals, it will be important to establish whether the ACE-inhibited renal scan is useful in this population. We report a case of stenosis involving a renal artery in a patient with multiple renal arteries, successfully identified by ACE-inhibited renal scintigraphy

Renal inflammatory myofibroblastic tumor

DEFF Research Database (Denmark)

Heerwagen, S T; Jensen, C; Bagi, P

2007-01-01

Renal inflammatory myofibroblastic tumor (IMT) is a rare soft-tissue tumor of controversial etiology with a potential for local recurrence after incomplete surgical resection. The radiological findings in renal IMT are not well described. We report two cases in adults with a renal mass treated...

Does complete renal denervation translate into superior clinical outcomes? Lessons learned from denervation of accessory renal arteries

OpenAIRE

Mendelsohn, Farrell O.

2014-01-01

Pre-clinical studies of renal denervation would suggest that the extent of renal nerve injury correlates with outcomes. The “completeness” of renal nerve injury following renal denervation correlates with treatment-based variables such as the depth of ablation, the number of ablations along the length of the artery, and the number of renal arteries successfully ablated. Renal denervation techniques targeting only main renal arteries may lead to suboptimal results in patients with accessory re...

Meningite e endocardite infecciosa causada por Rhodotorula mucilaginosa em paciente imunocompetente

Directory of Open Access Journals (Sweden)

Sergio Henrique Loss

2011-12-01

Full Text Available Os autores relatam o caso de um homem imunocompetente admitido com comprometimento agudo do sistema nervoso, crise hipertensiva e insuficiência renal, vindo a receber diagnóstico de meningite e endocardite infecciosa por Rhodotorula mucilaginosa. Até onde sabemos, esta é a primeira descrição de infecção simultânea das meninges e do endotélio causada por Rhodotorula em um paciente sem comprometimento imunológico.

Abdome agudo obstrutivo pela veia porta - relato de caso

Directory of Open Access Journals (Sweden)

Celeste Gomes Sardinha Oshiro

2016-10-01

Full Text Available Introdução: A veia porta pré-duodenal é uma anomalia congênita rara, sintomática em apenas 50% dos casos, sendo que seu diagnóstico é feito por laparotomia exploradora. O tratamento de escolha é cirúrgico, com bom prognóstico. Objetivo: Relatar um caso de Abdome Agudo Obstrutivo por Veia Porta Pré Doudenal (VPPD no período neonatal no Conjunto Hospitalar de Sorocaba. Metodologia: Descrição do referido caso e revisão de literatura. Relato de Caso: Recém-nascido de F.S.S., feminino, de parto normal em 30/05/2016, cuja mãe com 21 anos, apresentou durante pré-natal Diabetes Mellitus Gestacional e polihidrâmnio; negou consanguinidade, vícios e infecções. Ao nascimento, idade gestacional 38 1/7 semanas, peso 2865g, comprimento 47 cm, Apgar 9/9. Durante rotinas de sala de parto, à aspiração gástrica, saída de 55 ml de líquido claro com grumos (LCCG. No 4o dia de vida, episódios de vômito com sangue e distensão abdominal. No 11° dia de vida, realizada Laparotomia Exploradora que identificou dilatação gástrica e duodenal, principalmente na 3° porção, onde passa anteriormente a Veia Porta, comprimindo parcialmente a borda antimesentérica duodenal, o que comprometia seu esvaziamento. Realizada anastomose duodeno-jejunal. Recebeu alimentação parenteral por 15 dias. RN apresentou infecções fúngica e bacteriana, tratadas durante internação. Recebe alta com 46 dias de vida em aleitamento materno e boa recuperação clínica. Conclusão: Existem poucos relatos sobre a formação anômala da veia porta e suas consequências. O diagnóstico pré-natal ou pré-operatório de VPPD raramente é feito. Boa evolução pós correção cirúrgica.

Renal haemodynamic in essential hypertension assessed by 133Xe washout and selective renal angiography

International Nuclear Information System (INIS)

Gatta, A.; Merkel, C.; Pessina, A.C.; Milani, L.; Sacerdoti, D.; Zuin, R.

1982-01-01

The renal and intrarenal haemodynamic pattern in 17 patients with essential hypertension of different severity and duration was studied by means of the 133-Xenon washout technique and the selective renal angiography. The mean and the cortical renal blood flows were on average significantly decreased as compared to the controls. A good agreement was found between the reduction in renal perfusion and the degree of vascular abnormalities as shown by angiography; on the contrary no correlation was found between the impairment in renal blood flow and the degree and/or duration of hypertension

99mtechnetium-dimercapto-succinic acid renal scanning and excretory urography in diagnosis of renal scars in children

International Nuclear Information System (INIS)

McLorie, G.A.; Aliabadi, H.; Churchill, B.M.; Ash, J.M.; Gilday, D.L.

1989-01-01

We compared the ability of excretory urography (without tomography) and 99mtechnetium-dimercapto-succinic acid renal scanning to detect renal scars in 32 children with primary vesicoureteral reflux. These children did not have hydronephrosis, renal failure or urinary tract obstruction. In all cases both studies were conducted within a 10-month period. The findings from both modalities were in agreement for 51 of the 64 renal units evaluated (80%). Evaluation of the excretory urogram indicated 6 cases of diffuse and 2 of focal scarring that were not detected by evaluation of the renal scan. The sensitivity of excretory urography to detect renal scars was 84% and the specificity was 83%. The 99mtechnetium-dimercapto-succinic acid renal scan showed 5 cases of focal renal scarring not detected by excretory urography. The sensitivity of the renal scan to detect renal scars was 77% and the specificity was 75%. We conclude that neither study alone could effectively replace the other for the detection of renal scars, and recommend that both be included in the initial evaluation and followup of patients with renal scars

Evaluation of allograft perfusion by radionuclide first-pass study in renal failure following renal transplantation

International Nuclear Information System (INIS)

Baillet, G.; Ballarin, J.; Urdaneta, N.; Campos, H.; Vernejoul, P. de; Fermanian, J.; Kellershohn, C.; Kreis, H.

1986-01-01

To assess the diagnostic value of indices measured on a first-pass curve, we performed 72 radionuclide renal first-pass studies (RFP) in 21 patients during the early weeks following renal allograft transplantation. The diagnosis was based on standard clinical and biochemical data and on fine needle aspiration biopsy (FNAB) of the transplant. Aortic and renal first-pass curves were filtered using a true low-pass filter and five different indices of renal perfusion were computed, using formulae from the literature. Statistical analysis performed on the aortic and renal indices indicated excellent reproducibility of the isotopic study. Although renal indices presented a rather large scatter, they all discriminated well between normal and rejection. Three indices have a particularly good diagnostic value. In the discrimination between rejection and Acute Tubular Necrosis (ATN), only one index gave satisfying results. The indices, however, indicate that there are probably ATN with an alternation of renal perfusion and rejection episodes where perfusion is almost intact. We conclude that radionuclide first-pass study allows accurate and reproducible quantitation of renal allograft perfusion. The measured parameters are helpful to follow up the course of a post-transplantation renal failure episode and to gain more insight into renal ischemia following transplantation. (orig.)

CT features of renal infarction

International Nuclear Information System (INIS)

Suzer, Okan; Shirkhoda, Ali; Jafri, S. Zafar; Madrazo, Beatrice L.; Bis, Kostaki G.; Mastromatteo, James F.

2002-01-01

Purpose: To demonstrate the different patterns of renal infarction to avoid pitfalls. To present 'flip-flop enhancement' pattern in renal infarction. Materials and methods: Retrospective review of a total of 41 renal infarction in 37 patients were done. These patients underwent initial CT and the diagnosis of renal infarction was confirmed with either follow up CT or at surgery. Results: Twenty-three patients had wedge-shaped focal infarcts, nine patients had global and five patients had multifocal infarcts of the kidneys. Cortical rim sign was seen predominantly with global infarcts. In five patients, a 'flip-flop enhancement' pattern was observed. In two patients, planned renal biopsies due to tumefactive renal lesions were cancelled because of 'flip-flop enhancement' pattern on follow up CTs. Conclusion: Although most of our cases were straightforward for the diagnosis of renal infarction, cases with tumefactive lesions and global infarctions without the well-known cortical rim sign were particularly challenging. We describe a new sign, flip-flop enhancement pattern, which we believe solidified the diagnosis of renal infarction in five of our cases. The authors recommend further investigations for association of flip-flop enhancement and renal infarction

[Small renal mass].

Science.gov (United States)

Prokofiev, D; Kreutzer, N; Kress, A; Wissing, F; Pfeifer, H; Stolzenburg, J-U; Dietel, A; Schwalenberg, T; Do, M; Truß, M C

2012-10-01

The frequent application of ultrasound and radiological imaging for non-urological indications in recent years has resulted in an increase in the diagnosis of small renal masses. The treatment options for patients with a small renal mass include active surveillance, surgery (both open and minimally invasive) as well as ablative techniques. As there is a risk for metastatic spread even in small renal masses surgical extirpation remains the treatment of choice in most patients. Ablative procedures, such as cryoablation and radiofrequency ablation are appropriate for old and multi-morbid patients who require active treatment of a small renal mass. Active surveillance is an alternative for high-risk patients. Meticulous patient selection by the urologist and patient preference will determine the choice of treatment option in the future.

An experimental study on renal arterial and parenchymal change caused by selective renal infusion of epinephrine

International Nuclear Information System (INIS)

Jeon, Seok Chol; Yeon, Kyung Mo; Han, Man Chung

1981-01-01

Selective infusion of the epinephrine into the renal artery has been used in the field of the diagnostic and the therapeutic radiology for correct diagnosis and effective treatment, respectively. However, administration of overdose of epinephrine may cause serious complication, renal infarction. The study was undertaken to evaluate the sequential change of renal arterial constrictive effect of selective infusion of epinephrine into renal artery and to determine the critical doses of epinephrine producing irreversible renal infarct. A total of 25 rabbits are used, which are divided into 5 groups. Under the general anesthesia is made the selective infusion of various doses of epinephrine into the right renal artery of the rabbits. At the various time interval during and after the epinephrine infusion, renal angiography was done, and 24 hrs. later, gross and microscopic findings of the kidney were observed. The results are as follows; 1. Vasoconstriction of renal artery occurred within 2 mins. infusion, and maximum effect within 5 mins. 2. It seems that there is correlation between the amount of infused epinephrine and the time taken to recover from constriction of renal artery. 3. When epinephrine is infused into the renal artery in the rate of 1 ug/min., renal infarct is not noticed below the level of 10 mins., but correlation between the amount of infused epinephrine and the frequency of renal infarct occurs above 20 mins. infusion

Chemical renal denervation in the rat.

Science.gov (United States)

Consigny, Paul M; Davalian, Dariush; Donn, Rosy; Hu, Jie; Rieser, Matthew; Stolarik, Deanne

2014-02-01

The recent success of renal denervation in lowering blood pressure in drug-resistant hypertensive patients has stimulated interest in developing novel approaches to renal denervation including local drug/chemical delivery. The purpose of this study was to develop a rat model in which depletion of renal norepinephrine (NE) could be used to determine the efficacy of renal denervation after the delivery of a chemical to the periadventitial space of the renal artery. Renal denervation was performed on a single renal artery of 90 rats (n = 6 rats/group). The first study determined the time course of renal denervation after surgical stripping of a renal artery plus the topical application of phenol in alcohol. The second study determined the efficacy of periadventitial delivery of hypertonic saline, guanethidine, and salicylic acid. The final study determined the dose-response relationship for paclitaxel. In all studies, renal NE content was determined by liquid chromatography-mass spectrometry. Renal NE was depleted 3 and 7 days after surgical denervation. Renal NE was also depleted by periadventitial delivery of all agents tested (hypertonic saline, salicylic acid, guanethidine, and paclitaxel). A dose response was observed after the application of 150 μL of 10(-5) M through 10(-2) M paclitaxel. We developed a rat model in which depletion of renal NE was used to determine the efficacy of renal denervation after perivascular renal artery drug/chemical delivery. We validated this model by demonstrating the efficacy of the neurotoxic agents hypertonic saline, salicylic acid, and guanethidine and increasing doses of paclitaxel.

Infarction of renal transplant with extrarenal excretion of Tc-99m MAG3 demonstrated by renal scintigraphy

International Nuclear Information System (INIS)

Lim, Seok Tae; Kim, Min Woo; Sohn, Myung Hee

2003-01-01

A 38-year-old woman with end stage renal disease received a living related donor-renal transplant to the right iliac fossa. She developed anuria a week later. Tc-99m MAG 3 renal scintigraphy demonstrated no perfusion, uptake, or excretion of the radioactive tracer from the renal transplant. The expected area of the renal allograft appeared as a photopenic area with increased rim activity. The gallbladder and bowel activities were observed on delayed images at 24 hours. There was no blood flow within the renal artery on renal doppler examination. This case shows total absence of perfusion and function in the infarcted renal transplant with extrarenal excretion of Tc-99m MAG 3 caused by acute renal artery thrombosis

Intra-renal localised reno-renal collaterals in the dog after tying of the main renal artery

International Nuclear Information System (INIS)

Rosenbusch, G.; Vincent, J.; Douveren, W. van; Sktonicki, S.; Arts, T.H.M.; Katholieke Univ. Nijmegen; Katholieke Univ. Nijmegen

1984-01-01

In 7 kidneys of 6 dogs one of the main stem of the renal artery was ligated. The development of the renorenal collaterals could be followed in 5, as two dogs died after the operation. In all cases intrarenal collaterals could be demonstrated, even in the postoperative dead dogs. The vessels responsible for the collateral circulation are preformed interarterial anastomoses, belonging to the extraglomerular arterial system. From the results of these and former experimental studies it can be concluded, that the renal artery of the dog when entering the renal sinus cannot be regarded as an anatomic, but at most as a functional end artery. (orig.) [de

Intra-renal localised reno-renal collaterals in the dog after tying of the main renal artery

Energy Technology Data Exchange (ETDEWEB)

Rosenbusch, G.; Vincent, J.; Douveren, W. van; Sktonicki, S.; Arts, T.H.M.

1984-01-01

In 7 kidneys of 6 dogs one of the main stem of the renal artery was ligated. The development of the renorenal collaterals could be followed in 5, as two dogs died after the operation. In all cases intrarenal collaterals could be demonstrated, even in the postoperative dead dogs. The vessels responsible for the collateral circulation are preformed interarterial anastomoses, belonging to the extraglomerular arterial system. From the results of these and former experimental studies it can be concluded, that the renal artery of the dog when entering the renal sinus cannot be regarded as an anatomic, but at most as a functional end artery.

Influence of renal shielding on the incidence of late renal dysfunction associated with bone marrow transplantation

International Nuclear Information System (INIS)

Lawton, C.A.; Ash, R.C.; Murray, K.J.; Cohon, E.P.; Barher-Derus, S.W.; Moulder, J.E.

1991-01-01

This paper reports that late renal dysfunction following bone marrow transplantation has been described by a number of centers including the authors own. Total body irradiation seems to play a major causative role. In an effort to decrease the incidence of this renal toxicity, the authors have added customized partial transmission renal blocking to their total body irradiation regimen. The purpose of this study is to evaluate the effect of the renal blocking. The authors total body irradiation dose is 14 Gy. With the shielding used, the kidneys received approximately 12 Gy. Fifty-five adult patients have received total body irradiation with this renal shielding, compared with 73 adult patients who were treated without renal shielding. Eighteen percent (13 of 73) of patients who did not have renal shielding compared with only 7% (4 of 55) of patients with renal shielding have developed late renal dysfunction. Median follow-up in the non-blocked patients is 451 days after transplantation versus 282 days for the blocked patients

Accessory renal arteries: Prevalence in resistant hypertension and an important role in nonresponse to radiofrequency renal denervation

Energy Technology Data Exchange (ETDEWEB)

VonAchen, Paige [Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital, Minneapolis, MN (United States); Hamann, Jason [Boston Scientific Corporation, Maple Grove, MN (United States); Houghland, Thomas; Lesser, John R.; Wang, Yale; Caye, David; Rosenthal, Kristi; Garberich, Ross F. [Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital, Minneapolis, MN (United States); Daniels, Mary [Vital Images/Toshiba, Minnetonka, MN (United States); Schwartz, Robert S., E-mail: rss@rsschwartz.com [Minneapolis Heart Institute and Foundation at Abbott Northwestern Hospital, Minneapolis, MN (United States)

2016-10-15

Objective: The aim of this study was to understand the role of accessory renal arteries in resistant hypertension, and to establish their role in nonresponse to radiofrequency renal denervation (RDN) procedures. Background: Prior studies suggest a role for accessory renal arteries in hypertensive syndromes, and recent clinical trials of renal denervation report that these anomalies are highly prevalent in resistant hypertension. This study evaluated the relationships among resistant hypertension, accessory renal arteries, and the response to radiofrequency (RF) renal denervation. Methods: Computed Tomography Angiography (CTA) and magnetic resonance imaging (MRI) scans from 58 patients with resistant hypertension undergoing RF renal denervation (RDN) were evaluated. Results were compared with CT scans in 57 healthy, normotensive subjects undergoing screening as possible renal transplant donors. All scans were carefully studied for accessory renal arteries, and were correlated with long term blood pressure reduction. Results: Accessory renal arteries were markedly more prevalent in the hypertensive patients than normotensive renal donors (59% vs 32% respectively, p = 0.004). RDN had an overall nonresponse rate of 29% (response rate 71%). Patients without accessory vessels had a borderline higher response rate to RDN than those with at least one accessory vessel (83% vs 62% respectively, p = 0.076) and a higher RDN response than patients with untreated accessory arteries (83% vs 55%; p = 0.040). For accessory renal arteries and nonresponse, the sensitivity was 76%, specificity 49%, with positive and negative predictive values 38% and 83% respectively. Conclusions: Accessory renal arteries were markedly over-represented in resistant hypertensives compared with healthy controls. While not all patients with accessory arteries were nonresponders, nonresponse was related to both the presence and non-treatment of accessory arteries. Addressing accessory renal arteries in

Accessory renal arteries: Prevalence in resistant hypertension and an important role in nonresponse to radiofrequency renal denervation

International Nuclear Information System (INIS)

VonAchen, Paige; Hamann, Jason; Houghland, Thomas; Lesser, John R.; Wang, Yale; Caye, David; Rosenthal, Kristi; Garberich, Ross F.; Daniels, Mary; Schwartz, Robert S.

2016-01-01

Objective: The aim of this study was to understand the role of accessory renal arteries in resistant hypertension, and to establish their role in nonresponse to radiofrequency renal denervation (RDN) procedures. Background: Prior studies suggest a role for accessory renal arteries in hypertensive syndromes, and recent clinical trials of renal denervation report that these anomalies are highly prevalent in resistant hypertension. This study evaluated the relationships among resistant hypertension, accessory renal arteries, and the response to radiofrequency (RF) renal denervation. Methods: Computed Tomography Angiography (CTA) and magnetic resonance imaging (MRI) scans from 58 patients with resistant hypertension undergoing RF renal denervation (RDN) were evaluated. Results were compared with CT scans in 57 healthy, normotensive subjects undergoing screening as possible renal transplant donors. All scans were carefully studied for accessory renal arteries, and were correlated with long term blood pressure reduction. Results: Accessory renal arteries were markedly more prevalent in the hypertensive patients than normotensive renal donors (59% vs 32% respectively, p = 0.004). RDN had an overall nonresponse rate of 29% (response rate 71%). Patients without accessory vessels had a borderline higher response rate to RDN than those with at least one accessory vessel (83% vs 62% respectively, p = 0.076) and a higher RDN response than patients with untreated accessory arteries (83% vs 55%; p = 0.040). For accessory renal arteries and nonresponse, the sensitivity was 76%, specificity 49%, with positive and negative predictive values 38% and 83% respectively. Conclusions: Accessory renal arteries were markedly over-represented in resistant hypertensives compared with healthy controls. While not all patients with accessory arteries were nonresponders, nonresponse was related to both the presence and non-treatment of accessory arteries. Addressing accessory renal arteries in

Renal Sinus Fat Invasion and Tumoral Thrombosis of the Inferior Vena Cava-Renal Vein: Only Confined to Renal Cell Carcinoma

Directory of Open Access Journals (Sweden)

Turker Acar

2014-01-01

Full Text Available Epithelioid angiomyolipoma (E-AML, accounting for 8% of renal angiomyolipoma, is usually associated with tuberous sclerosis (TS and demonstrates aggressive behavior. E-AML is macroscopically seen as a large infiltrative necrotic tumor with occasional extension into renal vein and/or inferior vena cava. However, without history of TS, renal sinus and venous invasion E-AML would be a challenging diagnosis, which may lead radiologists to misinterpret it as a renal cell carcinoma (RCC. In this case presentation, we aimed to report cross-sectional imaging findings of two cases diagnosed as E-AML and pathological correlation of these aforementioned masses mimicking RCC.

Renal artery pseudoaneurysm

Directory of Open Access Journals (Sweden)

Luiz Inácio Roman

Full Text Available Abstract The renal artery pseudoaneurysm embody a rare vascular complication coming of percutaneous procedures, renal biopsy, nephrectomy, penetrating traumas and more rarely blunt traumas. The clinical can be vary according the patient, the haematuria is the symptom more commom. Is necessary a high level of clinical suspicion for your diagnosis, this can be elucidated by through complementary exams as the eco-color Doppler and the computed tomography scan (CT. This report is a case of a patient submitted a right percutaneous renal biopsy and that, after the procedure started with macroscopic haematuria, urinary tenesmus and hypogastric pain. The diagnosis of pseudoaneurysm was given after one week of evolution when the patient was hospitalized because gross haematuria, tachycardia, hypotension and hypochondrium pain. In the angiotomography revealed a focal dilation of the accessory right renal inferior polar artery, dilation of renal pelvis and all the ureteral course with presence hyperdenso material (clots inside the middle third of the ureter. The treatment for the majority of this cases are conservative, through arterial embolization, indicated for thouse of smaller dimensions in patients who are hemodynamically stable. However, it was decided by clinical treatment with aminocaproic acid 1 g, according to previous studies for therapy of haematuria. The patient received discharge without evidence of macroscopic haematuria and with normal renal ultrasound, following ambulatory care.

No effect of dietary fish oil on renal hemodynamics, tubular function, and renal functional reserve in long-term renal transplant recipients

DEFF Research Database (Denmark)

Hansen, J M; Løkkegaard, H; Høy, Carl-Erik

1995-01-01

Dietary supplementation with fish oil rich in n-3 polyunsaturated fatty acids has been suggested to protect the kidney against cyclosporin A (CsA) toxicity. This study investigated the effects of a 10-wk dietary supplementation with fish oil on renal function and renal functional reserve in healt...... transplant recipients treated with a low maintenance dose of CsA had a well-preserved renal functional reserve, and dietary supplementation with fish oil in these patients did not improve renal function.......Dietary supplementation with fish oil rich in n-3 polyunsaturated fatty acids has been suggested to protect the kidney against cyclosporin A (CsA) toxicity. This study investigated the effects of a 10-wk dietary supplementation with fish oil on renal function and renal functional reserve in healthy...... volunteers (N = 9) and two groups of stable long-term kidney-transplanted patients treated with maintenance low-dose CsA (3.0 +/- 0.6 mg/kg; N = 9) or without CsA (N = 9). After an overnight fast, the subjects were water loaded, and clearance studies were performed, postponing morning medication. GFR...

Ultrasonography in chronic renal failure

International Nuclear Information System (INIS)

Buturovic-Ponikvar, Jadranka; Visnar-Perovic, Alenka

2003-01-01

Many chronic renal diseases lead to the final common state of decrease in renal size, parenchymal atrophy, sclerosis and fibrosis. The ultrasound image show a smaller kidney, thinning of the parenchyma and its hyperechogenicity (reflecting sclerosis and fibrosis). The frequency of renal cysts increases with the progression of the disease. Ultrasound generally does not allow for the exact diagnosis of an underlying chronic disease (renal biopsy is usually required), but it can help to determine an irreversible disease, assess prognosis and avoid unnecessary diagnostic or therapeutic procedures. The main exception in which the ultrasound image does not show a smaller kidney with parenchymal atrophy is diabetic nephropathy, the leading cause of chronic and end-stage renal failure in developed countries in recent years. In this case, both renal size and parenchymal thickness are preserved until end-stage renal failure. Doppler study of intrarenal vessels can provide additional information about microvascular and parenchymal lesions, which is helpful in deciding for or against therapeutic intervention and timely planning for optimal renal replacement therapy option

Chemical Renal Denervation in the Rat

Energy Technology Data Exchange (ETDEWEB)

Consigny, Paul M., E-mail: paul.consigny@av.abbott.com; Davalian, Dariush, E-mail: dariush.davalian@av.abbott.com [Abbott Vascular, Innovation Incubator (United States); Donn, Rosy, E-mail: rosy.donn@av.abbott.com; Hu, Jie, E-mail: jie.hu@av.abbott.com [Abbott Vascular, Bioanalytical and Material Characterization (United States); Rieser, Matthew, E-mail: matthew.j.rieser@abbvie.com; Stolarik, DeAnne, E-mail: deanne.f.stolarik@abbvie.com [Abbvie, Analytical Pharmacology (United States)

2013-12-03

Introduction: The recent success of renal denervation in lowering blood pressure in drug-resistant hypertensive patients has stimulated interest in developing novel approaches to renal denervation including local drug/chemical delivery. The purpose of this study was to develop a rat model in which depletion of renal norepinephrine (NE) could be used to determine the efficacy of renal denervation after the delivery of a chemical to the periadventitial space of the renal artery. Methods: Renal denervation was performed on a single renal artery of 90 rats (n = 6 rats/group). The first study determined the time course of renal denervation after surgical stripping of a renal artery plus the topical application of phenol in alcohol. The second study determined the efficacy of periadventitial delivery of hypertonic saline, guanethidine, and salicylic acid. The final study determined the dose–response relationship for paclitaxel. In all studies, renal NE content was determined by liquid chromatography–mass spectrometry. Results: Renal NE was depleted 3 and 7 days after surgical denervation. Renal NE was also depleted by periadventitial delivery of all agents tested (hypertonic saline, salicylic acid, guanethidine, and paclitaxel). A dose response was observed after the application of 150 μL of 10{sup −5} M through 10{sup −2} M paclitaxel. Conclusion: We developed a rat model in which depletion of renal NE was used to determine the efficacy of renal denervation after perivascular renal artery drug/chemical delivery. We validated this model by demonstrating the efficacy of the neurotoxic agents hypertonic saline, salicylic acid, and guanethidine and increasing doses of paclitaxel.

Chemical Renal Denervation in the Rat

International Nuclear Information System (INIS)

Consigny, Paul M.; Davalian, Dariush; Donn, Rosy; Hu, Jie; Rieser, Matthew; Stolarik, DeAnne

2014-01-01

Introduction: The recent success of renal denervation in lowering blood pressure in drug-resistant hypertensive patients has stimulated interest in developing novel approaches to renal denervation including local drug/chemical delivery. The purpose of this study was to develop a rat model in which depletion of renal norepinephrine (NE) could be used to determine the efficacy of renal denervation after the delivery of a chemical to the periadventitial space of the renal artery. Methods: Renal denervation was performed on a single renal artery of 90 rats (n = 6 rats/group). The first study determined the time course of renal denervation after surgical stripping of a renal artery plus the topical application of phenol in alcohol. The second study determined the efficacy of periadventitial delivery of hypertonic saline, guanethidine, and salicylic acid. The final study determined the dose–response relationship for paclitaxel. In all studies, renal NE content was determined by liquid chromatography–mass spectrometry. Results: Renal NE was depleted 3 and 7 days after surgical denervation. Renal NE was also depleted by periadventitial delivery of all agents tested (hypertonic saline, salicylic acid, guanethidine, and paclitaxel). A dose response was observed after the application of 150 μL of 10 −5  M through 10 −2  M paclitaxel. Conclusion: We developed a rat model in which depletion of renal NE was used to determine the efficacy of renal denervation after perivascular renal artery drug/chemical delivery. We validated this model by demonstrating the efficacy of the neurotoxic agents hypertonic saline, salicylic acid, and guanethidine and increasing doses of paclitaxel

Renal cancer.

NARCIS (Netherlands)

Corgna, E.; Betti, M.; Gatta, G.; Roila, F.; Mulder, P.H.M. de

2007-01-01

In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all

Renal cancer

NARCIS (Netherlands)

Corgna, Enrichetta; Betti, Maura; Gatta, Gemma; Roila, Fausto; De Mulder, Pieter H. M.

2007-01-01

In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all

Renal osteodystrophy in non-dialysed patients with chronic renal failure

International Nuclear Information System (INIS)

Andresen, J.; Nielsen, H.E.

1980-01-01

Radiologic bone lesions in 92 non-dialysed patients with chronic renal failure are described. The bone disease increased with the severity of renal failure. In a prospective series of 20 patients progression of osteodystrophy and decrease in metacarpal bone mass were demonstrated. (Auth.)

Comparing Levels of Anxiety During Bed and Shower Baths in Patients with Acute Myocardial Infarction Comparación del nivel de ansiedad entre el baño de aspersión y el realizado en la cama en pacientes con infarto agudo del miocardio Comparação do nível de ansiedade entre o banho de aspersão e o de leito em pacientes com infarto agudo do miocárdio

Directory of Open Access Journals (Sweden)

Juliana de Lima Lopes

2010-04-01

Full Text Available This study compared the levels of anxiety presented by patients with acute myocardial infarction in bed and shower baths and the influence of antecedent variables: age, gender, medications, previous hospitalization and/or bed bath, patients' preference regarding the professional's gender, risk factors and anxiety-traits. This crossover study was conducted between February and August 2007 in coronary units. The sample was composed of 71 patients with acute myocardial infarction. The State-Trait Anxiety Inventory (STAI was applied before the baths (bed and shower baths, immediately after the baths and twenty minutes after the second evaluation. Results revealed that patients were more anxious in the bed bath than in the shower in the three assessments (p Este estudio tuvo como objetivo comparar los niveles de ansiedad, generados en el baño en la cama y en el de aspersión, en pacientes con infarto agudo del miocardio, así como la influencia de las variables antecedentes: edad, sexo, medicaciones, internación y/o baño en la cama previo, preferencia del paciente en cuanto al sexo del profesional, factores de riesgo y la ansiedad de trazo. Esta investigación es un estudio cross-over, realizado entre febrero y agosto de 2007, en Unidades Coronarias. La muestra fue constituida por 71 pacientes con infarto agudo del miocardio. El instrumento utilizado fue el IDATE-estado, siendo aplicado antes de los baños (cama y aspersión, inmediatamente después de los baños y veinte minutos después de la segunda evaluación. Los resultados mostraron que los pacientes quedaron más ansiosos cuando realizaron su baño en la cama que cuando realizaron el baño de aspersión, en las tres evaluaciones (pEste estudo teve como objetivo comparar os níveis de ansiedade, gerados no banho no leito e naquele de aspersão, em pacientes com infarto agudo do miocárdio, bem como a influência de variáveis antecedentes: idade, sexo, medicações, internação e/ou banho

Stages of Renal Cell Cancer

Science.gov (United States)

... Tumors Treatment Genetics of Kidney Cancer Research Renal Cell Cancer Treatment (PDQ®)–Patient Version General Information About Renal Cell Cancer Go to Health Professional Version Key Points Renal ...

Ultrasonography assessment of renal size and its correlation with body mass index in adults without known renal disease

International Nuclear Information System (INIS)

Raza, M.; Hameed, A.; Khan, M.I.

2012-01-01

Many conditions affect renal size. To evaluate abnormalities in renal size, knowledge of standardised values for normal renal dimensions is essential as it shows variability in the values of normal renal size depending on body size, age and ethnicity. Ultrasound, being an easily available, non-invasive, safe and less expensive modality, is widely used for evaluation of renal dimensions and repeated follow-ups. The objectives of this study were to determine renal size by ultrasound in adults without any known renal disease, and to determine the relationship of renal size with body mass index. Methods: Study was conducted in the Department of Diagnostic Radiology, Shifa International Hospital and PIMS Islamabad. Renal size was assessed by ultrasound in 4,035 adult subjects with normal serum creatinine and without any known renal disease, between November 2002 and December 2010. Renal length, width, thickness and volume were obtained and mean renal length and volume were correlated with body mass index and other factors like age, side, gender, weight and height of the subjects. Results: Mean renal length on right side was 101.6+-8.9 mm, renal width 42.7+-7.1 mm, and parenchymal thickness 14.4+-2.9 mm. On left side, mean renal length was 102.7+-9.2 mm, width 47.6+-7.0 mm, and parenchymal thickness 15.1+-3.1 mm. Mean renal volume on right was 99.8+-37.2 cm/sup 3/ and on left was 124.4+-41.3 cm/sup 3/. Left renal size was significantly larger than right in both genders. Relationship of mean renal length was significant when correlated with age, side, gender, height and weight, and body mass index. Renal volumes also showed a similar relationship with side, gender, height and weight, and body mass index; but with age such a relationship was seen only for left kidney. Conclusion: Pakistani population has mean renal size smaller than reference values available in international literature. Renal length and volume have a direct relationship with body mass index. Mean renal

Renal denervation prevents long-term sequelae of ischemic renal injury

Science.gov (United States)

Kim, Jinu; Padanilam, Babu J.

2014-01-01

Signals that drive interstitial fibrogenesis after renal ischemia reperfusion injury remain undefined. Sympathetic activation is manifest even in the early clinical stages of chronic kidney disease and is directly related to disease severity. A role for renal nerves in renal interstitial fibrogenesis in the setting of ischemia reperfusion injury has not been studied. In male 129S1/SvImJ mice, ischemia reperfusion injury induced tubulointerstitial fibrosis as indicated by collagen deposition and profibrotic protein expression 4 to 16 days after the injury.. Leukocyte influx, proinflammatory protein expression, oxidative stress, apoptosis, and cell cycle arrest at G2/M phase were enhanced after ischemia reperfusion injury. Renal denervation at the time of injury or up to 1 day post-injury improved histology, decreased proinflammatory/profibrotic responses and apoptosis, and prevented G2/M cell cycle arrest in the kidney. Treatment with afferent nerve-derived calcitonin gene-related peptide (CGRP) or efferent nerve-derived norepinephrine in denervated and ischemia reperfusion injury-induced kidneys mimicked innervation, restored inflammation and fibrosis, induced G2/M arrest, and enhanced TGF-β1 activation. Blocking norepinephrine or CGRP function using respective receptor blockers prevented these effects. Consistent with the in vivo study, treatment with either norepinephrine or CGRP induced G2/M cell cycle arrest in HK-2 proximal tubule cells, whereas antagonists against their respective receptors prevented G2/M arrest. Thus, renal nerve stimulation is a primary mechanism and renal nerve-derived factors drive epithelial cell cycle arrest and the inflammatory cascade causing interstitial fibrogenesis after ischemia reperfusion injury. PMID:25207878

Biopsia Renal en receptores de Trasplante Renal: cuidados de enfermería y complicaciones

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Esther Sanz Izquierdo

Full Text Available Introducción: La biopsia renal percutánea es una herramienta fundamental para el manejo del paciente trasplantado renal. La prueba es primordial para detectar y/o prevenir cualquier disfunción en el injerto, siendo un procedimiento tanto diagnóstico como preconizador. Objetivo: Describir los cuidados de enfermería e identificar las complicaciones derivadas de la biopsia renal en los receptores de Trasplante Renal. Material y métodos: Estudio cuantitativo, descriptivo y transversal realizado en la Unidad de Trasplante Renal, Servicio de Nefrología, del 2008 al 2014. La población objeto de estudio son los receptores de Trasplante Renal (TR. La muestra está compuesta por 368 biopsias renales de seguimiento que ingresan para someterse a una biopsia renal. Los criterios de inclusión son ser mayores de 18 años, trasplantados y que han firmado el consentimiento informado. Se recogen datos sociodemográficos, clínico-asistenciales y complicaciones post-biopsia renal. Resultados: Desde 1980 hasta el 2014 se han llevado a cabo 1868 TR, de 2008 a 2014 se estudiaron 368 biopsias de seguimiento. Se monitoriza la Tensión Arterial y la coagulación pre biopsia. Tras el procedimiento, se controla la presencia de sangrado por micción y constantes vitales. Inicialmente el reposo absoluto era de 24 h, a partir de 2014 se reduce a 6 horas, recomendando reposo relativo al alta, las complicaciones fueron mínimas. Conclusiones: Los resultados indican que la biopsia renal es un procedimiento eficaz, con escasas complicaciones. Destacar el papel de enfermería en la detección precoz de complicaciones.

Renal damage detected by DMSA, despite normal renal ultrasound, in children with febrile UTI.

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Bush, N C; Keays, M; Adams, C; Mizener, K; Pritzker, K; Smith, W; Traylor, J; Villanueva, C; Snodgrass, W T

2015-06-01

2011 American Academy of Pediatrics guidelines recommended renal-bladder ultrasound (RBUS) as the only evaluation after febrile urinary tract infection (FUTI) in infants aged 2-24 months. We determined the sensitivity, specificity, and false negative rate of RBUS to identify DMSA-detected renal damage in this age group as well as in older children. Consecutive patients referred to pediatric urology with a history of FUTI underwent DMSA ≥ 3 months after FUTI. Abnormal RBUS was defined as: Society of Fetal Urology hydronephrosis grades I-IV; hydroureter ≥ 7 mm; renal scar defined as focal parenchymal thinning; and/or size discrepancy ≥ 1 cm between kidneys. Abnormal DMSA was presence of any focal uptake defects and/or split renal function 24 months. RBUS had poor sensitivity (34%) and low positive predictive value (47%) to identify patients with renal damage. 99/149 (66%) children with renal damage on DMSA had normal RBUS. After FUTI, 66% of children with reduced renal function and/or renal cortical defects found by DMSA scintigraphy had a normal RBUS. Since abnormal DMSA may correlate with increased risk for VUR, recurrent FUTI and renal damage, our data suggest RBUS alone will fail to detect a significant proportion of patients at risk. The data suggest that imaging after FUTI should include acute RBUS and delayed DMSA, reserving VCUG for patients with abnormal DMSA and/or recurrent FUTI. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

CT diagnosis of simple renal cysts

International Nuclear Information System (INIS)

Nanakawa, Seito; Yasunaga, Tadamasa; Tsuchigame, Tadatoshi; Kawano, Shoji; Takahashi, Mutsumasa; Fukui, Koutaro.

1987-01-01

CT is indispensable in the evaluation of renal masses, providing noninvasive and clear transverse images. With wider clinical application of CT, renal cysts have been found more frequently. CT examinations on 500 patients, who underwent CT for the diagnosis of renal diseases except for renal cysts, have been reviewed and analysed. The incidence of renal cysts was 9.6 % without prediction for sexes, but the incidence and sizes of the cysts increased with the advancing age. The upper portion of the kidneys was more frequently involved, but there was no relationship between number, sex and age of the patients. Since renal cysts produce mass effect in the kidneys, understanding of the nature and incidence of the renal cysts is important in diagnosing renal mass lesions. (author)

Renal function after prolonged hypotensive anesthesia and surgery in dogs with reduced renal mass.

Science.gov (United States)

Stone, E A; Rawlings, C A; Finco, D R; Crowell, W A

1981-10-01

The effect of prolonged hypotensive anesthesia and surgery on renal function was studied in 8 dogs with decreased renal mass. Renal mass was reduced by unilateral nephrectomy and ligation of 4 of the 6 terminal renal artery branches of the opposite kidney. One week after reduction in renal mass, the dogs were azotemic with a serum urea nitrogen (SUN) value of 65.8 +/- 11.5 mg/dl. Glomerular filtration rate, as estimated by 14C-inulin clearance, was 0.66 +/- 0.19 ml/kg of body weight/hour. A mean arterial pressure of less than 75 mm of Hg was maintained for 4 hours in dogs given 2.3 +/- 0.7% halothane. An exploratory laparotomy lasting 1 hour was performed. The day after the hypotensive episode, 3 dogs began vomiting, became dehydrated, and had SUN values greater than 100 mg/dl. The SUN values returned to base-line values after the dogs were rehydrated. Eight days after the hypotensive episode, 14C-inulin clearance decreased 15.2 +/- 8.2% (P less than 0.005) compared with base-line clearance values. Light microscopic and electron microscopic observations of the kidneys did not demonstrate acute renal failure. Prolonged hypotensive anesthesia can cause a decrease in renal function, and may cause prerenal uremia and/or acute renal failure.

Renal vein oxygen saturation in renal artery stenosis

DEFF Research Database (Denmark)

Nielsen, K; Rehling, M; Henriksen, Jens Henrik Sahl

1992-01-01

Renal vein oxygen-saturation was measured in 56 patients with arterial hypertension and unilateral stenosis or occlusion of the renal artery. Oxygen-saturation in blood from the ischaemic kidney (84.4%, range 73-93%) was significantly higher than that from the 'normal' contralateral kidney (81...... than its blood flow. This is probably due to decreased filtration fraction and filtered sodium with subsequent reduction in absolute tubular re-absorption of sodium ions....

Renal artery anatomy affects the blood pressure response to renal denervation in patients with resistant hypertension.

Science.gov (United States)

Hering, Dagmara; Marusic, Petra; Walton, Antony S; Duval, Jacqueline; Lee, Rebecca; Sata, Yusuke; Krum, Henry; Lambert, Elisabeth; Peter, Karlheinz; Head, Geoff; Lambert, Gavin; Esler, Murray D; Schlaich, Markus P

2016-01-01

Renal denervation (RDN) has been shown to reduce blood pressure (BP), muscle sympathetic nerve activity (MSNA) and target organ damage in patients with resistant hypertension (RH) and bilateral single renal arteries. The safety and efficacy of RDN in patients with multiple renal arteries remains unclear. We measured office and 24-hour BP at baseline, 3 and 6 months following RDN in 91 patients with RH, including 65 patients with single renal arteries bilaterally (group 1), 16 patients with dual renal arteries on either one or both sides (group 2) and 10 patients with other anatomical constellations or structural abnormalities (group 3). Thirty nine out of 91 patients completed MSNA at baseline and follow-up. RDN significantly reduced office and daytime SBP in group 1 at both 3 and 6 months follow-up (Pkidney function in any group. While RDN can be performed safely irrespective of the underlying renal anatomy, the presence of single renal arteries with or without structural abnormalities is associated with a more pronounced BP and MSNA lowering effect than the presence of dual renal arteries in patients with RH. However, when patients with dual renal arteries received renal nerve ablation in all arteries there was trend towards a greater BP reduction. Insufficient renal sympathetic nerve ablation may account for these differences. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Respiratory Syncytial Virus Aggravates Renal Injury through Cytokines and Direct Renal Injury

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Songhui Zhai

2016-09-01

Full Text Available The purpose of this study was to investigate the relationship between renal injury and reinfection that is caused by respiratory syncytial virus (RSV and to analyze the mechanism of renal injury. Rats were repeatedly infected with RSV on days 4, 8, 14, and 28, then sacrificed and examined on day 56 after the primary infection. Renal injury was examined by transmission electron microscopy and histopathology. The F protein of RSV was detected in the renal tissue by indirect immunofluorescence. Proteinuria and urinary glycosaminoglycans (GAGs, serum levels of albumin, urea nitrogen, and creatinine, secretion of cytokines, T lymphocyte population and subsets, and dendritic cell (DC activation state were examined. The results showed that renal injury was more serious in the reinfection group than in the primary infection group. At a higher infection dose, 6×106 PFU, the renal injury was more severe, accompanied by higher levels of proteinuria and urinary GAGs excretion, and lower levels of serum albumin. Podocyte foot effacement was more extensive, and hyperplasia of mesangial cells and proliferation of mesangial matrix were observed. The maturation state of DCs was specific, compared with the primary infection. There was also a decrease in the ratio of CD4+ to CD8+T lymphocytes, due to an increase in the percentage of CD8+T lymphocytes and a decrease in the percentage of CD4+T lymphocytes, and a dramatic increase in the levels of IL-6 and IL-17. In terms of the different reinfection times, the day 14 reinfection group yielded the most serious renal injury and the most significant change in immune function. RSV F protein was still expressed in the glomeruli 56 days after RSV infection. Altogether, these results reveal that RSV infection could aggravate renal injury, which might be due to direct renal injury caused by RSV and the inflammatory lesions caused by the anti-virus response induced by RSV.

Evolução da função renal na fase aguda do infarto do miocárdio como fator prognóstico de eventos na fase intra-hospitalar e em um ano de seguimento Renal function outcome in acute myocardial infarction as a prognostic factor of in-hospital events and at one-year follow-up

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Eduardo Pimenta

2006-03-01

Full Text Available OBJETIVO: Analisar o papel da disfunção renal na internação ou durante a evolução nos pacientes com infarto agudo do miocárdio (IAM. MÉTODOS: Foram avaliados 274 pacientes com IAM, entre janeiro de 2000 e dezembro de 2001. A função renal foi monitorada com a dosagem de creatinina (Cr na internação e o valor pico durante a hospitalização. O clearance de creatinina (ClCr foi calculado pela fórmula de Cockcroft & Gault. Foi avaliada a morbidade e mortalidade intra-hospitalar e após um ano do evento. RESULTADOS: A média de idade foi 62,2 ± 13,5 anos e 73% eram do sexo masculino. A função renal esteve mais reduzida nos homens, em pacientes com hipertensão arterial sistêmica e cirurgia de revascularização prévia. A análise multivariada revelou aumento da mortalidade intra-hospitalar relacionada com a elevação nos níveis pico de Cr (OR:1,18 95% IC:1,18-2,77 p = 0,006, com o decréscimo no ClCr inicial (OR:0,96 95% IC:0,93-0,99 p = 0,025 e no ClCr pico (OR:0,96 95% IC:0,92-0,99 p = 0,023. A diferença percentual entre o ClCr inicial e o menor ClCr atingido também indicou maior mortalidade (OR:1,04 95% IC:1,00-1,07 p = 0,033. A piora da função renal não alterou a morbidade e mortalidade em um ano. CONCLUSÃO: Disfunção renal na internação, e sua deterioração durante a hospitalização, mostrou ser um importante marcador prognóstico de pior evolução imediata.OBJECTIVE: To analyze the role of renal dysfunction at admission or during hospitalization in patients with acute myocardial infarction (AMI. METHODS: Two hundred and seventy-four patients with AMI were assessed between January 2000 and December 2001. Renal function was monitored by serum creatinine (Cr measurement at admission and peak level during hospitalization. Creatinine clearance (CrCl was estimated by the Cockcroft-Gault formula. In-hospital and one-year morbidity and mortality were evaluated. RESULTS: Mean age of the population studied was 62.2 ± 13

Escore TIMI no infarto agudo do miocárdio conforme níveis de estratificação de prognóstico Score TIMI en el infarto agudo de miocardio según niveles de estratificación de pronóstico TIMI risk score for acute myocardial infarction according to prognostic stratification

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Jaqueline Locks Pereira

2009-08-01

Full Text Available FUNDAMENTO: O escore de risco TIMI (thrombolysis in myocardial infarction é derivado de ensaio clínico envolvendo pacientes elegíveis para fibrinólise. Como o perfil de risco desses casos difere do encontrado em populações não selecionadas, é importante que se analise a aplicabilidade do escore em condições clínicas habituais. OBJETIVO: Avaliar o manejo e a evolução hospitalar de pacientes internados com infarto agudo do miocárdio conforme estratificação de risco pelo escore TIMI. MÉTODOS: Foram avaliados, retrospectivamente, 103 casos de infarto agudo do miocárdio com supradesnivelamento do segmento ST, admitidos no Hospital Nossa Senhora da Conceição, em Tubarão, nos anos de 2004 e 2005. Os casos foram analisados em três grupos de risco de acordo com o escore TIMI. RESULTADOS: A mortalidade hospitalar pós-infarto foi de 17,5%. No grupo de baixo risco não houve óbito. A mortalidade foi de 8,1% no grupo de médio risco e de 55,6% no de alto risco. O risco de morte para casos de alto risco foi 14,1 vezes maior em relação aos casos de médio e baixo risco (IC95% = 4,4 a 44,1 e pFUNDAMENTO: El score de riesgo TIMI (thrombolysis in myocardial infarction se derivó de ensayo clínico que implicó a pacientes elegibles para fibrinólisis. Como el perfil de riesgo de esos casos difiere del encontrado en poblaciones no seleccionadas, es importante que se analice la aplicabilidad del score en condiciones clínicas habituales. OBJETIVO: Evaluar el manejo y la evolución hospitalaria de pacientes internados con infarto agudo de miocardio de acuerdo con la estratificación de riesgo mediante la puntuación TIMI. MÉTODOS: Se evaluaron, retrospectivamente, 103 casos de infarto agudo de miocardio con supradesnivelamiento del segmento ST, ingresados en el Hospital Nossa Senhora da Conceição, en Tubarão, en los años de 2004 y 2005. Se analizaron los casos en tres grupos de riesgo según el score TIMI. RESULTADOS: La mortalidad

Ablación miocárdica septal transluminal percutánea en pacientes con miocardiopatía hipertrófica septal obstructiva: Resultados agudos y seguimiento a 3 años

OpenAIRE

Llamas-Esperón,Guillermo A.; Loera Pinales,Armando; Sandoval Navarrete,Santiago; Zamora Muciño,Alberto; Ramírez Robledo,Miguel A.; Varela Ortiz,Samuel; Casas Juárez,Ulices; Fuantos Delgado,María de la Luz; Albarrán Domínguez,Javier; Muñoz Sandoval,Rocío; Sandoval Rodríguez,Eufracino; Ruiz Esparza,M. Eugenia

2009-01-01

Objetivo: Reportar los resultados agudos y a largo plazo de la ablación miocárdica septal transluminal percutánea (AMSTP) como tratamiento de la miocardiopatía hipertrófica septal obstructiva (MHSO). La AMSTP se considera una alternativa del tratamiento quirúrgico en pacientes con MHSO y sintomatología refractaria a otras opciones de tratamiento. La respuesta aguda suele ser satisfactoria, pero los resultados a largo plazo no se han descrito de forma suficiente. Métodos: Realizamos AMSTP en 8...

Effects of adenosine infusion into renal interstitium on renal hemodynamics

International Nuclear Information System (INIS)

Pawlowska, D.; Granger, J.P.; Knox, F.G.

1987-01-01

This study was designed to investigate the hemodynamic effects of exogenous adenosine in the interstitium of the rat kidney. Adenosine or its analogues were infused into the renal interstitium by means of chronically implanted capsules. In fusion of adenosine decreased glomerular filtration rate (GFR) from 0.81 +/- 0.06 to 0.37 +/- 0.06 ml/min while having no effect on renal blood flow (RBF). The metabolically stable analogue, 2-chloradenosine (2-ClAdo), decreased GFR from 0.73 +/- 0.07 to 021 +/- 0.06 ml/min. Interstitial infusion of theophylline, an adenosine receptor antagonist, completely abolished the effects of adenosine and 2-ClAdo on GFR. The distribution of adenosine, when infused into the renal interstitium, was determined using radiolabeled 5'-(N-ethyl)-carboxamidoadenosine (NECA), a metabolically stable adenosine agonist. After continuous infusion, [ 3 H]NECA was distributed throughout the kidney. The effects of NECA to reduce GFR were similar to those of adenosine and 2-ClAdo. They conclude that increased levels of adenosine in the renal interstitium markedly decrease GFR without affecting RBF in steady-state conditions. The marked effects of adenosine agonists during their infusion into the renal interstitium and the complete blockade of these effects by theophylline suggest an extracellular action of adenosine

Índice de resistividade renal como preditor da revascularização renal para hipertensão renovascular Índice de resistividad renal como predictor de la revascularización renal para hipertensión renovascular Renal resistance index predicting outcome of renal revascularization for renovascular hypertension

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Simone N. Santos

2010-04-01

Full Text Available FUNDAMENTO: A estenose arterial renal (EAR é uma causa potencialmente reversível de hipertensão arterial sistêmica (HAS e nefropatia isquêmica. Apesar da revascularização bem sucedida, nem todos os pacientes (pt apresentam melhora clínica e alguns podem piorar. OBJETIVO: O presente estudo se destina a avaliar o valor do índice de resistividade renal (IR como preditor dos efeitos da revascularização renal. MÉTODOS: Entre janeiro de 1998 e fevereiro de 2001, 2.933 pacientes foram submetidos ao duplex ultrassom renal. 106 desses pacientes apresentaram EAR significativa e foram submetidos a angiografia e revascularização renal. A pressão arterial (PA foi medida antes e depois da intervenção, em intervalos de até 2 anos e as medicações prescritas foram registradas. Antes da revascularização, o IR foi medido em 3 locais do rim, sendo obtida uma média dessas medições. RESULTADOS: Dos 106 pacientes, 81 tiveram IR80. A EAR foi corrigida somente por angioplastia (PTA em 25 pts, PTA + stent em 56 pts e cirurgicamente em 25 pts. Dos pacientes que se beneficiaram da revascularização renal; 57 dos 81 pacientes com IR 80. Usando um modelo de regressão logística múltipla, o IR esteve significativamente associado à evolução da PA (p = 0,001, ajustado de acordo com os efeitos da idade, sexo, PAS, PAD, duração da hipertensão, o tipo de revascularização, número de fármacos em uso, nível de creatinina, presença de diabete melito, hipercolesterolemia, volume sistólico, doença arterial periférica e coronariana e tamanho renal (OR 99,6-95%CI para OR 6,1-1.621,2. CONCLUSÃO: A resistividade intrarrenal arterial, medida por duplex ultrassom, desempenha um papel importante na predição dos efeitos pós revascularização renal para EAR.FUNDAMENTO: La estenosis arterial renal (EAR es una causa potencialmente reversible de hipertensión arterial sistémica (HAS y nefropatía isquémica. Pese a que la revascularización sea

Role of RENAL nephrometry scoring system in planning surgical intervention in patients with localized renal mas

OpenAIRE

Mohamed Samir Shaaban; Tamer Mohammed Abou Youssif; Ahmed Mostafa; Hossam Eldin Hegazy; Mohammed Adel Atta

2015-01-01

Purpose: The study was designed to validate the value of preoperative planning using RENAL nephrometry scoring system in patients having organ confined renal tumors and undergoing surgical intervention and to assess its correlation with the surgical technique. Patient and methods: Forty patients with organ-confined renal masses underwent RENAL nephrometry scoring which was correlated with the surgical technique either radical or nephron-sparing surgery. Result: RENAL nephrometry scoring...

Ultrasound scan in the diagnosis of neonatal renal candidiasis; Ecografia en el diagnostico de la candidiasis renal neonatal

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Muro, D.; Sanguesa, C.; Torres, D.; Berbel, O.; Andres, V. [Hospital Infantil La Fe. Valencia (Spain)

2003-07-01

To describe the most pertinent echographic findings regarding systemic and renal candidiasis in high-risk neonates. Echographic findings and clinical histories of 40 neonates in the neonatal intensive care unit were retrospectively analyzed. Thirty-eight presented systemic candidiasis with renal participation, while two showed only renal candidiasis. Ultrasound scans were performed using 7.5 MHz probes. Alterations in renal echo structure, presence of echogenic material without acoustic shadowing in the excretory system (mycetoma), presence of lithiasis, pyonephrosis and associated renal malformations were all evaluated. Ten patients presented renal alterations in ultrasound scan. Six children had originally shown increased eye-catching in the renal parenchyma which was resolved after medical treatment. Four children presented renal mycetoma, and in two there were renal malformations. Both of these exhibited a profile for pyonephrosis. One patient with renal mycetoma without urological abnormalities developed a lithiasis. Surgical intervention was unnecessary in all cases. The most common echographic findings in immature high-risk low-weight patients with systemic and renal candidiasis were alterations in the eye-catching of renal parenchyma and the presence of mycetoma. (Author) 22 refs.

Three-dimensional renal CT angiography for guiding segmental renal artery clamping during laparoscopic partial nephrectomy

International Nuclear Information System (INIS)

Xu, Yi; Shao, Pengfei; Zhu, Xiaomei; Lv, Qiang; Liu, Wangyan; Xu, Hai; Zhu, Yinsu; Yang, Guangyu; Tang, Lijun; Yin, Changjun

2013-01-01

Aim: To evaluate the effectiveness of three-dimensional (3D) renal computed tomography angiography (CTA) in guiding segmental renal artery clamping during laparoscopic partial nephrectomy (LPN). Materials and methods: Forty-three patients with renal tumours undergoing renal CTA before LPN were retrospectively enrolled in this study. 3D arteriogram reconstructed images were created to identify the renal tumour-supplying arteries. The number and location of these targeted vessels were annotated on 3D images preoperatively and compared with the clamped vessels during LPN. The consistency between target vessels annotated at CTA and clamped arteries at LPN was compared both using a patient-based analysis and vessel-based analysis. The χ 2 test was applied to analyse the influence of tumour size, location, and growth pattern on the number of clamped segmental renal branches. Results: On patient-based analysis, the number of targeted vessels was consistent with the clamped vessels during LPN in 33 of 43 patients. On vessel-based analysis, 56 of 65 target vessels annotated at CTA were clamped during LPN. More segmental renal branches (p = 0.04) were clamped in patients with tumours of larger size. Tumour location and growth pattern had no association with the number of clamped segmental branches during LPN. Conclusion: High-quality CTA images and 3D reconstruction images can detect detailed information of tumour-supplying arteries to renal tumours. 3D renal CTA is an effective way to guide segmental renal artery clamping during LPN

Impaired renal allograft function is associated with increased arterial stiffness in renal transplant recipients

DEFF Research Database (Denmark)

Kneifel, M; Scholze, A; Burkert, A

2006-01-01

It is important whether impairment of renal allograft function may deteriorate arterial stiffness in renal transplant recipients. In a cross-sectional study, arterial vascular characteristics were non-invasively determined in 48 patients with renal allograft using applanation tonometry and digital...

Renal involvement in behcet's disease

International Nuclear Information System (INIS)

Ardalan, Mohammad Reza; Noshad, Hamid; Sadreddini, Shahram; Ebrahimi, Aliasghar; Molaeefard, Mahsheed; Somi, Mohammad Hossein; Shoja, Mohammadali Mohajel

2009-01-01

There are conflicting reports about the renal involvement in Behcet's disease (BD). In this study we aimed to study the frequency and type of renal involvement in a group of patients with BD in Azerbaijan province that is one of the prevalent areas of BD in Iran. All cases of BD were prospectively followed between June 2004 and January 2007, and evaluated for renal dys-function (serum creatinine > 1.7 mg/dL), glomerular hematuria and proteinuria. Those patients with proteinuria > 500 mg/day and serum creatinine level > 2 mg/dL, underwent renal biopsy. From a total number of 100 patients, six patients (6%) had obvious renal involvements. Four patients had glomerular hematuria and proteinuria. Renal biopsy in two of them revealed measangial proliferative glumerulonephritis with IgA deposit in one of them and membranoproliferative glumerolonephritis in another one. Two remaining patients had serum creatinine > 2 mg/dL without any hematuria or proteinuria. Serologic study for viral agents and collagen vascular disease were negative in all patients with renal involvements. In conclusion, renal involvement in BD is not infrequent, although in most cases it is mild in nature and may be missed. (author)

Diagnosis of renal disease in rabbits.

Science.gov (United States)

Harcourt-Brown, Frances Margaret

2013-01-01

There are differences in renal anatomy and physiology between rabbits and other domestic species. Neurogenic renal ischemia occurs readily. Reversible prerenal azotemia may be seen in conjunction with gut stasis. Potentially fatal acute renal failure may be due to structural kidney damage or post-renal disease. Chronic renal failure is often associated with encephalitozoonosis. Affected rabbits cannot vomit and often eat well. Weight loss, lethargy, and cachexia are common clinical signs. Polydypsia/polyuria may be present. Derangements in calcium and phosphorus metabolism are features of renal disease. Radiography is always indicated. Urolithiasis, osteosclerosis, aortic and renal calcification are easily seen on radiographs. Copyright © 2013 Elsevier Inc. All rights reserved.

Hiperglucemia en el síndrome coronario agudo: informe científico multidisciplinario Hyperglycemia in acute coronary syndrome: multidisciplinary scientific report

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Patricia Blanco

2012-04-01

Full Text Available La hiperglucemia con o sin diabetes preexistente es un hallazgo frecuente en pacientes que cursan un síndrome coronario agudo. Estudios previos han demostrado que la hiperglucemia es altamente prevalente y se asocia a un mayor riesgo de muerte y complicaciones hospitalarias. Los mecanismos fisiopatológicos mediante los cuales la hiperglucemia provoca resultados adversos no son claros, y se desconoce si es un marcador de eventos o su causa. Los efectos perjudiciales de la hiperglucemia en el sistema cardiovascular son múltiples, y el control de los niveles de glucosa con insulina parece mejorar el pronóstico en estos pacientes. Se han desarrollado numerosos protocolos para el control de glucemia que demostraron ser seguros y efectivos. En una iniciativa originada en el Consejo de Emergencias de la Sociedad Argentina de Cardiología, se convocó a expertos de nuestro medio con el propósito de debatir estrategias para el control de la glucemia en pacientes que cursan un síndrome coronario agudo. Este documento refleja lo discutido en este evento académico con la intención de resumir los principales aspectos del control de la glucemia y ofrecer recomendaciones generales de tratamiento en la Unidad Coronaria.Hyperglycemia with or without pre-existing diabetes mellitus, occurs frequently in the setting of acute coronary syndrome. Previous studies have demonstrated that hyperglycemia is highly prevalent and is associated with an increased risk of hospital complications and death. The underlying pathophysiology related an adverse clinical outcome to hyperglycemia is unclear, and it is uncertain whether increased serum glucose is simply a marker of adverse outcomes or their cause. Detrimental effects of hyperglycemia on the cardiovascular system are multiple. Glycemia control with insulin would prevent adverse outcomes. Numerous glucose-control protocols have been developed and tested proving to be safe and effective. In an initiative from the

Renal denervation in a patient with Alport syndrome and rejected renal allograft

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Narayana Raju

2015-12-01

Full Text Available Renal denervation is a new intervention to treat resistant hypertension. By applying radiofrequency (RF to renal arteries, sympathetic nerves in adventitia layer of vascular wall can be denervated. Sympathetic hyperactivity is an important contributory factor in hypertension of hemodialysis patients. Hyperactive sympathetic nervous system aggravates hypertension and it can cause complications like left ventricular hypertrophy, heart failure, arrhythmias and atherogenesis. Our report illustrates the use of renal denervation using conventional RF catheter for uncontrolled hypertension in a patient with Alport syndrome and rejected renal allograft. Progressive and sustained reduction of blood pressure was obtained post-procedure and at 24 months follow-up with antihypertensives decreased from 6 to 2 per day, thereby demonstrating the safety, feasibility, and efficacy of the procedure. There are some reports available on the usefulness of this technique in hemodialysis patients; however, there are no studies of renal denervation in patients with Alport syndrome and failed allograft situation.

Renal denervation in a patient with Alport syndrome and rejected renal allograft.

Science.gov (United States)

Raju, Narayana; Lloyd, Vincent; Yalagudri, Sachin; Das, Bharati; Ravikishore, A G

2015-12-01

Renal denervation is a new intervention to treat resistant hypertension. By applying radiofrequency (RF) to renal arteries, sympathetic nerves in adventitia layer of vascular wall can be denervated. Sympathetic hyperactivity is an important contributory factor in hypertension of hemodialysis patients. Hyperactive sympathetic nervous system aggravates hypertension and it can cause complications like left ventricular hypertrophy, heart failure, arrhythmias and atherogenesis. Our report illustrates the use of renal denervation using conventional RF catheter for uncontrolled hypertension in a patient with Alport syndrome and rejected renal allograft. Progressive and sustained reduction of blood pressure was obtained post-procedure and at 24 months follow-up with antihypertensives decreased from 6 to 2 per day, thereby demonstrating the safety, feasibility, and efficacy of the procedure. There are some reports available on the usefulness of this technique in hemodialysis patients; however, there are no studies of renal denervation in patients with Alport syndrome and failed allograft situation. Copyright © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

Radionuclide renal dynamic and function study

International Nuclear Information System (INIS)

Guan Liang

1991-01-01

The radionuclide dynamic and function study, glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were reported in 14 cases of renal and ureteral calculi patients before and after extracorporeal shock wave lithotripsy (ESWL). In 12 cases with normal renal blood flow, within 3 months after ESWL, the GFR of shock and non-shock side decreased with different extent, while the individual ERPF had little change. In 5 cases followed up 1 year after ESWL, the individual GFR and ERPF were normal. In 2 cases of severe renal function insufficiency, there was no improvement in renal function in shock side, after 5 months and 1 year, the renal function was still at low level. Thereby it is considered that ESWL is not suitable for the renal calculi patients with severe renal function insufficiency

Superselective renal artery embolization with lipiodol and absolute alcohol emulsion for renal tumor

International Nuclear Information System (INIS)

Yu Miao; Li Jiakai; Sun Minglu; Wang Huixian

2008-01-01

Objective: To evaluate the efficacy of the renal arterial embolization with lipidol and absolute alcohol emulsion in the treatment of renal tumors. Methods: The superselective renal arterial embolization by using coaxial-cathaterization with infusion of lipiodol and absolute alcohol (in proportion of 2 :1) emulsion was performed in twenty patients with malignant and benign kidney tumors. 4 weeks later, the renal arteriography was taken routinely and repeated embolization was performed in case of necessary; and follow up was carried out periodically. Results: The imaging findings showed thorough tumor necrosis and feeding vessel abruption in 18 cases after one session of treatment. The volume of tumors decreased more than a half in 13 patients (82.25%, 13/18) associated with a well-distributed lipidol inside the tumors. The second session of treatment was performed in other 2 patients and the clinical symptoms relieved obviously. Conclusions: The superselective renal artery embolization with lipidol and absolute alcohol emulsion can permanently embolize all tumor feeding arteries in capillary vessel level with maximum reservation of renal function, providing definitively efficacy and worthwhile to be recommended widely. (authors)

Bilateral papillary renal cell carcinoma

International Nuclear Information System (INIS)

Gossios, K.; Vazakas, P.; Argyropoulou, M.; Stefanaki, S.; Stavropoulos, N.E.

2001-01-01

Papillary renal cell carcinoma is a subgroup of malignant renal epithelial neoplasms. We report the clinical and imaging findings of a case with multifocal and bilateral renal cell carcinoma which are nonspecific. (orig.)

Efeito agudo do método de facilitação neuromuscular proprioceptiva na flexibilidade de bailarinas

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Giane Andreia Souza Siqueira

2013-11-01

Full Text Available Objetivo: Verificar a resposta aguda do método de Facilitação Neuromuscular Proprioceptiva (FNP na flexibilidade e a influência das variáveis idade, peso, estatura em praticantes de Ballet Clássico. Método: A amostra foi composta por 11 bailarinas, com média de idade de 10,91 ± 0,79 anos praticantes regularmente de Ballet clássico duas vezes por semana com no mínimo de 5 anos de experiência. Foi utilizado o método de FNP nas bailarinas. Para avaliação da flexibilidade foi utilizado o Banco de Wells. Para analise estatística utilizou o teste de “t” de Student para amostras dependentes e análise de regressão Stepwise Forward com p≤0,05. Resultado:A diferença média de amplitude de movimento foi 4,81 ± 1,99 cm. Já a variável estatura demonstrou-se influenciar significativamente na flexibilidade. O método FNP demonstrou efeito agudo significativo na flexão de quadril em bailarinas.

Blunt renal trauma in children: healing of renal injuries and recommendations for imaging follow-up

International Nuclear Information System (INIS)

Abdalati, H.; Bulas, D.I.; Sivit, C.J.; Majd, M.; Rushton, H.G.; Eichelberger, M.R.

1994-01-01

Initial CT grading of renal injury was correlated with the frequency of complications and the time course of healing in 35 children. All renal contusions (grade 1, 8) and small parenchymal lacerations (grade 2, 8) healed without complications. All lacerations extending to the collecting system (grade 3, 9) resulted in mild to severe loss of renal function with progressive healing over 4 months. One of four segmental infarcts (grade 4 A), and five of six vascular pedicle injuries (grade 4 B) resulted in severe loss of renal function. Complications, including urinoma (2), sepsis (1), hydronephrosis (1), and persistent hypertension (2), were limited to grade 3 and 4 injuries. Our results suggest that mild renal injuries do not require follow-up imaging. Major renal lacerations and vascular pedicle injuries, however, often result in loss of renal function and should be followed up closely due to the risk of delayed complications. Follow-up examinations should continue for 3-4 months until healing is documented. (orig.)

Renal contrast-enhanced MR angiography: timing errors and accurate depiction of renal artery origins.

Science.gov (United States)

Schmidt, Maria A; Morgan, Robert

2008-10-01

To investigate bolus timing artifacts that impair depiction of renal arteries at contrast material-enhanced magnetic resonance (MR) angiography and to determine the effect of contrast agent infusion rates on artifact generation. Renal contrast-enhanced MR angiography was simulated for a variety of infusion schemes, assuming both correct and incorrect timing between data acquisition and contrast agent injection. In addition, the ethics committee approved the retrospective evaluation of clinical breath-hold renal contrast-enhanced MR angiographic studies obtained with automated detection of contrast agent arrival. Twenty-two studies were evaluated for their ability to depict the origin of renal arteries in patent vessels and for any signs of timing errors. Simulations showed that a completely artifactual stenosis or an artifactual overestimation of an existing stenosis at the renal artery origin can be caused by timing errors of the order of 5 seconds in examinations performed with contrast agent infusion rates compatible with or higher than those of hand injections. Lower infusion rates make the studies more likely to accurately depict the origin of the renal arteries. In approximately one-third of all clinical examinations, different contrast agent uptake rates were detected on the left and right sides of the body, and thus allowed us to confirm that it is often impossible to optimize depiction of both renal arteries. In three renal arteries, a signal void was found at the origin in a patent vessel, and delayed contrast agent arrival was confirmed. Computer simulations and clinical examinations showed that timing errors impair the accurate depiction of renal artery origins. (c) RSNA, 2008.

Renal embolic protection devices improve blood flow after stenting for atherosclerotic renal artery stenosis.

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Paul, Timir K; Lee, John H; White, Christopher J

2012-11-15

We sought to measure angiographic renal frame counts (RFC), as a quantitative angiographic assessment of renal blood flow, to evaluate microvascular compromise due to atheroembolism associated with RAS. Atheroembolism associated with renal artery stenting (RAS) has been implicated as a cause for worsening renal function following successful intervention. Use of a distal embolic protection device (EPD) during RAS has been shown to be safe with debris capture in a high percentage of cases. However, objective benefit for renal function with EPD has been difficult to demonstrate. A control group of 30 consecutive patients (33 kidneys) who underwent RAS without EPD were compared with 33 consecutive patients (33 kidneys) who underwent RAS with EPD using RFC measurement. The prestent and poststent mean RFC for the control group was 30.4 ± 12.1 vs. 23.7 ± 9.9 (P = 0.002) and for the EPD group it was 42.6 ± 12.6 vs. 28.3 ± 9.2 (P renal blood flow, manifested by a greater reduction of the RFC (Δ RFC) 14.2 ± 15.2 vs. 6.7 ± 11.7 (P = 0.03) compared with the control group. The use of an EPD was associated with a much larger improvement in renal blood flow (lower RFC) following RAS. This suggests that EPD's may be effective in preventing renal atheroembolic injury and that a controlled trial measuring the impact of EPD's on renal blood flow following RAS should be performed. Copyright © 2012 Wiley Periodicals, Inc.

Hypogonadism and renal failure: An update.

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Thirumavalavan, Nannan; Wilken, Nathan A; Ramasamy, Ranjith

2015-01-01

The prevalence of both hypogonadism and renal failure is increasing. Hypogonadism in men with renal failure carries with it significant morbidity, including anemia and premature cardiovascular disease. It remains unclear whether testosterone therapy can affect the morbidity and mortality associated with renal failure. As such, in this review, we sought to evaluate the current literature addressing hypogonadism and testosterone replacement, specifically in men with renal failure. The articles chosen for this review were selected by performing a broad search using Pubmed, Embase and Scopus including the terms hypogonadism and renal failure from 1990 to the present. This review is based on both primary sources as well as review articles. Hypogonadism in renal failure has a multifactorial etiology, including co-morbid conditions such as diabetes, hypertension, old age and obesity. Renal failure can lead to decreased luteinizing hormone production and decreased prolactin clearance that could impair testosterone production. Given the increasing prevalence of hypogonadism and the potential morbidity associated with hypogonadism in men with renal failure, careful evaluation of serum testosterone would be valuable. Testosterone replacement therapy should be considered in men with symptomatic hypogonadism and renal failure, and may ameliorate some of the morbidity associated with renal failure. Patients with all stages of renal disease are at an increased risk of hypogonadism that could be associated with significant morbidity. Testosterone replacement therapy may reduce some of the morbidity of renal failure, although it carries risk.

The valuation of 99Tcm-DMSA renal cortical scintigraphy for prediction of renal scarring in children with acute pyelonephritis

International Nuclear Information System (INIS)

Zhao Ruifang; Ji Zhiying; Lv Xiaomei; Wu Ha; Li Yiwei; Gu Fanlei; Zhao Xiaofei

2009-01-01

Objective: Acute pyelonephritis (APN) is a common infectious disease in childhood. APN may result in ineversible renal scarring. 99 Tc m -dimercaptsuccinic (DMSA) renal cortical scintigraphy was reported to be highly sensitive and specific for detection APN and renal scarring. The aim of this study was to determine the incidence of renal scarring in a group of children with APN and to evaluate the relative factors at risk of scarring using 99 Tc m -DMSA renal cortical scintigraphy. Methods: One hundred and eighteen patients (44 males, 74 females, age range: 1 month to 14 years) with APN underwent DMSA renal cortical scan before treatment and six month after treatment to identify renal damage and renal scarring. The degree of renal damage was divided to grade I to IV. A directed radionuclide cystography (DRC) was performed in 72 cases to evaluate vesicoureteric reflux (VUR). Statistical analysis between all those relative factors was performed using Spearman grading relational analysis. The software was SPSS 11.5. Results: The follow-up renal cortical scan revealed that 79 normal kidneys on first scan remained normal; of 64 kidneys with grade I damage, 7.81% (5/64) developed renal scar; of 51 kidneys with grade II, 49.02% (25/51) developed renal scar; of 19 with grade III, 68.42% (13/19) developed renal scar; of 23 with grade IV, 100.00% (23/23) developed renal scar. There was a significant relationship between the incidence of renal scar on follow-up and the grade of renal damage on first scan (r=0.877, P<0.01). VUR was found in 54.17% (78/144) per renal unit. Only 4.55% (3/66) of those with non-refluxing ureters developed renal scars on follow-up. One of four patients with mild-refluxing ureters developed renal scars. 46.51% (20/43) of those with moderate-refluxing ureters developed renal scars. 87.10% (27/31) of those with severe-refluxing ureters developed renal scars. There was a significant relationship between the incidence of renal scarring in follow-up and

Características clínicas, angiográficas y desenlaces clínicos en adultos mayores de 65 años con síndrome coronario agudo sin elevación del segmento ST

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James Díaz

2017-09-01

Discusión: Los pacientes de edad mayor con síndrome coronario agudo sin elevación del ST tienen características similares a las reportadas en publicaciones de otras latitudes. Sin embargo, a diferencia de lo reportado en la literatura internacional no se logró demostrar que la edad mayor a 65 años constituya un factor de riesgo independiente para desenlaces clínicos adversos en esta población.

Relationship between renal hemodynamic status and aging in patients without diabetes evaluated by renal Doppler ultrasonography.

Science.gov (United States)

Kawai, Tatsuo; Kamide, Kei; Onishi, Miyuki; Hongyo, Kazuhiro; Yamamoto-Hanasaki, Hiroko; Oguro, Ryosuke; Maekawa, Yoshihiro; Yamamoto, Koichi; Takeya, Yasushi; Sugimoto, Ken; Ohishi, Mitsuru; Rakugi, Hiromi

2012-10-01

Aging is well known as one of the major causes of a reduced glomerular filtration rate (GFR). The resistive index (RI) measured by renal Doppler ultrasonography (RDU) is thought to be a good indicator of renal vascular resistance induced by arteriosclerosis. In this study, we investigated whether RI could be used to evaluate the pathogenesis of renal damage or the mechanisms of reduction of renal function by aging. We investigated the correlation between RI and multiple clinical parameters and the influence of aging on the renal hemodynamic status of 194 in-patients (mean age 66.2 years) who underwent RDU at our hospital between February 2009 and July 2010. RI was significantly correlated with the age, estimated GFR (eGFR), diastolic blood pressure, pulse pressure, and degree of albuminuria. Subjects aged ≥75 years showed a significantly higher correlation coefficient between eGFR and RI. RI showed a stronger correlation with age in subjects aged ≥75 years compared to eGFR. The present study showed that renal vascular resistance and intra-renal arteriosclerosis had a greater impact on renal function in older than younger subjects, reflecting the possible mechanisms of renal function reduction due to aging.

Renal hemodynamics and renin-angiotensin system activity in humans with multifocal renal artery fibromuscular dysplasia.

Science.gov (United States)

van Twist, Daan J L; Houben, Alphons J H M; de Haan, Michiel W; de Leeuw, Peter W; Kroon, Abraham A

2016-06-01

Fibromuscular dysplasia (FMD) is the second most common cause of renovascular hypertension. Nonetheless, knowledge on the renal microvasculature and renin-angiotensin system (RAS) activity in kidneys with FMD is scarce. Given the fairly good results of revascularization, we hypothesized that the renal microvasculature and RAS are relatively spared in kidneys with FMD. In 58 hypertensive patients with multifocal renal artery FMD (off medication) and 116 matched controls with essential hypertension, we measured renal blood flow (Xenon washout method) per kidney and drew blood samples from the aorta and both renal veins to determine renin secretion and glomerular filtration rate per kidney. We found that renal blood flow and glomerular filtration rate in FMD were comparable to those in controls. Although systemic renin levels were somewhat higher in FMD, renal renin secretion was not elevated. Moreover, in patients with unilateral FMD, no differences between the affected and unaffected kidney were observed with regard to renal blood flow, glomerular filtration rate, or renin secretion. In men, renin levels and renin secretion were higher as compared with women. The renal blood flow response to RAS modulation (by intrarenal infusion of angiotensin II, angiotensin-(1-7), an angiotensin II type 1 receptor blocker, or a nitric oxide synthase blocker) was also comparable between FMD and controls. Renal blood flow, glomerular filtration, and the response to vasoactive substances in kidneys with multifocal FMD are comparable to patients with essential hypertension, suggesting that microvascular function is relatively spared. Renin secretion was not increased and the response to RAS modulation was not affected in kidneys with FMD.

CD47 regulates renal tubular epithelial cell self-renewal and proliferation following renal ischemia reperfusion.

Science.gov (United States)

Rogers, Natasha M; Zhang, Zheng J; Wang, Jiao-Jing; Thomson, Angus W; Isenberg, Jeffrey S

2016-08-01

Defects in renal tubular epithelial cell repair contribute to renal ischemia reperfusion injury, cause acute kidney damage, and promote chronic renal disease. The matricellular protein thrombospondin-1 and its receptor CD47 are involved in experimental renal ischemia reperfusion injury, although the role of this interaction in renal recovery is unknown. We found upregulation of self-renewal genes (transcription factors Oct4, Sox2, Klf4 and cMyc) in the kidney of CD47(-/-) mice after ischemia reperfusion injury. Wild-type animals had minimal self-renewal gene expression, both before and after injury. Suggestive of cell autonomy, CD47(-/-) renal tubular epithelial cells were found to increase expression of the self-renewal genes. This correlated with enhanced proliferative capacity compared with cells from wild-type mice. Exogenous thrombospondin-1 inhibited self-renewal gene expression in renal tubular epithelial cells from wild-type but not CD47(-/-) mice, and this was associated with decreased proliferation. Treatment of renal tubular epithelial cells with a CD47 blocking antibody or CD47-targeting small interfering RNA increased expression of some self-renewal transcription factors and promoted cell proliferation. In a syngeneic kidney transplant model, treatment with a CD47 blocking antibody increased self-renewal transcription factor expression, decreased tissue damage, and improved renal function compared with that in control mice. Thus, thrombospondin-1 via CD47 inhibits renal tubular epithelial cell recovery after ischemia reperfusion injury through inhibition of proliferation/self-renewal. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

Renal hemodynamics in uranyl acetate-induced acute renal failure of rabbits

International Nuclear Information System (INIS)

Sudo, M.; Honda, N.; Hishida, A.; Nagase, M.

1977-01-01

The role of renal hemodynamic alterations in the curtailment of renal function was studied in rabbits with uranyl acetate-induced acute renal failure. The day following the i.v. injection of uranyl acetate (2 mg/kg of body wt), renal blood flow (RBF) and clearance of creatinine (Ccr) decreased to approximately 60 and 20% of controls, respectively. Intracortical fractional flow distribution, estimated by radioactive microsphere method, did not change. The extraction ratio of para-aminohippurate (EPAH) decreased and the renal extraction of sodium (CNa/Ccr) increased, with minimal structural change in the kidney. Urine output increased two to three times that of the control. After three days oliguria appeared despite complete recovery of RBF. The zonal flow redistributed toward the deep cortex. CCr and EPAH reached their minimums, concomitantly with tubular necrosis and intratubular casts. After seven days animals could be divided into the oliguric and diuretic groups. CCr and EPAH were higher in the diuretic group, while there was no significant difference in RBF and the flow distribution between groups. Regeneration of damaged tubular cells was found in the diuretic group but not in the oliguric group. The findings suggest the minor roles of RBF and the intracortical flow distribution, and a fundamental role of back leakage of filtrate across damaged tubular epithelium in the maintenance of reduced CCR and urine output during the oliguric stage in rabbits with uranyl acetate-induced renal failure

Invasive assessment of renal artery atherosclerotic disease and resistant hypertension before renal sympathetic denervation.

Science.gov (United States)

Ribichini, Flavio; Pighi, Michele; Zivelonghi, Carlo; Gambaro, Alessia; Valvo, Enrico; Lupo, Antonio; Vassanelli, Corrado

2013-01-01

Renal sympathetic denervation (RSD) is emerging as a new therapeutic option for patients with severe hypertension refractory to medical therapy. The presence of a renal artery stenosis may be both a cause of secondary hypertension and a contraindication to RSD if a renal artery stent is implanted; therefore, the definition of the functional importance of a renal artery stenosis in a patient with refractory hypertension is crucial. We describe the imaging and functional intravascular assessment of an angiographically severe stenosis of the renal artery in a patient with severe refractory hypertension, by means of intravascular ultrasound (IVUS), and measurement of the translesional pressure gradient with a pressure wire. Pressure wire examination excluded any severity of the stenosis, and IVUS showed the presence of a dissected plaque that resolved spontaneously after 3 months of intensive medical therapy and high-dose statin. Subsequently the patient was treated with RSD, achieving a significant effect on blood pressure control. Intravascular imaging and functional assessment of renal artery anatomy in patients with atherosclerotic disease may prove particularly suited to patients with refractory hypertension and multilevel vascular disease who are considered for endovascular therapies, either renal artery stenting or RSD.

A bioartificial renal tubule device embedding human renal stem/progenitor cells.

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Anna Giovanna Sciancalepore

Full Text Available We present a bio-inspired renal microdevice that resembles the in vivo structure of a kidney proximal tubule. For the first time, a population of tubular adult renal stem/progenitor cells (ARPCs was embedded into a microsystem to create a bioengineered renal tubule. These cells have both multipotent differentiation abilities and an extraordinary capacity for injured renal cell regeneration. Therefore, ARPCs may be considered a promising tool for promoting regenerative processes in the kidney to treat acute and chronic renal injury. Here ARPCs were grown to confluence and exposed to a laminar fluid shear stress into the chip, in order to induce a functional cell polarization. Exposing ARPCs to fluid shear stress in the chip led the aquaporin-2 transporter to localize at their apical region and the Na(+K(+ATPase pump at their basolateral portion, in contrast to statically cultured ARPCs. A recovery of urea and creatinine of (20±5% and (13±5%, respectively, was obtained by the device. The microengineered biochip here-proposed might be an innovative "lab-on-a-chip" platform to investigate in vitro ARPCs behaviour or to test drugs for therapeutic and toxicological responses.

Renal pelvic calculi and neoplasm. New indication for treatment of asymptomatic renal pelvic calculi?

DEFF Research Database (Denmark)

Vibitis, H; Jørgensen, J B

1990-01-01

Metaplasia of the renal pelvis caused by chronic irritation, calculi, infection is a reversible pre-malignant condition. The application of ESWL on renal calculi as a safe treatment in relation to metaplasia is discussed and a case history is presented.......Metaplasia of the renal pelvis caused by chronic irritation, calculi, infection is a reversible pre-malignant condition. The application of ESWL on renal calculi as a safe treatment in relation to metaplasia is discussed and a case history is presented....

Retrograde Renal Cooling to Minimize Ischemia

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Janet L. Colli

2013-01-01

Full Text Available Objective: During partial nephrectomy, renal hypothermia has been shown to decrease ischemia induced renal damage which occurs from renal hilar clamping. In this study we investigate the infusion rate required to safely cool the entire renal unit in a porcine model using retrograde irrigation of iced saline via dual-lumen ureteral catheter. Materials and Methods: Renal cortical, renal medullary, bowel and rectal temperatures during retrograde cooling in a laparoscopic porcine model were monitored in six renal units. Iced normal saline was infused at 300 cc/hour, 600 cc/hour, 1000 cc/hour and gravity (800 cc/hour for 600 seconds with and without hilar clamping. Results: Retrograde cooling with hilar clamping provided rapid medullary renal cooling and significant hypothermia of the medulla and cortex at infusion rates ≥ 600 cc/hour. With hilar clamping, cortical temperatures decreased at -0.9° C/min. reaching a threshold temperature of 26.9° C, and medullary temperatures decreased at -0.90 C/min. reaching a temperature of 26.1° C over 600 seconds on average for combined data at infusion rates ≥ 600 cc/hour. The lowest renal temperatures were achieved with gravity infusion. Without renal hilum clamping, retrograde cooling was minimal at all infusion rates. Conclusions: Significant renal cooling by gravity infusion of iced cold saline via a duel lumen catheter with a clamped renal hilum was achieved in a porcine model. Continuous retrograde irrigation with iced saline via a two way ureteral catheter may be an effective method to induce renal hypothermia in patients undergoing robotic assisted and/or laparoscopic partial nephrectomy.

Vivendo o acidente vascular encefálico agudo: significados da doença para pessoas hospitalizadas

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Samia Jardelle Costa de Freitas Maniva

2013-04-01

Full Text Available Objetivou-se compreender o significado da experiência vivenciada pela pessoa adoecida por acidente vascular encefálico agudo. Trata-se de estudo qualitativo, fundamentado nos pressupostos teóricos do interacionismo simbólico, realizado em uma unidade especializada no tratamento de acidente vascular encefálico de um hospital terciário, situado na cidade de Fortaleza, CE. Participaram do estudo 10 pacientes. A coleta de dados ocorreu por meio de entrevista aberta e os dados foram organizados e analisados segundo a técnica de enunciação. Cumpriram-se todos os aspectos éticos. O significado da experiência de adoecimento foi construído com base na percepção dos sentimentos surgidos durante a hospitalização, caracterizados por medo da morte e das sequelas da doença; tristeza pelo distanciamento do lar; alívio, ao evidenciar-se melhora do quadro clínico, e desejo de mudança dos hábitos de vida. Apreendeu-se que a experiência de adoecimento por acidente vascular encefálico é complexa, e nela os significados são elaborados com base em sentimentos, ações e comportamentos dos sujeitos.

Vivendo o acidente vascular encefálico agudo: significados da doença para pessoas hospitalizadas

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Samia Jardelle Costa de Freitas Maniva

Full Text Available Objetivou-se compreender o significado da experiência vivenciada pela pessoa adoecida por acidente vascular encefálico agudo. Trata-se de estudo qualitativo, fundamentado nos pressupostos teóricos do interacionismo simbólico, realizado em uma unidade especializada no tratamento de acidente vascular encefálico de um hospital terciário, situado na cidade de Fortaleza, CE. Participaram do estudo 10 pacientes. A coleta de dados ocorreu por meio de entrevista aberta e os dados foram organizados e analisados segundo a técnica de enunciação. Cumpriram-se todos os aspectos éticos. O significado da experiência de adoecimento foi construído com base na percepção dos sentimentos surgidos durante a hospitalização, caracterizados por medo da morte e das sequelas da doença; tristeza pelo distanciamento do lar; alívio, ao evidenciar-se melhora do quadro clínico, e desejo de mudança dos hábitos de vida. Apreendeu-se que a experiência de adoecimento por acidente vascular encefálico é complexa, e nela os significados são elaborados com base em sentimentos, ações e comportamentos dos sujeitos.

Accessory renal arteries: Prevalence in resistant hypertension and an important role in nonresponse to radiofrequency renal denervation.

Science.gov (United States)

VonAchen, Paige; Hamann, Jason; Houghland, Thomas; Lesser, John R; Wang, Yale; Caye, David; Rosenthal, Kristi; Garberich, Ross F; Daniels, Mary; Schwartz, Robert S

The aim of this study was to understand the role of accessory renal arteries in resistant hypertension, and to establish their role in nonresponse to radiofrequency renal denervation (RDN) procedures. Prior studies suggest a role for accessory renal arteries in hypertensive syndromes, and recent clinical trials of renal denervation report that these anomalies are highly prevalent in resistant hypertension. This study evaluated the relationships among resistant hypertension, accessory renal arteries, and the response to radiofrequency (RF) renal denervation. Computed Tomography Angiography (CTA) and magnetic resonance imaging (MRI) scans from 58 patients with resistant hypertension undergoing RF renal denervation (RDN) were evaluated. Results were compared with CT scans in 57 healthy, normotensive subjects undergoing screening as possible renal transplant donors. All scans were carefully studied for accessory renal arteries, and were correlated with long term blood pressure reduction. Accessory renal arteries were markedly more prevalent in the hypertensive patients than normotensive renal donors (59% vs 32% respectively, p=0.004). RDN had an overall nonresponse rate of 29% (response rate 71%). Patients without accessory vessels had a borderline higher response rate to RDN than those with at least one accessory vessel (83% vs 62% respectively, p=0.076) and a higher RDN response than patients with untreated accessory arteries (83% vs 55%; p=0.040). For accessory renal arteries and nonresponse, the sensitivity was 76%, specificity 49%, with positive and negative predictive values 38% and 83% respectively. Accessory renal arteries were markedly over-represented in resistant hypertensives compared with healthy controls. While not all patients with accessory arteries were nonresponders, nonresponse was related to both the presence and non-treatment of accessory arteries. Addressing accessory renal arteries in future clinical trials may improve RDN therapeutic efficacy

The pulsatility index and the resistive index in renal arteries in patients with hypertension and chronic renal failure

DEFF Research Database (Denmark)

Petersen, L J; Petersen, J R; Ladefoged, S D

1995-01-01

The pulsatility index (PI) and the resistive index (RI) are used as pulsed-wave Doppler measurement of downstream renal artery resistance. Little information is available on their value in chronic renal failure and their correlation to parameters of renal function and haemodynamics. The aim...... was to compare PI and RI of renal arteries in healthy volunteers and in patients with hypertension and chronic renal failure, and furthermore to study the correlation of these indices to measurements of renal haemodynamics and function by standard methods in patients with renal failure and hypertension....

The dark side of the kidney in cardio-renal syndrome: renal venous hypertension and congestive kidney failure.

Science.gov (United States)

Di Nicolò, Pierpaolo

2018-03-01

Renal involvement in some forms of acute or chronic diseases, such as heart failure or sepsis, presents with a complex pathophysiological basis that is not always clearly distinguishable. In these clinical settings, kidney failure is traditionally and almost exclusively attributed to renal hypoperfusion and it is commonly accepted that causal elements are pre-renal, such as a reduction in the ejection fraction or absolute or relative hypovolemia acting directly on oxygen transport mechanisms and renal autoregulation systems, causing a reduction of glomerular filtration rate. Nevertheless, the concept emerging from accumulating clinical and experimental evidence is that in complex clinical pictures, kidney failure is strongly linked to the hemodynamic alterations occurring in the renal venous micro and macrocirculation. Accordingly, the transmission of the increased venous pressure to the renal venous compartment and the consequent increasing renal afterload has a pivotal role in determining and sustaining the kidney damage. The aim of this review was to clarify the physiopathological aspects of the link between worsening renal function and renal venous hypertension, analyzing the prognostic and therapeutic implications of the so-called congestive kidney failure in cardio-renal syndrome and in other clinical contexts of its possible onset.

Purinergic Signalling in Inflammatory Renal Disease

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Nishkantha eArulkumaran

2013-07-01

Full Text Available Extracellular purines have a role in renal physiology and adaption to inflammation. However, inflammatory renal disease may be mediated by extracellular purines, resulting in renal injury. The role of purinergic signalling is dependent on the concentrations of extracellular purines. Low basal levels of purines are important in normal homeostasis and growth. Concentrations of extracellular purines are significantly elevated during inflammation and mediate either an adaptive role or propagate local inflammation. Adenosine signalling mediates alterations in regional renal blood flow by regulation of the renal microcirculation, tubulo-glomerular feedback, and tubular transport of sodium and water. Increased extracellular ATP and renal P2 receptor-mediated inflammation are associated with various renal diseases, including hypertension, diabetic nephropathy, and glomerulonephritis. Experimental data suggests P2 receptor deficiency or receptor antagonism is associated with amelioration of antibody-mediated nephritis, suggesting a pathogenic (rather than adaptive role of purinergic signalling. We discuss the role of extracellular nucleotides in adaptation to ischaemic renal injury and in the pathogenesis of inflammatory renal disease.

Renal denervation: Results of a single-center cohort study; Renale Denervation. Ergebnisse einer Single-Center Kohortenstudie

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Luetkens, J.A.; Thomas, D.; Doerner, J.; Schild, H.H.; Naehle, C.P. [Bonn Univ. (Germany). Dept. of Radiology; Wilhelm, K. [Johanniter Hospital, Bonn (Germany). Dept. of Radiology; Duesing, R. [Hypertension Center, Bonn (Germany); Woitas, R.P.; Hundt, F. [Bonn Univ. (Germany). Dept. of Internal Medicine I

2015-01-15

To investigate the effect of renal denervation on office-based and 24-h ambulatory blood pressure measurements (ABPM) in a highly selective patient population with drug-resistant hypertension. Patients with drug resistant hypertension eligible for renal denervation were included in the study population. Office blood pressure and ABPM were assessed prior to and after renal denervation. To detect procedure related renal or renal artery damage, magnetic resonance imaging (MRI) and angiography (MRA) were performed pre-interventional, one day post-interventional, and one month after renal denervation. Mean follow-up time between renal denervation and blood pressure re-assessment was 9.5 ± 3.9 months. Between August 2011 and March 2013, 17 patients prospectively underwent renal denervation. Pre-interventional mean office blood pressure and ABPM were 177.3 ± 20.3/103.8 ± 20.4 mmHg and 155.2 ± 20.5/93.7 ± 14.5 mmHg, respectively. Post-interventional, office blood pressure was significantly reduced to 144.7 ± 14.9/89.5 ± 12.1 (p < 0.05). ABPM values remained unchanged (147.9 ± 20.3/90.3 ± 15.6, p > 0.05). The number of prescribed antihypertensive drugs was unchanged after renal denervation (4.7 ± 2.0 vs. 4.2 ± 1.2, p = 0.18). No renovascular complications were detected in follow-up MRI. After renal denervation, no significant decrease in ABPM was observed. These results may indicate a limited impact of renal denervation for drug resistant hypertension.

Renal nerves and nNOS

DEFF Research Database (Denmark)

Kompanowska-Jezierska, Elzbieta; Wolff, Helle; Kuczeriszka, Marta

2008-01-01

). This was tested by NaLoad after chronic renal denervation with and without inhibition of nNOS by S-methyl-thiocitrulline (SMTC). In addition, the acute effects of renal denervation on MABP and sodium balance were assessed. Rats were investigated in the conscious, catheterized state, in metabolic cages...... of acutely and chronically denervated rats were less than control (15% and 9%, respectively, P reduced by renal denervation (14.5 +/- 0.2 vs. 19.3 +/- 1.3 mIU/l, P reduced...... PRC (P sodium excretion six-fold, irrespective of renal denervation and SMTC. The metabolic data demonstrated that renal denervation lowered sodium balance during the first days after denervation (P

Efectividad y seguridad de la laparotomía vs laparoscopía en abdomen agudo de origen gineco-obstétrico causado por embarazo ectópico roto y quiste de ovario roto.

OpenAIRE

Luna Aveiga, Cristhian

2014-01-01

Comparar efectividad, tiempo y sangrado operatorio, estadía y complicaciones entre laparotomía y laparoscopía en abdomen agudo (AA) por embarazo ectópico roto (EER) y quiste de ovario roto (QOR). Métodos: Estudio retrospectivo en el Hospital de Santa Elena y Clínica Granados de Enero 2010-Diciembre 2011. Se obtuvieron las causas, procedimientos, edad, hemoglobina, edad gestacional, antecedentes personales y complicaciones. Tiempo, sangrado operatorio y estadía fueron comparadas por T de stud...

Renal myogenic constriction protects the kidney from age-related hypertensive renal damage in the Fawn-Hooded rat

NARCIS (Netherlands)

Vavrinec, Peter; Henning, Robert H.; Goris, Maaike; Landheer, Sjoerd W.; Buikema, Hendrik; van Dokkum, Richard P. E.

Introduction:Intact myogenic constriction plays a role in renal blood flow autoregulation and protection against pressure-related (renal) injury. However, to what extent alterations in renal artery myogenic constriction are involved in development of renal damage during aging is unknown. Therefore,

Demoras en la realización de la angioplastia primaria en los pacientes trasladados con infarto agudo de miocardio: un problema médico-asistencial

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Rodrigo Blanco

2009-01-01

Full Text Available IntroducciónEn el infarto agudo de miocardio (IAM está comprobado que cuanto más tempranamente se realice la reperfusión, mejores serán sus resultados a corto y a largo plazos, por lo que el tiempo entre el inicio de los síntomas y la reperfusión coronaria es un elemento de gran importancia en la estrategia de su tratamiento. Este lapso se encuentra conformado por dos períodos: “tiempo paciente” y “tiempo médico-asistencial”. En la angioplastia primaria, el análisis de estos tiempos y sus intervalos es el paso obligado para lograr una reducción de la demora a la reperfusión.ObjetivosAnalizar los tiempos en cada etapa del proceso traslado-realización de una angioplastia, ya sea primaria o de rescate, en pacientes con infarto agudo de miocardio con elevación del segmento ST (IAMEST que debieron ser trasladados desde un hospital derivador a un centro de referencia en el ámbito de la ciudad de Buenos Aires para someterse al procedimiento, como primer paso para un programa de optimización de los tiempos.Material y métodosEstudio prospectivo, observacional, de pacientes derivados al Hospital General de Agudos “Dr. Cosme Argerich” con diagnóstico de IAMEST e indicación de ATC. Se analizaron los tiempos parciales desde el inicio de los síntomas hasta la reperfusión coronaria, para lo cual se consideró “tiempo paciente” desde el inicio de los síntomas hasta la llegada al hospital derivador y “tiempo médico-asistencial” al comprendido entre la llegada al hospital derivador y la insuflación del balón.ResultadosSe incluyeron 313 pacientes, 225 (72% con angioplastia primaria (ATCP y 88 (28% con angioplastia de rescate (ATCR. Las medianas (cuartiles de tiempo en ATCP fueron: tiempo paciente: 90’ (40-240, llegada al hospital derivador-llamada al Equipo de Hemodinamia Cardiovascular de Urgencia (EHCU: 80’ (35-150, llamada EHCU-ingreso hemodinamia: 75’ (55-100, ingreso hemodinamia-balón: 35’ (23-52, tiempo m

Studies on renal function in the elderly by analysis of radioisotope renal images

International Nuclear Information System (INIS)

Ohishi, Yukihiko

1990-01-01

This study was carried out to evaluate the potential of radionuclide renal imagings for examining senile renal function in a total of 178 subjects. Single photon emission computed tomography (SPECT) with Tc-99m-dimercaptosuccinic acid (Tc-DMSA) was performed in the senile group (60-87 years) and in the adult group to determine renal uptake rate of Tc-DMSA and renal volume. Renography studies with I-131 hippuran (n=100) and Tc-99m diethylentriaminepentaacetic acid (Tc-DTPA) (n=20) were also performed for deconvolution analysis. Mean transit time (MTT) was mainly assessed as one of the retention function parameters. Blood residual rates (R15%) at fifteen minutes were also investigated. Renal volume and renal uptake rate for healthy persons were significantly lower in the senile group (n=17) than the adult group (n=24), 205±50 ml vs 225±27 ml; and 22±5% vs 26±2%. I-133 hippuran renography in healthy persons (n=35) showed a tendency toward higher MTT values with aging; however, there was no significant difference among age groups. R15%, obtained by I-133 hippuran renograms, tended to be higher with aging in age groups of persons younger than 70 years. A decreased number of effective nephrons was considered to result in higher R15% values even when aged persons had normal MTT values of I-131 hippuran. Split renal function values for healthy persons, calculated by the two radionuclide imagings, were lower in the senile group than the adult group, suggesting the usefulness of radionuclide imagings in renal function examination. (N.K.)

Cigarette smoking and cardio-renal events in patients with atherosclerotic renal artery stenosis.

Directory of Open Access Journals (Sweden)

Christopher A Drummond

Full Text Available Cigarette smoking causes cardiovascular disease and is associated with poor kidney function in individuals with diabetes mellitus and primary kidney diseases. However, the association of smoking on patients with atherosclerotic renal artery stenosis has not been studied. The current study utilized data from the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL, NCT00081731 clinical trial to evaluate the effects of smoking on the risk of cardio-renal events and kidney function in this population. Baseline data showed that smokers (n = 277 out of 931 were significantly younger at enrollment than non-smokers (63.3±9.1 years vs 72.4±7.8 years; p<0.001. In addition, patients who smoke were also more likely to have bilateral renal artery stenoses and peripheral vascular disease (PVD. Longitudinal analysis showed that smokers experienced composite endpoint events (defined as first occurrence of: stroke; cardiovascular or renal death; myocardial infarction; hospitalization for congestive heart failure; permanent renal replacement; and progressive renal insufficiency defined as 30% reduction of GFR from baseline sustained for ≥ 60 days at a substantially younger age compared to non-smokers (67.1±9.0 versus 76.1±7.9, p<0.001. Using linear regression and generalized linear modeling analysis controlled by age, sex, and ethnicity, smokers had significantly higher cystatin C levels (1.3±0.7 vs 1.2±0.9, p<0.01 whereas creatinine and estimated glomerular filtration rate (eGFR were not different from non-smokers. From these data we conclude that smoking has a significant association with deleterious cardio-renal outcomes in patients with renovascular hypertension.

Renal imaging in paediatrics

International Nuclear Information System (INIS)

Porn, U.; Hahn, K.; Fischer, S.

2003-01-01

The most frequent renal diseases in paediatrics include urinary tract infections, hydronephrosis, kidney anomalies and reflux. The main reason for performing DMSA scintigraphy in paediatrics is the detection of cortical abnormalities related to urinary tract infection. Because the amount of tracer retained in the tubular cells is associated with the distribution of functioning renal parenchyma in the kidney, it is possible, to evaluate the split renal function. In comparison to ultrasound and intravenous urography the sensitivity in the detection of acute as well as chronic inflammatory changes is very high, however less specific. An indication for a renography in neonates and children is beside an estimation of the total renal function and the calculation of the split renal function, the assessment of renal drainage in patients with unclear dilatation of the collecting system in ultrasound. The analysis of the time activity curve provides, especially for follow-up studies, a reproducible method to assess the urinary outflow. The diuretic scintigraphy allows the detection of urinary obstruction. Subsequently it is possible to image the micturition phase to detect vesico-ureteric reflux (indirect MCU) after drainage of tracer from the renal pelvis. An reflux in the ureters or the pelvicalyceal system is visible on the scintigraphic images and can be confirmed by time activity curves. A more invasive technique is the direct isotope cystography with bladder catheterization. The present paper should give an overview about the role of nuclear medicine in paediatric urology. (orig.) [de

Trasplante renal y disminución de la mortalidad en los programas de diálisis crónica

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Walter G. Douthat

2014-02-01

Full Text Available El trasplante renal (TR presenta mejor supervivencia, calidad de vida y costos que la diálisis en la insuficiencia renal crónica (IRC. Estudiamos pacientes en diálisis que recibieron TR durante 2010, las causas de finalización del tratamiento y la supervivencia en diálisis. Evaluamos si criterios más amplios para la aceptación de trasplantes hubieran afectado los resultados del procedimiento en ese período. Incluimos 118 pacientes en diálisis, edad media 56.9 ± 18.4 años, tiempo en diálisis 45.5 ± 59.6 meses, 35 (30% presentaban diabetes como causa de IRC, y 58 (49% estaban en espera del TR. Treinta y cuatro finalizaron diálisis, 18 por TR y 12 por fallecimiento. Las principales causas de muerte fueron cardiovasculares, 6 (50% e infecciones, 2 (17%. La supervivencia al año fue 85% para el grupo total, 98% para los pacientes inscriptos en lista de espera y 72% para no inscriptos. Durante 2010 se realizaron 88 TR (62 con donantes cadavéricos [DC], 18 donantes vivos y 8 dobles trasplantes páncreas-riñón. Los receptores de DC tenían en promedio 50.7 años, 67 meses en diálisis, 8 (13% eran diabéticos, 12 (20% con TR previos y 3 cross match contra panel de anticuerpos > 20%. Los donantes tenían edad media 45 años, 28 (45% con criterios expandidos y 27.7 h de isquemia fría. A los 11.4 meses de seguimiento, 13 (21% presentó rechazo agudo, la supervivencia para injerto fue de 88% y 93% para pacientes. La principal causa de finalización de diálisis fue TR, sin detectarse que el empleo de DC afectara la supervivencia del TR.

Live Donor Renal Anatomic Asymmetry and Posttransplant Renal Function.

Science.gov (United States)

Tanriover, Bekir; Fernandez, Sonalis; Campenot, Eric S; Newhouse, Jeffrey H; Oyfe, Irina; Mohan, Prince; Sandikci, Burhaneddin; Radhakrishnan, Jai; Wexler, Jennifer J; Carroll, Maureen A; Sharif, Sairah; Cohen, David J; Ratner, Lloyd E; Hardy, Mark A

2015-08-01

Relationship between live donor renal anatomic asymmetry and posttransplant recipient function has not been studied extensively. We analyzed 96 live kidney donors, who had anatomical asymmetry (>10% renal length and/or volume difference calculated from computerized tomography angiograms) and their matching recipients. Split function differences (SFD) were quantified with technetium-dimercaptosuccinic acid renography. Implantation biopsies at time 0 were semiquantitatively scored. A comprehensive model using donor renal volume adjusted to recipient weight (Vol/Wgt), SFD, and biopsy score was used to predict recipient estimated glomerular filtration rate (eGFR) at 1 year. Primary analysis consisted of a logistic regression model of outcome (odds of developing eGFR>60 mL/min/1.73 m(2) at 1 year), a linear regression model of outcome (predicting recipient eGFR at one-year, using the chronic kidney disease-epidemiology collaboration formula), and a Monte Carlo simulation based on the linear regression model (N=10,000 iterations). In the study cohort, the mean Vol/Wgt and eGFR at 1 year were 2.04 mL/kg and 60.4 mL/min/1.73 m(2), respectively. Volume and split ratios between 2 donor kidneys were strongly correlated (r = 0.79, P 10%) were not different (P = 0.190). On multivariate models, only Vol/Wgt was significantly associated with higher odds of having eGFR > 60 mL/min/1.73 m (odds ratio, 8.94, 95% CI 2.47-32.25, P = 0.001) and had a strong discriminatory power in predicting the risk of eGFR less than 60 mL/min/1.73 m(2) at 1 year [receiver operating curve (ROC curve), 0.78, 95% CI, 0.68-0.89]. In the presence of donor renal anatomic asymmetry, Vol/Wgt appears to be a major determinant of recipient renal function at 1 year after transplantation. Renography can be replaced with CT volume calculation in estimating split renal function.

Renal failure in patients with multiple myeloma.

Science.gov (United States)

Almueilo, Samir H

2015-01-01

Renal dysfunction is encountered in 20-25% of patients with multiple myeloma (MM) at the time of diagnosis. There is often a precipitating event. Several biochemical and clinical correlations with renal failure in MM have been reported. Renal failure in MM is associated with worse outcome of the disease. We retrospectively analyzed the medical records of 64 patients with MM admitted to our institution during the period January 1992 to December 2012. Abnormal renal function was observed in 24 (37.5%) patients and 17 (26.6%) of them had renal failure; 14 of the 17 (82.4%) of patients with renal failure had Stage III MM. Urine Bence- Jones protein was positive in ten (58.8%) patients with renal failure versus ten (21.3%) patients without renal failure (P = 0.004). Potential precipitating factors of renal failure were determined in nine patients. Renal function normalized in 11 patients with simple measures, while six patients required hemodialysis; one remained dialysis dependent till time of death. Early mortality occurred in five (29.4%) patients with renal failure as compared with two (4.3%) patients in the group without renal failure (P = 0.005). In conclusion, renal failure is associated with a higher tumor burden and Bence-Jones proteinuria in patients with MM. It is reversible in the majority of patients; however, early mortality tends to be higher in patients with persistent renal failure.

Renal vasculitis presenting with acute kidney injury.

Science.gov (United States)

Villacorta, Javier; Diaz-Crespo, Francisco; Acevedo, Mercedes; Cavero, Teresa; Guerrero, Carmen; Praga, Manuel; Fernandez-Juarez, Gema

2017-06-01

Renal failure secondary to ANCA-associated vasculitis represents a clinical and therapeutic challenge. In this study, we aimed to assess the treatment response rates and long-term outcomes of vasculitis patients presenting with renal failure. This retrospective study included 151 patients with renal vasculitis from three hospitals who underwent a renal biopsy between 1997 and 2014. Patients with renal failure which required dialysis at the onset were compared to those presenting with more preserved renal function. The primary end point was treatment response and patient surivival. Patients with severe renal involvement had a lower response to treatment compared to those having preserved renal function (26.6 versus 93.4%; p renal recovery (41.6 versus 12.5%; p = 0.05). A higher incidence of severe infections was observed among patients with severe renal involvement (38.4 versus 18.1%, p = 0.01). The mortality rate was significantly higher among vasculitis patients presenting with renal failure (53.8 versus 22.2%, p = 0.001). Global survival at 1 and 5 years was 60 and 47% in patients requiring dialysis compared with 90 and 80% among those with more preserved renal function (p renal dysfunction represents an independent risk factor for patient survival in renal vasculitis. Patients requiring dialysis associate a lower response rate to immunosuppressive therapy and a higher incidence of severe infections.

Several issues regarding evaluation of renal injury and renal insufficiency in patients with liver disease

Directory of Open Access Journals (Sweden)

HAO Kunyan

2016-07-01

Full Text Available In patients with liver disease such as viral hepatitis and liver cirrhosis, renal injury and renal insufficiency can be generally classified as acute kidney injury (AKI, chronic kidney disease, and acute-on-chronic nephropathy. AKI can be classified as stage 1 (risk stage, stage 2 (injury stage, and stage 3 (failure stage. Traditionally hepatorenal syndrome is classified as types Ⅰ and Ⅱ, and in recent years, type Ⅲ hepatorenal syndrome with organic renal injury has been proposed. Hepatorenal disorder(HRD is used to describe any renal disease which occurs in patients with liver cirrhosis. At present, sensitive and accurate biochemical parameters used to evaluate renal function in patients with liver disease in clinical practice include estimated glomerular filtration rate, increase in serum creatinine within unit time, and serum cystatin C level, and urinary microalbumin level also plays an important role in the early diagnosis of nephropathy. Causes of liver disease, severity, complications including infection, nutritional status, therapeutic drugs, and underlying nephropathy may be associated with renal injury and renal insufficiency in patients with liver disease and should be differentiated.

A case of septic pulmonary embolism associated with renal abscess mimicking pulmonary metastases of renal malignancy

International Nuclear Information System (INIS)

Jung, Jo sung; Lee, Sang Mi; Kim, Han Jo; Jang, Si-Hyong; Lee, Jeong Won

2014-01-01

We report the case of a 46-year-old woman with acute febrile symptom who had multiple pulmonary nodules and a renal mass. She underwent 18 F-fluorode-oxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) to find a hidden malignancy and the cause of her fever. FDG PET/CT images demonstrated a renal mass and multiple lung nodules with intense FDG uptake, which was suspicious of a renal malignancy with multiple pulmonary metastatic lesions. CT-guided biopsies of the pulmonary and renal lesions only showed chronic inflammatory infiltrates without evidence of malignancy. She was diagnosed with septic pulmonary embolism from a renal abscess. One month after antibiotic treatment, the follow-up chest and abdomen CT showed improvement of the lung and renal lesions. This is the first case demonstrating the FDG PET/CT finding of septic pulmonary embolism associated with renal abscess in the published literature. (author)

Changes of renal sinus fat and renal parenchymal fat during an 18-month randomized weight loss trial.

Science.gov (United States)

Zelicha, Hila; Schwarzfuchs, Dan; Shelef, Ilan; Gepner, Yftach; Tsaban, Gal; Tene, Lilac; Yaskolka Meir, Anat; Bilitzky, Avital; Komy, Oded; Cohen, Noa; Bril, Nitzan; Rein, Michal; Serfaty, Dana; Kenigsbuch, Shira; Chassidim, Yoash; Sarusi, Benjamin; Thiery, Joachim; Ceglarek, Uta; Stumvoll, Michael; Blüher, Matthias; Haviv, Yosef S; Stampfer, Meir J; Rudich, Assaf; Shai, Iris

2018-08-01

Data regarding the role of kidney adiposity, its clinical implications, and its dynamics during weight-loss are sparse. We investigated the effect of long-term weight-loss induced intervention diets on dynamics of renal-sinus-fat, an ectopic fat depot, and %renal-parenchymal-fat, lipid accumulation within the renal parenchyma. We randomized 278 participants with abdominal obesity/dyslipidemia to low-fat or Mediterranean/low-carbohydrate diets, with or without exercise. We quantified renal-sinus-fat and %renal-parenchymal-fat by whole body magnetic-resonance-imaging. Participants (age = 48 years; 89% men; body-mass-index = 31 kg/m 2 ) had 86% retention to the trial after 18 months. Both increased renal-sinus-fat and %renal-parenchymal-fat were directly associated with hypertension, and with higher abdominal deep-subcutaneous-adipose-tissue and visceral-adipose-tissue (p of trend vs. baseline) but not %renal-parenchymal-fat (-1.7%; p = 0.13 vs. baseline) significantly decreased, and similarly across the intervention groups. Renal-sinus-fat and %renal-parenchymal-fat changes were correlated with weight-loss per-se (p < 0.05). In a model adjusted for age, sex, and visceral-adipose-tissue changes, 18 months reduction in renal-sinus-fat associated with decreased pancreatic, hepatic and cardiac fats (p < 0.05 for all) and with decreased cholesterol/high-density lipoprotein-cholesterol (HDL-c) (β = 0.13; p = 0.05), triglycerides/HDL-c (β = 0.13; p = 0.05), insulin (β = 0.12; p = 0.05) and gamma glutamyl transpeptidase (β = 0.24; p = 0.001), but not with improved renal function parameters or blood pressure. Decreased intake of sodium was associated with a reduction in %renal-parenchymal-fat, after adjustment for 18 months weight-loss (β = 0.15; p = 0.026) and hypertension (β = 0.14; p = 0.04). Renal-sinus-fat and renal-parenchymal-fat are fairly related to weight-loss. Decreased renal-sinus-fat is associated with improved hepatic

Renal endothelial function and blood flow predict the individual susceptibility to adriamycin-induced renal damage

NARCIS (Netherlands)

Ochodnicky, Peter; Henning, Robert H.; Buikema, Hendrik; Kluppel, Alex C. A.; van Wattum, Marjolein; de Zeeuw, Dick; van Dokkum, Richard P. E.

Background. Susceptibility to renal injury varies among individuals. Previously, we found that individual endothelial function of healthy renal arteries in vitro predicted severity of renal damage after 5/6 nephrectomy. Here we hypothesized that individual differences in endothelial function in

CT differentiation of renal tumor invading parenchyma and pelvis: renal cell carcinoma vs transitional cell carcinoma

International Nuclear Information System (INIS)

Lee, Chang Hee; Cho, Seong Beum; Park, Cheol Min; Cha, In Ho; Chung, Kyoo Byung

1994-01-01

The differentiation between renal cell carcinoma(RCC) and transitional cell carcinoma(TCC) is important due to the different methods of treatment and prognosis. But occasionally it is difficult to draw a distinction between the two diseases when renal parenchyma and renal collecting systems are invaded simultaneously. We reviewed CT scans of 37 cases of renal cell carcinoma and 12 cases of transitional cell carcinoma which showed involvement of renal parenchyma and renal sinus fat on CT. Retrospective analysis was performed by 3 abdominal radiologists. Check points were renal contour bulging or reinform shape, location of mass center, intact parenchyma overlying the tumor, cystic change, calcification, LN metastasis, vessel invasion, and perirenal extention. There were renal contour bulging due to the tumor mass in 33 out of 37 cases of renal cell carcinoma, where a and nine of 12 cases of transitional cell carcinoma maintained the reinform appearance. This is significant statiscal difference between the two(P<0.005). Center of all TCCs were located in the renal sinus, and 24 out of 35 cases of RCC were located in the cortex(P<0.005). Thirty-six out of 37 cases of RCC lost the overlying parenchyma, where as 4 out of 9 cases of well enhanced TCC had intact overlying parenchyma(P<0.005) RCC showed uptic change within the tumor mags in 31 cases which was significanity higher than the 4 cases in TCC(P<0.05). CT findings of renal cell carcinoma are contour bulging, peripheral location, obliteration of parenchyma, and cystic change. Findings of transitional cell carcinoma are reinform appearance, central location within the kidney, intact overlying parenchyma, and rare cystic change

Renal artery anatomy assessed by quantitative analysis of selective renal angiography in 1,000 patients with hypertension.

Science.gov (United States)

Lauder, Lucas; Ewen, Sebastian; Tzafriri, Abraham Rami; Edelman, Elazer Reuven; Lüscher, Thomas Felix; Blankenstijn, Peter J; Dörr, Oliver; Schlaich, Markus; Sharif, Faisal; Voskuil, Michiel; Zeller, Thomas; Ukena, Christian; Scheller, Bruno; Böhm, Michael; Mahfoud, Felix

2018-05-20

With increasing attention to renovascular causes and targets for hypertension there arises a critical need for more detailed knowledge of renal arterial anatomy. However, a standardised nomenclature is lacking. The present study sought to develop a standardised nomenclature for renal anatomy considering the complexity and variation of the renal arterial tree and to assess the applicability of the nomenclature. One thousand hypertensive patients underwent invasive selective renal artery angiography in nine centres. Further, renovasography was performed in 249 healthy swine as a surrogate for normotensive anatomy. Anatomical parameters were assessed by quantitative vascular analysis. Patients' mean blood pressure was 168/90±26/17 mmHg. The right main renal artery was longer than the left (41±15 mm vs. 35±13 mm, prenal arteries and renal artery disease were documented in 22% and 9% of the patients, respectively. Other than exhibiting a longer left main renal artery in uncontrolled hypertensives (+2.7 mm, p=0.034) there was no anatomical difference between patients with controlled and uncontrolled hypertension. Main renal artery mean diameter was smaller in patients with impaired kidney function (GFR Renal arterial anatomy differs between sides but shows no difference between patients with and without blood pressure control. Impaired GFR was associated with small main renal artery diameter.

Renal dynamic scintigraphy in renal graft evaluation; Cintilografia renal dinamica na avaliacao do transplante renal

Energy Technology Data Exchange (ETDEWEB)

Cervo, Marco Antonio Cadorna; Amarante Junior, Jose Luiz de Medeiros; Souza, Ricardo Alberto Manhaes de; Evangelista, Maria Gardenia; Cavalcante, Carlos Alberto Provasi; Neder, Jacqueline de Roure e; Espinola, Ircania Jorge [Hospital Naval Marcilio Dias, Rio de Janeiro, RJ (Brazil). Servico de Medicina Nuclear

1996-12-31

The goal of this was to describe the use of the dynamic renal scintigraphy in patients grafted. The authors described the scintigraphy method utilised and results were discussed 8 refs., 9 figs., 1 tab.

Renal PTA stenting

International Nuclear Information System (INIS)

Tsetis, D.

2012-01-01

Full text: Renal artery stenosis (RAS) is a common condition that may lead to hypertension, progressive renal dysfunction and cardiovascular morbidity. Catheter-based therapy for symptomatic, haemodynamically significant, RAS has become the preferred method of revascularization. Balloon angioplasty has been the traditional treatment of choice for fibromuscular dysplasia, however stents are increasingly used for the treatment of atheromatous lesions; in many cases-such as in ostial lesions-, direct stenting is strongly indicated. Despite the increased use of endovascular therapy for renal artery stenosis, there is still controversy regarding the optimal management and the net benefit of this treatment. Several randomized trials of balloon angioplasty or stenting for renal artery stenosis compared with medical therapy alone have been conducted, however these could not show definite advantage of endovascular therapy. Problems encountered with those trials include enrollment of small number of patients, frequent crossover from medical to interventional therapy compromising the intention-to-treat results, or selection of patients that are not expected to show clear benefit. The Angioplasty and Stenting for Renal Artery Lesions (ASTRAL) is the most important of these trials; however, it,s study design was faulty and therefore did not provide conclusive evidence to answer the question of whether angioplasty and stenting or medical therapy is the best treatment for haemodynamically significant RAS. All expectations are now focused on the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) trial which was designed to answer the same question, and its methodologies took into consideration the weaknesses of the ASTRAL trial. Regarding stent device itself, it seems that the optimal design is probably a stainless steel, laser cut, open-cells stent mounted on a rapid exchange delivery balloon catheter compatible with 0.014-in and 0.018-in guidewire. As a future

The pulsatility index and the resistive index in renal arteries. Associations with long-term progression in chronic renal failure

DEFF Research Database (Denmark)

Petersen, L J; Petersen, J R; Talleruphuus, U

1997-01-01

The pulsatility index (PI) and the resistive index (RI) are used as pulsed-wave Doppler measurements of downstream renal artery resistance. PI and RI have been found to correlate with renal vascular resistance, filtration fraction and effective renal plasma flow in chronic renal failure. The aim...... of the present study was to evaluate the potential relationship between these indices and the rate of decline in renal function, as reflected by changes in different parameters of renal function in patients with chronic renal failure....

The renal arterial resistive index and stage of chronic kidney disease in patients with renal allograft

DEFF Research Database (Denmark)

Winther, Stine O; Thiesson, Helle C; Poulsen, Lene N

2012-01-01

The study investigated the optimal threshold value of renal arterial resistive index as assessed by Doppler ultrasonography determining chronic kidney disease stage 4 or higher in patients with renal allograft.......The study investigated the optimal threshold value of renal arterial resistive index as assessed by Doppler ultrasonography determining chronic kidney disease stage 4 or higher in patients with renal allograft....

Dynamic CT of the renal parenchyma

International Nuclear Information System (INIS)

Ohyama, Yukio; Imanishi, Yoshimasa; Ishikawa, Tohru; Fujii, Masamichi; Uji, Teruyuki

1985-01-01

Normal renal dynamic CT findings of 57 cases were analysed in termes of sequential change of renal parenchymal CT image. Cortex, outer medulla and inner medulla were delineated and their sequential CT image was well correlated with the anatomicophysiological character of the kidney. Dynamic CT of 32 abnormal cases showed abnormal sequential CT findings explaining the mechanism of the abnormalities. Especially, delayed enhancement of renal cortex was noted in 17 of 19 kidneys with arterial obstruction and delayed enhancement of renal medulla in 22 of 25 cases with renal dysfunction. Compaired with excretory urography in 11 cases with renal dysfunction, advantage of dynamic CT were noted. (author)

Renal Infarction Caused by Spontaneous Renal Artery Dissection: Treatment with Catheter-Directed Thrombolysis and Stenting

International Nuclear Information System (INIS)

Jeon, Yong Sun; Cho, Soon Gu; Hong, Ki Cheon

2009-01-01

Spontaneous renal artery dissection (SRAD) is rare and presents a diagnostic and therapeutic challenge. We report a case of a 36-year-old man who had an SRAD-complicated renal infarction. The patient experienced severe unilateral flank pain. Enhanced abdominal computed axial tomography scan showed renal infarction, and urinalysis showed no hematuria. Selective renal angiography was essential to evaluate the extent of dissection and suitability for repair. The patient was treated with catheter-directed thrombolysis and frenal artery stenting.

Nuclear medicine in the management of renal vein thrombosis post renal transplantation - a case study

International Nuclear Information System (INIS)

Waran, L.; Unger, S.

2005-01-01

Renal scintigraphy allows the assessment of both perfusion and function of the transplanted kidney. Treatment of renal dysfunction depends on its cause. Nuclear medicine plays an important role in determining the cause of renal dysfunction, thereby providing appropriate intervention. Renal vein thrombosis (RVT) is a rare occurrence (1-2%) in renal transplants, and constitutes a surgical emergency. Early detection of RVT is critical in order to prevent infarction and subsequent loss of the graft. A 43-year-old woman with end stage renal disease as a result of diabetic nephropathy underwent transplantation of a living-related-donor kidney. The patient underwent a post operative Tc-MAG, scan that demonstrated good perfusion to the graft. Three days post-transplantation, the patient complained of acute pain and swelling. Creatinine increased from 0.13 to 0.16. and urine output decreased. The m Tc-MAG, scan revealed dramatic deterioration, with absent perfusion to the kidney. Immediate allograft exploration was performed in theatre and RVT was revealed, followed by thrombectomy. A follow-up renal scan performed the next day demonstrated a viable kidney with improved but patchy perfusion throughout, indicating patchy cortical infarction as well as acute tubular necrosis. On day 19. the patient again complained of severe pain over the graft, and the 99 mTc-MAG, scan again revealed absent perfusion, this time with residual function. Further surgical exploration confirmed re-thrombosis of the renal vein, and subsequent genetic analysis revealed that the patient had a rare mutation of her clotting Factor V gene, leading to an increased thrombogenic tendency. Following full anticoagulation, the patient was finally discharged on day 58. This case illustrates a rare case of renal allograft infarction secondary to renal vein thrombosis. The ability of nuclear medicine to provide immediate functional information helped confirm the diagnosis, and salvage the kidney

Validation of a Functional Pyelocalyceal Renal Model for the Evaluation of Renal Calculi Passage While Riding a Roller Coaster.

Science.gov (United States)

Mitchell, Marc A; Wartinger, David D

2016-10-01

The identification and evaluation of activities capable of dislodging calyceal renal calculi require a patient surrogate or validated functional pyelocalyceal renal model. To evaluate roller coaster facilitation of calyceal renal calculi passage using a functional pyelocalyceal renal model. A previously described adult ureteroscopy and renoscopy simulator (Ideal Anatomic) was modified and remolded to function as a patient surrogate. Three renal calculi of different sizes from the patient who provided the original computed tomographic urograph on which the simulator was based were used. The renal calculi were suspended in urine in the model and taken for 20 rides on the Big Thunder Mountain Railroad roller coaster at Walt Disney World in Orlando, Florida. The roller coaster rides were analyzed using variables of renal calculi volume, calyceal location, model position on the roller coaster, and renal calculi passage. Sixty renal calculi rides were analyzed. Independent of renal calculi volume and calyceal location, front seating on the roller coaster resulted in a passage rate of 4 of 24. Independent of renal calculi volume and calyceal location, rear seating on the roller coaster resulted in a passage rate of 23 of 36. Independent of renal calculi volume in rear seating, calyceal location differed in passage rates, with an upper calyceal calculi passage rate of 100%; a middle calyceal passage rate of 55.6%; and a lower calyceal passage rate of 40.0%. The functional pyelocalyceal renal model serves as a functional patient surrogate to evaluate activities that facilitate calyceal renal calculi passage. The rear seating position on the roller coaster led to the most renal calculi passages.

Impact of renal transplantation on erectile dysfunction due to chronic renal failure in male patients

International Nuclear Information System (INIS)

Ahmad, M.; Rafiudding, Q.; Ahmad, A.

2009-01-01

Erectile dysfunction can be defined as the persistent inability of man to achieve penile erection and maintain it sufficient for satisfactory coitus. The objectives of this study were to find out the impact of successful renal transplantation on the degree and frequency of erectile dysfunction. Thirty patients of end stage renal disease that were on regular haemodialysis and candidates of renal transplantation of age range 20-55 years were included in the study after getting informed consent. Erectile functions were assessed by history, examination, investigations and international index of erectile function (IIEF) before and 3 and 6 months after renal transplantation, other information regarding disease and patient were collected in the performa. Out of thirty patients 14 (46.6%) patients had sever erectile dysfunction while 16 (53.3%) patients had moderate erectile dysfunction in the pre renal transplantation period. After three months of renal transplantation 15 (50%) had severe erectile dysfunction, 6 (20%) patients moderate erectile dysfunction and 9 (30%) patients mild erectile dysfunction. After six months 11 (36.6%), 10 (33.3%) and 8 (26.6%) patients had severe, moderate and mild erectile dysfunction respectively. There was improvement in 40%, no change in 53.3% and deterioration in 6.6% patients in the erectile functions after getting renal transplantation for end stage renal disease. (author)

Renal artery stenosis.

Science.gov (United States)

Tafur-Soto, Jose David; White, Christopher J

2015-02-01

Atherosclerotic renal artery stenosis (RAS) is the single largest cause of secondary hypertension; it is associated with progressive renal insufficiency and causes cardiovascular complications such as refractory heart failure and flash pulmonary edema. Medical therapy, including risk factor modification, renin-angiotensin-aldosterone system antagonists, lipid-lowering agents, and antiplatelet therapy, is advised in all patients. Patients with uncontrolled renovascular hypertension despite optimal medical therapy, ischemic nephropathy, and cardiac destabilization syndromes who have severe RAS are likely to benefit from renal artery revascularization. Screening for RAS can be done with Doppler ultrasonography, CT angiography, and magnetic resonance angiography. Copyright © 2015 Elsevier Inc. All rights reserved.

Blood transfusion improves renal oxygenation and renal function in sepsis-induced acute kidney injury in rats.

Science.gov (United States)

Zafrani, Lara; Ergin, Bulent; Kapucu, Aysegul; Ince, Can

2016-12-20

The effects of blood transfusion on renal microcirculation during sepsis are unknown. This study aimed to investigate the effect of blood transfusion on renal microvascular oxygenation and renal function during sepsis-induced acute kidney injury. Twenty-seven Wistar albino rats were randomized into four groups: a sham group (n = 6), a lipopolysaccharide (LPS) group (n = 7), a LPS group that received fluid resuscitation (n = 7), and a LPS group that received blood transfusion (n = 7). The mean arterial blood pressure, renal blood flow, and renal microvascular oxygenation within the kidney cortex were recorded. Acute kidney injury was assessed using the serum creatinine levels, metabolic cost, and histopathological lesions. Nitrosative stress (expression of endothelial (eNOS) and inducible nitric oxide synthase (iNOS)) within the kidney was assessed by immunohistochemistry. Hemoglobin levels, pH, serum lactate levels, and liver enzymes were measured. Fluid resuscitation and blood transfusion both significantly improved the mean arterial pressure and renal blood flow after LPS infusion. Renal microvascular oxygenation, serum creatinine levels, and tubular damage significantly improved in the LPS group that received blood transfusion compared to the group that received fluids. Moreover, the renal expression of eNOS was markedly suppressed under endotoxin challenge. Blood transfusion, but not fluid resuscitation, was able to restore the renal expression of eNOS. However, there were no significant differences in lactic acidosis or liver function between the two groups. Blood transfusion significantly improved renal function in endotoxemic rats. The specific beneficial effect of blood transfusion on the kidney could have been mediated in part by the improvements in renal microvascular oxygenation and sepsis-induced endothelial dysfunction via the restoration of eNOS expression within the kidney.

Edad avanzada y factores de riesgo para infarto agudo de miocardio

Directory of Open Access Journals (Sweden)

M. A. Ciruzzi

2002-12-01

Full Text Available Este estudio caso-control analizó en los sujetos añosos el rol de los factores de riesgo coronario en el desarrollo del infarto agudo de miocardio (IAM, estableció la naturaleza de esta asociación y el grado de riesgo. Los datos fueron obtenidos en una investigación que incluyó 1060 casos y 1071 controles, realizada en 35 unidades coronarias de centros médicos de Argentina entre noviembre de 1991 y agosto de 1994. Nuestro análisis se basó en la información de los sujetos mayores de 65 años. Los casos fueron 427 pacientes con un primer IAM. Los controles fueron 396 sujetos sin evidencias clinicas de enfermedad cardiovascular, seleccionados en los mismos centros que los casos. Los Odds Ratios (OR y su intervalo de confianza del 95% (IC 95% se obtuvieron mediante un análisis de regresión logística, incluyendo variables como la edad, educación, clase social, tabaquismo, antecedente de diabetes o hipertensión arterial, índice de masa corporal e historia familiar de enfermedad coronaria. Los factores de riesgo relacionados independientemente con IAM fueron los siguientes: hipercolesterolemia (colesterol sérico > 240 mg/dl: OR=1.76 (IC 95%: 1.25-2.49, tabaquismo: OR=1.6 (IC 95%: 1.06-2.4, hipertensión arterial: OR=2.05 (IC 95%: 1.51-2.73, diabetes OR=1.71 (IC 95%: 1.12-2.70, historia de un familiar con enfermedad coronaria: OR=1.36 (IC 95%: 0.93-1.97 y de dos o más familiares: OR=2.63 (IC 95%: 1.21-5.71. Este estudio, confirma en los sujetos de edad avanzada la importancia de la hipercolesterolemia, del tabaquismo, la hipertesión arterial, la diabetes y la historia familiar de enfermedad coronaria como factores de riesgo de IAM

Management of chronic renal failure.

NARCIS (Netherlands)

de Zeeuw, D.; Apperloo, AJ; de Jong, P.

1992-01-01

There is growing evidence that treatment of patients with renal function impairment will undergo a major shift within the next few years. Along with more or less successful attempts to alleviate the signs and symptoms of reduced renal function, new insights into renal pathophysiology as well as new

Contrast-enhanced magnetic resonance angiography: evaluation of renal arteries in living renal transplant donors

International Nuclear Information System (INIS)

Firat, Ali; Akin, Oguz; Muhtesem Agildere, Ahmet; Aytekin, Cuneyt; Haberal, Mehmet

2004-01-01

One of the most important steps before living-donor nephrectomy is assessment of renal vascular anatomy. The number, origins and lengths of the renal arteries and variations of renal veins must be determined in order to identify the kidney that is most suitable for transplantation. Digital subtraction angiography was long considered the standard procedure for this purpose, but this method has been replaced by non-invasive techniques. Contrast-enhanced magnetic resonance angiography is an accurate, safe and reliable method for imaging vasculature. This article reviews the technique and the clinical features of this method in the evaluation of living renal transplant donors

Contrast-enhanced magnetic resonance angiography: evaluation of renal arteries in living renal transplant donors

Energy Technology Data Exchange (ETDEWEB)

Firat, Ali; Akin, Oguz; Muhtesem Agildere, Ahmet; Aytekin, Cuneyt; Haberal, Mehmet

2004-10-01

One of the most important steps before living-donor nephrectomy is assessment of renal vascular anatomy. The number, origins and lengths of the renal arteries and variations of renal veins must be determined in order to identify the kidney that is most suitable for transplantation. Digital subtraction angiography was long considered the standard procedure for this purpose, but this method has been replaced by non-invasive techniques. Contrast-enhanced magnetic resonance angiography is an accurate, safe and reliable method for imaging vasculature. This article reviews the technique and the clinical features of this method in the evaluation of living renal transplant donors.

Efecto de un tratamiento agudo con norgestomet en la dinámica folicular de vacas Cebú x Holstein sincronizadas con implantes de norgestomet y eCG

Directory of Open Access Journals (Sweden)

R. Páez

2005-01-01

Full Text Available El objetivo del presente estudio fue evaluar el efecto de una inyección de norgestomet en la dinámica folicular de vacas Cebú x Holstein sincronizadas con implantes de norgestomet. Se utilizaron 50 vacas en lactación con más de 60 días posparto, las cuales recibieron un implante de 3 mg de norgestomet y una dosis luteolítica de PGF2a (día cero. El día cinco, a 25 vacas (grupo Norg, se les administraron 1.8 mg de norgestomet intramuscular (IM y 25 vacas (grupo testigo, recibieron 3 ml de solución salina. El noveno día se retiró el implante, se realizó un destete temporal por 72 h y los animales fueron divididos al azar dentro de sus tratamientos para recibir (n = 23 o no (n = 27 500 UI de eCG. Posteriormente, las vacas fueron observadas durante cinco días en forma continua para la detección de signos de estro. Se realizaron diariamente ecografías de los ovarios desde el día de la inserción del implante hasta la presentación de estro. El tratamiento agudo con norgestomet provocó recambio del folículo dominante (FD en 40% (10/25 de las vacas, contra 16% (4/25 del grupo testigo (P 0.05 el porcentaje de vacas que presentaron estro ni el tiempo de presentación del mismo. Se concluye que el tratamiento agudo con norgestomet, durante la sincronización del estro con progestágenos, provoca atresia y recambio folicular. Sin embargo, este efecto depende de la etapa de desarrollo del folículo dominante al momento del tratamiento.

Acute renal failure after rifampicin

Directory of Open Access Journals (Sweden)

Adriana Weinberg

1984-12-01

Full Text Available A patient with miliary tuberculosis and a chronic urogenital focus is described, who had a borderline renal function at diagnosis and developed overt renal failure upon daily treatment with rifampin (RMP, isoniazid (INH and ethambutol (EMB. This is the first Brazilian report of BMP induced renal damage. A renal biopsy taken on the third day of oliguria showed recent tubular necrosis with acute interstitial inflammation and granuloma formation. The aspect of the granulomatous lesion hightly suggested drug etiology because of the lack of palisading, high incidence of neutrophils and absence of facid-fast bacilli. This is the first presentation of an acute granulomatous interstitial nephritis probably due to RMP. Furthermore the pathogenesis of the renal damage caused by tuberculosis and RMP are discussed.

Renal manifestations of primary hyperparathyroidism

Directory of Open Access Journals (Sweden)

Anurag Ranjan Lila

2012-01-01

Full Text Available Primary hyperparathyroidism (PHPT is associated with nephrolithiasis and nephrocalcinosis. Hypercalciuria is one of the multiple factors that is implicated in the complex pathophysiology of stone formation. The presence of a renal stone (symptomatic or asymptomatic categorizes PHPT as symptomatic and is an indication for parathyroid adenomectomy. Progression of nephrocalcinosis is largely reversible after successful surgery, but the residual risk persists. PHPT is also associated with declining renal function. In case of asymptomatic mild PHPT, annual renal functional assessment is advised. Guidelines suggest that an estimated glomerular filtration rate (eGFR < 60 ml / minute / 1.73 m 2 is an indication for parathyroid adenomectomy. This article discusses how to monitor and manage renal stones and other related renal parameters in case of PHPT.

[Kidney function and renal cancer surgery].

Science.gov (United States)

Izzedine, Hassan; Méjean, Arnaud; Escudier, Bernard

2014-02-01

Although radical nephrectomy is still practiced in many patients with large renal tumors, oncology and nephrology arguments for kidney-sparing approach for small renal masses has taken over this first. Indeed, partial nephrectomy provides equivalent oncologic results while preserving renal function and thereby limit morbidity and cardiovascular mortality related to chronic kidney disease. In addition, patients who develop kidney cancer often have medical comorbidities that may affect renal function, such as diabetes and hypertension. Histological examination of renal tissue adjacent to the tumor showed significant pathological changes in the majority of patients. For elderly patients or patients with comorbidities, active surveillance allows kidney-sparing approach with extremely low rates of progression and metastasis of cancer disease. Despite these significant advances in understanding for the treatment of small renal masses, partial nephrectomy remains underused. Better management must take into account the preservation of renal function in order to increase overall survival. A strategy for the systematic evaluation of renal function in patients with CR, with multidisciplinary staff (nephrologist urologist and oncologist), is therefore highly desirable.

Acute gastric volvulus: report of a case Vólvulo gástrico agudo: etiopatogénesis, diagnóstico y tratamiento

Directory of Open Access Journals (Sweden)

Sergio Hoyos

1997-03-01

Full Text Available This paper presents a case of acute gastric volvulus related to diaphragmatic elevation due to a lung resection performed twenty eight years before, as a consequence of pulmonary tuberculosis. Gastric volvulus is rarely found; the disorder is usually chronic and originales from concurrent diaphragmatic defects or derangements. Pathogenesis and diagnosis of acute gastric volvulus as well as different treatment alternatives are discussed. Se presenta un caso de vólvulo gástrico agudo asociado a elevación del diafragma, secundaria a una neumonectomía practicada 28 años antes por tuberculosis pulmonar. El vólvulo gástrico es una entidad clínica poco frecuente que ocurre, en general, en forma crónica y secundaria a patología diafragmática. Se discuten la etiopatogénesis, el diagnóstico y las diferentes alternativas de tratamiento en pacientes con esta entidad.

Aneurisma da Artéria Renal: caso clínico Renal Artery Aneurysm

Directory of Open Access Journals (Sweden)

Joana Moreira

2011-12-01

Full Text Available Apresenta-se o caso clínico de um doente com volumoso aneurisma da artéria renal esquerda. Do sexo masculino, de 22 anos de idade, com lombalgia à esquerda com algumas semanas de evolução. Recorreu ao médico assistente que solicitou estudo imagiológico por ecografia abdominal. Detectada imagem sugestiva de aneurisma da aorta abdominal. Este achado motivou a transferência para o nosso Hospital onde foi admitido consciente e orientado, hemodinamicamente estável, apresentando uma massa pulsátil epigástrica, com frémito e sopro sistólico à auscultação. Angio-TC revelou um aneurisma da artéria renal esquerda com 16 cm de diâmetro. Dada a estabilidade clínica e topografia lesional optou-se por tentar embolizar, sem sucesso, o tronco da artéria renal esquerda antes da abordagem cirúrgica. O doente foi então submetido a Nefrectomia total esquerda por via toraco-abdominal. Pós-operatório sem complicações, locais ou sistémicas. Alta ao 8ºdia, mantendo boa função renal e com níveis normais de hemoglobina. Diagnóstico de aneurisma da artéria renal confirmado por estudo anátomo-patológico da peça operatória.One case of a large left renal artery aneurysm in a young patient 22 years old is presented. He appealed to his assistant physician a few weeks after development of left back pain. Abdominal ultrasound imaging study has been requested. Suggestive abdominal aortic aneurysm was detected. This finding led to the transfer to our hospital where he was admitted conscious and hemodynamically stable. A pulsatile epigastric mass with a systolic murmur on auscultation and thrill were detected. Angio-CT scan revealed a left renal artery aneurysm, 16 cm in diameter. Given the clinical stability and lesional topography we decide a previous embolization of left renal artery, unsuccessfully. The patient underwent then left total nephrectomy, through thoraco-abdominal incision. No local or systemic complications in the postoperative

Preoperative transcatheter renal artery embolization with absolute alcohol for the treatment of renal carcinoma: a clinical efficacy analysis

International Nuclear Information System (INIS)

Shang Mingyi; Wang Guoliang; Han Hongjie; Xi Qian; Huang Zongliang; Tang Junjun; Gao Xiaolong; Wang Peijun; Lu Ying; Xu Weiguo

2010-01-01

Objective: To access the effectiveness of preoperative transcatheter renal artery embolization with absolute alcohol performed before nephrectomy in treating renal carcinoma. Methods: Preoperative transcatheter renal artery embolization with absolute alcohol was performed in 32 patients with renal carcinoma. The renal arteries of the diseased side were progressively occluded, from distal small branches to proximal larger ones, and the renal artery trunk was embolized with gelatin sponge. Radical nephrectomy was carried out 2-5 days after the embolization procedure. The resectional rate of the tumor, the blood loss during the surgery and the operation time were recorded and analyzed. Results: Angiography performed immediately after the embolization showed that complete embolization of the main renal artery was achieved in all 32 patients. The resectional rate of the tumor was 100%. During the surgery, shrinkage of tumor, collapse of renal superficial veins and marked perinephric edema were observed. The blood loss during the surgery was much less and the operation time cost was much shorter than a usual nephrectomy did. Conclusion: The preoperative transcatheter renal artery embolization with absolute alcohol is an effective therapeutic means for renal carcinoma, it can definitely reduce the surgical blood loss and shorten the operative time. (authors)

Primary renal synovial sarcoma

Directory of Open Access Journals (Sweden)

Girish D. Bakhshi

2012-03-01

Full Text Available Primary Renal Sarcoma is rare tumor comprising only 1% of all renal tumours. Synovial sarcomas are generally deep-seated tumors arising in the proximity of large joints of adolescents and young adults and account for 5-10% of all soft tissue tumours. Primary synovial sarcoma of kidney is rare and has poor prognosis. It can only be diagnosed by immunohistochemistry. It should be considered as a differential in sarcomatoid and spindle cell tumours. We present a case of 33-year-old female, who underwent left sided radical nephrectomy for renal tumour. Histopathology and genetic analysis diagnosed it to be primary renal synovial sarcoma. Patient underwent radiation therapy and 2 years follow up is uneventful. A brief case report with review of literature is presented.

Lithium and Renal Impairment

DEFF Research Database (Denmark)

Nielsen, René Ernst; Kessing, Lars Vedel; Nolen, Willem A

2018-01-01

INTRODUCTION: Lithium is established as an effective treatment of mania, of depression in bipolar and unipolar disorder, and in maintenance treatment of these disorders. However, due to the necessity of monitoring and concerns about irreversible adverse effects, in particular renal impairment......, after long-term use, lithium might be underutilized. METHODS: This study reviewed 6 large observational studies addressing the risk of impaired renal function associated with lithium treatment and methodological issues impacting interpretation of results. RESULTS: An increased risk of renal impairment...... associated with lithium treatment is suggested. This increased risk may, at least partly, be a result of surveillance bias. Additionally, the earliest studies pointed toward an increased risk of end-stage renal disease associated with lithium treatment, whereas the later and methodologically most sound...

CUTANEOUS MANIFESTATIONS OF CHRONIC RENAL FAILURE AND RENAL TRANSPLANTATION

OpenAIRE

R. Suganya Gnanadeepam; S. Kayalvizhi Money

2017-01-01

BACKGROUND The kidney and the skin are the two large networks of the body with abundant blood supply associated with various cutaneous manifestations. This study aims to detect the various cutaneous manifestations and its incidence in patients with chronic renal failure and renal transplantation. MATERIALS AND METHODS This study was done for a period of 1 year from January 2016 to December 2016 at Nephrology OPD ward and Medicine wards, Government KAPV Medical College Hos...

Comparative assessment of renal Tc-99m DMSA scan and renal sonography findings in complication of urinary tract infections

International Nuclear Information System (INIS)

Alavi, M.; Rasekhi, A.

2002-01-01

Urinary tract infection is a common disease in childhood specially in female. In this study 50 patients with established diagnosis of urinary tract infection were evaluated by both renal scan with Tc-99m DMSA and renal sonography. The study revealed that most urinary tract infections are in children, female sex between 5-9 years of age. Therefore the most important complications (renal scarring) are also common in this age-sex distribution. Occurrence of renal scars increase with increasing the number of recurrent infections. Vesicoureteral reflux is one of the most important, common risk factors for renal scarring. Renal Tc-99m Dmsa scan is more sensitive than renal sonography in detecting the renal scars

Bone scan appearance of renal osteodystrophy in diabetic chronic renal failure patients

International Nuclear Information System (INIS)

So, Young; Hyun, In Young; Lee, Dong Soo; Ahn, Curie; Chung, June-Key; Kim, Suhnggwon; Lee, Myung Chul; Lee, Jung Sang; Koh, Chang-Soon

1998-01-01

To investigate Tc-99m methylenediphosphonate (MDP) bone scan appearance in diabetic chronic renal failure patients, we compared the bone scan images of chronic renal failure patients with and without diabetes. The number of patients studied was 134, of whom 43 had diabetes. Two nuclear medicine physicians read Tc-99m MDP bone scan images and for six areas - the axial skeleton, long bone, skull and mandible, periarticular areas, costochondral junction, and sternum - assigned a score of either 1 or 0. The sums of scores were compared. We also performed multivariate analysis including sex, age, and serum creatinine level using analysis of covariance. DM group patients scored significantly lower (2.01±0.95) than those of the non-DM group (3.26±1.16). Analysis of covariance revealed that the lower DM group score was independent of sex, age, and serum creatinine level. The bone scans of diabetic chronic renal failure patients showed less Tc-99m MDP uptake than those of non-diabetic patients. Thus, diagnosing renal osteodystrophy in diabetic chronic renal failure patients on bone scan images could be difficult. (author)

Renal Hemangiopericytoma

Directory of Open Access Journals (Sweden)

İbrahim Halil Bozkurt

2015-03-01

Full Text Available Hemangiopericytoma is an uncommon perivascular tumor originating from pericytes in the pelvis, head and tneck, and the meninges; extremely rarely in the urinary system. We report a case of incidentally detected renal mass in which radiologic evaluation was suggestive of renal cell carcinoma. First, we performed partial nephrectomy, and then, radical nephrectomy because of positive surgical margins and the pathological examination of the surgical specimen that revealed a hemangiopericytoma. No additional treatment was administered.

Noninvasive method using multidetector CT for calculating the relative blood supply ratio of duplicated renal arteries in renal donors

International Nuclear Information System (INIS)

Kuwabara, Masatomo; Kim, Tonsok; Nakamura, Hironobu; Narumi, Yoshifumi; Takahashi, Satoru; Sato, Yoshinobu; Murakami, Takamichi

2006-01-01

The aim of this study was to evaluate the correlation between the renal artery cross-sectional area measured by multidetector computed tomography (MDCT) and the nephrogram area calculated by renal arteriography in potential living renal donors with duplicated renal arteries. Medical records of 18 patients with duplicated renal arteries who underwent both MDCT angiography and renal arteriography between 2001 and 2003 were retrospectively reviewed. All 20 kidneys were evaluated. Renal artery cross-sectional areas were measured using the workstation to which the CT data were transferred; the nephrogram areas on the digitized angiographic images were calculated using public domain software. Bland-Altman analysis was performed to compare the cross-sectional area ratio of the accessory arteries to the main renal arteries, with the ratios obtained from the nephrogram areas calculated from the arteriograms. The mean cross-sectional areas of the accessory and main renal arteries were 6.78 and 20.9 mm 2 , respectively. The ratio of the nephrogram areas calculated from the arteriograms ranged from 0.094 to 0.809. Bland-Altman analysis showed no significant difference. It is possible to predict the supply volume of accessory renal arteries by measuring the cross-sectional area of the accessory and main renal arteries in potential living renal donors. (author)

Hyperdense renal masses: a CT manifestation of hemorrhagic renal cysts

International Nuclear Information System (INIS)

Sussman, S.; Cochran, S.T.; Pagani, J.J.; McArdle, C.; Wong, W.; Austin, R.; Curry, N.; Kelly, K.M.

1984-01-01

Eleven patients with sharply circumscribed round to ovoid renal cysts measuring 70-90 H on CT are reported. The cysts were hyperdense on unenhanced scans, measuring 30-60 H greater than the adjacent parenchyma, and either hypodense, isodense, or hyperdense on enhanced scans. Four patients had polycystic kidney disease; of the other 7 patients, the cysts were cortical in 6 and parapelvic in 1. Eight patients had a solitary cyst and 3 had multiple cysts. Sonography demonstrated internal echoes and/or lack of increased through-transmission in 6 patients. Pathological analysis was available in 6 cases and indicated a benign, hemorrhagic renal cyst. This hyperdense CT appearance is characteristic of some hemorrhagic renal cysts, though differentiation between benign and malignant cysts requires cyst puncture and/or surgery

Terapia trombolítica en pacientes con infarto agudo de miocardio en Cienfuegos

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Lázaro Abilio Hernández Rodríguez

2014-03-01

Full Text Available Fundamento: el tratamiento trombolítico practicado a menos de dos horas, tras el inicio del infarto tiene resultados similares a la reperfusión mecánica. Objetivo: describir aspectos relevantes de la terapia trombolítica en pacientes con infarto agudo de miocardio con elevación del segmento ST en Cienfuegos. Métodos: estudio descriptivo, prospectivo, en 225 pacientes egresados (vivos y fallecidos desde el 1o de abril de 2012 al 31 marzo de 2013, de la Unidad de Cuidados Integrales del Corazón y la Unidad de Cuidados Intensivos Polivalentes, del Hospital Dr. Gustavo Aldereguía Lima. Las variables estudiadas se obtuvieron de la revisión de las historias clínicas e incluyeron: variables demográficas y clínicas, tiempos de demora, sitio, motivo de exclusión y nivel de prioridad para la trombolisis. Resultados: la media de edad superó los 60 años. Predominaron los hombres, hipertensos y de alto riesgo según la escala GRACE. El 29,7 % de los pacientes no recibió terapia trombolítica, debido mayormente al factor tiempo y la mayoría (82,3 % se trató en el Hospital. Las medianas de los tiempos de demora: síntomas-puerta, puerta-droga y síntomas-droga fueron 90, 35 y 140 minutos respectivamente. Conclusiones: la trombolisis extrahospitalaria acorta el tiempo total de isquemia, pero pocos pacientes se beneficiaron de ella. Los retrasos para la terapia trombolítica en Cienfuegos continúan por encima de los estándares requeridos.

Stent sizing strategies in renal artery stenting: the comparison of conventional invasive renal angiography with renal computed tomographic angiography.

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Kadziela, Jacek; Michalowska, Ilona; Pregowski, Jerzy; Janaszek-Sitkowska, Hanna; Lech, Katarzyna; Kabat, Marek; Staruch, Adam; Januszewicz, Andrzej; Witkowski, Adam

2016-01-01

Randomized trials comparing invasive treatment of renal artery stenosis with standard pharmacotherapy did not show substantial benefit from revascularization. One of the potential reasons for that may be suboptimal procedure technique. To compare renal stent sizing using two modalities: three-dimensional renal computed tomography angiography (CTA) versus conventional angiography. Forty patients (41 renal arteries), aged 65.1 ±8.5 years, who underwent renal artery stenting with preprocedural CTA performed within 6 months, were retrospectively analyzed. In CTA analysis, reference diameter (CTA-D) and lesion length (CTA_LL) were measured and proposed stent diameter and length were recorded. Similarly, angiographic reference diameter (ANGIO_D) and lesion length (ANGIO_LL) as well as proposed stent dimensions were obtained by visual estimation. The median CTA_D was 0.5 mm larger than the median ANGIO_D (p < 0.001). Also, the proposed stent diameter in CTA evaluation was 0.5 mm larger than that in angiography (p < 0.0001). The median CTA_LL was 1 mm longer than the ANGIO_LL (p = NS), with significant correlation of these variables (r = 0.66, p < 0.0001). The median proposed stent length with CTA was equal to that proposed with angiography. The median diameter of the implanted stent was 0.5 mm smaller than that proposed in CTA (p < 0.0005) and identical to that proposed in angiography. The median length of the actual stent was longer than that proposed in angiography (p = 0.0001). Renal CTA has potential advantages as a tool adjunctive to angiography in appropriate stent sizing. Careful evaluation of the available CTA scans may be beneficial and should be considered prior to the planned procedure.

Renal I-131-hippurate clearance overestimates true renal blood flow in the instrumented conscious dog

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Visscher, CA; DeZeeuw, D; Navis, G; VanZanten, AK; DeJong, PE; Huisman, RM

We evaluated renal I-131-hippurate clearance (ERPF(hip)) as a measure of renal blood flow (RBF) in chronically instrumented conscious dogs. When adjusted for renal hippurate extraction (E(hip), 0.77 +/- 0.01) and hematocrit (Hct, 39.7 +/- 1%), calculated RBF(hip) (656 +/- 37 ml/min) markedly

Recirculation zone length in renal artery is affected by flow spirality and renal-to-aorta flow ratio.

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Javadzadegan, Ashkan; Fulker, David; Barber, Tracie

2017-07-01

Haemodynamic perturbations such as flow recirculation zones play a key role in progression and development of renal artery stenosis, which typically originate at the aorta-renal bifurcation. The spiral nature of aortic blood flow, division of aortic blood flow in renal artery as well as the exercise conditions have been shown to alter the haemodynamics in both positive and negative ways. This study focuses on the combinative effects of spiral component of blood flow, renal-to-aorta flow ratio and the exercise conditions on the size and distribution of recirculation zones in renal branches using computational fluid dynamics technique. Our findings show that the recirculation length was longest when the renal-to-aorta flow ratio was smallest. Spiral flow and exercise conditions were found to be effective in reducing the recirculation length in particular in small renal-to-aorta flow ratios. These results support the hypothesis that in renal arteries with small flow ratios where a stenosis is already developed an artificially induced spiral flow within the aorta may decelerate the progression of stenosis and thereby help preserve kidney function.

Linfoma renal: espectro de imagens na tomografia computadorizada Renal lymphoma: spectrum of computed tomography findings

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Carol Pontes de Miranda Maranhão

2005-04-01

Full Text Available O acometimento renal no linfoma é raro, uma vez que o rim não possui tecido linfóide. O envolvimento secundário é mais freqüente, ocorrendo em até um terço das autópsias dos portadores de linfoma. Alguns autores acreditam que esta seja a única forma de acometimento renal, questionando a existência do linfoma primário. O linfoma renal representaria metástases hematogênicas ou invasão direta do tumor ocorrendo no espaço perirrenal. A partir destes tipos de envolvimento decorrem as formas de apresentação do linfoma renal: múltiplos nódulos, massa solitária, invasão renal por doença retroperitoneal contígua, doença perirrenal e infiltração difusa. Neste trabalho são discutidas e apresentadas imagens destas diferentes formas de acometimento.Isolated renal lymphoma is rare due to the absence of lymphoid tissue in kidneys. Secondary involvement occurs more frequently and is reported in up to 1/3 of the autopsies of patients who died from lymphoma. Some authors believe this is actually the only existing form of renal lymphoma. The involvement of the kidney by lymphoma would occur through hematogenic metastasis or direct tumor invasion of the perirenal space. These different types of involvement determine the several forms of renal lymphoma presentation: multiple nodules, solitary mass, renal invasion from contiguous retroperitoneal disease, perirenal disease and diffuse infiltration. In this study the imaging findings features of the different forms of involvement are presented and discussed.

General Information about Renal Cell Cancer

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... Tumors Treatment Genetics of Kidney Cancer Research Renal Cell Cancer Treatment (PDQ®)–Patient Version General Information About Renal Cell Cancer Go to Health Professional Version Key Points Renal ...

Treatment Option Overview (Renal Cell Cancer)

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... Tumors Treatment Genetics of Kidney Cancer Research Renal Cell Cancer Treatment (PDQ®)–Patient Version General Information About Renal Cell Cancer Go to Health Professional Version Key Points Renal ...

Acute renal insufficiency and renal replacement therapy after pediatric cardiopulmonary bypass surgery

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Kist-van Holthe tot Echten, J. E.; Goedvolk, C. A.; Doornaar, M. B.; van der Vorst, M. M.; Bosman-Vermeeren, J. M.; Brand, R.; van der Heijden, A. J.; Schoof, P. H.; Hazekamp, M. G.

2001-01-01

The aim of the study was to investigate renal function and renal replacement therapy after cardiopulmonary bypass surgery in children. Patient characteristics (sex, age, diagnosis), operation type, and death were listed. The study was performed retrospectively using serum creatinine level before,

Infra-renal angles, entry into inferior vena cava and vertebral levels of renal veins.

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Satyapal, K S

1999-10-01

Current norms for renal vasculature hold true in only half the population. Standard textbooks perpetuate old misconceptions regarding renal venous anatomy. This study is aimed to determine left and right infra-renal angles (L-IRA, R-IRA); entry level of renal veins into the inferior vena cava (IVC), and height of IVC under renal vein influence; and their vertebral level. One hundred morphologically normal en-bloc renal specimens randomly selected from post-mortem examinations were dissected and resin casted. IRA were also measured from venograms of 32 adult and 11 foetal cadavers, as were vertebral entry levels. IRA measurements (degrees) were as follows: left, 55 degrees +/- 16 degrees (20 degrees -102 degrees ); right, 60 degrees +/- 17 degrees (10 degrees -93 degrees ). Left vein entered IVC higher than right 54%, lower 36%, and opposite each other 10%. Vertical distance between lower borders of veins was 1.0 +/- 0.9 cm. Vertical distance of IVC under renal vein influence was 2.3 +/- 1.0 cm. Vertebral level of veins in adults lies between TI2-L2. In foetuses, IRA was as follows: left, 65 degrees +/- 12 degrees (45 degrees -90 degrees ); right, 58 degrees +/- 7 degrees (40 degrees -70 degrees ); vertebral level between T12 and L3. Similar IRA values from literature noted on right, 51 degrees (26 degrees -100 degrees ); differences on left, 77 degrees (43 degrees -94 degrees ), clearly differing from Williams et al. (Gray's Anatomy, 37(th) ed, 1989) statement that renal veins "open into the inferior vena cava almost at right angles." Large variations of IRA are not surprising since kidneys are considered normally "floating viscera," varying position with posture and respiratory movement as well as in live vs. cadaveric subjects. The entry level into the IVC also differs from Williams et al. This study uniquely quantitated actual height difference between lower borders of left and right veins. The data presented appears to be the first documentation of vertebral

Angiography for renal artery stenosis: no additional impairment of renal function by angioplasty

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Lufft, Volkmar; Fels, Lueder M.; Egbeyong-Baiyee, Daniel; Olbricht, Christoph J. [Abteilung Nephrologie, Medizinische Hochschule Hannover (Germany); Hoogestraat-Lufft, Linda; Galanski, Michael [Abteilung Diagnostische Radiologie, Medizinische Hochschule Hannover (Germany)

2002-04-01

The aim of this study was to compare renal function between patients with renal angiography and patients with renal angiography and angioplasty (AP) for renal artery stenosis (RAS). Forty-seven patients with suspected RAS were prospectively investigated by digital subtraction angiography (DSA) using non-ionic low osmolar contrast media (CM). In 22 patients RAS was detected and in 16 cases an angioplasty was performed in the same session. The following parameters were determined 1 day prior to and after the DSA, respectively: serum creatinine (S-Crea, {mu}mol/l) and single-shot inulin clearance (In-Cl, ml/min) for the evaluation of renal function; and urine alpha 1-microglobuline (AMG, {mu}g/g Crea) and beta-N-acetyl-glucoseaminidase (beta-NAG, U/g Crea) as markers of tubular toxicity. Serum creatinine was measured additionally 2 days after CM had been injected. In both groups with and without AP 174{+-}65 and 104{+-}56 ml of CM (p<0.0005) were used, respectively. There were no differences with regard to renal function or risk factors for CM nephrotoxicity between both groups. In the group with AP S-Crea and In-Cl (each: mean{+-}SD) did not change significantly (before DSA: 171{+-}158 and 61{+-}24, after DSA: 189{+-}177 and 61{+-}25, respectively), beta-NAG (median) rose from 4 to 14 (p<0.05) and AMG from 8 to 55 (n.s., because of high SD). In the group without AP S-Crea increased from 134{+-}109 to 141{+-}113 (p<0.01), In-Cl dropped from 65{+-}26 to 62{+-}26 (p<0,01), beta NAG (median) rose from 4 to 8 (p=0.01), and AMG from 7 to 10 (n.s.). A rise in baseline S-Crea by more than 25% or 44 {mu}mol/l occurred in 4 and 2 patients in the group with and without AP, respectively. Creatinine increase was reversible in all cases within 7 days. In this study using sensitive methods to detect changes of renal function and tubular toxicity no additional renal function impairment in DSA with angioplasty for RAS compared with DSA alone could be demonstrated. Our data suggest

Power doppler ultrasound findings of renal infarct after experimental renal artery occlusion: comparison with spiral CT

International Nuclear Information System (INIS)

Jung, Seung Eun; Shinn, Kyung Sub; Kim, Hak Hee; Mun, Seok Hwan; Lee, Young Joon; Lee, Bae Young; Choi, Byung Gil; Lee, Jae Mun; Lee, Hee Jeong

1999-01-01

To evaluate the efficacy of power Doppler ultrasonography (PDUS) in depicting renal infarction in rabbits during experimental renal segmental arterial occlusion, and to compare the results with those of CT scanning. In 28 rabbits weighing 2.5 4kg, the segmental renal artery was occluded through the left main renal artery by embolization with Ivalon (Nycomed, Paris, France). Power Doppler ultrasonography and spiral CT scanning were performed before and at 2, 5, 8, 15, and 24 hours, and 3 and 7 days after occlusion of the segmental renal artery. The location of infarcted areas and collaterals, as seen on PDUS and CT scans, was evaluated by two radiologists. In all cases, as seen on power Doppler ultrasonography, infarcted areas-when compared with normal parenchyma, clearly demonstrated wedge-shaped perfusion defects in the kidney. The location of the lesion closely corresponded to the location seen during CT scanning. After renal arterial occlusion, transiently congested capsular arteries, which were named 'capsular sign', were seen in 63% of rabbits in the two and five-hour groups. No significant cortical rim sign was demonstrated on power Doppler ultrasonography, though it was noted on spiral CT at 15 and 24 hours, and 3 and 7 days after renal arterial occlusion. Power Doppler ultrasonography was useful for the diagnosis of renal infarction. Congested capsular artery seen in the early stage of renal infarction might be a characteristic finding of this condition, as seen on power Doppler ultrasonography

Doppler Flow Wire Evaluation of Renal Blood Flow Reserve in Hypertensive Patients with Normal Renal Arteries

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Beregi, Jean-Paul; Mounier-Vehier, Claire; Devos, Patrick; Gautier, Corinne; Libersa, Christian; McFadden, Eugene P.; Carre, Alain

2000-01-01

Purpose: To study the vasomotor responses of the renal microcirculation in patients with essential hypertension.Methods: We studied the reactivity of the renal microcirculation to papaverine, with intraarterial Doppler and quantitative arteriography, in 34 renal arteries of 19 hypertensive patients without significant renal artery stenosis. Isosorbide dinitrate was given to maximally dilate proximal renal arteries. APV (average peak blood flow velocity) was used as an index of renal blood flow.Results: Kidneys could be divided into two distinct subgroups based on their response to papaverine. An increase in APV of up to 55% occurred in 21 kidneys, an increase > 55% in 13 kidneys. Within each group the values were normally distributed. Both baseline APV and the effect of papaverine on mean velocity differed significantly between groups.Conclusion: There seems to be a subgroup of patients with essential hypertension that has an impaired reactivity to papaverine, consistent with a functional impairment of the renal microcirculation. Further studies are required to determine whether this abnormality contributes to or results from elevated blood pressure

Renal autotransplantation--a possibility in the treatment of complex renal vascular diseases and ureteric injuries.

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Hau, Hans Michael; Bartels, Michael; Tautenhahn, Hans-Michael; Morgul, Mehmet Haluk; Fellmer, Peter; Ho-Thi, Phuc; Benckert, Christoph; Uhlmann, Dirk; Moche, Michael; Thelen, Armin; Schmelzle, Moritz; Jonas, Sven

2012-12-31

We report our contemporary experiences with renal autotransplantation in patients with complicated renal vascular diseases and/or complex ureteral injuries. Since its first performance, renal autotransplantation has been steadily improved and become a safe and effective procedure. Between 1998 and 2006, 6 renal autotransplantations in 6 patients were performed at the University Medical Center of Leipzig. After nephrectomy and renal perfusion ex vivo, the kidney was implanted standardized in the fossa iliaca. The vessels were anastomized to the iliac vessels, the ureter was reimplanted in an extravesical tunneled ureteroneocystostomy technique according to Lich-Gregoir. Demographic, clinical, and laboratory data of the patients were collected and analyzed for pre-, intra-, and postoperative period. Indications for renal autotransplantation were complex renovascular diseases in 2 patients (1 with fibromuscular dysplasia and 1 with Takayasu's arteritis) and in 4 patients with complex ureteral injuries. The median duration of follow-up was 9.7 years (range: 5.6-13.3). The laboratory values of our 6 patients showed improvements of creatinine, urea and blood pressure levels in comparison to the preoperative status at the end of follow-up period. The present study reports excellent results of renal autotransplantation in patients with renovascular disease or complex ureteric injuries. After a median follow-up of 9.7 years all 6 patients present with stable renal function as well as normal blood pressure values. Postoperative complications were observed with a rate comparable to other studies.

Reinnervation following catheter-based radio-frequency renal denervation.

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Booth, Lindsea C; Nishi, Erika E; Yao, Song T; Ramchandra, Rohit; Lambert, Gavin W; Schlaich, Markus P; May, Clive N

2015-04-20

What is the topic of this review? Does catheter-based renal denervation effectively denervate the afferent and efferent renal nerves and does reinnervation occur? What advances does it highlight? Following catheter-based renal denervation, the afferent and efferent responses to electrical stimulation were abolished, renal sympathetic nerve activity was absent, and levels of renal noradrenaline and immunohistochemistry for tyrosine hydroxylase and calcitonin gene-related peptide were significantly reduced. By 11 months after renal denervation, both the functional responses and anatomical markers of afferent and efferent renal nerves had returned to normal, indicating reinnervation. Renal denervation reduces blood pressure in animals with experimental hypertension and, recently, catheter-based renal denervation was shown to cause a prolonged decrease in blood pressure in patients with resistant hypertension. The randomized, sham-controlled Symplicity HTN-3 trial failed to meet its primary efficacy end-point, but there is evidence that renal denervation was incomplete in many patients. Currently, there is little information regarding the effectiveness of catheter-based renal denervation and the extent of reinnervation. We assessed the effectiveness of renal nerve denervation with the Symplicity Flex catheter and the functional and anatomical reinnervation at 5.5 and 11 months postdenervation. In anaesthetized, non-denervated sheep, there was a high level of renal sympathetic nerve activity, and electrical stimulation of the renal nerve increased blood pressure and reduced heart rate (afferent response) and caused renal vasoconstriction and reduced renal blood flow (efferent response). Immediately after renal denervation, renal sympathetic nerve activity and the responses to electrical stimulation were absent, indicating effective denervation. By 11 months after denervation, renal sympathetic nerve activity was present and the responses to electrical stimulation

Imaging of Renal Leiomyomas

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Derchi, L. E.; Grenier, N.; Heinz-Peer, G.; Dogra, V.; Franco, F.; Rollandi, G. A.; Deminiere, C. (Radiologia - DICMI, Univ. di Genova, Genova (Italy))

2008-09-15

Background: Renal leiomyomas are rare benign tumors of the kidney which can be found at autopsy as small capsular nodules in about 5% of cases. The clinical incidence of such lesions is much smaller, and only case reports or small series have been reported in the imaging literature. Purpose: To describe the imaging characteristics observed in a series of eight patients with pathology-proven asymptomatic leiomyomas of the kidney. Material and Methods: We reviewed the imaging findings observed in eight patients with pathologically proven asymptomatic renal leiomyomas discovered during studies performed for reasons unrelated to the kidney. All patients had undergone computed tomography (CT), two ultrasonography, and one magnetic resonance imaging (MRI). Results: Lesions ranged in size from 1.2 to 13 cm. Six were at the periphery of the kidney, compressed its outer surface, but did not cause disruption of the cortex; two involved the renal cortex. All had regular outer margins. A cleavage plane between the tumor and the kidney was revealed at CT and/or ultrasonography in three of the cases located at the periphery. At ultrasonography, leiomyomas appeared hypoechogenic. At CT, they were slightly hyperdense before contrast medium injection; all were hypodense to the renal cortex after contrast medium. Four were homogeneous, two were slightly heterogeneous, and the remaining two were frankly heterogeneous. The lesion studied by MRI, which was homogeneous at the postcontrast CT study, had a heterogeneous structure on both T1- and T2-weighted images, with internal areas of hypointensity on T1. Conclusion: There are some imaging findings that can help to suggest the diagnosis of renal leiomyomas. First, their density: all tumors examined before contrast were hyperdense to the kidney, with density similar to that of muscles, and all had lower enhancement than the adjacent renal parenchyma. Second, the location and margins of the tumors: most were peripheral, without

Renal manifestations in children with Alagille syndrome.

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Di Pinto, Diana; Adragna, Marta

2018-04-01

Alagille syndrome (AS) is a cholestatic disease secondary to scarcity of interlobular bile ducts. It is associated with extrahepatic manifestations, and renal involvement is frequent. To describe the prevalence, type and outcome of renal pathology in children with AS. The presence and outcome of renal pathology was retrospectively studied in 21 children who met AS criteria. Renal pathology was observed in 18 patients (85.7%): (1) ultrasound variations in 7 patients (6 cases of bilateral renal dysplasia and 1 case of renal agenesis); (2) distal renal tubular acidosis in 2 patients; (3) a drop in glomerular filtration and/or proteinuria in 16 patients. The frequency of a drop in glomerular filtration was similar between patients with and without pathological kidney ultrasound findings. Our study confirms a high prevalence of renal involvement, which enhances the importance of diagnosis and renal function follow-up in children with AS. Sociedad Argentina de Pediatría.

Infection by Cryptosporidium parvum in renal patients submitted to renal transplant or hemodialysis

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Chieffi Pedro Paulo