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Sample records for renal severa caso

  1. Pancreatitis aguda por hipertrigliceridemia severa: reporte de caso y revisión de la literatura

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    Herrera Del Águila, Dwight Denis; Garavito Rentería, Jorge; Linarez Medina, Karen; Lizarzaburu Rodríguez, Víctor

    2015-01-01

    La pancreatitis aguda por hipertrigliceridemia se presenta en aproximadamente 1-4 % de los casos, es la tercera causa de pancreatitis luego de la etiología biliar y alcohólica. La hipertrigliceridemia puede ser producida por causas primarias asociadas a trastornos genéticos en el metabolismo de los lípidos, y por casusas secundarias. Se presenta el caso de un paciente varón de 32 años de edad, natural de Huancayo, con antecedentes de diabetes mellitus tipo 2, dislipidemia mixta severa con hip...

  2. Hiponatremia severa e hidrocefalia normotensiva del adulto: Reporte de un caso

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    Rosano, Sebastián; González, Noelia; Zabiaurre, Valentina; Retamoso, Irene; Sosa, Leonardo

    2015-01-01

    Presentamos una paciente de 62 años de edad que ingresa por cefalea, alteraciones conductuales, síndrome tónico-frontal simétrico y síndrome cerebeloso de dos meses de evolución asociado a hiponatremia crónica severa. Se plantea el diagnóstico de síndrome de secreción inadecuada de hormona antidiurética (ADH) secundario a hidrocefalia normotensiva del adulto, presentando clara mejoría con la derivación ventrículo-peritoneal. Este caso pretende aportar información sobre una asociación descrita...

  3. Hemorragia digestiva alta severa por úlceras de Cameron. Reporte de caso

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    Carolina Salinas

    2016-01-01

    Full Text Available Se reporta el caso de una mujer anciana con hemorragia digestiva alta y choque hipovolémico secundario a úlceras de Cameron. Dado que estas lesiones se caracterizan por presentar cuadros crónicos de hemorragia sin aparente repercusión, se hace una revisión de esta exótica causa de sangrado digestivo masivo con repercusión hemodinámica. Estas ulceras se deben a abrasión de la mucosa por la contracción del diafragma durante los movimientos respiratorios, lo que genera pérdidas crónicas de sangre.

  4. TEST DE FUROSEMIDA : SU PATRÓN EN LA INSUFICIENCIA RENAL CRÓNICA NO SEVERA

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    Carlos G. Musso

    2008-01-01

    Full Text Available El test de furosemida consiste en una prueba de fisiología renal que se utiliza para evaluar la capacidad de los túbulos colectores para secretar potasio. Dicho estímulo está mediado por acción de la hormona aldosterona, cuyos niveles séricos se elevan tras el suministro de furosemida. Si bien el patrón de respuesta de este test ha sido descrito en niños y jóvenes sanos, no se lo ha hecho aun en pacientes portadores de insuficiencia renal crónica. Por este motivo se decidió realizar el siguiente estudio a fin lograr su descripción.Material y Método: Se estudiaron veintiséis voluntarios jóvenes (edad: 20 - 40 años, sometidos a una dieta baja en potasio (40 mmol de potasio/día: veinte de ellos eran jóvenes sanos (no presentaban ninguna enfermedad ni tomaban ninguna medicación, y el resto eran pacientes jóvenes portadores de enfermedad renal crónica estadío II/III (filtrado glomerular (FG entre 83,1 ml/min - 39,2 ml/min secundaria a glomerulopatía (diagnóstico por biopsia renal. Ninguno de los pacientes estudiados era portador de diabetes mellitus, obstrucción urinaria, ni estaban en tratamiento con drogas potencialmente inductoras de diskalemia: diuréticos, inhibidores de la enzima convertidora, y antagonistas del receptor de angiotensina II. Desde el comienzo del test y hasta 180 minutos post recibir una dosis única de furosemida endovenosa (1 mg/kg, se obtuvieron muestras de orina y sangre para medir niveles de creatinina y potasio. A partir de estos datos se calculó la excreción fraccional de potasio (EFK correspondiente a cada muestra. El análisis estadístico fue realizado aplicando el test de Student.Resultados: Si bien no hubo diferencia estadísticamente significativa ni en el valor basal (pre-furosemida, ni promedio (post-furosemida de la EFK, entre los sujetos sanos y los pacientes con insuficiencia renal crónica (IRC: EFK basal 16,4 ± 8,6% ( IRC vs 11,5 ± 4,6% (sanos (p= NS; EFK promedio 40,8 ± 3

  5. Inmunodeficiencia combinada severa

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    Lina Jaramillo

    2000-07-01

    Full Text Available El caso presentado ilustra ampliamente el comportamiento de una inmunodeficiencia Severa Combinada, con un paciente que con una inmunidad aparentemente normal durante dos años, inicia su enfermedad con un problema respiratorio que se vuelve crónico y fallece en estado caquéctico siete meses más tarde. Tiene un desarrollo pondoestatural de un niño de ocho meses y desarrolla como consecuencia de su problema inmune una micosis profunda sistémica por Criptococos y un Linfoma primario del Sistema Nervioso Central.

  6. NEUMONÍA SEVERA ADQUIRIDA EN LA COMUNIDAD EN ADULTOS SIN FACTORES DE RIESGO: A PROPÓSITO DE UN CASO

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    Liliana Vicente

    2012-01-01

    Full Text Available La Neumonía Adquirida en la Comunidad (NAC es una enfermedad de evolución aguda, generalmente de manejo ambulatorio. Los Gram negativos como la Klebsiella pneumoniae son poco frecuentes (1,2%, su frecuencia aumenta considerablemente en NAC severa representando el 12% de las etiologías. Las condiciones clínicas del paciente y la presencia de factores de riesgo son indicadores de la evolución, riesgo de mortalidad y conducta terapéutica.Se presenta el caso de un paciente de 22 años, sin factores de riesgo ni antecedentes de importancia, con diagnóstico de NAC severa con un CURB-65 de 3 puntos. La radiografía y tomografía describen absceso pulmonar, derrame pleural y neumotórax derecho. Se realiza drenaje toráxico, ingresa a la Unidad de Cuidados Intensivos (UCI e inicia antibioticoterapia con Clindamicina-Ceftazidima, evoluciona tórpidamente, se realiza decorticación pleuro-pulmonar y resección cuneiforme de segmento fistulado. El cultivo inicial reporta Klebsiella pneumoniae y el segundo Acinetobacter sp y Pseudomona sp. Se considera una infec- ción nosocomial, se cambia antibioticoterapia, evolucionando satisfactoriamente.

  7. NEUMONÍA SEVERA ADQUIRIDA EN LA COMUNIDAD EN ADULTOS SIN FACTORES DE RIESGO: A PROPÓSITO DE UN CASO

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    Liliana Vicente

    2013-08-01

    Full Text Available La Neumonia Adquirida en la Comunidad (NAC es una enfermedad de evolucion aguda, generalmente de manejo ambulatorio. Los Gram negativos como la Klebsiella pneumoniae son poco frecuentes (1,2%, su frecuencia aumenta considerablemente en NAC severa representando el 12% de las etiologias. Las condiciones clinicas del paciente y la presencia de factores de riesgo son indicadores de la evolucion, riesgo de mortalidad y conducta terapeutica.Se presenta el caso de un paciente de 22 anos, sin factores de riesgo ni antecedentes de importancia, con diagnostico de NAC severa con un CURB-65 de 3 puntos. La radiografia y tomografia describen absceso pulmonar, derrame pleural y neumotorax derecho. Se realiza drenaje toraxico, ingresa a la Unidad de Cuidados Intensivos (UCI e inicia antibioticoterapia con Clindamicina-Ceftazidima, evoluciona torpidamente, se realiza decorticacion pleuro-pulmonar y reseccion cuneiforme de segmento fistulado. El cultivo inicial reporta Klebsiella pneumoniae y el segundo Acinetobacter sp y Pseudomona sp. Se considera una infeccion nosocomial, se cambia antibioticoterapia, evolucionando satisfactoriamente.

  8. Abordagem da hipertrigliceridemia severa na gravidez: a propósito de um caso clínico

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    Giestas, A.; Palma, I.; Teixeira, S.; Carvalho, R.; Pichel, F.; Ramos, M. H.

    2008-01-01

    RESUMO Durante a gravidez o metabolismo lipídico é afectado pelas hormonas placentárias de modo a assegurar um adequado aporte nutricional para o feto, constatando-se um aumento fisiológico dos níveis de triglicerídeos (TG), em particular no terceiro trimestre. Se o aumento do valor dos triglicerídeos for superior ao esperado na gravidez a paciente deve ser cuidadosamente monitorizada. A principal complicação da hipertrigliceridemia severa é a pancreatite aguda que está associa...

  9. Minimizando perdas e maximizando eficiência na detecção de casos de desnutrição aguda severa Minimizing losses and maximizing efficiency in the detection of acute severe malnutrition

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    Michael E Reichenheim

    2001-02-01

    Full Text Available OBJETIVO: Alguns dos muitos desafios enfrentados por epidemiologistas são planejar adequadamente e otimizar o processo de captação de sujeitos em termos de efetividade e eficiência. Nesse sentido, no contexto de um estudo caso-controle envolvendo desnutrição aguda severa, usa-se o procedimento de captação em duas etapas. Os objetivos da pesquisa são identificar o melhor ponto de corte do indicador de rastreamento e obter equilíbrio entre perdas, eficiência da desnutrição severa e uso do procedimento em duas etapas. MÉTODOS: São usadas informações de 154 crianças abaixo de dois anos, em dois hospitais. Para a exploração do ponto de corte ótimo de peso para idade (PI, são de interesse as proporções de falso-negativos (PFN, falso-positivos (PFP e percentual de ganho (temporal total (pgt. O índice de peso para comprimento (PC (ponto de corte de -2 desvios-padrão é usado como padrão diagnóstico de desnutrição aguda severa. RESULTADOS: A magnitude de falso-negativos declinou rapidamente até o percentil 3 (P3 de PI e chegou a zero próximo de P9. Nesse ponto, a PFP esteve em torno de 0,4. O pgt decresceu acentuadamente até o P4, declinando suavemente até P10 (54,5%. CONCLUSÕES: Pode-se recomendar o P10 de PI, ponto de corte de rastreamento em que a eficiência é expressiva sem maiores perdas de verdadeiros casos de desnutrição aguda severa.OBJECTIVE: One of the many challenges faced by epidemiologists is to adequately plan and optimize subject selection procedures in terms of effectiveness and efficiency. In the context of a case-control study involving severe acute malnutrition, a two-step subject selection procedure is used. The aim of the article is to establish an appropriate cut-off point for the screening phase and to achieve a common ground for standards, efficiency in detecting severe malnutrition and the two-step procedure. METHODS: The study includes 154 children under the age of 2 from two different

  10. Reporte de un caso de coexistencia de feocromocitoma y adenoma cortical adrenal en un paciente con hipertensión severa

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    César A. Restrepo, MD

    2012-05-01

    Full Text Available Se reporta el caso de una paciente con hipertensión paroxística asociada a síntomas adrenérgicos, en quien se encontraron niveles elevados de metanefrinas totales en orina de 24 horas, hipopotasemia persistente y nódulo en la glándula suprarrenal. Fue llevada a cirugía en la que se identificaron dos masas suprarrenales, una con características histológicas de feocromocitoma y otra de adenoma suprarrenal.

  11. Reporte de un caso de coexistencia de feocromocitoma y adenoma cortical adrenal en un paciente con hipertensión severa

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    Restrepo, César A.; Etayo, Edwin

    2012-01-01

    Se reporta el caso de una paciente con hipertensión paroxística asociada a síntomas adrenérgicos, en quien se encontraron niveles elevados de metanefrinas totales en orina de 24 horas, hipopotasemia persistente y nódulo en la glándula suprarrenal. Fue llevada a cirugía en la que se identificaron dos masas suprarrenales, una con características histológicas de feocromocitoma y otra de adenoma suprarrenal.

  12. Aneurisma da Artéria Renal: caso clínico Renal Artery Aneurysm

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    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

  13. Necrosis cutánea severa por picadura de raya en el miembro inferior: presentación de un caso y revisión de la literatura Stingray injury causing severe cutaneous necrosis: case report and literature review

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    M.A. Hoyos Franco

    2009-12-01

    Full Text Available El propósito de este trabajo es presentar nuestra experiencia con un caso de picadura por raya en el área maleolar interna del pie derecho de un hombre de 25 años, que sufrió mientras pescaba. Inicialmente presentó dolor urente, seguido de edema severo, con necrosis de la piel suprayacente. Ingresa a nuestra institución 24 horas después y con edema, eritema y secreción purulenta en el sitio afectado. Se inicia tratamiento con antibióticos sistémicos y se realizan tres lavados y desbridamientos en días subsecuentes. Evolucionó con solución de continuidad y exposición ósea sobre el maléolo interno en un área de 7 x 5 cms que se cubrió con un colgajo safeno interno de flujo reverso que evolucionó satisfactoriamente. Las lesiones ocasionadas por la picadura de raya (Myliobatidae son escasamente referidas en Cirugía Plástica, pues la lesión tisular severa de las extremidades es poco frecuente. Revisamos la fisiopatología, los tipos de lesiones que se producen y los principios de tratamiento.The purpose of this paper is to present our experience with one case of stingray injury, in a 25 years old man, while he was fishing, compromising his right feet at the internal malleolus. At the beginning he had severe pain, and during the first hours after the accident progressive edema was evident. He arrived to our hospital 24 hours later, when purulent discharge and eritem was obvious. Intravenous antibiotics were initiated and three surgical debridements where performed during the following week. After the process was complete, a soft tissue defect was created on the internal malleolus (7 x 5 cm. Reconstruction was achieved using a reverse internal saphenous flap that evolved satisfactorily. Severe skin injuries caused by stingrays (Myliobatidae have been reported shortly in plastic surgery literature, because these lesions usually heal without surgical procedures. We review skin injury physiopathology, showing the different kind of

  14. Acidosis láctica severa y leucemia aguda

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    David Loja

    2004-03-01

    Full Text Available Reportamos el caso de una paciente de 27 años de edad con leucemia linfoblástica aguda, quien presentó acidosis láctica severa como complicación metabólica. Ella acudió con desnutrición severa, anemia marcada y síndrome consuntivo. No había compromiso del sistema reticuloendotelial y un mielograma inicial fue normal. Estos factores retardaron el diagnóstico y obligaron a ampliar el diagnóstico diferencial. La sospecha de neoplasia hematológica asociada a acidosis láctica sin causa aparente permitió reevaluar el caso con un nuevo mielograma y establecer el diagnóstico.

  15. Edema pulmonar refractario secundario a estenosis valvular aórtica severa - valvuloplastia aórtica como terapia puente a cirugía: Presentación de un caso Refractory pulmonary edema secondary to severe aortic valvular stenosis - aortic valvuloplasty as bridge therapy to surgery

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    Santiago Salazar

    2009-04-01

    Full Text Available La estenosis valvular aórtica es una entidad progresiva, que cuando es severa y produce síntomas, tiene un pronóstico sombrío que afecta de forma adversa la sobrevida. En estos casos el tratamiento de elección es la cirugía de cambio valvular, la cual, bajo determinadas circunstancias clínicas, puede ser de muy alto riesgo, y obliga así a considerar alternativas de manejo menos agresivas que permitan solucionar el problema. Se muestra el caso de un hombre de 65 años, con estenosis valvular aórtica severa, quien desarrolló edema pulmonar refractario al manejo médico, que se resolvió mediante valvuloplastia aórtica, como terapia puente a cirugía.Aortic valve stenosis is a progressive disease; when it is severe and symptomatic has a bleak prognosis that affects adversely the patient survival. In these cases, the treatment of choice is valve replacement surgery that under certain circumstances can bear a huge risk that forces the physician to consider less aggressive management alternatives to solve the problem. The case of a 65 years old male with severe aortic valve stenosis is reported. He developed pulmonary edema refractory to medical treatment that was solved by aortic valvuloplasty as bridge therapy to surgery.

  16. INSUFICIENCIA RENAL AGUDA POR CISPLATINO: REPORTE DE UN CASO

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    Rodriguez Macías EL

    2016-01-01

    Full Text Available Cisplatin nephrotoxicity should always be considered as a potential cause of renal damage in acute renal failure installed in the context of its use. Among its mechanisms of renal functional impairment are: acute tubular necrosis, proximal tubular and loop of Henle dysfunctions, as well as the deterioration of various organelles, especially the mitochondria.

  17. Reacciones cutáneas severas a medicamentos Dress y sulfasalazina

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    Patiño, Adulkarin; Echeverry, Tatiana; de la Cruz, Giovanni; Guerra, Nelcy Teresa; Murcia, Lina María; Aldana, Carlos; de Zubiría, Alberto

    2012-01-01

    Las reacciones cutáneas severas son una de las manifestaciones adversas de los medicamentos que llegan a poner en peligro la vida. El objetivo del presente artículo es presentar el caso de una paciente con este tipo de reacciones atendido en el Hospital Universitario de La samaritana. Se trata de una mujer con síntomas cutáneos en quien se documenta reacción severa medicamentosa por sulfasalazina asociado a compromiso hepático y gastrointestinal que responde a la terapia con esteroides y la s...

  18. Agenesia renal unilateral e criptorquidismo ipsilateral em um felino: relato de caso

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    E.R. Santos

    2015-04-01

    Full Text Available A agenesia renal é uma afecção congênita rara na espécie felina, frequentemente associada a uma malformação reprodutiva. O presente trabalho relata o caso de um felino com agenesia renal unilateral associada a criptorquidismo ipsilateral, com ênfase no diagnóstico, tratamento e acompanhamento. O paciente foi conduzido ao Hospital de Clínicas Veterinárias da Universidade Federal do Rio Grande do Sul para avaliação de criptorquidismo. A agenesia renal foi um achado durante a ecografia abdominal do felino. Durante a laparotomia, foi confirmada a ausência do rim e ureter direito, hipertrofia do rim esquerdo e presença de um testículo ectópico. O paciente teve alta após a recuperação anestésica e se mantém clinicamente estável, transcorridos seis meses da cirurgia. A agenesia renal unilateral é uma condição compatível com a vida, contanto que o rim existente apresente funcionamento aceitável. Assim, sugere-se que a possibilidade de rim único em felinos criptorquidas deve ser investigada sempre que possível, tendo em vista a alta correlação entre essas malformações, e objetivando um acompanhamento da função renal do paciente ao longo da vida.

  19. Tumor neuroectodérmico primitivo renal. Reporte de un caso

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    Nestor Moisés Tineo Araque; Helen Daniela Uzcátegui Camacaro; Henrry Ramirez; Humberto Ruz

    2011-01-01

    El cáncer de riñón representa entre el 2 y 3% del total de las neoplasias malignas, encontrándose entre ellas el tumor neuroectodérmico (1,1% dentro del cáncer renal). En muchos casos el diagnóstico es tardío y se describe la triada clásica: dolor, hematuria y masa palpable. El ultrasonido y la tomografía axial computarizada son los métodos de diagnóstico más importantes y el éxito terapéutico se basa en la cirugía radical. Se presenta caso de paciente femenina de 23 años quien inicia enferm...

  20. Trombose da artéria renal e síndrome do anticorpo antifosfolípide: um relato de caso Renal arterial thrombosis and the antiphospholipid antibody syndrome: a case report

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    Célia S. Macedo

    2001-12-01

    Full Text Available OBJETIVO: descrever um caso clínico raro na infância, com achados clínicos da síndrome do anticorpo antifosfolípide. DESCRIÇÃO: criança, sexo masculino, com 2 anos e 6 meses de idade, com insuficiência renal, trombose da artéria renal e diagnóstico de síndrome do anticorpo antifosfolípide, foi internada com dor abdominal, palidez, letargia e anúria há 36 horas. Ao exame físico, apresentava-se desnutrida, com hipertensão arterial severa, edema moderado e dor em hipocôndrio. Os achados laboratoriais incluíram: uréia=112mg/dl; creatinina plasmática=4,5 mg/dl; pH sangüíneo=7,47; bicarbonato sangüíneo=12,8 mmol/L; K=7,2 mEq/L. A diálise peritoneal foi iniciada e mantida por 11 dias. Após 7 semanas de evolução, o paciente ainda necessitava de droga anti-hipertensiva e a função renal estava anormal. A biópsia renal revelou infarto renal anêmico; ultra-sonografia renal com doppler, fluxo sangüíneo renal ausente no lado direito, e a arteriografia mostrou oclusão total da artéria renal direita. A pesquisa de doenças do colágeno foi negativa. Foi realizada nefrectomia à direita obtendo-se normalização da pressão arterial. Aos 5 anos e 8 meses, foi novamente hospitalizada com quadro de crises de ausência e dores abdominais e precordiais. A dosagem do anticorpo anticardiolipina foi positiva. Atualmente aos 7 anos, está em seguimento ambulatorial, assintomática e com dosagens negativas do anticorpo anticardiolipina. COMENTÁRIOS: as observações deste caso mostram que crianças com quadro de trombose arterial, mesmo na ausência de doenças do colágeno, devem ser investigadas para uma possível associação com a síndrome do anticorpo antifosfolípide.OBJECTIVE: to describe an unusual case with clinical features of the antiphospholipid syndrome. DESCRIPTION: white child, two years and six months old, with renal failure, renal arterial thrombosis, and diagnosis of antiphospholipid syndrome was hospitalized with

  1. Reporte de un caso de coexistencia de feocromocitoma y adenoma cortical adrenal en un paciente con hipertensión severa Report of a case of coexistence of pheochromocytoma and adrenal cortical adenoma in a patient with severe hypertension

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    César A Restrepo

    2012-06-01

    Full Text Available Se reporta el caso de una paciente con hipertensión paroxística asociada a síntomas adrenérgicos, en quien se encontraron niveles elevados de metanefrinas totales en orina de 24 horas, hipopotasemia persistente y nódulo en la glándula suprarrenal. Fue llevada a cirugía en la que se identificaron dos masas suprarrenales, una con características histológicas de feocromocitoma y otra de adenoma suprarrenal.We report the case of a female patient with paroxysmal hypertension associated with adrenergic symptoms. Elevated levels of total metanephrines in 24 hour urine were found, as well as persistent hypokalemia and a nodule in the adrenal gland. She was taken to surgery, and two adrenal masses were identified, one with histological characteristics of pheochromocytoma and another one of adrenal adenoma.

  2. 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.

  3. Seguridad residual en los forjados con corrosión severa

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    VERCHER SANCHIS, JOSÉ MARÍA

    2013-01-01

    En muchos casos de forjados con patología severa se observa que no existen daños importantes en los elementos constructivos. Incluso con todos los nervios con la armadura inferior corroída en muchas ocasiones no hay una fisuración alarmante ni de solados ni de tabiquería. Esta investigación analiza los mecanismos resistentes que colaboran y evalúa la seguridad remanente para los casos de corrosión en los forjados más habituales en los edificios de viviendas: los forjados unidireccionales...

  4. Carcinoma renal com metástase hepática - relato de caso

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    Cibele Isaac Saad Rodrigues

    2015-10-01

    Full Text Available O Carcinoma de Células Renais (CCR é uma neoplasia genito-urinária derivada do córtex renal, associada a fatores de risco como tabagismo, obesidade, exposição ocupacional ao cádmio, asbesto ou derivados do petróleo, além de doença cística renal adquirida. Seu diagnóstico eventualmente é obtido como achado de exame realizado por outras causas, caso contrário, é feito tardiamente, visto que os sintomas surgem, geralmente, quando já está em estágio avançado. O tratamento é cirúrgico, com nefrectomia radical e ressecção de toda a fáscia de Gerota. Relato de caso: ACRS, 53 anos, masculino. Paciente apresenta hematúria macroscópica, sem edema ou hipertensão arterial. Nega disúria, polaciúria ou qualquer tipo de trauma recente. Urina I revelou hemácias e leucócitos superiores a um milhão e nitrito negativo. Ausência de anemia e de distúrbios da coagulação. Na TC, o rim direito apresentava formações arredondadas hipoatenuantes, com acentuada dilatação do sistema pielocalicial, com retardo na eliminação de contraste. Formações nodulares sólidas heterogêneas em projeção da cadeia ilíaca direita. Parênquima pulmonar com múltiplas formações nodulares sólidas, difusamente distribuídas compatíveis com metástases. Foi realizada nefroureterectomia direita. Discussão e Conclusão: O caso relatado é condizente com o perfil epidemiológico do CCR, que é mais prevalente em homens e predominantemente diagnosticado entre 50 e 70 anos. A hematúria, que representou a queixa do paciente, compõe a tríade sintomática dos casos avançados de CCR, a qual inclui também massa abdominal e dor no flanco. Durante a sua evolução, o CCR pode acometer linfonodos – neste caso, a cadeia ilíaca direita – e ocasionar metástases para fígado, ossos e pulmão, dentre os quais apenas o último foi acometido neste caso. A presença de metástases reflete um cenário corriqueiro nos CCR sintomáticos e ilustra o car

  5. Hematuria renal idiopática: reporte de un caso clínico

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    María A. Serna Valencia

    2008-12-01

    Full Text Available Se describe un caso de hematuria renal idiopática en un canino de la raza Mastín Napolitano de 7,5 años de edad, presentado a consulta por hematuria con varios meses de evolución; los análisis de sangre, orina y las ayudas de imagenología (radiografía y ecografía no fueron suficientes para indicar un diagnóstico. Se recomendó la celiotomía exploratoria y, después de cateterizar los uréteres desde el interior de la vejiga, se estableció que el sangrado provenía del riñón derecho, el cual fue extirpado con su uréter. Se realizaron exámenes de histopatología del riñón extirpado, encontrándose nefrosis y un proceso degenerativo generalizado a nivel de corteza y médula renal. La hematuria no se resolvió en el postoperatorio, seguramente por ser de origen bilateral; el paciente murió de otra causa no relacionada, y no fue posible evaluar el riñón contralateral.

  6. Três casos de hipertensão e Fístula Arteriovenosa Renal: com uma fístula de novo Tres casos de hipertención y Fístula Arteriovenosa Renal: con una fístula de novo Three cases of hypertension and Renal Arteriovenous fistula with a de novo fistula

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    Natalia Correa Vieira Melo

    2009-05-01

    Full Text Available Fístula Arteriovenosa Renal (FAVR é uma causa rara e potencialmente reversível de hipertensão e insuficiência renal e/ou cardíaca. O tratamento da FAVR visa preservar o máximo de parênquima renal e, concomitantemente, erradicar os sintomas e efeitos hemodinâmicos decorrentes da FAVR. No presente estudo, serão relatados três casos de FAVR, incluindo um caso de FAVR idiopática de novo, que se apresentaram com hipertensão e insuficiência renal e/ou cardíaca, e descrever a terapêutica adotada e os resultados obtidos.La Fístula Arteriovenosa Renal (FAVR es una causa rara y potencialmente reversible de hipertensión e insuficiencia renal y/o cardíaca. El tratamiento de la FAVR busca preservar el máximo de parénquima renal y, concomitantemente, erradicar los síntomas y efectos hemodinámicos resultantes de la FAVR. En el presente estudio, se relatarán tres casos de FAVR, incluyendo un caso de FAVR idiopática de novo, que se presentaron con hipertensión e insuficiencia renal y/o cardíaca, y describir la terapéutica adoptada y los resultados obtenidos.The Renal Arteriovenous Fistula (RAVF is a rare and potentially reversible cause of hypertension and kidney and/or heart failure. The treatment of RAVF aims at preserving the most of the renal parenchyma and, concomitantly, eradicating the symptoms and hemodynamic effects caused by the RAVF. The present study reports three cases of RAVF, including one case of a de novo idiopathic RAVF, which presented with hypertension and kidney and/or heart failure and describes the therapeutic measures used to treat these patients as well as the outcomes.

  7. Insuficiência renal aguda em paciente tratada com ATRA e anfotericina B: relato de caso

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    Gelcimar Moresco

    2011-06-01

    Full Text Available O presente relato apresenta o caso clínico de uma paciente com leucemia promie-locítica aguda tratada com ácido todo-transretinoico (ATRA, que apresentou suspeita de síndrome do ácido transreti-noico (síndrome de ATRA. Com a ocor-rência de leucopenia febril inespecífica, foram associados ao tratamento antimi-crobianos e antifúngicos. A diminuição da função renal, observada inicialmente, contribuiu para a suspeita de síndrome de ATRA, que foi agravada pelos antifúngi-cos. Assim, o uso de ATRA foi suspenso, mas somente 8 dias depois foi caracteriza-da pneumonia e descartada a hipótese de síndrome de ATRA. Nesse contexto, foi discutida a nefrotoxicidade do ATRA e a potencialização desse efeito adverso pelo uso de antifúngicos nefrotóxicos, em par-ticular da anfotericina B, assim como a im-portância do diagnóstico diferencial entre síndrome de ATRA e doença infecciosa.

  8. Cistadenocarcinoma renal e dermatofibrose nodular em cães pastor alemão: 4 casos Renal cystadenocarcinoma and nodular dermatofibrosis in german shepherd dogs: 4 cases

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    Ingeborg Maria Langohr

    2002-08-01

    Full Text Available São descritos quatro casos da síndrome cistadenocarcinoma renal-dermatofibrose nodular em Pastor Alemão. Todos eram cães machos, com idades entre 6 e 10 anos. Os aspectos clínicos incluíam hematúria e retenção urinária, emagrecimento progressivo, anorexia, vômito, polidipsia e dificuldade respiratória. Em um animal, foram observados múltiplos nódulos recidivantes na pele. Três cães tiveram morte espontânea e um foi submetido à eutanásia. Os principais achados de necropsia incluíram nódulos multifocais ou coalescentes na pele e múltiplos nódulos, muitas vezes císticos, em ambos os rins. Na avaliação histológica, observaram-se dermatofibrose nodular na pele e cistos, hiperplasia, displasia e neoplasia de células epiteliais dos túbulos renais. As neoplasias foram classificadas como cistadenoma em um dos casos e como cistadenocarcinoma nos outros três. Metástases foram observadas em dois casos: no fígado, no baço e no pulmão em um cão e no linfonodo renal em outro.Renal cystadenocarcinoma-nodular dermatofibrosis syndrome of German shepherd are described in four 6 to 10-year-old male dogs. Clinical findings included hematuria and urinary retention, progressive weight loss, polydipsia, anorexia, vomiting, and respiratory distress. Several recurrent skin nodules were observed in one of the dogs. Three dogs died spontaneously and one was euthanatized. Main gross findings included multifocal to coalescent skin nodules and multiple nodules, mostly cystic, in both kidneys. Microscopically there was nodular dermatofibrosis in the skin and renal cysts, dysplastic, hyperplastic and neoplastic changes of the renal tubular epithelium. The neoplasms were classified as cystadenoma in one case and cystadenocarcinoma in the other three. There were metastases in the liver, spleen and lung of one dog and in the renal lymph node in another one.

  9. Amiloidose renal em cão Shar-Pei: Relato de Caso Renal amyloidosis in a Shar-Pei dog: A case report

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    J.L. Reis Jr.

    2001-08-01

    Full Text Available O presente relato descreve os achados clínicos e anatomopatológicos de um caso de amiloidose renal em um cão macho de nove anos da raça Shar-Pei. O animal apresentava quadro clínico de esporotricose e de insuficiência renal e exames positivos para erlichiose e leishmaniose. No dia anterior ao óbito, o cão apresentou apatia, desidratação e anúria. À necropsia foram observados inúmeros pontos milimétricos esbranquiçados localizados no córtex renal e hepatização do lobo diafragmático esquerdo. O achado histológico mais importante foi deposição de material eosinofílico, amorfo e acelular localizado nos tufos glomerulares que se corou positivamente pelo vermelho congo (amilóide. Observaram-se nefrite supurada multifocal, espessamento da cápsula de Bowman e broncopneumonia supurada crônica, com fibrose intensa. A origem da amiloidose, no presente caso, poderia ser hereditária, assemelhando-se à amiloidose familiar descrita em cães da raça Shar-Pei, ou ser devida à inflamação supurada crônica e/ou leishmaniose.The clinical and pathological findings of a case of renal amyloidosis in a nine-year-old male Shar-Pei dog were described. Clinically, there were signs of sporotrichosis and renal insufficiency, besides being positive to leishmaniasis and ehrlichiosis. On the day before death, the animal became apathetic, dehydrated and anuric. On gross examination, there were several whitish millimetric spots seen widespread in both renal cortices and consolidation of the left diaphragmatic pulmonary lobe. The most important microscopic finding was a deposition of amorphous acellular material on the glomerular tufts which stained positively by congo red stain. Other changes were multifocal suppurative nephritis, thickening of the Bowman capsule and chronic suppurative bronchopneumonia. The origin of the amyloidosis in this case could be hereditary, being similar to familiar amyloidosis described in Shar-Pei breed, or due to

  10. Lúpus eritematoso sistêmico e tuberculose renal: descrição de nove Casos Systemic lupus erythematosus and renal tuberculosis: description of nine cases

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    Daniela Cabral de Sousa

    2008-02-01

    Full Text Available OBJETIVO: O presente estudo tem por objetivo principal descrever uma série de nove casos de tuberculose (TB renal em pacientes portadores de lúpus eritematoso sistêmico (LES ocorridos em um período de seis anos em um hospital terciário do Nordeste brasileiro. MÉTODOS: Foram identificados nove pacientes portadoras de LES com baciloscopia e/ou cultura de urina positivas para Mycobacterium tuberculosis no período de outubro de 1998 a novembro de 2004, por intermédio dos registros do Serviço de Microbiologia do Hospital Universitário Walter Cantídio. Foram coletados dados demográficos, dados sobre o LES e sobre a TB renal das respectivas pacientes. RESULTADOS: Todas as pacientes eram do sexo feminino, com idade entre 19 e 58 anos. Quanto às características do LES, todas haviam tido nefrite lúpica em algum momento da evolução, das quais três haviam utilizado ciclofosfamida previamente à infecção. A dose média de prednisona antes do diagnóstico de TB renal variou entre 7, 5 e 20 mg/dia. O diagnóstico de TB renal foi feito por meio de cultura positiva em cinco pacientes e por intermédio de baciloscopia apenas em quatro pacientes. As manifestações laboratoriais mais freqüentes foram leucocitúria e hematúria. A recidiva da TB renal ocorreu em quatro pacientes. CONCLUSÃO: A ocorrência de TB renal em pacientes com LES deve ser suspeitada na presença de piúria estéril e/ou hematúria persistentes, em especial em populações de países em desenvolvimento.OBJECTIVE: The main objective of the present study was to describe a series of nine cases of renal tuberculosis (TB in patients diagnosed with systemic lupus erythematosus (SLE over a period of six years at a tertiary-level hospital in Northeastern Brazil. METHODS: Nine SLE patients with renal TB confirmed by bacterioscopy (n=4 or urine culture (n=5 positive for M. tuberculosis between October 1998 and November 2004 were sampled from the records of the microbiology

  11. Aneurisma da Artéria Renal: cirurgia renal ex-vivo - a propósito de um caso clínico Renal Artery Aneurysm: ex-vivo repair - a case report

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    Clara Nogueira

    2012-09-01

    Full Text Available Os aneurismas da artéria renal (AAR são raros, frequentemente assintomáticos, de etiologia variada, frequentemente secundários a aterosclerose e anomalias congénitas. Os AAR com diâmetro superior a 2 cm têm indicação cirúrgica. A escolha da técnica cirúrgica depende da localização anatómica e complexidade do AAR, bem como do tempo previsível de isquemia renal. Os autores descrevem um caso de auto-transplante renal, para tratamento de dois AAR complexos.Renal artery aneurysms (RAA are rare, frequently asymptomatic, with variable etiology, frequently due to atherosclerosis and congenital anomalies. Surgical treatment is indicated for RAA with a diameter greater to 2 cm. Surgical technique will depend on RAA anatomic localization and complexity, as well as, predicted renal isquemic time. The authors report an auto-transplant for treatment of two complex RAA.

  12. Urgencia hipertensiva secundaria a enfermedad poliquística renal autosómica recesiva en lactante. Reporte de caso

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    Roxana Quisbert-Cruz

    2017-06-01

    Full Text Available La enfermedad poliquística renal asociada a la fibrosis hepática congénita es una enfermedad hereditaria; se encuentra dentro del espectro de las enfermedades fibroquísticas hepatorrenales. Su frecuencia estimada es de 1 en 20.000 nacidos vivos para la variedad de enfermedad poliquística renal autosómica recesiva y más rara para la variedad autosómica dominante. Se presenta un reporte de caso de un paciente cuyo padecimiento se inició con crisis hipertensiva de difícil control, debido a enfermedad poliquística renal y fibrosis hepática congénita, presentación clínica poco frecuente; cabe mencionar sobre la importancia del control de la tensión arterial para prevenir complicaciones causadas por la hipertensión arterial: hipertrofia cardiaca, falla cardiaca y retinopatía crónica.

  13. Ligadura endoscópica endonasal da artéria esfenopalatina para epistaxe severa

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    Santos Rodrigo P.

    2002-01-01

    Full Text Available Introdução: A epistaxe severa, geralmente associada a fatores predisponentes como hipertensão arterial sistêmica e coagulopatia, é uma doença desafiadora, e pode necessitar de uma abordagem cirúrgica nos casos que não respondem ao tratamento conservador, como cauterização e tamponamento nasal. Objetivo: avaliar os resultados da ligadura endoscópica endonasal da artéria esfenopalatina no tratamento da epistaxe severa refratária à abordagem terapêutica conservadora. Forma de estudo: Clínico prospectivo. Material e Método: foram avaliados doze casos de pacientes submetidos à ligadura endoscópica endonasal da artéria esfenopalatina no tratamento da epistaxe severa não responsiva ao tratamento conservador, observando-se a história clínica, os fatores predisponentes, a evolução e as complicações deste procedimento. Resultados: a idade média foi de 50,9 anos, e a distribuição por sexo foi de 33% do sexo feminino e 67% do sexo masculino; 33% apresentaram HAS e 16,6% coagulopatia (hepatopatia como fatores predisponentes. Um paciente (8,3% apresentou ressangramento após o procedimento cirúrgico. Discussão: a ligadura endoscópica endonasal da artéria esfenopalatina representa uma abordagem segura e garante um controle satisfatório do sangramento, com índice de ressangramento de 8,3% entre os nossos casos. Conclusão: a ligadura endoscópica endonasal da artéria esfenopalatina representa uma opção cirúrgica adequada, pois não apresenta as complicações das técnicas anteriores, atinge um controle satisfatório do sangramento e pode ser realizada por otorrinolaringologistas habituados à cirurgia endoscópica nasal.

  14. Fallas del mercado de la salud en Colombia: el caso de la insuficiencia renal crónica

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    Chicaíza , Liliana

    2005-06-01

    Full Text Available La insuficiencia renal crónica es una de las patologías de alto costo con mayor impacto financiero para el Sistema General de Seguridad Social en Salud de Colombia. La alta concentración de casos de alto costo en algunas empresas del sector hizo necesaria la redistribución de recursos y pacientes para contrarrestar el desequilibrio financiero. El artículo señala que la inducción a la demanda es la principal falla de este mercado oligopólico. Expone algunas hipótesis sobre los incentivos de las empresas y muestra que la entidad reguladora debe intervenir en el control de los precios y la calidad y, sobre todo, adaptar medidas orientadas a prevenir la enfermedad.

  15. Sepsis severa postaborto secundaria a tuberculosis miliar

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    Angel Müller, Edith; Sánchez Baracaldo, Lilia

    2012-01-01

    Caso clínicoMujer de 24 años de edad, natural y procedente de Bogotá, de nivel socio-económico medio-bajo, sin antecedentes medico quirúrgicos importantes y con historia obstétrica: G2 P1 A1 VI. Esta paciente ingresó al Hospital del Guavio el día 1-05- 95, con diagnósticos de embarazo de 18 semanas, amenaza de aborto e infección de vías urinarias altas. Presenta expulsión espontanea del feto y se le realiza legrado uterino en el cual se encuentran restos ovulares fétidos, La paciente además p...

  16. Sepsis severa postaborto secundaria a tuberculosis miliar

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    Edith Angel Müller; Lilia Sánchez Baracaldo

    1995-01-01

    Caso clínico Mujer de 24 años de edad, natural y procedente de Bogotá, de nivel socio-económico medio-bajo, sin antecedentes medico quirúrgicos importantes y con historia obstétrica: G2 P1 A1 VI. Esta paciente ingresó al Hospital del Guavio el día 1-05- 95, con diagnósticos de embarazo de 18 semanas, amenaza de aborto e infección de vías urinarias altas. Presenta expulsión espontanea del feto y se le realiza legrado uterino en el cual se encuentran restos ovulares fétidos, La paciente adem...

  17. ASMA SEVERA EN ADULTOS: ENFOQUE DIAGNÓSTICO Y TRATAMIENTO

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    Paulina Barría P., DRA.

    2015-05-01

    Full Text Available El asma es una enfermedad frecuente de fisiopatología compleja. El asma severa constituye aproximadamente el 5% de la población de asmáticos, sin embargo representa un desafío clínico y una carga sanitaria importante. Estudios recientes demuestran la existencia de fenotipos en todo el espectro de gravedad. La eosinofilia en esputo y sangre ha demostrado utilidad como marcador de inflamación Th-2 y de respuesta clínica a esteroides, sin embargo aún no existe mucho conocimiento sobre el asma no-eosinofílica. Los tratamientos actuales en asma se enfocan a estrategias de terapia escalonada según severidad, pero en pacientes con asma severa se requiere también del manejo multidisciplinario de las comorbilidades y la determinación del fenotipo, para aplicar terapias más especificas. El desarrollo acelerado de nuevos tratamientos en asma severa como consecuencia del mejor conocimiento de los distintos fenotipos ha ampliado el arsenal terapéutico para un enfrentamiento personalizado y específico en los pacientes con asma severa.

  18. NEFRECTOMIA UNILATERAL EM CADELA PARASITADA POR Dioctophyma renale : RELATO DE CASO

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    Hermeto, Larissa; Mauad, Juliana Rosa Carrijo; Universidade Federal da Grande Dourados; Mattei, Douglas Rodrigo; Faculdade Anhanguera de Dourados; Ferrarezi, Ana Paula Ferreira; Faculdade Anhanguera de Dourados; Ventura, Arlene Sobrinho; Faculdade Anhanguera de Dourados

    2012-01-01

    O dioctophyma renale, conhecido como verme gigante renal é um nematóide de ocorrência mundialque parasita os rins, podendo ser encontrado na cavidade peritoneal e em outros órgãos do cão, e em outras espéciesde animais domésticos e silvestres, inclusive o homem. Foi atendida uma cadela sem raça definida, apresentandosecreção vaginal sanguinolenta persistente, neoformação vaginal, hiporexia e hematúria. Foram solicitados examescomplementares, e através da ultrassonografia abdominal foi detecta...

  19. ESCLEROSIS TUBEROSA Y AFECCIÓN RENAL: REPORTE DE UN CASO CLÍNICO

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    Ciocchini M

    2016-05-01

    Full Text Available A 27 year-old woman was initially referred to the division of nephrology because of polyuria and the finding of renal cysts. She did not have nervous system manifestations. According to the "2012 International Tuberous Sclerosis Complex Consensus Conference" the diagnosis of Tuberous Sclerosis Complex (TSC was completed. TSC is an autosomal dominant inherited multisystem disease with nearly complete penetrance. Clinical manifestations can vary widely even in patients belonging to a same linage. The morbidity and mortality depends on renal or respiratory complications on adulthood. This report highlight the need of a high level of suspicions in patients with manifestations compatible with this disease and shows the importance of a multidisciplinary team working together to arrive to the appropriate diagnosis.

  20. Necesidad de estudio genético para el diagnóstico de algunos casos de acidosis tubular renal distal

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    Manuel Heras Benito

    2016-09-01

    Full Text Available Describimos el caso de una mujer joven, que fue diagnosticada de insuficiencia renal avanzada, con un hallazgo casual de una nefrocalcinosis sin una etiología clara, al haberse encontrado asintomática a lo largo de su vida. El estudio genético por paneles de genes conocidos asociados a enfermedad tubulointersticial permitió descubrir una acidosis tubular renal distal autosómica dominante, asociada a una mutación de novo en el exón 14 del gen SLC4A1, que hubiera sido imposible diagnosticar clínicamente por lo avanzado de la enfermedad renal cuando fue descubierta.

  1. Tratamento endovascular de aneurisma da artéria renal por embolização com micromolas preservando o fluxo sangüíneo renal: relato de caso Endovascular treatment of renal artery aneurysm using microcoil embolization and renal blood flow preservation: case report

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    Marco Aurélio Cardozo

    2007-06-01

    Full Text Available O tratamento endovascular da doença aneurismática da artéria renal tem sido, cada vez mais, aceito como uma alternativa à cirurgia convencional, especialmente em casos de aneurismas complexos intra-parenquimatosos ou que comprometam a bifurcação da artéria renal. Os autores relatam a experiência do tratamento endovascular de uma paciente com aneurisma sacular da bifurcação da artéria renal direita, associado à hipertensão renovascular de difícil controle. Foi realizada a cateterização seletiva da artéria renal, com a inserção de micromolas no saco aneurismático. O aneurisma foi completamente ocluído com preservação total do fluxo sanguíneo renal. A evolução clínica foi satisfatória com redução significativa das medicações anti-hipertensivas. A angio-tomografia de controle, após o oitavo mês do procedimento, confirmou o sucesso do tratamento.Endovascular treatment of renal artery aneurysmal disease has been increasingly accepted as an alternative to conventional surgery, especially in cases of renal artery bifurcation or complex intrarenal aneurysms. The authors report a case of endovascular treatment of a saccular aneurysm of the right renal artery bifurcation associated with poorly controlled renovascular hypertension. Selective catheterization of the renal artery was performed and microcoils were inserted into the aneurysmal sac. The aneurysm was completely obliterated with total preservation of renal blood flow. Clinical evolution was satisfactory with significant reduction in anti-hypertensive drugs. Control tomographic angiography, after eight months, confirmed treatment success.

  2. Linfangioleimiomatose pulmonar - LAM. Um caso de associação de LAM e angiomiolipoma renal

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    Carlos Mendonça

    1997-09-01

    Full Text Available RESUMO: Relatase o caso clínico de uma jovem mulber, que é submetida a uma nefrectomia radical por volumoso tumor à direita, tendo verificado tratarse dum angiomiolipoma. Até então sem qualquer queixa, sinal ou sintoma do foro respiratório. No decurso do pós-operatório, fez complicação aparatosa no contexto da qual foi identificado um pneumotorax espontâneo bilateral. Após a alta hospitalar, foram observados e registados vários episódios de pneumotorax espontâneo, unilateral. A partir do episodio inicial desenvolve, lenta e progressivamente, um quadro clínico de dispneia. Apresenta-se a evolução clínica e alguns parâmetros caracterizadores das alterações funcionais respiratórias, ao longo de seis anos, bem como a documentação de TAC-HR do tórax e histológica, que permitiram fundamentar o diagnóstico desta associação de entidades raras. SUMMARY: We present the case report of a young woman submited to a radical nefrectomy of the right kidney due to the presence of a large tumor diagnosed as an angiomyolipoma. Until such time no respiratory signs and symptoms were referred. Complications during post-op led to the identification of a bilateral spontaneous pneumothorax. After being released from the hospital the patient returned several times due to unilateral spontaneous pneumothorax. After the first of these episodes she developed slowly progressive dyspnea. We present the clinical evolution and respiratory function parameters for a six year follow-up as well as thoracic HR-CT scan documentation and histologic studies that permit the diagnosis of these associated and rare entities. Palavras chave: Linfangioleirniomatose pulmonar - LAM, angiomiolipoma, pneumotorax espontâneo bilateral, : Key -words, Pulmonary Lymphangioleiomyomatosis - LAM, angiomyolipoma, Bilateral spontaneous pneumothoraces

  3. Relato de caso: Insuficiência renal crônica estádio 5 D em paciente com doença renal crônica medicado com varfarina

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    Claudia Patricia Quiterio Bento

    2015-06-01

    Full Text Available Resumo Introdução A terapêutica com varfarina pode provocar hematúria grave e lesão renal aguda pela formação de cilindros eritrocitários oclusivos. Estas alterações são sugestivas de uma doença recentemente conhecida como nefropatia relacionada pela varfarina. Caso Clínico: Apresentamos um doente de 74 anos de idade com doença renal crônica estádio 3 A, que progrediu com declínio na taxa de filtração glomerular (TFG após o início de terapêutica com varfarina devido a um quadro fibrilação atrial. O diagnóstico foi confirmado pela histologia renal, que demonstrou a presença de oclusão tubular por cilindros eritrocitários, achados consistentes com este diagnóstico. O paciente não recuperou a TFG, tendo iniciado terapêutica substitutiva da função renal. Discussão: O objetivo da descrição deste caso clínico é alertar para a complicação associada a este fármaco e reforçar a necessidade de monitorização cuidada da função renal e dos parâmetros de coagulação em doentes tratados com a varfarina. A patogênese e o prognóstico desta entidade também serão discutidos.

  4. Pseudoaneurisma de arteria renal principal asociado a fistula cecal tras nefrectomia radical: caso clínico y revisión de la literatura

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    A. Hernando Arteche; C. Alpuente Roman; R. Martin del Toro; A. Pérez-Piqueras Gómez; F. Sainz González; JA. Cabrera Cabrera

    2014-01-01

    Las complicaciones vasculares secundarias al tratamiento quirúrgico del cáncer de riñón localizado son más frecuentes cuando se realiza una cirugía conservadora de nefronas. Sin embargo, la nefrectomía radical no está exenta de ellas. Presentamos el caso de un pseudoaneurisma de la arteria renal principal con comunicación fistulosa a colon ascendente tras nefrectomía radical. El paciente debutó con un episodio de shock hipovolémico debido a hemorragia digestiva baja.

  5. Pseudoaneurisma de arteria renal principal asociado a fistula cecal tras nefrectomia radical: caso clínico y revisión de la literatura

    OpenAIRE

    Hernando Arteche, A.; Alpuente Roman, C.; Martin del Toro, R.; Pérez-Piqueras Gómez, A.; Sainz González, F.; Cabrera Cabrera, JA.

    2014-01-01

    Las complicaciones vasculares secundarias al tratamiento quirúrgico del cáncer de riñón localizado son más frecuentes cuando se realiza una cirugía conservadora de nefronas. Sin embargo, la nefrectomía radical no está exenta de ellas. Presentamos el caso de un pseudoaneurisma de la arteria renal principal con comunicación fistulosa a colon ascendente tras nefrectomía radical. El paciente debutó con un episodio de shock hipovolémico debido a hemorragia digestiva baja. Vascular complications...

  6. Carcinoma de células renais com metástase cutânea: relato de caso Renal cell carcinoma with cutaneous metastasis: case report

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    Thaís Alves de Paula

    2010-06-01

    Full Text Available O adenocarcinoma do rim, ou hipernefroma, é a terceira neoplasia mais comum do trato geniturinário, sendo o de células claras o tipo principal, representando 60% dos casos, com pico de incidência entre 50 e 70 anos. A presença de metástase ao diagnóstico acomete em torno de 30% dos pacientes, tendo como principais sítios pulmões, ossos, pele, fígado e cérebro. Relatamos o caso de um paciente portador de carcinoma de células renais com metástase ao diagnóstico que, apesar de inserido na faixa etária predominante, tipo histológico mais frequente e quadro clínico característico, apresentava metástase a distância em local pouco observado na prática clínica. O paciente evoluiu para o óbito sem tempo hábil para o tratamento.Renal cell carcinoma or hypernephroma is the third most common neoplasia of the genitourinary tract. Its most common type, representing 60% of the cases, is the clear cell carcinoma, with an incidence peak between 50 and 70 years. Metastases are present at the time of diagnosis in approximately 30% of the patients, the major sites being lungs, bones, skin, liver, and brain. We report the case of a male patient with renal cell carcinoma, whose age, clinical findings, and tumor histological type matched with the most common ones for that pathology. Nevertheless, he already had distant metastasis in an uncommon site at the time of diagnosis. The patient died without undergoing specific treatment for renal cell carcinoma.

  7. Tratamento das formas severas de miastenia pelo ACTH por via intravenosa

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    José Lamartine de Assis

    1960-12-01

    caso 2, por exemplo, somente na terceira série de ACTH, foi conseguida remissão da sintomatologia acentuada para leve. Dos 10 casos relatados neste trabalho, em 6 houve agravação dos sintomas miastênicos nos primeiros 10 dias de tratamento. O autor considera o ACTH, utilizado por via intravenosa, como importante contribuição na terapêutica da miastenia grave, sendo especialmente indicado nas formas severas que não regridem mediante o emprego dos medicamentos anticolinesterásicos habitualmente usados.

  8. Long-term follow-up of kidney allografts in patients with sickle cell hemoglobinopathy Transplante renal na anemia falciforme

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    João R. Friedrisch

    2003-06-01

    Full Text Available Although sickle cell anemia and sickle cell disease produce a variety of functional renal abnormalities they uncommonly cause end stage renal failure. Renal transplantation has been a successful alternative for the treatment of the rare terminal chronic renal failure with outcomes comparable with non-sickle recipients. This approach, however, has not been often described on patients with renal failure associated with SC hemoglobinopathy. Here we report the outcomes of two patients with chronic renal failure due to SC hemoglobinopathies who underwent renal transplantation. At the time of the transplantation they were both severely anemic and had frequent vasoocclosive pain crises. Both patients evolved with good allograft function, near normal hematological parameters, and very rare pain crisis, thirteen and eight years after transplant. These cases illustrate that terminal renal failure due to SC hemoglobinopathy can be successfully managed by renal transplantation and satisfactory long-term results are achievable not only in terms of renal allograft function but also of their hematological condition.Embora a anemia falciforme e as síndromes falciformes freqüentemente causem várias alterações funcionais renais, não é comum a insuficiência renal terminal. Nestes casos, o transplante renal é uma alternativa que se acompanha de resultados comparáveis aos obtidos em receptores sem hemoglobinopatias. Esta estratégia terapêutica tem sido, no entanto, pouco relatada para portadores de hemoglobinopatia SC. Este relato descreve a evolução de dois pacientes portadores de hemoglobinopatia SC que foram submetidos ao transplante renal. No momento do transplante ambos apresentavam severa anemia e crises dolorosas freqüentes. Os pacientes evoluíram com boa função do enxerto, parâmetros hematológicos quase normais e praticamente assintomáticos do ponto de vista da hemoglobinopatia, treze e oito anos após o transplante. Estes casos ilustram

  9. Plasmacitosis reactiva severa y agranulocitosis debido a metimazol

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    Ruíz Gil

    2005-06-01

    Full Text Available El presente reporte muestra un efecto tóxico inusual asociado al uso de metimazol en el tratamiento del hipertiroidismo. Una niña de 14 años se presentó con fiebre, compromiso general y una tumoración eritematosa en el muslo izquierdo. Dos meses antes había sido diagnosticada de hipertiroidismo e iniciado metimazol a razón de 30 mg/d. El laboratorio mostró: leucocitos en 1 200 /mm³ con 25 % de neutrófilos, hematocrito en 31 % y plaquetas en 350 000/ mm³. Se inició antibióticos y filgastrim y se debridó el abceso. Nueve días después los leucocitos estaban en 9 200 /mm³ con 55 % de neutrófilos. La MO mostró una celularidad baja pero representada en un 80 % por células plasmáticas, muchas de ellas atípicas. En resumen una mujer con enfermedad de Graves estando con metimazol desarrolló una severa agranulocitosis con plasmacitosis medular que simula mieloma múltiple y que mejoró con tratamiento.(Rev Med Hered 2005;16:157-161.

  10. 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

  11. Síndrome diencéfalico como causa de desnutrición severa

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    Leonor Báez Segurola

    2013-03-01

    Full Text Available El síndrome diencefálico es un complejo de síntomas y signos causados por disfunción de esta área del encéfalo caracterizado por una marcada desnutrición aun cuando la ingesta calórica es normal. Se presentan dos casos, el primero de ellos una niña de 13 meses de edad con antecedentes de un fallo de medro a partir del tercer mes de vida, que ingresó en este servicio para el estudio de una desnutrición proteico energética severa que presentó en el transcurso de su evolución un apetito inestable y al mes de ingresada un evento paroxístico. Se le realizó resonancia magnética nuclear y se comprobó imagen hipodensa, redondeada, que medía aproximadamente 3 x 3 cm en región supraselar; fue intervenida quirúrgicamente en 2 ocasiones, se realizó exéresis del tumor, y se confirmó anatomopatológicamente un astrocitoma pilocítico de bajo grado. El segundo paciente, un lactante que ingresó con el diagnóstico confirmado de tumor intracraneal para estudio, semejante al caso presentado anteriormente, mostraba una marcada desnutrición proteico energética, se le realizó tomografía axial computarizada en la que se pudo apreciar una extensa masa tumoral supraselar con dilatación del sistema ventricular. Durante su evolución presentó marcada anorexia con pérdida de peso progresiva, por lo que se realizó gastrostomía. A los 59 días falleció como consecuencia de una pancitopenia, y la necropsia concluyó: astrocitoma pilocítico de bajo grado.

  12. 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.

  13. Intoxicação por carambola em paciente com insuficiência renal crônica: relato de caso Star fruit intoxication in a chronic renal failure patient: case report

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    Fábio Gonzaga Moreira

    2010-12-01

    Full Text Available A insuficiência renal crônica é doença de elevada morbidade e mortalidade e sua incidência e prevalência em estágio terminal têm aumentado progressivamente a cada ano. Segundo a Sociedade Brasileira de Nefrologia, as principais causas de insuficiência renal crônica são hipertensão arterial, glomerulonefrite e diabetes mellitus. Diversos fatores elevam o risco de mortalidade em pacientes com nefropatia crônica, principalmente idade, presença de diabetes e número de comorbidades associadas. Para pacientes com menos de 50 anos de idade a taxa de sobrevida em 5 anos é de 62% e para aqueles acima desta idade e com diagnóstico de diabetes mellitus a sobrevida é de apenas 23%. A carambola, fruta originária da Ásia e muito difundida na maioria dos países tropicais, tem sido reportada como contendo uma neurotoxina capaz de provocar graves alterações neurológicas em pacientes com histórico de nefropatia crônica. Dentre estas alterações podemos observar desde quadros leves, como soluços e confusão mental, até quadros mais sérios, como convulsões e morte. Essa neurotoxina parece apresentar especificamente inibição sobre o sistema de condução GABAérgico. Descrevemos o caso de um paciente nefropata crônico que, após ingestão de carambola, inicia quadro de mal-estar, náuseas e vômitos, seguidos de episódios convulsivos reentrantes e vai a óbito mesmo com o tratamento hemodialítico convencional.Chronic renal failure is a high morbidity and mortality condition, with its terminal phase incidence and prevalence steadily growing year after year. According to the Sociedade Brasileira de Nefrologia [Brazilian Society of Nephrology], the main causes of renal failure are arterial hypertension, glomerulonephritis and diabetes mellitus. Several factors are implied on chronic renal failure patients' risk of mortality, particularly age, diabetes and associated co-morbidities. For patients below 50 years old, the 5 years

  14. Hepatitis alcohólica severa no respondedora a glucocorticoides:

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    Felipe Olivares A.; María José de la Piedra B; Aranzazu Jugo B.; Verónica Vial L; Nicolás Morán C.; Hernán Oyarzún R.; Carolina Wenk

    2014-01-01

    RESUMEN INTRODUCCIÓN: La hepatitis alcohólica corresponde a un daño inflamatorio agudo sobre un hígado progresivamente dañado por la ingesta excesiva y prolongada de alcohol. Puede presentar ictericia, manifestaciones de alcoholismo crónico e insuficiencia hepática progresiva. PRESENTACIÓN DEL CASO: Varón de 60 años con antecedentes de daño hepático crónico secundario a alcoholismo activo, que presentó cuadro de dos semanas de ictericia progresiva, prurito y bradipsiqu...

  15. Insuficiências respiratória e renal desencadeadas por miopatia metabólica por acúmulo de lipídios: relato de caso Respiratory and renal dysfunctions due to lipid storage metabolic myopathy: case report

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    Walther de Oliveira Campos Filho

    2002-09-01

    Full Text Available Relatamos o caso de um paciente de 26 anos que apresentou quadro clínico de rabdomiólise e mioglobinúria associadas a insuficiência renal e respiratória, três dias após o início de infecção de vias aéreas superiores. Os dados clínicos e laboratoriais, eletroneuromiografia e biópsia muscular conduziram ao diagnóstico de miopatia metabólica por deficiência enzimática relacionada ao metabolismo dos ácidos graxos. O paciente evoluiu favoravelmente com a instituição de suporte avançado de vida, incluindo assistência ventilatória e terapia dialítica, adequação dietética e reposição de L-carnitina. Discorremos sobre as diversas miopatias metabólicas, o diagnóstico, o diagnóstico diferencial e o tratamento.We report a case of a 26-years old male patient with rhabdomyolisis with myoglobinuria associated with acute renal and respiratory failure, that occurred three days after upper airway infection. In the clinical and laboratory investigation of the patient, including electromyography and muscular biopsy, the diagnostic lead to a metabolic myopathy due to an enzymatic deficiency related to a disorder of lipid metabolism. The patient improved successfully with institution of advanced life support, including ventilatory assistence, dialysis, dietary adjust and L-carnitine reposition.

  16. Ectopia renal cruzada con fusión, reflujo vesicoureteral y riñón ectópico afuncional:: informe de un caso Crossed renal ectopia with fusion, vesicoureteral reflux and dysfunctional ectopic kidney:: A case report

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    Sandalio Durán Álvarez

    2010-03-01

    Full Text Available Se presenta el caso de un niño cuyo ultrasonido materno-fetal de la semana 20 de la gestación no detectó alteraciones, pero el de la semana 23,6 mostró un riñón pélvico derecho. A los 22 días de nacido el ultrasonido renal mostró un riñón derecho de tamaño y posición normal y dilatación pélvica moderada, e inmediatamente por debajo del polo inferior de éste, un bolsón hidronefrótico que parecía corresponder a una ectopia renal cruzada con hidronefrosis grave. El padre padeció reflujo vesicoureteral derecho que desapareció espontáneamente. A pesar de la profilaxis con cefalexina, hubo una infección urinaria que se trató satisfactoriamente con ceftriaxona. Investigaciones ultrasonográficas y radioisotópicas arrojaron la existencia de una anomalía congénita dada por dilatación pélvica no obstructiva del riñón derecho, ectopia renal cruzada con fusión del riñón izquierdo afuncional y reflujo vesicoureteral bilateral, de grado II del riñón derecho y de grado V del izquierdo ectópico cruzado. A los 11 meses de edad se le realizó una lumbotomía y se comprobó la fusión del bolsón hidronefrótico con el polo inferior del riñón derecho. Se resecó el bolsón y se realizó una ligadura baja del uréter.This is the case of a child whose maternal-fetus ultrasound (US at twenty weeks pregnancy not detected alterations, but at the 23, 6 weeks it showed the presence of a right pelvic kidney. At twenty two days the renal US showed a right kidney with a normal size and location as well as a moderate pelvic dilation and immediately beneath its lower pole a hydronephrosis big sac in correspondence with a crossed renal ectopia with severe hydronephrosis. His father had right vesiculorectal reflux disappeared spontaneously. Despite the prophylaxis with Cephalexin there was a urinary infection adequately treated with Cephtriaxone. Ultrasonography and radioisotope researches demonstrated the presence of a congenital anomaly

  17. Legrado uterino o nifedipina durante el posparto en pacientes con preeclampsia severa

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    Santos-Bolívar, Joel; Guerra-Velásquez, Mery; Reyna-Villasmil, Eduardo; Mejia-Montilla, Jorly; Reyna-Villasmil, Nadia

    2011-01-01

    Objetivo: Comparar la eficacia del legrado uterino o la nifedipina durante el posparto en pacientes con preeclampsia severa. Ambiente: Maternidad “Dr. Nerio Belloso”, Hospital Central “Dr. Urquinaona”, Maracaibo. Estado Zulia. Métodos: Se realizó una investigación en 60 pacientes con diagnóstico de preeclampsia severa que fueron divididas de la siguiente manera: grupo A (n = 30) que fueron sometidas a legrado uterino inmediatamente después del parto y grupo B (n = 30) que recibieron nifedipin...

  18. Cintilografia renal com ácido dimercaptossuccínico marcado com tecnécio no diagnóstico da pielonefrite na infância: estudo de 17 casos Renal scintigraphy using technetium dimercaptosuccinic acid in the diagnosis of pyelonephritis in children: study of 17 cases

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    Eliana B.M. Guidoni

    2001-04-01

    Full Text Available OBJETIVO: a infecção do trato urinário é uma das doenças bacterianas mais freqüentes em pediatria. O envolvimento infeccioso renal (pielonefrite pode evoluir com formação de cicatriz renal irreversível com conseqüente perda funcional e dano renal progressivo. Estudos recentes sugerem que até 50-60% das cicatrizes renais poderiam ser evitadas ou atenuadas com o diagnóstico precoce da pielonefrite. O objetivo deste estudo é determinar se a presença de alterações na cintilografia renal com DMSA na fase aguda da infecção urinária pode ser indicadora de pielonefrite. MÉTODOS: empregamos a técnica de washout em 17 meninas portadoras de infecção urinária como padrão-ouro na localização do sítio da infecção. Todas as crianças realizaram cintilografia renal com DMSA na fase aguda da infecção. Os resultados foram analisados pelo teste do qui-quadrado ou de Fisher. RESULTADOS: a cintilografia renal com DMSA detectou alterações em todos os cinco casos de pielonefrite diagnosticados pelo washout sugerindo envolvimento renal. Observamos também que apenas uma das crianças com cistite (total = 12 casos apresentava alterações ao DMSA. Portanto, a sensibilidade e especificidade deste estudo com DMSA na fase aguda da infecção foi de 100% e 92% respectivamente no diagnóstico da pielonefrite. CONCLUSÕES: a cintilografia renal com DMSA mostrou-se método sensível no diagnóstico da pielonefrite aguda em crianças.OBJECTIVE: to determine whether the presence of abnormal results in DMSA renal scintigraphy indicates pyelonephritis. METHODS: we performed the washout test in 17 children with urinary tract infection, as a criterion standard, to locate the infection site. All the children underwent DMSA renal scintigraphy in the acute phase of the disease. The results were analyzed by the chi-square test or Fisher test. RESULTS: DMSA renal scintigraphy revealed changes in all five cases of pyelonephritis, suggesting acute kidney

  19. Hiperpotassemia pela solução Euro-Collins na anestesia para transplante renal: relato de caso

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    Eunice Sizue Hirata

    2013-10-01

    Full Text Available OBJETIVOS: Descrever uma anestesia para transplante renal que se complicou com a elevação brusca de potássio, pela reperfusão do rim com solução Euro-Collins no campo operatório. Também será relatado o diagnóstico e o tratamento empregados nessa complicação. CONCLUSÃO: O uso de soluções de perfusão no campo cirúrgico requer cuidados na monitoração, como eletrocardioscopia e dosagem de potássio sérico, e disponibilidade para uso imediato de gluconato de cálcio, insulina e salbutamol. A substituição da solução Euro-Collins por soro fisiológico imediatamente antes do implante pode ser uma opção útil em pacientes com níveis de potássio sabidamente elevados.

  20. Acute lower gastrointestinal hemorrhage originating in the small intestine Hemorragia digestiva baja severa originada en el intestino delgado

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    A. Ríos

    2006-03-01

    las etiologías más frecuentes se localizan a nivel colónico. El objetivo es analizar el manejo diagnóstico-terapéutico de las HDB severas cuya etiología se localizaba en el intestino delgado. Pacientes y métodos: entre 1975 y marzo del 2002 ingresaron en nuestro servicio 12 HDB severas originadas en el intestino delgado. Todos consultaron por rectorragia franca, precisando al menos transfusión de 3 unidades de concentrados de hematíes. La edad media fue de 54 ± 21 años, el 58% eran mujeres, y el 83% había presentado cuadros previos de HDB. Resultados: en once casos (92% se realizó una endoscopia digestiva alta y baja urgente no objetivando el origen del sangrado. La arteriografía se indicó en 7 pacientes (58%, localizando en 5 de ellos el sangrado. En dos casos se hizo una gammagrafía mostrando en uno un divertículo de Meckel y en el otro fue normal. Todos se intervinieron, 8 (67% de urgencias, encontrándose un tumor en 9 casos y un divertículo de Meckel en 3, realizándose resección de todas las lesiones. La histología informó de leiomioma en 7 casos, de divertículo de Meckel en 3, de leiomioblastoma en 1 y de angioma en el caso restante. Tras un seguimiento medio de 132 ± 75 meses, fue éxitus el leiomioblastoma, y recidivó el angioma, el cual fue embolizado radiológicamente con éxito. Conclusiones: la HDB severa de origen en intestino delgado debe considerarse como posibilidad etiológica cuando la endoscopia digestiva no objetiva el origen del sangrado, siendo la arteriografía una técnica diagnóstica útil para localizar el sangrado. La cirugía supone el tratamiento definitivo del proceso, confirma la etiología, y descarta la presencia de malignidad.

  1. Colite por citomegalovirus em paciente transplantada renal: relato de caso e revisão da literatura Citomegalovirus colitis in kidney transplant patient: case report and literature review

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    Rogério Saad Hossne

    2007-06-01

    Full Text Available A infecção do citomegalovírus ocorre geralmente em pacientes imunocomprometidos sejam pós-transplantados ou pelas doenças que comprometem o sistema imune (AIDS; apresentamos um caso de um paciente do sexo feminino de 49 anos de idade, que se encontrava em pós-operatório tardio de transplante renal (14 anos, fazendo uso de medicações imunossupressoras. Evolui com quadro de dor abdominal, perda do peso e diarréia não sanguinolenta na fase inicial, necessitando de hospitalização, durante a qual desenvolveu severos quadros de hematoquezia e hipotensão. Submetida a colonoscopia que revelou mucosa de aspecto friável, com úlceras do tipo aftóides, fibrina e formação de pseudopólipos; a biopsia revelou tratar-se de citomegalovírus. Evolui sem melhora com o uso do foscarnet r, necessitando de tratamento cirúrgico, indo a óbito após 5 dias.Cytomegalovirus infection frequently develops in immunocompromised patients, either in post-transplanted patients or in patients with diseases that affects the immune system, such as AIDS; we present a case of a 49 year old female patient in late post surgery (14 years of a kidney transplant, using immunosuppressing medication. The patient presented abdominal pain, weight loss and initial diarrhea, she was hospitalized and developed severe hematochezia and hypotension. The patient was submitted to a colonoscopy and presented friable aspect mucosa, with aphthoid ulcers, fibrin and pseudopolyp formation; biopsy revealed cytomegalovirus. Her condition did not improve after the use of foscarnet, and surgical treatment was necessary. The patient died 5 days later.

  2. Severe perioperative bleeding in renal cell carcinoma after elective pericardiocentesis associated left ventricular puncture: case report

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    Javier Lasala

    2016-07-01

    Full Text Available Resumen En los Estados Unidos se estimó que, durante el 2015, unos 61 560 pacientes serían diagnosticados con cáncer renal y que 14 080 morirían por esta enfermedad. Presentamos el caso de un paciente con carcinoma de células renales y trombo tumoral de vena cava inferior que sufrió una hemorragia perioperatoria grave y coagulopatía después de una esternotomía de emergencia. También abordamos aspectos relevantes del cuidado anestésico perioperatorio incluyendo consideraciones y manejo de coagulopatía, falla renal y hepática en un paciente oncológico. El caso es un hombre de 49 años que fue llevado a embolización tumoral guiada por radiología, nefrectomía radical izquierda y trombectomía de vena cava inferior. En el período postoperatorio desarrolló sepsis, falla orgánica múltiple y efusión pericárdica que requirió pericardiocentesis. Durante la pericardiocentesis sufrió perforación iatrogénica de ventrículo izquierdo que necesitó esternotomía de emergencia y reparación del ventrículo izquierdo. Los pacientes con cáncer son a menudo un reto para el equipo de cirugía y anestesia, y el cuidado de emergencia requiere un abordaje integral y organizado. El uso de factor recombinante VIIa NovoSeven puede ayudar en el manejo de la hemorragia severa perioperatoria después de cirugía cardiotorácica en pacientes oncológicos, pero se deben hacer estudios posteriores para confirmarlo.

  3. Histiocitosis maligna: Reporte de un caso

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    Oscar Ruiz

    2004-12-01

    Full Text Available Paciente varón de 14 años, procedente de Huancayo, que presenta un mes antes de su hospitalización intolerancia gástrica, ictericia, fiebre y síndrome linfoproliferativo. Se encontró en los exámenes de laboratorio pancitopenia severa por hemofagocitosis. El diagnóstico hematológico y anatomopatológico fue histiocitosis maligna. Se presenta este caso por ser una entidad infrecuente y una emergencia médica.

  4. Revascularización quirúrgica en pacientes con disfunción ventricular severa

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    Carlos A. Martínez-Cano

    2016-09-01

    Conclusiones: Este estudio sugiere que el pronóstico de los pacientes con disfunción sistólica severa que son llevados a la revascularización quirúrgica es similar a lo reportado en otros estudios y adicionalmente se acompaña de mejoría de la fracción de eyección.

  5. Amiloidosis cardiaca: presentación de un caso y revisión de la literatura

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    Luis Enrique Núñez Moscoso, MD

    2012-01-01

    Se presenta el caso de un paciente de género masculino, con signos de disfunción cardiaca diastólica severa y se analizan los hallazgos de la historia clínica y los datos de ayuda al diagnóstico. Finalmente, se hace una revisión de la literatura.

  6. Reação anafilática durante transplante renal intervivos em criança alérgica ao látex: relato de caso Reacción anafiláctica durante transplante renal intervivos en niño alérgico al látex: relato de caso Anaphylaxis during renal transplantation of live donor graft in a child with latex allergy: case report

    Directory of Open Access Journals (Sweden)

    Glória Maria Braga Potério

    2009-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A alergia ao látex vem se tornando frequente, atingindo pacientes e profissionais de saúde. O objetivo deste relato foi apresentar um caso de criança alérgica ao látex que desenvolveu crise anafilática durante anestesia para transplante renal e destacar algumas condutas multiprofissionais empregadas para diminuir o risco de choque anafilático após a reperfusão do transplante. RELATO DO CASO: Criança do sexo masculino, com 5 anos e 10 meses, P3 pela classificação da ASA, com história de alergia ao látex, diagnosticada após contato com bexigas de festa e confirmada por testes Rast específico para o látex e Prick teste, foi submetida a transplante renal intervivos, por insuficiência renal terminal em consequência de malformação urológica. Os cuidados para evitar a exposição da criança ao látex seguiram os protocolos para paciente alérgico ao látex, adotados pelo Serviço de Anestesia e de Enfermagem do Hospital das Clínicas da UNICAMP. Foram iniciados na véspera da operação com a limpeza terminal das salas cirúrgicas e a substituição de todos os produtos médico-hospitalares por produtos isentos de látex. Os equipamentos e materiais utilizados durante o procedimento possuíam laudo técnico de isenção completa de látex, fornecido pelo fabricante. A operação foi realizada sob anestesia geral com ventilação controlada mecânica. Ao final da operação necessitou de transfusão de concentrado de hemácias administrado com auxílio de pressurizador, apresentando rash cutâneo, cessou-se a transfusão, administrou-se hidrocortisona e aumentou-se a infusão de cristaloides. A resposta ao tratamento foi satisfatória e imediata. CONCLUSÕES: A alergia ao látex tornou-se um problema de saúde pública e o conhecimento de condutas terapêuticas específicas possibilita o pronto atendimento e menor risco para os pacientesJUSTIFICATIVA Y OBJETIVOS: La alergia al látex ha venido alcanzando

  7. Tratamento de aneurisma da artéria renal por embolização e técnica de remodelamento de colo: relato de caso Endovascular treatment of renal artery utilizing embolization and aneurism neck remodeling technique: case report

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    Luis Carlos Mendes de Brito

    2011-06-01

    Full Text Available O tratamento endovascular dos aneurismas de artéria renal tem sido descrito como alternativa à cirurgia convencional. Relatamos o caso de uma paciente com um aneurisma de artéria renal complexo à direita que apresentava hipertensão arterial de difícil controle. O tratamento endovascular foi realizado com a técnica de remodelagem de colo (técnica de Moret, ou técnica de embolização assistida por balão. A paciente obteve normalização da pressão arterial após o procedimento sem recidiva dos sintomas ou necessidade do uso de drogas anti-hipertensivas.Endovascular treatment of renal artery aneurysms has been described as an alternative to conventional surgery. We report the case of a patient with complex renal artery aneurysm on the right kidney who had hard-to-control arterial hypertension. Endovascular treatment was performed with the aneurysm neck remodeling technique (Moret technique, or balloon-assisted coil embolization. The patient achieved blood pressure normalization after the procedure without recurrence of symptoms or need for antihypertensive drugs.

  8. Demanda turística por destinos com severas limitações de acesso: casos brasileiros

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    Glauber E.O. Santos

    2017-01-01

    Full Text Available One of the main strategies of the Brazilian Tourism Ministry to increase tourist flows at national destinations was the nomination of 65 key destinations for tourism in the country. This research aimed to analyze the leisure tourism demand for key destinations with severe access limitations. A survey was conducted with tourists of 3 selected key destinations: Diamantina (MG, Parnaíba (PI and Lençóis (BA. The main findings indicate the predominance of tourists of middle age, males and varied income levels. São Paulo is the single most important market for all 3 destinations. Among the main conclusions are the questioning of the key role of these destinations for tourism, and the positive opinion of tourists about access conditions, despite the large distances travelled (average of 1,333 Km and the fact that a significant share of them used mainly inland modes of transport.

  9. Globulina antilinfocítica en el tratamiento de la anemia aplásica severa

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    Víctor Ulloa Perez

    1999-10-01

    Full Text Available Objetivo: Describir la experiencia en nuestro hospital en el tratamiento de anemia aplásica severa con globulina antilinfocítica. Materiales y Metodos: Se estudiaron 58 pacientes con AAS diagnosticados entre 1988-1998 de los cuales 25 recibieron Globulina antilinfocítica (GAL, 56% de ellos eran menores a 20 años de edad,19 de los pacientes tratados con GAL son del sexo masculino . Resultado: Respondieron favorablemente 68%(17pacientes,la mayoría de ellos (64%alcanzaron esta respuesta durante los primeros 6 meses. Un paciente evolucionó a Hemoglobinuria paroxística nocturna (HPN, efectos adversos fueron leves y de corta duración. (Rev Med Hered;1999 ;10:132 - 136 .

  10. Imersão em água fria para o manejo da hipertermia severa

    OpenAIRE

    Viveiros,Jacqueline de Paula; Meyer,Flávia; Kruel,Luiz Fernando Martins

    2009-01-01

    A incapacidade de dissipar o calor gerado pela atividade muscular prejudica o desempenho e aumenta a predisposição a lesões do organismo. A hipertermia severa induzida pelo esforço físico (HTE) prejudica a saúde e está associada à morbidade e mortalidade de indivíduos em diferentes atividades ocupacionais e atléticas. Estudos sobre a eficiência de métodos de resfriamento corporal têm recomendado a imersão em água fria para o tratamento da HTE. Sua utilização nos minutos iniciais pós-hipertemi...

  11. Renal involvement in human rabies: clinical manifestations and autopsy findings of nine cases from northeast of Brazil Envolvimento renal na raiva em humanos: manifestações clínicas e achados de autópsia de nove casos do nordeste do Brasil

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    Elizabeth De Francesco Daher

    2005-12-01

    Full Text Available A retrospective study was conducted in nine patients with rabies admitted to a hospital of Fortaleza, Brazil. Autopsy was performed in all cases. The ages ranged from three to 81 years and six were males. They all were bitten by dogs. The time between the accident and the hospital admission ranged from 20 to 120 days (mean 45 ± 34 days. The time until death ranged from one to nine days (mean 3.3 ± 5.5 days. The signs and symptoms presented were fever, hydrophobia, aerophobia, agitation, disorientation, dyspnea, sialorrhea, vomiting, oliguria, sore throat, pain and hypoesthesia in the site of the bite, headache, syncope, cough, hematemesis, mydriasis, hematuria, constipation, cervical pain and priapism. In three out of six patients, there was evidence of acute renal failure, defined as serum creatinine > 1.4 mg/dL. The post-mortem findings in the kidneys were mild to moderate glomerular congestion and mild to intense peritubular capillary congestion. Acute tubular necrosis was seen in only two cases. This study shows some evidence of renal involvement in rabies. Histopathologic findings are nonspecific, so hemodynamic instability, caused by autonomic dysfunction, hydrophobia and dehydration must be responsible for acute renal failure in rabies.Foi realizado estudo retrospectivo de nove casos de raiva internados em um hospital de Fortaleza, Brasil. Autópsia foi realizada em todos os casos. As idades variaram de 3 a 81 anos. Todos foram agredidos por cães. O tempo entre o acidente e a admissão hospitalar variou de 20 a 120 dias (média de 45 ± 34 dias. O tempo de internamento variou de 1 a 9 dias (média de 5.5 ± 3.1 dias. Os sinais e sintomas observados foram febre, hidrofobia, aerofobia, agitação, desorientação, dispnéia, sialorréia, vômitos, oligúria, faringite, dor e hipoestesia no local da mordida, cefaléia, síncope, tosse, hematêmese, midríase, hematúria, constipação, dor cervical e priapismo. Em três de seis pacientes

  12. Síndrome de Allgrove. Informe de casos.

    OpenAIRE

    Alejandro Román; Catalina Montoya; Juliana Zapata; Juan Manuel Alfaro; Vital Balthazar

    2009-01-01

    El síndrome de Allgrove fue descrito en 1978 por Allgrove et al. como una entidad familiar de origen desconocido caracterizada por deficiencia aislada de glucorticoides, acalasia esofágica y producción defectuosa de lágrimas, por lo que ha sido denominado síndrome triple AAA (adrenal insufficiency, achalasia, alacrima); por lo general aparece durante la primera década de la vida con disfagia o con crisis suprarrenal severa; son pocos los casos diagnosticados de novo en los adultos en quienes...

  13. Eritrocitosis post trasplante renal y su tratamiento farmacológico: inhibidores de la enzima convertidora de angiotensina versus bloqueadores de los receptores de angiotensina en un caso

    OpenAIRE

    Duclos H,Jaime

    2000-01-01

    A 35 years old male is presented. Eight months after receiving a renal allograft his hypertension worsened and his packed red cell volume raised to 53.7%. Enalapril was started and a 500 ml phlebotomy was performed. In three occasions packed red cell volumes decreased excessively and enalapril was discontinued. Finally, the drug was replaced with losartan, normalizing blood pressure values and stabilizing packed red cell volumes. This case illustrates the different reductions in packed red ce...

  14. Duodenal angiodysplasia: case report and literature review Angiodisplasia duodenal: relato de caso e revisão da literatura

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    Roberto Pelegrini Coral

    2007-06-01

    Full Text Available BACKGROUND: Angiodysplasia is a distinct mucosal vascular lesion associated with acute or chronic gastrointestinal bleeding. It occurs most frequently in the right colon and is extremely rare. Its etiology is unknown, but theories of its pathogenesis have evolved from its similarity to colonic angiodysplasia and the lesion appears to be associated with renal insufficiency. CASE REPORT: Sixty-five-year-old woman with repeated melena and severe anemia due to angiodysplasia in the first portion of the duodenum. The diagnosis was done by upper endoscopy. As the patient presented repeated gastrointestinal bleeding with hemodynamic instability and recurrent anemia, surgery was indicated. At laparotomy the lesion was identified and resected with an Y-en-Roux reconstruction. The patient went on well at the immediate and late (four years postoperative periods with no more recurrent gastrointestinal bleeding. CONCLUSION: Although most of the patients suffering from gastrointestinal angiodysplasia goes on well with conservative management, there is a small portion of them that will need a more aggressive approach, as in this case.RACIONAL: Angiodisplasia duodenal é uma lesão vascular distinta da mucosa intestinal associada com sangramento agudo ou crônico. Embora seja extremamente rara no duodeno, ocorre com maior freqüência no cólon direito. Tem etiologia desconhecida, mas sua patogênese parece semelhante com a do cólon. Em alguns casos está associada à insuficiência renal. RELATO DO CASO: Paciente de 65 anos de idade com episódios repetidos de melena e anemia severa devido à presença de lesão angiodisplásica na primeira porção do duodeno, cujo diagnóstico fôra estabelecido por endoscopia digestiva alta. Como ela apresentara-se com episódios repetidos de hemorragia digestiva alta acompanhados de instabilidade hemodinâmica, foi-lhe indicada cirurgia. À laparotomia, identificou-se a lesão, que foi ressecada, sendo realizada reconstru

  15. Um caso de recuperação da função renal na síndrome hemolítico-urêmica tratada com eculizumab

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    João Samuel de Holanda Farias

    2016-03-01

    Full Text Available Resumo A síndrome hemolítico-urêmica atípica (SHUa é uma doença grave, pouco prevalente, com acometimento em qualquer idade e apresentação esporádica ou familiar. A SHUa é causada por uma ativação descontrolada do sistema complemento. A plasmaférese foi o tratamento padronizado por anos, com resultados desfavoráveis, levando à doença renal crônica terminal ou morte em aproximadamente 40% dos pacientes durante as primeiras manifestações clínicas. O Eculizumab é um anticorpo monoclonal humanizado contra o componente C5 do complemento e nos últimos anos vem sendo utilizado como novo arsenal terapêutico com resultados promissores. O presente caso descreve uma paciente adulta tratada com eculizumab em que se obteve resultados satisfatórios evitando-se potenciais riscos e aumento da morbidade com o procedimento de plasmaférese.

  16. Eficacia de la aplicación de criterios de bajo riesgo de infección bacteriana severa en recién nacidos febriles

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    Manuel Díaz Alvarez

    1996-12-01

    Full Text Available Se estudiaron 229 recién nacidos febriles sin signos de focalización en su evaluación inicial, en los cuales se consideró una serie de datos clínicos y de laboratorio, con el objetivo de valorar la efectividad de éstos como medio de predicción negativa de infección bacteriana severa (IBS, y así poder calificar un grupo como de bajo riesgo de IBS, y comparar estos criterios con los de Rochester aplicados a este mismo grupo de pacientes. La evaluación diagnóstica dio un valor predictivo negativo de 98,9 %. Con estos datos se conformó un test de evaluación que permitió calificar eficazmente a un grupo de pacientes como de bajo riesgo de IBS, al presentarse dentro de éstos sólo un caso con IBS, a diferencia de 40 casos en el grupo calificado como de alto riesgo. La comparación de los criterios de Rochester con los del presente trabajo destacó un saldo superior para los nuestros.229 febrile newborns with no signs of focalization in their initial evaluation were studied. A series of clinical and laboratory data was considered with the aim of assessing their effectiveness as a means of negative prediction of serious bacterial infection (SBI, and of qualifying a group as of low risk serious bacterial infection and comparing these criteria with those of Rochester applied to this same group of patients. The diagnostic evaluation showed a negative predictive value of 98,9 %. With these data it was possible to make an evaluation test which allowed the effective qualification of a group of patients as of low risk serious bacterial infection, taking into account that only a case of SBI was found among them, compared with 40 cases detected in the high risk group. On comparing Rochester's criteria with the ones included in the present paper, a higher balance was obtained for ours.

  17. Polisomnografía neonatal en recién nacidos con asfixia severa al nacer

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    Yolma Ruiz Tellechea

    2000-06-01

    Full Text Available Se evaluó la utilidad de la polisomnografía neonatal en 101 neonatos con asfixia severa, nacidos en el Hospital Ginecoobstétrico "Ramón González Coro", en el período comprendido entre octubre de 1988 y agosto de 1994, para lo cual se realizó estudio polisomnográfico en la primera semana de vida, se tuvo en cuenta la presencia o no de encefalopatía hipóxico-isquémica, se estudió la correlación del estudio neurofisiológico con el examen neurológico y con el registro electroencefalográfico de seguimiento y se utilizó el estadígrafo Kappa para medir el grado de concordancia entre las variables. Se concluye que la polisomnografía neonatal resultó ser un buen indicador del estado anatomofuncional del sistema nervioso central en el período de recién nacido.The usefulness sof polysomnography was evaluated in 104 neonates with severe birth asphyxia, who had been born in "Ramón Gónzalez Coro" Gynecologic and Obstetric Hospital from October 1988 to August 1994. To this end, polysomnographic studies were conducted in the first week of life taking into consideration the presence or absence of hypoxic-ischemic encephalopathy, the correlation of neurophysiological study with the neurological examination and the follow-up electroencephalograph register were analyzed; and Kappa stadigraph to measure the level of agreement among variables was used. It was concluded that neonatal polysomnography was a good indicator of anatomic and functional status of the central nervous system in neonatal period.

  18. Síndrome de Phelan-McDermid: reporte de un caso y revisión de la literatura

    OpenAIRE

    Mariana Hernández Gómez; Ricardo Meléndez Hernández; Eva Ramírez Arroyo; Dora Gilda Mayén Molina

    2018-01-01

    El síndrome de Phelan-McDermid (SPMD) es un desorden del neurodesarrollo, también llamado síndrome de deleción 22q13.3, que genera la pérdida de la función del gen SHANK3. Se caracteriza por hipotonía neonatal severa, retardo global del desarrollo, retraso severo o ausencia de lenguaje y dismorfias menores. El 80% de los casos son de novo y, a pesar de que su prevalencia es desconocida, se han descrito aproximadamente 1200 casos alrededor del mundo. Es una causa frecuente de desorden con espe...

  19. Protección oportuna y diferenciada a madres de hijos con discapacidad severa.

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    Norma Echemendía Gómez

    2007-03-01

    Full Text Available En el Estudio Integral de la discapacidad llamó poderosamente la atención las madres de hijos con discapacidad severa, que en condiciones muy adversas se mantenían trabajando o habían dejado de hacerlo. Siendo emitidas por la Dirección Nacional de Seguridad Social las Indicaciones Metodológicas para la protección salarial, laboral y de seguridad social de estas mujeres, prioridad del Ministerio de Trabajo y de Seguridad Social la atención de estas madres en cada territorio. Es el municipio de Sancti Spíritus el de mayor cantidad de madres protegidas en la provincia, estas razones justifican este trabajo. El Objetivo General: valorar los resultados obtenidos en los núcleos protegidos posterior a la aplicación de las Indicaciones Metodológicas en el municipio cabecera. Los objetivos específicos: caracterizar la protección económica alcanzada en estos núcleos, constatar la valoración que realizan estas madres sobre la atención médica, educativa y social que reciben. Se aplicó revisión de documentos primarios, tomándose como muestra a 25 expedientes de prestaciones de la Seguridad Social de la Dirección Municipal de Trabajo y se le aplicó entrevista individual a 15 de ellas. Entre los resultados: Se expone el alcance y características de la protección económica y los resultados alcanzados en las esferas Médico, Educacional y Social. A partir de las recomendaciones surgidas de los resultados, la Subdirección de Seguridad Social del municipio reconoció conveniente adecuar un solo expediente laboral y de prestaciones para cada madre y la CTC municipal aprobó la afiliación de las madres trabajadoras a la correspondiente sesión sindical, dando respuesta a la principal petición de las madres entrevistadas.

  20. Fenestración videolaparoscópica de un linfocele sintomático posterior a un trasplante renal

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    Miguel Ángel Martín González

    2003-09-01

    Full Text Available Este trabajo tiene el objetivo de describir un caso tratado por videolaparoscopia, de un linfocele sintomático posterior a trasplante renal. Se refiere a una mujer de 54 años con insuficiencia renal crónica terminal, secundaria a hipertensión arterial severa, la cual se le realizó en el 2001 un trasplante renal de donante cadáver. Presenta, 3 meses después, molestias en la zona del trasplante, sin síntomas urinarios por la presencia de un catéter ureteral utilizado como férula y en tiempo para ser retirado. Se diagnostica un linfocele sintomático. Posterior al chequeo preoperatorio se efectúa drenaje interno por vía videolaparoscópica sin accidentes ni complicaciones quirúrgicas inmediatas y el retirado del catéter ureteral y el alta a las 24 y 48 h de la operación, respectivamente. Después de 10 meses de evolución no se ha encontrado ninguna complicación. El abordaje videolaparoscópico del linfocele sintomático posterior al trasplante renal constituye la terapéutica de elecciónThis paper is aimed at describing a case of symptomatic lymphocele after kidney transplantation, which was treated with videolaparoscopy. It was a 54 years-old woman with terminal chronic renal failure secondary to several blood hypertension, who was transplanted a kidney from a dead donor in 2001. She presented with some discomfort in the transplant area, without urinary symptoms, owing to a urethral catheter used as rod and due to be withdrawn. The diagnosis was symptomatic lymphocele. After pre-operative checking, internal drainage by videolaparoscopy was performed, with no accidents or immediate surgical complications; the urethral catheter was withdrawn at 24 hours and the patient was discharged at 48 hours. Ten months later, no complication was found. The videolaparoscopic treatment of symptomatic lymphocele after kidney transplantation is the therapy of choice

  1. Metapneumovirus humano (hMPV asociado con exacerbación de asma aguda bronquial severa Human Metapneumovirus (hMPV associated to severe bronchial asthmatic crisis

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    M. A. López

    2006-09-01

    Full Text Available El metapneumovirus humano (hMPV es un nuevo agente causal de infección aguda del tracto respiratorio, recientemente reportado tras su hallazgo en niños, jóvenes, adultos y ancianos. Las manifestaciones clínicas producidas por el hMPV son indistinguibles de aquellas provocadas por los virus respiratorios clásicamente conocidos, y varían desde infección asintomática hasta neumonía complicada. Por otro lado, se han descrito casos de exacerbación de asma bronquial asociados a la infección con hMPV. En este trabajo se describe el caso de un niño hospitalizado que presentó una crisis asmática bronquial severa con sospecha de una infección viral asociada. Por el test de inmunofluorescencia indirecta no se detectaron virus sincicial respiratorio (VSR, adenovirus, virus influenza a - b ni virus parainfluenza 1, 2 y 3. En un intento por detectar la presencia de hMPV, se realizó una RT-PCR para la amplificación de los genes N y F con resultado positivo. Conforme a nuestro conocimiento, esta sería la primera descripción de un caso de exacerbación de asma asociado a hMPV en nuestra región. Los resultados de este estudio serían similares a los reportados por otros autores, quienes postulan que, a semejanza de lo que ocurre con el VSR, una infección por hMPV puede gatillar una enfermedad respiratoria crónica, como el asma.Human Metapneumovirus (hMPV is a recently reported agent of acute infection in the respiratory tract. It has been found in children as well as in young adults and elders. The clinical manifestations produced by hMPV are indistinguishable from those by common respiratory virus, and can evolve from asymptomatic infection into severe pneumonia. On the other hand, some authors have described cases of bronchial asthma exacerbation associated with hMPV infection. In this work we report a case of a child who presented a severe bronchial asthmatic crisis with a suspected viral associated infection. Immunofluorescence tests

  2. Afectación ocular severa bilateral por déficit de vitamina A

    OpenAIRE

    Ruiz-Martín, MM; Boto-de-los-Bueis, A; Romero-Martín, R

    2005-01-01

    Caso clínico: Se presenta un paciente con pancreatitis crónica alcohólica con una queratitis ulcerativa periférica (QUP) en el ojo derecho (OD) y una úlcera estromal necrotizante e hifema en el ojo izquierdo (OI) asociadas a una malnutrición calórico-proteica con déficit de vitaminas liposolubles. Discusión: Aunque es raro en los países desarrollados, debe considerarse el déficit de vitamina A ante afectación corneal bilateral en pacientes alcohólicos, con patología gastrointestinal, pancreát...

  3. Acrosteolisis severa en artritis gotosa y síndrome de Down

    OpenAIRE

    Toro Gutiérrez, Carlos-Enrique; Medina, John Jairo; Coral-Alvarado, Paola; Mejía-Vallejo, Jimi; Rondón, Federico; Iglesias-Gamarra, Antonio; Restrepo, José Félix

    2007-01-01

    La asociación de gota y síndrome de Down (SD) es poco frecuente a pesar que ambas enfermedades son comunes en la población general. Más interesante aún es el hecho que la hiperuricemia sí es una característica frecuente entre las alteraciones metabólicas del SD. A continuación se informa el caso de un paciente de sexo masculino de 35 años con SD que consultó por artritis de tres años de evolución, inicial-mente en el quinto y luego en el primer dedo del pie izquierdo. Debido a la presencia de...

  4. Miasis orbital severa causada por Cochliomyia hominivorax en la región andina de Ecuador

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    Juan Dominguez Enríquez

    2016-01-01

    Full Text Available Presentamos el caso de una indígena kichwa de 91 años con miasis orbital destructiva que compromete globo ocular derecho con destrucción de tejido óseo orbital, nasal, etmoidal y del seno frontal, confirmado por tomografía axial computarizada y con reconstrucción ósea tridimensional. Infectada en una zona templada a 2,418 m de altitud en la provincia andina de Imbabura, Ecuador. La paciente se presentó en el Hospital de Cotacachi con una tumoración cavitaria en el globo ocular derecho acompañada de secreción maloliente, supurativa, observando y extrayéndose más de 100 larvas de moscas desde su interior. Estas fueron identificadas como Cochliomyia hominivorax, por la disposición de sus espiráculos respiratorios.

  5. Síndrome diencéfalico como causa de desnutrición severa Diencephalic syndrome as a cause of severe malnutrition

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    Leonor Báez Segurola

    2013-03-01

    Full Text Available El síndrome diencefálico es un complejo de síntomas y signos causados por disfunción de esta área del encéfalo caracterizado por una marcada desnutrición aun cuando la ingesta calórica es normal. Se presentan dos casos, el primero de ellos una niña de 13 meses de edad con antecedentes de un fallo de medro a partir del tercer mes de vida, que ingresó en este servicio para el estudio de una desnutrición proteico energética severa que presentó en el transcurso de su evolución un apetito inestable y al mes de ingresada un evento paroxístico. Se le realizó resonancia magnética nuclear y se comprobó imagen hipodensa, redondeada, que medía aproximadamente 3 x 3 cm en región supraselar; fue intervenida quirúrgicamente en 2 ocasiones, se realizó exéresis del tumor, y se confirmó anatomopatológicamente un astrocitoma pilocítico de bajo grado. El segundo paciente, un lactante que ingresó con el diagnóstico confirmado de tumor intracraneal para estudio, semejante al caso presentado anteriormente, mostraba una marcada desnutrición proteico energética, se le realizó tomografía axial computarizada en la que se pudo apreciar una extensa masa tumoral supraselar con dilatación del sistema ventricular. Durante su evolución presentó marcada anorexia con pérdida de peso progresiva, por lo que se realizó gastrostomía. A los 59 días falleció como consecuencia de una pancitopenia, y la necropsia concluyó: astrocitoma pilocítico de bajo grado.Diencephalic syndrome is a set of symptoms and signs caused by dysfunction in this area of the encephalon and characterized by marked malnutrition despite adequate intake of calories. Two cases were reported in this paper. The first one was a 13-years old girl with a history of medro failure since her 3rd month of life, who was admitted to this service for the study of her severe protein/energy malnutrition. In the course of her hospitalization, she presented with unstable appetite and

  6. Factores de riesgo de violencia escolar (bullying severa en colegios privados de tres zonas de la sierra del Perú

    Directory of Open Access Journals (Sweden)

    Isabel Amemiya

    2009-12-01

    Full Text Available Objetivo: Identificar los factores de riesgo de violencia escolar (bullying severa en alumnos de colegios privados de tres zonas de la sierra del Perú. Diseño: Estudio tipo encuesta. Institución: Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú. Participantes: Alumnos entre quinto de primaria y quinto de secundaria de colegios privados. Intervenciones: Una encuesta validada en estudios previos, para identificar violencia escolar (bullying, fue aplicada a 736 alumnos, entre quinto de primaria y quinto de secundaria, de colegios privados de Ayacucho, Huancavelica y Cusco (Sicuani. Se consideró bullying severo cuando contestaron positivamente 5 a más de las 9 opciones posibles de la pregunta que indagaba sobre los tipos de violencia. Se comparó 37 alumnos portadores de bullying severo con 74 alumnos tomados al azar del grupo que no tuvo violencia. Con análisis bivariado y multivariado de regresión logística se identificó factores asociados significativamente a la violencia escolar severa. Principales medidas de resultados: Factores de riesgo de violencia escolar (bullying severa. Resultados: La violencia escolar severa se asoció significativamente con reacción de padres al conocer el hecho, repetición de la amenaza a pesar de comunicar las agresiones, presencia de pandilleros en el colegio, tener amigos pandilleros y poseer defecto físico. La regresión logística encontró asociación significativa con la reacción de los padres, presencia de pandilleros y poseer un defecto físico. Conclusiones: Se ha encontrado que la violencia escolar severa se asocia a múltiples factores de riesgo, que pueden y deben ser detectados precozmente, debido al daño psicológico que produce en los estudiantes.

  7. Un caso raro de valvulopatía causada por alcaptonuria

    Directory of Open Access Journals (Sweden)

    Sara de Cima

    2018-01-01

    Full Text Available La alcaptonuria es una enfermedad rara autosómica recesiva del metabolismo de la tirosina que provoca el acúmulo de ácido homogentísico en determinados tejidos del cuerpo humano, como el tejido cartilaginoso, causando calcificación, degeneración y fibrosis. Las manifestaciones cardiovasculares son poco frecuentes, habiendo pocos casos descritos en la literatura en los que se produce afectación valvular cardíaca. Presentamos el caso de una mujer de 76 años con historia de alcaptonuria que fue diagnosticada de doble lesión aórtica severa e insuficiencia mitral moderada, requiriendo intervención quirúrgica para recambio valvular aórtico y mitral. Revisamos la etiología, la patogénesis, las manifestaciones clínicas, el diagnóstico y el tratamiento de esta patología.

  8. Infección bacteriana severa en niños febriles: Parámetros predictivos

    Directory of Open Access Journals (Sweden)

    Alicia Álvarez Rodríguez

    1997-12-01

    Full Text Available Diferentes investigadores han realizado estudios sobre el manejo del niño febril y plantean que es un dilema al que se enfrenta a diario el médico que atiende niños. Motivados por este tema se efectuó un estudio descriptivo retrospectivo de los niños febriles, sin causa aparente en su valoración inicial, que asistieron al servicio de urgencias en un período de 9 meses, con el objetivo de identificar el diagnóstico definitivo al egreso y se precisó el tipo de infección bacteriana severa y relacionó la presencia de éstos con parámetros clínicos y de laboratorios. El mayor número de niños febriles valorados e ingresados mostraron edades desde 91 días hasta 36 meses. El menor porcenaje de ellos ingresaron y desarrollaron alguna infección bacteriana severa principalmente neumonía, y fue mayor el porcentaje de niños con esta patología a menos edad con predominio del aspecto tóxico y de la temperatura 39 EC. Resultó el manejo ambulatorio del niño febril mayor de 90 días y bajo riesgo de infección bacteriana severa un ahorro en vidas y dinero, por lo que se recomienda generalizar el flujograma propuesto para la evaluación y manejo del niño febril de 3 a 36 meses de edad.Different researches have performed studies on the management of the febrile infant and they point out that this is a dilemma faced by every physician who takes care of children. Motivated by this subject, a descriptive and retrospective study of febrile infants was conducted. The study was carried out to evaluate febrile infants without evident cause at the baseline evaluation who attended the emergency service during a period of 9 months with the objective of identifying the definite diagnosis at admission. The type of bacterial infection was accurately assessed and the presence of this was related to clinical and laboratory parameters. The greatest number of febrile infants evaluated and admitted to hospital were 91 days-36 months old. The lowest percentage

  9. Modelo Ovino de Suspensión Laríngea para Disfagia Orofaríngea Severa

    Directory of Open Access Journals (Sweden)

    cristina Martin Villares

    2018-05-01

    Full Text Available Resumen Introducción y objetivo: la literatura científica ha validado el uso del model ovino no vivo para estudio e investigación de la disfagia orofaríngea severa. A partir de este modelo quirúrgico experimental, proponemos evaluar la eficacia de varias t?cnicas quirúrgicas indicadas en pacientes con disfagia orofaringea crónica y aspiración intratable que ocasionalmente se realizan en enfermos muy seleccionados . Material y Método: Realizamos comparación de riesgo de aspiración en 4 t?cnicas quirúrgicas indicadas para el tratamiento de disfagias severas con aspiración intratable: la tiroplastia de medialización, la traqueotom?a con sutura de ambas cuerdas vocales, la miotomía del cricofaríngeo y la suspensión laríngea. La valoración de la aspiración en los diferentes modelos quirúrgicos experimentales se realizará mediante 20 ml de líquido coloreado introducido en bolos por cavidad orofaríngea. Resultados: La combinación de Suspensión Laríngea con Miotomía del músculo Cricofaríngeo consigue la mejor protección de la vía aerea en el modelo experimental ovino frente a las otras técnicas propuestas. Conclusiones: El modelo ovino no-vivo nos ha permitido realizar una valoración inicial de resultados de diferentes técnicas quirúrgicas que intentan evitar la aspiración intratable de los pacientes con disfagia orofaríngea severa. A pesar de las limitaciones evidentes del modelo experimental, el trabajo sobre este modelo nos permite iniciar una línea de trabajo sobre técnicas quirúrgicas rehabilitadoras que ayuden pacientes neurológicos seleccionados mantener la ingesta oral.Palabras clavesuspension laringea disfagia orofaríngea modelo experimentaSummarySurgical treatment ca be considered in chronic oropharyngeal dysphagy withh sever aspiration. Several sugical techniques can be performed in occassionally and high selected patients. The aim of this study is to evaluate the risk of aspitaion of various

  10. Renal Osteodystrophy

    Directory of Open Access Journals (Sweden)

    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.

  11. Cárie precoce e severa na infância: uma abordagem integral Severe early childhood caries: an integral approach

    Directory of Open Access Journals (Sweden)

    Estela M. Losso

    2009-08-01

    Full Text Available OBJETIVO: Fornecer informações para auxiliar o médico pediatra a reconhecer os fatores de risco para o início da cárie precoce na infância e da cárie severa na infância (CSI, possibilitando a intervenção precoce de tais fatores, e, assim, evitar a instalação dessa doença prevenível e as suas consequências. FONTES DOS DADOS: As informações foram coletadas a partir de artigos científicos publicados nas bases de dados SciELO, MEDLINE e PUBMED nos últimos 25 anos, livros técnicos e publicações de consenso de organismos internacionais. As palavras-chave utilizadas foram: early childhood caries, severe early childhood caries, dental caries e children. SÍNTESE DOS DADOS: A CSI é uma forma de cárie dentária que afeta bebês e crianças. É infecciosa, de etiologia multifatorial e de desenvolvimento rápido, iniciando logo após a erupção dos dentes. Por apresentar fatores de risco local e sociocultural, deve ser considerada como sintoma de uma alteração na criança e de falta de cuidados adequados. Suas manifestações incluem dor, abscessos e dificuldades mastigatórias, afetando a alimentação e o sono da criança. Além disso, afeta também sua saúde geral, fala e autoestima. CONCLUSÕES: A CSI é uma doença com métodos preventivos estabelecidos, que devem ser introduzidos o mais precocemente possível, por meio de programas preventivos na comunidade e no núcleo familiar. Os profissionais que atendem bebês e crianças devem estar atentos aos casos com risco para o desenvolvimento da doença cárie e interceder a fim de se obter saúde.OBJECTIVE: To provide information with the purpose of helping pediatricians to recognize the risk factors for the onset of severe early childhood caries, allowing for early intervention and thus avoiding this preventable disease and its consequences. SOURCES: Information was collected from scientific articles published on the databases SciELO, MEDLINE and PUBMED in last 25 years, as

  12. 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 ...

  13. Factores de riesgo de violencia escolar (bullying) severa en colegios privados de tres zonas de la sierra del Perú

    OpenAIRE

    Isabel Amemiya; Miguel Oliveros; Armando Barrientos

    2009-01-01

    Objetivo: Identificar los factores de riesgo de violencia escolar (bullying) severa en alumnos de colegios privados de tres zonas de la sierra del Perú. Diseño: Estudio tipo encuesta. Institución: Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú. Participantes: Alumnos entre quinto de primaria y quinto de secundaria de colegios privados. Intervenciones: Una encuesta validada en estudios previos, para identificar violencia escolar (bullying), fue aplicada a 736 alumno...

  14. 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 ...

  15. Climatología de las tormentas eléctricas locales severas (TELS en la Zona Metropolitana de Guadalajara

    Directory of Open Access Journals (Sweden)

    Omar García Concepción

    2012-02-01

    Full Text Available La aparición de los fenómenos severos en el tiempo meteorológico (tornados, granizos y vientos lineales con rachas destructoras está relacionada con cambios importantes en la morfología de las tormentas eléctricas. Las tormentas que alcancen ese estadio son consideradas como un tipo especial de tormentas eléctricas llamadas tormentas eléctricas locales severas (TELS. El desarrollo de las TELS en la Zona Metropolitana de Guadalajara (ZMG es una realidad y se debe considerar en la protección de la sociedad, debido a las pérdidas de vidas, daños materiales y cuantiosas afectaciones que ocurren como consecuencia de éstas. Al no contar con una cronología de las TELS en la ZMG fue necesaria la compilación de las mismas como base para realizar su climatología. Entre los resultados obtenidos se destaca que las TELS ocurren desde mayo hasta noviembre, en particular, en los meses de junio, julio y agosto. La mayoría se presenta durante horas de la tarde o de la noche, pero un grupo nada despreciable también ocurre durante la madrugada. Queda establecido que las TELS constituyen un elemento importante del clima de la ZMG que no puede ser ignorado desde el punto de vista científico y mucho menos en la práctica, por los efectos que produce en muchas ocasiones.

  16. RENAL CRYOABLATION

    Directory of Open Access Journals (Sweden)

    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.

  17. 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

  18. 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

  19. Left kidney angiomyolipoma, spreading to the renal vein, inferior vena cava and involving the heart. Report of one case

    OpenAIRE

    INNOCENTI C, FRANCO; ALARCÓN C, EMILIO; ARIAS O, ESTEBAN; STOCKINS L, ALECK; SÁNCHEZ U, ROBERTO; MADARIAGA B, JAIME; TORRES-QUEVEDO Q, RODRIGO; CABRERA E, FELIPE; DÍAZ J, RAMÓN

    2008-01-01

    El angiomiolipoma renal es un tumor benigno mesenquimático. Constituyen sólo del 2 al 6% de los tumores renales. Existen alrededor de 12 casos reportados con invasión a las venas renales y la cava inferior. En menos de 5, hay extensión de trombo tumoral hasta aurícula derecha. Objetivo: Presentar el caso clínico, manejo y evolución de una paciente con un angiomiolipoma renal con extensión tumoral a vena renal y cava inferior y que compromete la cavidad auricular derecha casi en su totalidad. ...

  20. Hematoma masivo esofágico con compromiso supraglótico: Reporte de un caso y revisión de la literatura

    OpenAIRE

    Pardo J,Javiera; Abarca A,Alfredo; Walker J,Katherine; Celedón L,Carlos

    2010-01-01

    Se presenta el caso de un paciente de 67 años de sexo masculino, hipertenso, diabético y usuario de aspirina en dosis anticoagulante, que consulta en el servicio de urgencia por un cuadro de inicio súbito de dolor retroesternal asociado a disnea severa y estridor. La evaluación mediante nasofibroscopfa muestra una gran masa supraglótica que obstruye el 80% del lumen, compatible con una masa esofágica. La tomograffa computarizada de tórax muestra una imagen compatible con un hematoma disecante...

  1. O nefrologista como consultor ante a intoxicação aguda: epidemiologia das intoxicações graves no Rio Grande do Sul e métodos de aumento da depuração renal

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    José Alberto Rodrigues Pedroso

    2010-12-01

    Full Text Available Intoxicações acidentais e intencionais constituem- se em fonte significativa de morbimortalidade. Em emergências ou UTIs, frequentemente o Nefrologista é chamado como consultor para auxiliar na indicação de medidas de aumento da depuração renal de agentes tóxicos. Revisamos o emprego de diálise nas intoxicações agudas por medicamentos ou pesticidas, cujo suporte especializado toxicológico foi realizado por telefone pelo Centro de Informação Toxicológica do Rio Grande do Sul (CIT-RS. Avaliamos a correlação entre necessidade de diálise e óbitos em coorte retrospectivo (1998- 2000. Dos 36.055 atendimentos, 337 foram identificados como graves, 245 preenchendo os critérios de inclusão exigidos. A idade média foi 30 ± 18 anos; 53% mulheres. Medicamentos frequentemente envolvidos foram anticonvulsivantes e antidepressivos, entre outros; quanto aos pesticidas, organofosforados, bipiridílicos e glifosato. Métodos de aumento da eliminação incluíram alcalinização urinária (n = 37 e métodos dialíticos. Diálise entre intoxicações severas ocorreu em 4,5% (n = 11, 3,67 procedimentos/ano (1/22,7 relatos de casos severos. No grupo que dialisou, em 91%, a circunstância foi tentativa de suicídio (principalmente fenobarbital e paraquat. Dois casos requereram hemoperfusão (cloranfenicol e paraquat. Óbitos entre pacientes graves não submetidos a diálise ocorreram em 25,6%, versus 36,3% entre dialisados (RR = 0,89; IC 95% = 0,54-1,35. Os achados podem ser explicados pelo poder estatístico associado ao número de procedimentos realizados. O Nefrologista deve estar atento para situações que requerem o emprego de medidas dialíticas, ainda que não necessariamente para substituição renal, mas para aumento da depuração do agente tóxico.

  2. Crisis de esclerodermia renal normotensiva

    Directory of Open Access Journals (Sweden)

    M. Villaverde

    2003-01-01

    Full Text Available Paciente de sexo masculino de 60 años con esclerosis sistémica que evolucionó con crisis de esclerodermia renal normotensiva. Tenía compromiso poliarticular, esofágico, pulmonar y cutáneo. Antes de internarse en nuestro hospital recibió tratamiento con altas dosis de corticoides, lo que probablemente precipitó el daño renal que presentó en su evolución, caracterizado por falla renal, anemia hemolítica microangiopática sin elevación de la presión arterial. La ausencia de hipertensión se observa sólo en el 10% de los casos de esclerodermia renal. Recibió tratamiento con enalapril y hemodiálisis. Evolucionó en forma desfavorable, sin respuesta a la terapeútica y falleció a los siete días de internado.A 60 year old male patient having systemic scleroderma and normotensive scleroderma renal crisis was admitted in our hospital. He presented polyarticular, esophagic, lung and skin compromise. Before admission he had been treated with high doses of corticosteroids. We believe corticosteroids led to the worsening of renal damage with renal failure, microangiopathic hemolytic anemia without high blood pressure. The 10% of these cases have normal blood pressure. The patient was treated with enalapril and hemodyalisis. There was no favourable response to this treatment and he died seven days after admission.

  3. Caso e caos

    CERN Document Server

    Ruelle, David

    1992-01-01

    Caso e caos – Il caso ha la sua ragione. Ma quale? E cos’è in realtà il caso? Da dove viene e come può fare irruzione nella nostra descrizione dell’universo? A tutte queste domande, in una chiara e lucida esposizione, cerca di dare risposta David Ruelle. Curiosando tra i risultati scientifici del XX secolo e soffermandosi anche su fenomeni e problemi estranei alla scienza tradizionale – le lotterie, gli oroscopi, la teoria dei giochi, la genesi della turbolenza – Ruelle ci guida a conoscere il caso avendo la matematica, la fisica e tutte le scienze naturali come compagne. Ancora oggi il modo in cui il caso irrompe nelle nostre vite e nel mondo può essere un mistero, ma grazie ai progressi della scienza, qui raccontati, riusciamo a saperne un poco di più.

  4. Caracterización molecular de la cadena gama común y Jak3 en un individuo afectado con inmunodeficiencia severa combinada

    Directory of Open Access Journals (Sweden)

    Pablo Javier Patiño Grajales

    2001-04-01

    Full Text Available

    La Inmunodeficiencia Severa Combinada (IDSC es una enfermedad
    de origen genético, que se puede heredar de forma autosómica
    recesiva o ligada al cromosoma X. La IDSC se caracteriza por un
    defecto en el número y la diferenciación de los linfocitos T y NK. Los
    individuos afectados desarrollan diarrea crónica, infecciones persistentes y severas como neumonía, septicemia e infecciones fúngicas.
    Estos pacientes presentan retardo en el crecimiento y pueden morir a
    temprana edad si no se realiza una terapia de corrección genética o un
    trasplante de células hematopoyéticas. Las mutaciones responsables
    de la IDSC comprometen principalmente el gen de la cadena gama
    común (γc y la proteína Jak3 que son proteínas fundamentales en la
    transducción de señales de los receptores para varias citoquinas esenciales en la diferenciación y activación de células del sistema inmune, las cuales incluyen IL-2, IL-4, IL-7, IL-9 e IL-15 (1,2.

     

     

  5. Fatores de morbimortalidade na cirurgia eletiva do aneurisma da aorta abdominal infra-renal: experiência de 134 casos Morbidity and mortality factors in the elective surgery of infrarenal abdominal aortic aneurysm: a case study with 134 patients

    Directory of Open Access Journals (Sweden)

    Aquiles Tadashi Ywata de Carvalho

    2008-09-01

    Full Text Available CONTEXTO: O tratamento cirúrgico convencional do aneurisma da aorta abdominal (AAA infra-renal pode resultar em complicações graves. A fim de otimizar os resultados na evolução do tratamento, é importante que sejam identificados os pacientes predispostos a determinadas complicações e instituídas condutas preventivas. OBJETIVOS: Avaliar a taxa de mortalidade operatória precoce, analisar as complicações pós-operatórias e identificar os fatores de risco relacionados com a morbimortalidade. MÉTODO: Foram analisados 134 pacientes com AAA infra-renal submetidos a correção cirúrgica eletiva no período de fevereiro de 2001 a dezembro de 2005. RESULTADOS: A taxa de mortalidade foi de 5,2%, sendo secundária principalmente a infarto agudo de miocárdio (IAM e isquemia mesentérica. As complicações cardíacas foram as mais freqüentes, seguidas das pulmonares e renais. A presença de diabetes melito (DM, insuficiência cardíaca congestiva (ICC, insuficiência coronariana (ICO e cintilografia miocárdica positiva para isquemia estiveram associadas às complicações cardíacas. A idade avançada, a doença pulmonar obstrutiva crônica (DPOC e a capacidade vital forçada reduzida aumentaram os riscos de atelectasia e pneumonia. História de nefropatia, tempo de pinçamento aórtico prolongado e níveis de uréia elevados aumentaram os riscos de insuficiência respiratória aguda (IRA. A isquemia dos membros inferiores esteve associada ao tabagismo e à idade avançada, e a maior taxa de mortalidade, à presença de coronariopatia, tempos prolongados de pinçamento aórtico e de cirurgia. CONCLUSÃO: A taxa de morbimortalidade esteve compatível com a literatura nacional e internacional, sendo secundária às complicações cardíacas, respiratórias e renais. Os fatores de risco identificados no pré e transoperatório estiveram relacionados com essas complicações.BACKGROUND: Conventional surgical treatment of infrarenal abdominal

  6. Renal scan

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003790.htm Renal scan To use the sharing features on this ... anaphylaxis . Alternative Names Renogram; Kidney scan Images Kidney anatomy Kidney - blood and urine flow References Chernecky CC, ...

  7. Hemorragia macular en anemia aplásica: reporte de un caso

    Directory of Open Access Journals (Sweden)

    Alfonso Cardenas Merino

    2007-01-01

    Full Text Available Se presenta el caso de una paciente mujer de 31 años, con diagnóstico de anemia aplásica, quién refería disminución de agudeza visual central en el ojo derecho. Al examen del segmento anterior no había signos de sangrado. A la fundoscopía se encontraron hemorragias retinales en mancha en distinto cuadrante en cada ojo; hemorragia macular que comprometía la fovea en el ojo derecho y hemorragia preretinal con nivel en el cuadrante temporal inferior en el ojo izquierdo. Su evolución fue desfavorable, a la semana, presentó gran compromiso del sensorio, malestar general y al examen oftalmológico se encontraron hematomas subconjuntivales en ambos ojos como signo evolutivo de la severa plaquetopenia.(Rev Med Hered 2007;18:45-48.

  8. 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.

  9. Impacto de la maniobra de inspiración profunda en el intercambio gaseoso del sujeto con obesidad severa e hipertensión arterial pulmonar asociada a síndrome de Eisenmenger

    OpenAIRE

    Santos-Martínez,Luis-Efren; Martínez-Guerra,María-Luisa; Bautista,Edgar; Castillo,Francisco; Castañón,Alicia; Pulido,Tomás; Hernández,José-Luis; Sandoval,Julio

    2008-01-01

    La obesidad y el síndrome de Eisenmenger son entidades ampliamente estudiadas. Sin embargo, su asociación es inusual y no informada. Ambas cursan con alteraciones del intercambio gaseoso de grado variable. En la obesidad severa son atribuidas a trastornos en la relación ventilación/perfusión y al cortocircuito venoarterial pulmonar que dependen del volumen pulmonar. En el síndrome de Eisenmenger con obesidad severa, esta dependencia se desconoce. Material y métodos: Se estudiaron 28 sujetos o...

  10. Aneurisma gigante do segmento intracavernoso da carótida interna associado a doença renal policística autossômica dominante: relato de caso Giant aneurysm of the intracavernous internal carotid artery associated with autosomal dominant polycystic kidney disease: case report

    Directory of Open Access Journals (Sweden)

    Keven F. Ponte

    2006-09-01

    Full Text Available Apresenta-se o caso de mulher de 60 anos com doença renal policística autossômica dominante (DRPAD que desenvolveu quadro de cefaléia e oftalmoplegia completa à direita. A TC levantou a hipótese de um aneurisma gigante do segmento intracavernoso da carótida interna direita, o que foi confirmado pela arteriografia. Realizou-se, então, tratamento endovascular por oclusão do vaso parental com molas destacáveis no segmento supraclinóideo. A paciente evoluiu com a interrupção da cefaléia e com redução parcial da ptose e da oftalmoplegia. Neste artigo, enfatiza-se a relação entre DRPAD e aneurismas intracranianos. Comenta-se a história natural dos aneurismas originados no segmento intracavernoso da artéria carótida interna e comparam-se as opções terapêuticas no manejo destas lesões.We report the case of a 60 years-old woman with autosomal dominant polycystic kidney disease (ADPKD that presented with headache and right complete ophthalmoplegia. The CT scan raised the possibility of a giant aneurysm of the right intracavernous internal carotid artery, confirmed by angiography. The patient underwent endovascular occlusion of parent vessel with detachable coils, then she presented interruption of headache and partial recovery of ptosis and ophthalmoplegia. We emphasize the relationship between ADPKD and intracranial aneurysms. We also discuss the natural history and compare the therapeutic options for the management of giant aneurysms of the cavernous portion of the carotid artery.

  11. Lung and renal transplantation

    Directory of Open Access Journals (Sweden)

    Patrícia Caetano Mota

    2009-11-01

    ória. Material e métodos: Estudo retrospectivo de todos os doentes admitidos na UTR por doença respiratória, durante um período de 12 meses. Resultados: Foram incluídos 36 doentes, com uma média de idades de 55,2 ( ± 13,4 anos; 61,1% do sexo masculino. Os esquemas imunossupressores mais utilizados foram: prednisolona e micofenolato mofetil com ciclosporina (38,9% ou tacrolimus (22,2% ou rapamicina (13,9%. Trinta e um doentes (86,1% apresentaram doença infecciosa respiratória. Neste grupo destacaram-se: 23 casos (74,2% de pneumonia, 5 casos (16,1% de infecção oportunista, 2 (6,5% de traqueobronquite, e 1 (3,2% de abcessos pulmonares. O agente etiológico foi identificado em 7 casos (22,6%. Cinco doentes (13,9% apresentaram doença pulmonar iatrogénica pela rapamicina. Em 15 doentes (41,7% foi necessário recorrer à realização de broncofibroscopia, diagnóstica em 10 casos (66,7%. O tempo médio de internamento foi de 17,1 ( ± 18,5 dias, e não se verificou nenhum óbito. Conclusão: A infecção constituiu a principal complicação pulmonar no grupo de doentes estudado. O diagnóstico de doença pulmonar induzida por fármacos implica reconhecimento das suas características e monitorização rigorosa dos níveis séricos dos mesmos. O recurso a técnicas de diagnóstico invasivas contribuiu para maior precocidade e especificidade terapêuticas. Key-words: Lung, renal transplantation, immunosuppression, Palavras-chave: Pulmão, transplante renal, imunossupressão

  12. Factores de riesgo para la preeclampsia severa y temprana en el Hospital General de Medellín (HGM 1999-2001

    Directory of Open Access Journals (Sweden)

    Mercedes Jimeno

    2001-04-01

    Full Text Available Se ha calculado, por estudios en otras partes del mundo, que la
    frecuencia de presentación del Síndrome Hipertensivo del embarazo
    oscila entre 7% y 10% de los embarazos, y que el 30% corresponde a Preeclampsia y de éstos, menos del 10% a Preeclampsia temprana. Entre los factores maternos, uno de los que más peso ha tenido es la paridad materna y en segundo lugar la edad materna. Además, también se ha encontrado asociación con el antecedente de hipertensión esencial. Se pretendió con este estudio evaluar si la presencia de factores de riesgo en esta población se relaciona con la presentación del síndrome en sus formas severas y con las formas tempranas del mismo.

  13. A propósito de un caso de malnutrición muy extrema en una paciente que presenta Anorexia Nerviosa Restrictiva de larga evolución y no recibía tratamiento

    OpenAIRE

    Pelegrina Cortés, Beatriz; Guillén Sacoto, María Augusta; Palma Milla, Samara; Lisbona Catalán, Arturo; Martín Fuentes, María; Gómez-Candela, Carmen

    2014-01-01

    La anorexia nerviosa es un trastorno de la conducta alimentaria que con frecuencia ocasiona malnutrición y asocia riesgo de mortalidad. Requiere la colaboración de un equipo multidisciplinar con amplia experiencia clínica para obtener óptimos resultados, una exitosa educación nutricional y evitar el síndrome de realimentación. El caso que se presenta constituye la malnutrición más severa secundaria a anorexia nerviosa que hemos tratado en nuestra unidad: una paciente de 33 años con IMC de 8.8...

  14. Atrofia muscular neurogénica en miopatía nemalínica: ¿Fenómeno primario o secundario? A propósito de un caso

    OpenAIRE

    Alvarez L, Alberto José; Céspedes, Ghislaine; González, Jesús Enrique; Lara, Carmen

    2003-01-01

    La miopatía nemalínica es una miopatía congénita estructural que cursa con debilidad muscular generalmente no progresiva y se caracteriza por la presencia de los llamados "bastones" o "nemalines" en las fibras musculares. Se presenta el estudio anatomoclínico de una forma neonatal severa de la enfermedad en la cual encontramos, además, atrofia muscular neurogénica y escasas motoneuronas de la médula espinal con degeneración simple, sin otra evidencia de denervación. Se revisan otros casos sim...

  15. Adrenoleucodistrofia (leucodistrofia melanodermica: registro de um caso anatomo-clinico

    Directory of Open Access Journals (Sweden)

    Mario Wilson Iervolino Brotto

    1979-06-01

    Full Text Available É relatado o caso de um paciente de 14 anos, do sexo masculino, com esclerose cerebral difusa precedida em 7 anos de sinais de insuficiência do córtex supra-renal, com antecedentes familiares. Clinicamente a doença é caracterizada por deterioração mental, distúrbios da marcha e da visão, associados com insuficiência do córtex supra-renal. Confirmando os dados da literatura, em nosso caso o estudo anátomo-patológico revelou desmielinização e gliose difusa na substância branca cerebral, poupando as fibras subcorticais. Células inflamatórias são comuns e têm distribuição perivascular. Na zona fasciculada e reticular da supra-renal, células "balonadas" são evidentes, muitas delas apresentando citoplasma vacuolizado e com estriações. Inclusões lipídicas similares têm sido encontradas nas células de Schwann dos nervos periféricos e dos testículos. Os achados são comparados com vinte casos da literatura.

  16. Renal candidiasis

    International Nuclear Information System (INIS)

    Khanna, S.; Malik, N.; Khandelwal, N.

    1990-01-01

    Most fungal infections of the urinary tract are caused by Candida albicans, a yeast-like saprophytic fungus which may become apathogen under various conditions which lower the host resistance. The use of computed tomography in the diagnosis of renal fungus balls is the subject of this communication with emphasis on the radiologists role in the recognition of this entity. (H.W.). 6 refs.; 2 figs

  17. Renal hemangioma

    Directory of Open Access Journals (Sweden)

    Theodorico F. da Costa Neto

    2004-06-01

    Full Text Available INTRODUCTION: Renal hemangioma is a relatively rare benign tumor, seldom diagnosed as a cause of hematuria. CASE REPORT: A female 40-year old patient presented with continuous gross hematuria, anemia and episodic right lumbar pain, with onset about 3 months previously. The patient underwent multiple blood transfusions during her hospital stay and extensive imaging propedeutics was performed. Semi-rigid ureterorenoscopy evidenced a bleeding focus in the upper calix of the right kidney, with endoscopic treatment being unfeasible. The patient underwent right upper pole nephrectomy and presented a favorable outcome. Histopathological analysis of the surgical specimen showed that it was a renal hemangioma. COMMENTS: Imaging methods usually employed for diagnostic investigation of hematuria do not have good sensitivity for renal hemangioma. However, they are important to exclude the most frequent differential diagnoses. The ureterorenoscopy is the diagnostic method of choice and endoscopic treatment can be feasible when the lesion is accessible and electrocautery or laser are available. We emphasize the open surgical treatment as a therapeutic option upon failure of less invasive methods.

  18. 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

  19. 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

  20. Condiciones térmicas de un dispositivo electrónico en caso de incendio Primera parte: estudio experimental

    Directory of Open Access Journals (Sweden)

    Bruno Chine

    2007-11-01

    Full Text Available En este trabajo se presentan los resultados de un estudio experimental para determinar las condiciones térmicas a la cual un sistema electrónico, usado para radiocomunicaciones en túneles, podría estar sujeto en caso de incendio. El sistema se compone de un dispositivo electrónico contenido en una caja metálica de acero inoxidable 316, un cable coaxial interno y un cable coaxial externo de cobre. Sobre el sistema, que se alberga en una cámara de polímero concreto, ha sido realizada una prueba al fuego con registro experimental de los valores de temperatura en diferentes puntos del sistema mismo. El trabajo experimental ha permitido analizar eficazmente la respuesta del dispositivo electrónico y de los distintos materiales que lo componen a las severas condiciones térmicas de prueba.

  1. 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...

  2. Notalgia parestésica: relato de caso

    Directory of Open Access Journals (Sweden)

    José Otávio Alquezar Gozzano

    2016-10-01

    Full Text Available Introdução: Notalgia parestésica (NP é uma condição neurocutânea, caracterizada por crises pruriginosas, hiperpigmentação e neuropatia sensorial. Apesar de pouco descrita em literatura, a doença é mais frequente do que se imagina, sendo subdiagnosticada em muitos casos. NP pode afetar qualquer idade e sexo, mas acomete principalmente pessoas de média idade e mulheres. Sua etiologia inclui alterações degenerativas vertebrais, trauma vertebral e predisposição genética. NP envolve o trajeto anatômico dos nervos espinhais e está relacionada com o comprometimento de neuropeptídios, dando origem a marcapassos neurais ectópicos, responsáveis pela clínica da NP. O diagnóstico é clínico, a partir da identificação de máculas hiperpigmentadas unilaterais em zona escapular, sem eritema ou descamação, com piora ao estresse. Deve-se diferenciar de líquen simples, amiloidose macular e hanseníase. Na anatomopatologia observa-se acantose focal e queratinócitos necróticos; a derme papilar mostra depósito de substância amiloide. Com sintomas leves o tratamento medicamentoso nem sempre é necessário, se mais severa utiliza-se capsaicina tópica, gabapentina, oxicarba-mazepina, corticoides e toxina botulínica. Objetivo: Relatar caso de NP. Material e métodos: Paciente atendida ambulatorialmente com revisão de literatura. Relato de Caso: Feminina, 50 anos, com queixa de mancha em dorso há 2 anos; refere dor na coluna torácica. Ao exame: presença de mácula hipercrômica. Hipótese diagnóstica: NP. Foi prescrito corticoide tópico para alívio de sintomas. Conclusão: Por tratar-se de uma doença subdiagnosticada, o conhecimento médico da clínica de NP é fundamental para o diagnóstico precoce, permitindo a escolha do tratamento específico, o que melhora a evolução dos pacientes e evita o uso de fármacos ineficazes.

  3. Pancitopenia por anemia de Fanconi: presentación de un caso clínico.

    Directory of Open Access Journals (Sweden)

    Miguel Zúñiga

    2010-08-01

    Full Text Available La anemia de Fanconi es una patología genética caracterizada por una alteración en la reparación del ADN que se expresa con alteraciones físicas y hematológicas. Es una enfermedad congénita rara y corresponde a la primera causa de anemia aplásica en la infancia. Tiene un curso desfavorable tanto por el deterioro de sus parámetros sanguíneos, así como también por el riesgo aumentado de malignización hematológica. Su único tratamiento curativo es el trasplante de médula ósea. Se presenta el caso de un niño de 3 años, hijo de padres judíos, portador de malformaciones mayores y menores, que presentó un cuadro infeccioso por Mycoplasma pneumoniae que evolucionó a una pancitopenia severa. En el  estudio del caso se buscaron etiologías  que abarcaron desde las infecciosas e inmunológicas hasta  las que involucraban a la medula ósea Una vez que los exámenes realizados descartaron patologías linfoproliferativas, la clínica y la persistencia del cuadro orientaron a buscar alguna condición genética que explicara esta situación.

  4. Renal tuberculosis

    Directory of Open Access Journals (Sweden)

    Džamić Zoran

    2016-01-01

    Full Text Available Tuberculosis is still a significant health problem in the world, mostly in developing countries. The special significance lies in immunocompromised patients, particularly those suffering from the HIV. Urogenital tuberculosis is one of the most common forms of extrapulmonary tuberculosis, while the most commonly involved organ is the kidney. Renal tuberculosis occurs by hematogenous dissemination of mycobacterium tuberculosis from a primary tuberculosis foci in the body. Tuberculosis is characterized by the formation of pathognomonic lesions in the tissues - granulomata. These granulomata may heal spontaneously or remain stable for years. In certain circumstances in the body associated with immunosuppression, the disease may be activated. Central caseous necrosis occurs within tuberculoma, leading to formation of cavities that destroy renal parenchyma. The process may gain access to the collecting system, forming the caverns. In this way, infection can be spread distally to renal pelvis, ureter and bladder. Scaring of tissue by tuberculosis process may lead to development of strictures of the urinary tract. The clinical manifestations are presented by nonspecific symptoms and signs, so tuberculosis can often be overlooked. Sterile pyuria is characteristic for urinary tuberculosis. Dysuric complaints, flank pain or hematuria may be presented in patients. Constitutional symptoms of fever, weight loss and night sweats are presented in some severe cases. Diagnosis is made by isolation of mycobacterium tuberculosis in urine samples, by cultures carried out on standard solid media optimized for mycobacterial growth. Different imaging studies are used in diagnostics - IVU, CT and NMR are the most important. Medical therapy is the main modality of tuberculosis treatment. The first line anti-tuberculosis drugs include isoniazid, rifampicin, pyrazinamide and ethambutol. Surgical treatment is required in some cases, to remove severely damaged kidney, if

  5. Renal denervation

    DEFF Research Database (Denmark)

    Olsen, Lene Kjær; Kamper, Anne-Lise; Svendsen, Jesper Hastrup

    2015-01-01

    PURPOSE OF REVIEW: Renal denervation (RDN) has, within recent years, been suggested as a novel treatment option for patients with resistant hypertension. This review summarizes the current knowledge on this procedure as well as limitations and questions that remain to be answered. RECENT FINDINGS...... selection, anatomical and physiological effects of RDN as well as possible beneficial effects on other diseases with increased sympathetic activity. The long awaited Symplicity HTN-3 (2014) results illustrated that the RDN group and the sham-group had similar reductions in BP. SUMMARY: Initial studies...

  6. 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. ...

  7. La neutropenia severa febril en niños con cáncer: Estudio descriptivo en el Hospital Universitario de Santander Severe febrile neutropenia in children with cancer: A descriptive study at the Hospital Universitario de Santander

    Directory of Open Access Journals (Sweden)

    Ernesto Rueda

    2010-08-01

    Full Text Available Objetivos: Describir una población oncológica afectada por neutropenia severa febril, sus características demográficas, nutricionales, microbiológicas, de tratamiento y severidad de la enfermedad. Materiales y métodos: Esta es una serie de casos prospectiva de los pacientes atendidos en el Hospital Universitario de Santander entre enero/2007 y enero/2008. Resultados: Veintiun (21 pacientes aportaron 35 episodios de neutropenia febril; 65,7% eran hombres, la edad promedio 5,6 años; 38,3% vivían en el Área Metropolitana de Bucaramanga y 91,4% en estrato socioeconómico bajo. El diagnóstico oncológico más frecuente fue leucemia linfocítica aguda. Ninguno presentó dolor abdominal o síntomas neurológicos. La neutropenia se detectó 8,5 días en promedio posterior a la última quimioterapia. El 31,4% no tuvieron neutrófilos absolutos, 54,2% plaquetas Objective: To describe an oncological population affected with severe febrile neutropenia, its demographic, nutritional, and microbiological features, their treatment and severity of the illness. Materials and methods: A descriptive-prospective clinical chart review from attended patients at the Hospital Universitario de Santander, from January/2007 to January/2008. Results: Twenty (21 patients contributed with 35 febrile neutropenia episodes; 65.7% were male; they aged average was 5.6-years; 38.37% lived in Bucaramanga Metropolitan Area; 91.4% had low economic status. The most frequent oncological diagnosis was acute lumphocytic leukemia. No one presented abdominal pain or neurological symptoms. The neutropenia was detected 8.5 days after the last chemotherapy cycle. 31.4% patients had no absolute neutrophils; 54.2% blood platelets <50,000/mm3, 45.7% had reactive C protein <90 mg|/dL. The bloodculture was positive only in 7 patients. It was found the infection focus in 88.6% of the episodes and the most frequently diagnosis were related with the gastrointestinal tract. The most used

  8. Síndrome de Stevens Johnson, presentación de un caso en edad pediátrica

    Directory of Open Access Journals (Sweden)

    Maritza Morales Solís

    2015-11-01

    Full Text Available El síndrome de Stevens-Johnson (SSJ es una variante severa del eritema multiforme, consistente en una reacción de hipersensibilización que afecta piel y mucosa, además de otros órganos internos, y que se manifiesta con lesiones en zonas genitales, bucales y cutáneas, es idiopático en el 50% de los casos, generalmente producido por alergia a medicamentos. La muerte sobreviene en el 5-15% de los casos sin tratar. El riesgo de recurrencia es del 37% o más.  Al Hospital Pediátrico Provincial Docente “Mártires de Las Tunas”  fue  traído un niño de seis años  de edad, que tras el uso del Sulfaprín comenzó con lesiones que afectaban la piel y  todas las mucosas, además de toma del estado general. Inmediatamente fue admitido en la Unidad de Cuidados  Intensivos Pediátricos, donde fueron tomadas medidas que incluyeron supresión del agente causal,  corticoterapia endovenosa, antibioticoterapia endovenosa, tratamiento de las lesiones, vigilancia del balance hidromineral y atención oftalmológica, respondiendo favorablemente. Se presenta el caso, por ser una enfermedad poco frecuente y de muy mal pronóstico.

  9. Renal calculus

    CERN Document Server

    Pyrah, Leslie N

    1979-01-01

    Stone in the urinary tract has fascinated the medical profession from the earliest times and has played an important part in the development of surgery. The earliest major planned operations were for the removal of vesical calculus; renal and ureteric calculi provided the first stimulus for the radiological investigation of the viscera, and the biochemical investigation of the causes of calculus formation has been the training ground for surgeons interested in metabolic disorders. It is therefore no surprise that stone has been the subject of a number of monographs by eminent urologists, but the rapid development of knowledge has made it possible for each one of these authors to produce something new. There is still a technical challenge to the surgeon in the removal of renal calculi, and on this topic we are always glad to have the advice of a master craftsman; but inevitably much of the interest centres on the elucidation of the causes of stone formation and its prevention. Professor Pyrah has had a long an...

  10. Vasculitis inducida por metimazol: Reporte de caso

    Directory of Open Access Journals (Sweden)

    Miguel Pinto

    2011-07-01

    Full Text Available Se reporta el caso de una paciente con enfermedad de Graves, que presentó vasculitis asociada al uso de metimazol. Mujer de 14 años, que acudió a consulta por presentar intolerancia al calor, tremor distal y palpitaciones. El examen físico mostró bocio difuso, y el perfil tiroideo, TSH suprimida y hormonas tiroideas elevadas. Los anticuerpos antiperoxidasa tiroidea fueron positivos. Se inició tratamiento con metimazol y beta bloqueadores. Después de 20 días, la paciente regresó por presentar malestar general, fiebre, poliartralgia, lesiones cutáneas maculopapulares y edema de miembros inferiores. Los anticuerpos antinucleares fueron negativos y los anticuerpos anticitoplasma de los neutrófilos (ANCA, positivos. Se suspendió el metimazol y se inició prednisona. Después de 10 días de tratamiento, las molestias desaparecieron y la paciente recibió I 131.Las vasculitis asociadas al uso de tionamidas son poco frecuentes, no dependen de la dosis y están asociadas a la presencia de anticuerpos tipo ANCA. Clásicamente, afectan a los vasos pequeños de la piel; sin embargo, también pueden afectar los riñones y pulmones. El cuadro clínico se caracteriza por artralgias y mialgias. En algunos casos puede ocurrir insuficiencia renal de grado variable. En la mayoría de casos, el cuadro remite con la suspensión de la droga; pero, en algunos se requiere el uso de glucocorticoides o inmunosupresores.(Rev Med Hered 2011;22:147-150.

  11. Dos estudios de casos

    Directory of Open Access Journals (Sweden)

    Hernán Guillermo Salazar Morales

    1989-04-01

    Full Text Available RESUMEN A continuación se presenta dos casos de estudio en donde se puede apreciar a la forma  como se establecen  las relaciones en una organización y lo que una DECISION  puede llegar a incidir en el desarrollo de las operaciones de una empresa. Decisiones basadas en la intuición, o en corazonadas, frecuentemente conducen en dirección equivocada, ocasionando pérdidas en tiempo, personal y dinero. El proceso de toma de decisiones deben ser TAREAS ESTRUCTURADAS que se sustenten con hechos. Su ejecución debe hacerse secuencialmente y cumplir con cada uno de sus pasos. El diseño de los  casos está orientado para que  sirvan como material de aplicación en la asignatura de  taller de planeación.

  12. Adenoma de paratireóide em caso de hiperparatireoidismo primário no idoso: relato de caso = Parathyroid adenoma in primary hyperparathyroidism in the elderly: Case report

    Directory of Open Access Journals (Sweden)

    Chies Júnior, Ademar

    2005-01-01

    Conclusão: O diagnóstico de hiperparatireoidismo primário deve ser lembrado em todo paciente com osteoporose severa ou naqueles que se apresentam com fraturas espontâneas ou após trauma mínimo (trauma igual ou menor que o equivalente a uma queda do próprio nível. Para pacientes idosos assintomáticos, sem perda de função renal ou de massa óssea significativa, pode ser indicado apenas o manejo ambulatorial. Entretanto, quando indicado, o tratamento cirúrgico – através da remoção do tecido paratireóideo hiperfuncionante – ainda é o padrão

  13. TRANSPLANTE RENAL

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    Soraia Geraldo Rozza Lopes

    2014-01-01

    Full Text Available El objetivo del estudio fue comprender el significado de espera del trasplante renal para las mujeres en hemodiálisis. Se trata de un estudio cualitativo-interpretativo, realizado con 12 mujeres en hemodiálisis en Florianópolis. Los datos fueron recolectados a través de entrevistas en profundidad en el domicilio. Fue utilizado el software Etnografh 6.0 para la pre-codificación y posterior al análisis interpretativo emergieron dos categorías: “las sombras del momento actual”, que mostró que las dificultades iniciales de la enfermedad están presentes, pero las mujeres pueden hacer frente mejor a la enfermedad y el tratamiento. La segunda categoría, “la luz del trasplante renal”, muestra la esperanza impulsada por la entrada en la lista de espera para un trasplante.

  14. pacientes con insuficiencia renal terminal

    Directory of Open Access Journals (Sweden)

    Karen Herrera Herrera

    2011-01-01

    Full Text Available La presente investigación fundamenta en la clínica psicoanalítica el estudio de dos casos de tres personas diagnosticadas con IRT que reciben tratamiento de hemodiálisis, en razón a que dadas las características y el aumento de los reportes que se presentan, ya esto se considera un problema de salud pública. El objetivo principal es describir las características dinámicas del proceso de duelo en pacientes con IRT en un centro de terapia renal de la ciudad de Cartagena. El procedimiento metodológico empleó un diseño de tipo cualitativo; la investigación se desarrolló con un diseño clínico mediante el estudio de casos, y fundamentada en la hermenéutica psicoanalítica. Todo esto respaldado en la historia clínica, la entrevista semiestructurada individual y familiar, los test proyectivos, test del dibujo de la figura humana Machover y TAT de Murray, para la debida integración de los análisis. Se concluye que predominan funciones fallidas de los progenitores y que son individuos provenientes de familias psicosomáticas, que utilizan la enfermedad para obtener un beneficio secundario.

  15. 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...

  16. Comparativa de la reparación valvular mitral y el dispositivo MitraClip® en el tratamiento de la insuficiencia mitral severa

    Directory of Open Access Journals (Sweden)

    Isabel Pernía-Oreña

    2017-03-01

    Conclusiones: El dispositivo MitraClip®, en este grupo de bajo riesgo, mostró peores resultados con mayor mortalidad, reingresos, descompensaciones y alta tasa de insuficiencia mitral residual. Podría ser una alternativa en casos desestimados de cirugía.

  17. Tres casos de odontomas

    Directory of Open Access Journals (Sweden)

    Salvador Javier Santos Medina

    2015-03-01

    Full Text Available Los odontomas son los tumores odontogénicos más comunes, casi siempre se diagnostican accidentalmente, en exámenes radiográficos; pueden sospecharse al retardar el brote dentario o producir maloclusiones. Se clasifican en odontomas compuestos y complejos, ambos constituidos por estructuras dentales como: esmalte, dentina, cemento y tejido pulpar. Su eliminación quirúrgica y la biopsia es el tratamiento de elección. El propósito de este trabajo es reportar tres casos de pacientes atendidos en el Hospital Pediátrico de Las Tunas, todos remitidos previamente por el ortodoncista. El primero, tipo compuesto, en un escolar de 9 años de edad, masculino, asociado a un 31 retenido; el segundo caso se trata de un gran odontoma complejo en una escolar de 11 años de edad, femenina, que produjo interferencia en el brote del 11 y el tercero compuesto; en un escolar de 10 años, masculino, en la línea media entre 11 y 21, con producción de diastema y brote del 12 por palatino. De ellos uno fue descubierto por un examen radiográfico de rutina y los otros dos sospechados por la maloclusión secundaria; todos se trataron quirúrgicamente. Estos casos demuestran la frecuencia de estos tumores en la cavidad bucal y la importancia de la realización de exámenes clínicos y radiográficos para su detección y tratamiento precoz, así como la importancia de la interrelación entre el ortodoncista y el maxilofacial en la resolución satisfactoria de esta entidad

  18. Factores pronósticos de mortalidad por sepsis severa en unidades de cuidado crítico del área metropolitana de Bucaramanga

    Directory of Open Access Journals (Sweden)

    María Eugenia Niño Mantilla

    2012-07-01

    Full Text Available Introducción La sepsis es la principal causa de mortalidad en unidades de cuidado crítico, factores de riesgo de mortalidad como la edad, el género y las escalas de severidad han sido estudiados. En nuestra población de estudio las otras complicaciones durante la hospitalización fueron las más relacionadas con el descenlace. Materiales y métodos Estudio de cohorte de 150 pacientes admitidos a unidad de cuidado critico de cuatro unidades del área metropolitana de Bucaramanga, con diagnostico de sepsis severa o choque séptico fueron estudiados mediante un cuestionario sobre variables socio-económicas, clínicas y microbiológicas. Se realizó análisis bivariado con pruebas t de student y chi cuadrado. El análisis multivariado mediante regresión de cox con el tiempo al evento como variable de descenlace. Resultados Los pacientes sobrevivientes tuvieron un promedio de edad de 64 años y los no sobrevivientes de 67 años, sin que se demostraran diferencias estadísticas entre los dos grupos de pacientes. No se encontraron diferencias en cuanto al género. El factor de riesgo más importante asociado a mortalidad por sepsis fueron las complicaciones durante la hospitalización, incluso luego de ajustar por el puntaje sofá inicial, el sitio de infección y los indicadores de respuesta inflamatoria como la hiperlactatemia e hiperbilirrubinemia. Conclusiones Se encontraron tres modelos de riesgo para mortalidad por sepsis con otras complicaciones durante la hospitalización como el factor de riesgo más relevante y el control glicemico como el factor de protección más importante. Factores pronóstico.

  19. um estudo de caso

    OpenAIRE

    Costa, Cátia Filipa Pereira da

    2011-01-01

    Dissertação apresentada à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Psicologia Jurídica As situações de abuso sexual de crianças nas quais o perpetrador pertence ao sexo feminino obtiveram ao longo dos últimos anos um acrescido reconhecimento por parte da comunidade científica, evidenciado pelo significativo incremento das investigações no âmbito desta temática consistindo na sua maioria estudos de caso. Um conjunto de particularidades encont...

  20. Scintigraphic diagnosis of infectious complications in renal failure patients undergoing hemodialysis, continuous ambulatory peritoneal dialysis or renal transplant

    Directory of Open Access Journals (Sweden)

    Ana María García Vicente

    2005-10-01

    Full Text Available Patients with end-stage renal disease have two therapeutic options, dialysis and renal transplantation. Infectious complications occurring in such patients will not only condition the effectiveness of such treatments, but are among the main causes of morbidity and mortality in such cases. Knowledge of the advantages and limitations of nuclear techniques is essential for management of these conditions.Pacientes em estágio final de doença renal têm duas opções terapêuticas, diálise e transplante renal. Complicações infecciosas que ocorrem em cada paciente são as principais causas de morbidade e mortalidade nestes casos. Conhecimentos das vantagens e limitações de técnicas nucleares são essenciais para o acompanhamento nestas condições.

  1. Confiabilidade das aferições de estudo sobre violência familiar e desnutrição severa na infância Measurement reliability in a study on family violence and severe acute malnutrition

    Directory of Open Access Journals (Sweden)

    Maria Helena Hasselmann

    1998-10-01

    Full Text Available INTRODUÇÃO: Como parte do programa de investigação sobre violência familiar e desnutrição severa na infância, especificamente um estudo do tipo caso-controle foi avaliada a confiabilidade dos instrumentos utilizados no processo de obtenção de dados. Estudou-se a confiabilidade de quatro componentes do instrumento principal: (a as Escalas sobre Táticas de Conflitos (Conflicts Tactics Scales - CTS que medem o grau de conflito/violência familiar; (b o instrumento CAGE (Cut-down; Annoyed; Guilty & Eye-opener usado para indicar suspeição de alcoolismo; (c o NSDUQ (Non-student Drugs Use Questionnaire que visa aferir o uso de drogas ilícitas; e (d a medida antropométrica de comprimento. MÉTODO: Para os três primeiros componentes citados foram avaliadas a estabilidade (confiabilidade intra-observador ou teste-reteste e a equivalência (confiabilidade inter-observador, usando-se os 50 primeiros sujeitos captados no estudo caso-controle de fundo. Para a análise, usou-se o índice Kappa (k com ajustamento (pseudo-Bayes para lidar com problemas de estimabilidade. Em relação ao componente "d", foi estudada somente a equivalência (n=73, usando-se o Coeficiente de Correlação Intraclasse (Intra-class Correlation Coefficient - ICC como estimador. RESULTADOS: Todos os componentes mostraram estabilidade e equivalência aceitáveis. Quanto à estabilidade das CTS, CAGE e NSDUQ, as estimações de k foram em torno de 0,70, 0,78 e 0,85, respectivamente. Em relação à equivalência, encontrou-se os valores de 1,0 para as CTS e NSDUQ e 0,75 para CAGE. A equivalência estimada através do ICC para comprimento foi de 0,99. Algumas situações desviantes foram observadas. Os resultados apontam para uma adequada padronização dos observadores e refletem a boa qualidade do processo de aferição referente ao estudo de fundo, encorajando a equipe de pesquisa a prosseguir com maior segurança.INTRODUCTION: This study is nested within a research

  2. Carlo Caso (1940 - 2007)

    CERN Multimedia

    Leonardo Rossi

    Carlo Caso (1940 - 2007) Our friend and colleague Carlo Caso passed away on July 7th, after several months of courageous fight against cancer. Carlo spent most of his scientific career at CERN, taking an active part in the experimental programme of the laboratory. His long and fruitful involvement in particle physics started in the sixties, in the Genoa group led by G. Tomasini. He then made several experiments using the CERN liquid hydrogen bubble chambers -first the 2000HBC and later BEBC- to study various facets of the production and decay of meson and baryon resonances. He later made his own group and joined the NA27 Collaboration to exploit the EHS Spectrometer with a rapid cycling bubble chamber as vertex detector. Amongst their many achievements, they were the first to measure, with excellent precision, the lifetime of the charmed D mesons. At the start of the LEP era, Carlo and his group moved to the DELPHI experiment, participating in the construction and running of the HPC electromagnetic c...

  3. dos estudios de caso

    Directory of Open Access Journals (Sweden)

    Daniel Kersffeld

    2013-01-01

    Full Text Available La UNASUR se ha destacado desde sus inicios en la compleja labor de mediación y resolución de conflictos internacionales. Para ello, esta entidad multilateral ha apelado a distintas fórmulas políticas tendientes al encausamiento de problemáticas y conflictos apartados del camino de la institucionalidad y de los medios tradicionales de resolución. Con todo, y pese a la búsqueda de caminos alternativos, han sido las cumbres presidenciales la principal herramienta destinada a encontrar soluciones innovadoras y respetuosas del orden democrático y constitucional de los países sudamericanos. En este artículo se analiza de manera específica la actuación de la unasur en dos casos de profunda gravedad institucional: el intento de golpe de Estado ocurrido en Ecuador el 30 de septiembre de 2010 y el derrocamiento del ex presidente Fernando Lugo en Paraguay en junio de 2012. Luego de analizar estos dos casos extremos, y las implicancias políticas generadas, se avanza en una visión comprensiva acerca del éxito o el fracaso del papel político de la unasur como instancia de resolución de conflictos a nivel internacional.

  4. Trasplantectomía tras fallo del injerto renal

    OpenAIRE

    Antón-Pérez, Gloria; Gallego-Samper, Roberto; Marrero-Robayna, Silvia; Henríquez-Palop, Fernando; Rodríguez-Pérez, José C.

    2012-01-01

    El 4-10% de los pacientes incidentes en diálisis portan un injerto renal no funcionante y hasta en el 32% de los casos, según las series, se requiere la realización de trasplantectomía por diversas causas. La mortalidad de estos pacientes es significativamente mayor que la de aquéllos con injerto funcionante o en terapia renal sustitutiva sin injerto previo. Se han sugerido como indicaciones actuales de trasplantectomía el síndrome de intolerancia al injerto, la pérdida precoz de éste, la pre...

  5. Sarcoma de Kaposi em paciente transplantada renal em uso de Fk-506 Kaposi's Sarcoma in a renal transplant patient receiving Fk-506

    Directory of Open Access Journals (Sweden)

    Jorge David Rocha Zanol

    2002-12-01

    Full Text Available O Sarcoma de Kaposi (SK é neoplasia maligna multicêntrica, cutânea e extracutânea, que tem sido descrita em pacientes transplantados renais que recebem terapia imunossupressora clássica. Este estudo descreve um caso de sarcoma de Kaposi em paciente transplantada renal recebendo FK-506, que surgiu 10 meses após o transplante.Kaposi's sarcoma is a cutaneous and extra cutaneous multicentric malignancy that has been widely described in renal-transplant patients under classic immunosuppressive therapy. This study describes a renal-transplant patient under immunosuppressive therapy with FK-506 who presented Kaposi's sarcoma 10 months after the transplantation.

  6. 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

  7. CRIPTOCOCOSE: RELATO DE CASO

    Directory of Open Access Journals (Sweden)

    Fernanda Alvarez GENTIL

    2016-12-01

    Full Text Available Criptococose, doença infecciosa fúngica, oportunista, potencialmente fatal, que acomete animais silvestres e domésticos, principalmente cachorro e gato e o homem. Causada pela levedura, Cryptococcus neoformans. Mais frequente em adultos, comumente diagnosticada em pacientes imunodeprimidos, como os soropositivos, fator predisponente mais frequente. Outros fatores são: uso prolongado de medicações imunossupressoras, doenças como diabetes, sarcoidose, doença de Hodgkin e outras neoplasias hematológicas, lúpus eritematoso, artrite reumatoide, doença de Behçet, e transplante de vísceras sólidas. Geralmente adquirida pela inalação do agente etiológico. Objetivo: este estudo objetiva relatar o caso de um paciente portador de criptococose, que esteve invernado no Hospital São José do Avaí (HSJA de Itaperuna, no mês de setembro de 2016, corroborando na literatura descrita sobre o tema, justifica-se o tema pela raridade do caso. Metodologia: inicialmente realizou-se pesquisa bibliográfica através da seleção de autores que asseguraram uma fundamentação teórico-metodológica que serviu de arcabouço para o desenvolvimento do estudo. A metodologia apresentada refere-se a um relato de caso, realizado a partir do prontuário do paciente e dos exames disponíveis. Resultados: a Radiografia de tórax evidenciou massa pulmonar em lobo inferior direito e a Tomografia de tórax também demonstrou esse acometimento; sendo realizada biópsia desse fragmento, que consolidou o diagnóstico de criptococose. A lâmina do paciente, corada com hematoxilina-eosina demonstrou aspectos característicos do acometimento por esse fungo. Conclusão: para o tratamento, pode-se utilizar antifúngicos como a anfotericina B associado com 5-flucitosina, em infecções disseminadas; ou fluconazol e itraconazol, para infecções cutâneas. 

  8. Distal renal tubular acidosis

    Science.gov (United States)

    ... this disorder. Alternative Names Renal tubular acidosis - distal; Renal tubular acidosis type I; Type I RTA; RTA - distal; Classical RTA Images Kidney anatomy Kidney - blood and urine flow References Bose A, Monk RD, Bushinsky DA. Kidney ...

  9. Nuevos casos de Paracoccidioidomicosis

    Directory of Open Access Journals (Sweden)

    J Casquero

    1998-01-01

    Full Text Available La paracoccidioidomicosis es causada por el hongo Paracoccidioides brasiliensis. Esta infección es crónica y usualmente asintomática en niños. La distribución geográfica está limitada a Centroamérica y América del Sur. En el presente estudio se describen las características clínicas y epidemiológicas de 06 casos confirmados de paracoccidioidomicosis por el Instituto Nacional de Salud. Se observó la presencia del hongo por examen directo y cultivo en muestras de biopsias, absceso, y aspirado de ganglio. Las pruebas de inmunodifusión fueron realizadas en muestras de sangre provenientes de 04 pacientes. Todos los pacientes proceden de zonas tropicales o semitropicales (Tingo María, Oxapampa, Pucallpa y Chanchamayo que tienen una precipitación media anual de 1500 mm/año, humedad relativa del 82%, temperatura anual de 28°C - 30°C y altura inferior a 1814 m.s.n.m. Las principales características sintomatológicas encontradas incluyen aumento del tamaño de ganglios y tuberculosis pulmonar. P. brasiliensis fue aislado en 2/6 pacientes y en 4/6 de los casos se observó la presencia de anticuerpos precipitantes por inmunodifusión. Se concluye que el 83% de los pacientes presentaron linfoadenopatias y el laboratorio permite confirmar el diagnóstico.

  10. Validación de nuevos parámetros predictivos de infecciones bacterianas severas en niños febriles menores de 36 meses de edad

    Directory of Open Access Journals (Sweden)

    Alicia Álvarez Rodríguez

    1999-12-01

    Full Text Available Se realizó una investigación descriptiva-prospectiva con el objetivo de validar nuestros criterios de riesgos en la identificación de la infección bacteriana severa (IBS en niños febriles, para lo cual se establecieron las categorías de riesgos y se aplicaron en 215 niños febriles que habían ingresado por esta causa en un período de 12 meses. Se obtuvo que el 54,9 % de los niños se clasificaron como bajo riesgo y el 71,6 % sin IBS. No obstante, la frecuencia de dicha afección resultó elevada, 28,4 %, con predominio de las infecciones urinarias. Se triplicó el riesgo de padecer IBS en los niños con aspecto tóxico, temperatura mayor o igual a 39°C, test clínico de Bonadio mayor que 8, cituria mayor o igual a 10 000 células/mm³, con diferencias significativas entre las categorías de riesgo y la IBS, y fue mayor la frecuencia en los niños tóxicos y de riesgos, 92,8 y 54,3 %, respectivamente. Uno de cada 4 niños febriles presentó IBS. Se introdujo la categoría "Riesgo" y se recomienda un flujograma de evaluación.A descriptive-prospective research study was carried out to validate our risk criteria in the identification of severe bacterial infection in febrile young children. For this purpose, risk categories were set and applied in 215 febrile children who had been admitted in a period of 12 months. 54.9 % of febrile children were at low risk for serious bacterial infections whereas 71.6 % presented no risk at all. Nevertheless, the frequency of this affection was high, accounting for 28.4 % with predominance of urinary infections. The risk of getting SBI trippled in children who shared toxic look, temperature greater than or equal to 39 °C, Bonadium clinical test higher than 8, cyturia values over or equal to 10 000 cell/mm³, significant differences between risk and SBI categories and the highest frequency of such affection found in toxic children and in children at low risk (92.8 vs 54.3 %. One in every four febrile

  11. Imersão em água fria para o manejo da hipertermia severa Cold water immersion to the control of exertional heat illness

    Directory of Open Access Journals (Sweden)

    Jacqueline de Paula Viveiros

    2009-08-01

    Full Text Available A incapacidade de dissipar o calor gerado pela atividade muscular prejudica o desempenho e aumenta a predisposição a lesões do organismo. A hipertermia severa induzida pelo esforço físico (HTE prejudica a saúde e está associada à morbidade e mortalidade de indivíduos em diferentes atividades ocupacionais e atléticas. Estudos sobre a eficiência de métodos de resfriamento corporal têm recomendado a imersão em água fria para o tratamento da HTE. Sua utilização nos minutos iniciais pós-hipertemia parece a melhor recomendação por reduzir o tempo no qual a temperatura central permanece elevada. A manutenção de infraestrutura necessária para a realização desse procedimento deve ser considerada em atividades físicas e condições ambientais nas quais os indivíduos estão mais suscetíveis ao acometimento da HTE. As taxas de resfriamento observadas através da imersão em água a diferentes temperaturas podem servir de referência para o controle da duração do procedimento. Esta revisão analisa a recomendação da imersão em água fria como procedimento de resfriamento corporal para o manejo da HTE.The incapacity of dissipating heat generated by muscular activity hampers performance and increases predisposition to physical injuries. Exertional heat illness (HTE harms health and is associated with morbidity and mortality of individuals in different occupational and athletic activities. Studies on the efficiency of body cooling methods have recommended cold-water immersion for the treatment of HTE. Its use in the initial minutes of post-hyperthermia seems to be the best recommendation to reduce the time central temperature remains high. Maintenance of the infrastructure needed to perform this procedure should be considered in physical activities and environmental conditions in which the individuals are more prone to HTE. The cooling rates observed through water immersion in different water temperatures may serve as reference

  12. 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.

  13. 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...

  14. Síndrome de lennox-gastaut com início na vida adulta? a respeito de um caso

    Directory of Open Access Journals (Sweden)

    P. C. Trevisol-Bittencourt

    1990-12-01

    Full Text Available Apesar de ter sido relatada anteriormente, a sindrome de Lennox-Gastaut (SLG só foi definitivamente aceita como entidade distinta em 1966. Desde então, o epônimo tem sido utilizado para designar encefalopatia severa da infância, caracterizada fundamentalmente por crises epilépticas refratárias de diversos tipos associadas com alterações eletrográficas típicas. Entretanto, vários autores consideram que o rótulo de SLG está abrigando quadros nosológicos distintos, que deveriam ser separados e individualizados. Ilustrando esta situação, o caso de um paciente que iniciou quadro de «SLG-like» aos 20 anos de idade é relatado. Adicionando mais confusão, alguns casos semelhantes têm sido descritos nos últimos anos sob variada nomenclatura. Desde que um dos principais critérios para o diagnóstico da SLG é a idade dependência, como deverão então ser chamados tais quadros? Revisão dos critérios empregados para o diagnóstico da SLG se faz necessária.

  15. Diabetes tipo 2 y pionefrosis: una complicación potencialmente fatal. Presentación de un caso

    Directory of Open Access Journals (Sweden)

    Miguel Ángel Serra Valdés

    2013-09-01

    Full Text Available La infección bacteriana del tracto urinario es un problema común en la práctica médica diaria. Son complicaciones agudas muy frecuentes y severas en pacientes diabéticos. La motivación a la presentación de este caso radica en su importancia para la docencia, e invita a la reflexión de cómo se está realizando la práctica clínica de esta entidad. Se presenta el caso de una paciente que hacía 2 meses había comenzado con dolor en la región lumbar izquierda, que se irradiaba a la parte anterior del abdomen de ese lado hasta el muslo, este era un dolor mantenido, intenso, punzante, que se aliviaba con calmantes y algunas veces al flexionar la pierna de ese sector. Además presentaba decaimiento, inapetencia, nauseas, fiebres de 38-39˚C, ardor miccional con orinas frecuentes de poca cantidad y de color oscuro. El examen físico planteó la posibilidad diagnóstica que fue corroborada por la tomografía axial computarizada de pionefrosis obstructiva. Se realizó tratamiento médico y se efectuó nefrectomía radical izquierda.

  16. Análisis experimental del simulador de conducción UPV-DGT para la evaluación de conductores con discapacidades severas que conducen con Joysticks de 4 vías

    OpenAIRE

    BRUNA REMIRO, FRANCISCO JAVIER

    2016-01-01

    [ES] El objetivo de este TFG es el análisis experimental del simulador de conducción FIATDGT para la evaluación de conductores con discapacidades severas. Para poder determinar si es válido, se ha realizado un análisis estadístico entre un grupo de control ( personas sin discapacidad ) y un grupo de experimental ( personas con discapacidades) de los datos obtenidos de una batería de pruebas seleccionadas previamente, las cuáles serán comunes para ambos grupos, par...

  17. 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)

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Diabetes tipo 2 en niños: Reporte de caso

    Directory of Open Access Journals (Sweden)

    Miguel Pinto

    2010-04-01

    Full Text Available Se reporta el caso de una niña de 14 años con antecedentes de obesidad, dislipidemia y diabetes que es referida a nuestro servicio por polidipsia, poliuria y sobrepeso. La paciente tenía el antecedente familiar de ambos padres con diagnóstico de diabetes tipo 2. El examen físico mostró obesidad central y acantosis nigricans severa en los pliegues cutáneos. Los análisis de laboratorio mostraron hiperglicemia, hiperinsulinemia y péptido C normal. Los autoanticuerpos anti-GAD y anti-ICA fueron negativos. El tratamiento con metformina fue continuado; y la dieta y actividad física fueron reforzadas. Actualmente, los niveles de hemoglobina glicosilada y glicemia en ayunas han mejorado. El incremento en la obesidad infantil ha resultado en un marcado aumento en la incidencia de síndrome metabólico y diabetes tipo 2 en la población infantil.(Rev Med Hered 2010;21:103-106.

  20. Hiperplasia linfoide de íleon terminal, presentación de un caso

    Directory of Open Access Journals (Sweden)

    Arley Fajardo Ochoa

    2014-08-01

    Full Text Available Se presenta el caso de un adolescente masculino de 16 años de edad que acudió a la consulta por dolor abdominal recurrente, localizado en la fosa ilíaca derecha, el cual había recibido tratamiento sintomático con antiespasmódicos y antiparasitarios sin lograr mejoría del dolor, por lo que fue remitido a la consulta de Gastroenterología donde se le realizaron exámenes complementarios que evidenciaron la existencia de una patología en el íleon terminal, se remitió al Instituto de Gastroenterología, donde se le realizó una colonoscopia y se le diagnosticó una hiperplasia linfoide severa de Ileon terminal que con el tratamiento higiénico dietético, se logró disminuir la frecuencia y la intensidad del dolor, sin embargo en las colonoscopías evolutivas se observó un incremento en la intensidad y la extensión de la hiperplasia por lo que se le indicaron exámenes endoscópicos e histológicos cada seis meses, llama la atención que a pesar de la severidad del cuadro, nunca se ha observado ningún episodio de sangrado digestivo que es la forma de presentación más frecuente de esta entidad

  1. Ictericia e incompatibilidad por grupo Kell: caso clínico.

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    Miguel Zúñiga

    2010-08-01

    Full Text Available Dentro de las patologías más frecuentes que afectan al recién nacido se encuentra la ictericia. Sus etiologías son diversas y conforman una larga lista que varía desde causas infecciosas, metabólicas, hematológicas, inmunológicas, entre otras. Sin embargo, cuando se presenta durante las primeras horas, las causas más frecuentes corresponden a incompatibilidades de grupo sanguíneo y de ellas, la incompatibilidad Rh y ABO suelen ser más frecuentes. La incompatibilidad por grupo Kell, en cambio, es un trastorno mucho menos frecuente. Se presenta en un recién nacido con ictericia secundaria a una anemia hemolítica y que posee anticuerpos relacionados con el grupo sanguíneo Kell. Su evolución puede ser compleja y severa, requiriendo en algunos casos manejo en cuidados intensivos y apoyo importante de hemoderivados. Todo lo anterior hace importante conocer esta patología, de manera de poder identificarla y actuar a tiempo en su tratamiento.

  2. Enfermedad de Carrión grave complicada con leptospirosis aguda: reporte de un caso

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    Anderson Huerta

    Full Text Available Se reporta el caso de un adulto varón de 56 años, procedente de Sihuas (Ancash que acude al Hospital Nacional Dos de Mayo con cuadro clínico caracterizado por un síndrome ictérico febril anemizante, en cuya evolución tórpida de solo tres días de hospitalizado presenta anemia severa (Hb: 11,8 a 6,7 g/dL así como mialgias generalizadas asociadas a un empeoramiento brusco de la ictericia correlacionada con elevación de bilirrubinas (BT: 3,2 a 19,6 mg/dL a predominio directo y deterioro general del paciente; por ello, se realizó la investigación microbiológica donde se encontró frotis y cultivo positivo para Bartonella bacilliformis, posteriormente, la serología (microaglutinación resultó positiva para Lesptospira serovar Pomona. El paciente recibe tratamiento antibiótico específico (ceftriaxona y ciprofloxacino, se le transfunde dos paquetes globulares, mejora clínicamente y es dado de alta

  3. Xeroderma pigmentoso. Síndrome de Sanctis Cacchione: Presentación de 1 caso

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    Leopoldina Falcón Lincheta

    1998-06-01

    Full Text Available El xeroderma pigmentoso es una afección genética poco frecuente que traduce la hipersensibilidad celular a la radiación ultravioleta en asociación con una anormal reparación del ácido dexosirribonucleico, y que produce pecosidades, fotofobia y subsecuentemente cambios neoplásicos en zonas expuestas al sol. En este trabajo se presenta el primer caso reportado en Cuba en un niño de 5 años de edad, con la entidad clínica en su forma más severa de manifestarse, el síndrome de Sactis Cacchione, que involucra las manifestaciones cutáneas y oculares con trastornos neurológicos y somáticos graves, y provoca daños letales.Xeroderma pigmentosum is a rare genetic affection that transforms cellular hypersensitivity to ultraviolet radiation in association with an abnormal repairing of the desoxyribonucleic acid, and that produces freckles, photophobia and, subsequently, neoplasitc changes in zones exposed to sunlight. In this paper it is reported the first case detected in Cuba in a five-year-old child suffering from the most severe manifestation of this disease, the Sanctis Cacchione´s syndrome, which involves skin and ocular manifestations with serious somatic and neurological disorders and provokes lethal damages.

  4. Mielopatia necrotizante e neoplasias: registro clinico-patologico de dois casos

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    Marcos R. G. de Freitas

    1983-06-01

    Full Text Available São relatados dois casos de mielopatia transversa subaguda associada a tumores malignos. O primeiro paciente apresentava neoplasia de células reticulares histiocitárias e o segundo, carcinoma renal. Os autores fazem revisão dos casos similares descritos na literatura. As alterações anátomo-patológicas medulares encontradas foram semelhantes às descritas nos relatos prévios, sendo que no primeiro caso havia também intenso infiltrado inflamatório perivascular e a presença de astrócitos bizarros. Tais alterações encontradas sugerem ser esta afecção de natureza viral.

  5. 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.

  6. 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)

  7. Growth speed in patients with chronic renal failure undergoing to renal transplantation between 2000 and 2009 in the Hospital Nacional de Ninos: research protocol; Velocidad de crecimiento en pacientes con insuficiencia renal cronica sometidos a trasplante renal entre el ano 2000 y el 2009 en el Hospital Nacional de Ninos: protocolo de investigacion

    Energy Technology Data Exchange (ETDEWEB)

    Arroyo Molina, Ana Victoria

    2013-07-01

    The growth speed was investigated in children with chronic renal failure after renal transplantation, in the Hospital Nacional de Ninos during the study period January 2000-December 2009. Factors that have influenced are analyzed: age of onset of renal disease, etiology of renal disease, metabolic acidosis, anemia, renal osteodystrophy, episodes of infection and rejection. Besides, on the growth rate and expected family size, to intervene or prevent them in future cases. Also, the use that has given in the hospital to growth hormone, before and after renal transplantation is determined to eventually use parallel therapies to the transplantation. An echocardiographic study is recommended to perform as part of the treatment of chronic renal failure to identify the existence of left ventricular hypertrophy and heart failure, which may occur as a result of complications of the failure [Spanish] La velocidad del crecimiento fue investigada en ninos con insuficiencia renal cronica despues del transplante renal, en el Hospital Nacional de Ninos durante el periodo de estudio enero 2000-diciembre 2009. Factores que han influido son analizados: edad de inicio de la enfermedad renal, etiologia de la enfermedad renal, la acidosis metabolica, la anemia, la osteodistrofia renal, los episodios de infecciones y rechazos. Ademas, sobre la velocidad de crecimiento y la talla familiar esperada, para intervenir en ellos o prevenirlos en casos futuros. Tambien, el uso que se ha dado en el hospital a la hormona de crecimiento, tanto antes como despues del transplante renal es determinado para eventualmente utilizar terapias paralelas al transplante, fueron determinadas. Un estudio ecocardiografico es recomendado realizar como parte del tratamiento de la insuficiencia renal cronica para identificar la existencia de hipertrofia ventricular izquierda e insuficiencia cardiaca, que pueden ocurrir como consecuencia de las complicaciones de la insuficiencia.

  8. Urolitíase no alotransplante renal

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    Cologna Adauto José

    2003-01-01

    Full Text Available OBJETIVO: A litíase urinária é uma complicação incomum no alotransplante renal, a incidência varia de 0,02 a 3,4%. A maioria dos cálculos forma-se após o transplante, porém alguns podem ser transferidos junto com o enxerto para o hospedeiro. O tratamento desta complicação está baseado em alguns casos descritos na literatura. O objetivo deste trabalho é o de relatar a incidência da litíase renal no paciente com transplante renal, assim como a conduta adotada no HCFMRPUSP. MÉTODOS: Foram analisados 953 pacientes submetidos a transplante renal no HCFMRPUSP, de fevereiro 1968 a maio de 2003. A idade média foi de 47,2 anos (35 a 63 anos. Em 09 pacientes, o rim foi proveniente de doador cadáver e apenas 01 doador vivo. RESULTADOS:Foram diagnosticados 10 casos de litíase (1,05%. Em 02 pacientes (20% o cálculo foi diagnosticado no intraoperatório, em 01 (10% no peri-operatório (5º. dia, os 07 restantes (70% no pós-operatório tardio. Em 04 pacientes (57% não havia sintomatologia específica, 02 (29% apresentaram ITU, em 03 (43% ocorreu elevação da creatinina sérica. De 8 pacientes com litíase no pós-operatorio, em 06 os cálculos estavam localizados no rim e 02 no ureter. Dos pacientes com cálculos renais, 02 foram observados, 02 submetidos a LECO, 01 a nefrolitripsia percutânea, 01 à pielolitotomia. Em 01 paciente com cálculo ureteral foi realizada pielovesicostomia (cálculo + estenose, no outro paciente foi feita a ureterorrenoscopia retrógrada. CONCLUSÃO: A urolitíase é complicação rara no transplante renal, a conduta terapêutica no pós-operatório tardio é semelhante à da população geral.

  9. Estudo epidemiológico da doença renal crônica terminal no oeste do Paraná: uma experiência de 878 casos atendidos em 25 anos Epidemiological study of end-stage kidney disease in western Paraná: an experience of 878 cases in 25 years

    Directory of Open Access Journals (Sweden)

    Luis Alberto Batista Peres

    2010-03-01

    Full Text Available INTRODUÇÃO: A incidência e prevalência dos pacientes em fase final da doença renal crônica (DRC continuam a crescer em todo o mundo. O transplante renal continua tendo preferência na terapia renal substitutiva, mas, dada a limitada oferta de doadores de órgãos, terapias dialíticas são as modalidades mais realizadas. OBJETIVOS: Avaliar um registro de pacientes admitidos para terapia renal substitutiva no período de 1984 a 2009, em um único Centro. MÉTODOS: Este é um estudo epidemiológico retrospectivo. Foram analisadas as características demográficas e clínicas, incidência, principal doença renal de base, modalidades dialíticas, mortalidade e causas de óbitos. Para comparar as variáveis, foram utilizados o teste do qui-quadrado, teste t de Student, ANOVA e teste de Tukey. Curvas de Kaplan-Meier foram utilizadas para estimar a sobrevida dos pacientes. Um valor de p INTRODUCTION: The incidence and prevalence of treated end-stage chronic kidney disease (CKD patients continue to grow throughout the world. Renal transplantation remains the preferred form of renal substitutive therapy, but given the limited number of donors, dialytic therapies are the most common modalities. OBJECTIVES: To assess a registry of patients admitted for renal substitutive therapy at a single centre from 1984 to 2009. METHODS: This is a retrospective epidemiological study. The following were analyzed: demographic and clinical characteristics; incidence of CKD; underlying kidney disease; dialysis modalities; mortality; and causes of death. The variables were compared by using the chi-square test, Student t test, ANOVA, and Tukey test. Kaplan-Meier curves were used to estimate patient's survival. A p value < 0.05 was considered statistically significant. RESULTS: In the period studied, 878 patients were admitted to dialysis. Their mean age was 47.0 ± 16.2 years, 549 (62.5% were males, and 712 (81.1% were white. The major cause of CKD was hypertension

  10. Fibrose congênita de reto inferior atípica com hipotonia muscular generalizada: relato de um caso Atipical inferior rectus congenital fibrosis with generalizated muscular hypotonia: case report

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    Ezon Vinicius Alves Pinto Ferraz

    1999-10-01

    Full Text Available O caso descrito apresentava uma hipotropia pouco severa com acuidade visual normal e binocularidade em infra-versão; além de uma hipotonia muscular generalizada, ao contrário da severa hipotropia e ambliopia encontrada nessa afecção. O procedimento cirúrgico levou estes fatos em consideração, tendo-se optado por um retrocesso pequeno do reto inferior para que se corrigisse o torcicolo sem interferir na posição de leitura. Os resultados pós-operatórios foram satisfatórios.A case report of an atipical inferior rectus congenital fibrosis associated with a generalized muscular hypotonia is presented. It shows mild hipotropia with a normal visual acuity and binocularity in infraversion position contrasting with the severe hipotropia and ambliopy found. The surgical procedure took these facts into consideration, so we performed a small retrocess of the muscle with the objective to correct the head position without changes in the reading position. The postoperative results were satisfactory.

  11. Injúria renal aguda: um alerta global

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    Philip Kam Tao Li

    2013-03-01

    Full Text Available A Injúria Renal Aguda (IRA é cada vez mais prevalente nos países desenvolvidos e nos em desenvolvimento, e está associada com morbidade e mortalidade severas. A maioria das causas da IRA pode ser evitada por meio de intervenções em nível individual, comunitário, regional e intra-hospitalar. Medidas efetivas devem incluir, em toda a comunidade, os esforços para aumentar a consciência dos efeitos devastadores do IRA e fornecer orientações sobre as estratégias de prevenção, bem como o reconhecimento e tratamento precoces. Os esforços devem ser focados em minimizar as causas de IRA, aumentando a consciência da importância de medidas seriadas de creatinina sérica em pacientes de alto risco para IRA, e documentar o volume de urina em pessoas gravemente doentes para obtenção de diagnóstico precoce; até o momento, não há ainda um papel definitivo para outros biomarcadores. Há a necessidade de protocolos para sistematizar a conduta em condições de IRA pré-renal e em infecções específicas. Dados mais precisos sobre a verdadeira incidência e o impacto clínico da IRA ajudarão a melhor conhecer a importância desta doença, a aumentar o conhecimento de IRA por parte dos governantes, dos médicos em geral e de outros profissionais de saúde para ajudar na prevenção da doença. A prevenção é a chave para evitar a pesado ônus de mortalidade e morbidade associada com IRA.

  12. 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.

  13. 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

  14. El caso Moro

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    Óscar Hernández Chinarro

    2012-06-01

    Full Text Available Se cumple el trigésimo tercer aniversario del secuestro y asesinato de Aldo Moro, todavía persisten muchos interrogantes sobre el caso. La historiografía de los últimos 20 años ha explicado la muerte de Moro como un hecho ineludible. La ratificación del Compromiso Histórico presentada por Berlinguer determinó que la CIA organizase una acción punitiva cuya finalidad era la eliminación física de Moro. El presente artículo intenta desmitificar el papel jugado por los servicios secretos norteamericanos y centra su atención en las Brigadas, planteando una nueva hipótesis para entender que ocurrió durante esos 55 días y que determinó la muerte de MoroPalabras claves: Aldo Moro, Brigadas Rojas, Italia, 1978, Democracia Cristiana, Mario Moretti, Estados Unidos _________________________AbstractUpon completion of the thirty-third anniversary the kidnapping and murder of Aldo Moro, there are still many questions about the case. The historiography of the last 20 years explained Moro's death as an inescapable fact. Ratification of Historic Commitment by Berlinguer determined that the CIA organize a punitive action was aimed at the physical elimination of Moro. This article attempts to demystify the role played by the U.S. secret services and focuses on the Brigades, proposing a new hypothesis to understand what happened during those 55 days and determined the death of Moro.Keywords: Aldo Moro, Red Brigades, Italy, 1978, Christian democracy,  Mario Moretti, United States

  15. MEXCODE* CASO DE ESTUDIO

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    Gabriel Arturo García Gómez

    2000-01-01

    Full Text Available El caso plantea la reactivación de un proyecto que se presentó en el año 1995 como alternativa para el desarrollo del centro del Valle y mejora de la eficiencia en el manejo del comercio exterior de la Cuenca Pacífica. El proyecto se revivió a raíz de la necesidad de la compañía patrocinadora de mejorar sus flujos de caja proyectados y la reciente autorización para su funcionamiento. El proyecto es el popularmente denominado “Puerto Seco” de la ciudad de Guadalajara de Buga, internamente nombrado Mexcode. Los estudios iniciales estaban encaminados a que el proyecto fuera manejado por el municipio de Buga, sin embargo, posteriormente se vio la necesidad de buscar que pasara a manos de la empresa privada. El municipio, después de analizar las propuestas de varios inversionistas de la región en las cuales se evaluaba la ubicación dentro de la zona de los predios de sus empresas, su área, proximidad a la línea férrea y a la doble calzada Buga-Tuluá (sitio de paso del 80% de la carga de importación y exportación por Buenaventura y evaluar aspectos relativos a su trayectoria empresarial y compromiso con el desarrollo de la región, decidió otorgarle el proyecto al Grupo Empresarial Agri-Supplies S.A.

  16. COMENTARIO AL CASO PINOCHET

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    Alberto Contreras Clunes

    2002-01-01

    Full Text Available El fallo en el caso Pinochet tiene distintas formas de ser analizado. De partida, desde un punto de vista político, también constitucional, del derecho penal. Sin embargo, nos abocaremos al estudio desde el punto de vista procesal, en especial a lo referido al Debido Proceso. Para ello se analizará los presupuestos, la solución dada por la Excma. Corte Suprema y las consecuencias del mismo. Además, se criticará la solución dada, desde la óptica de las garantías procesales del imputado, contenidas en el nuevo proceso penal y lo dispuesto en la Constitución y la Convención Americana de Derechos Humanos. Finalmente, se argumentará en favor de una interpretación finalista y armónica de la Constitución y los tratados internacionales de derechos humanos.The verdict of the Pinochet Case has different ways of being analyzed: from the political, the constitutional, and the penal law points of view. However, we will approach this study from the legal point of view, especially to that referred to as the Proper Process. To do this, the budgets, the solution given by the Most Excellent Supreme Court, and its consequences will be analyzed. Furthermore, the given solution will be criticized from the point of view of the legal guarantees of the accused contained in the new penal process and what is contained in the Constitution and in the American Convention of Human Rights. In conclusion, we will argue in favor of a final and harmonious interpretation of the Constitution and the international agreement of human rights.

  17. 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

  18. 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...

  19. 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.

  20. 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 ...

  1. 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.)

  2. Neuroblastomicose: registro de três casos

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    Ehrenfried O. Wittig

    1968-03-01

    Full Text Available São relatados três casos de neuroblastomicose de sintomatologia variada (urna forma tumoral cerebelar, urna forma abscedante troncular e cerebral e urna forma granulomatosa difusa. No caso da forma tumoral cerebelar havia associação com cisticercose cerebral. Alterações medulares não foram evidenciadas no único caso em que foi possível examinar êste setor do sistema nervoso central (caso 2.

  3. Raquitismo carencial: relato de caso

    OpenAIRE

    Porto, Juliana Antola et al.

    2005-01-01

    Introdução: O raquitismo é uma doença do tecido ósseo em formação, onde há falha na calcificação e conseguinte acúmulo de tecido osteóide. O raquitismo carencial é decorrente da deficiência dos precursores da vitamina D, sendo a causa de raquitismo mais facilmente evitável e tratável. Objetivo: Relatar um caso, revisar a etiopatogenia e o tratamento do raquitismo carencial. Relato de caso: Paciente masculino com 2 anos de idade, previamente hígido, consulta com dificuldade de deambular progre...

  4. Cicatriz renal: factores de riesgo relacionados con infección urinaria Renal scar: risk factors related to urinary infection

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    Lourdes María Pérez Clemente

    2007-06-01

    Full Text Available La infección urinaria es una de las infecciones bacterianas más frecuente en la niñez, superada solamente por las infecciones respiratorias. En algunos casos, puede causar cicatrices renales que pueden inducir complicaciones futuras, como la hipertensión arterial y enfermedad renal crónica. Los métodos de diagnóstico por imagen en los niños tienen como objetivo identificar a los pacientes en riesgo de desarrollar cicatrices renales o daño renal permanente, o de prevenir la progresión del daño renal preexistente. Se evaluaron retrospectivamente los datos clínicos de 100 niños con diagnóstico de infección urinaria, a los cuales se les realizó gammagrafía renal con ácido dimercaptosuccínico (DMSA. Se correlacionó la presencia de cicatriz renal con la edad, sexo, número de episodios de infección urinaria y presencia de reflujo vesicoureteral. Se demostró que todo niño con infección urinaria, independientemente del sexo, corre el riesgo de desarrollar cicatriz renal, el cual aumenta con la presencia de reflujo vesicoureteral, infecciones recurrentes y en la medida en que aumenta la edad. Por ello sugerimos estudiar, mediante ultrasonido, cistografía y gammagrafía con DMSA marcado con tecnecio 99 (Tc99m-DMSA, a todo niño con infección urinaria, para detectar oportunamente a quienes están en riesgo de desarrollar cicatriz renal o daño renal permanente.Urinary infection is one of the most common bacterial infections in childhood after respiratory infections. In some cases, it can cause renal scars that may lead to future complications like blood hypertension and chronic renal disease. The diagnostic imaging methods for children are aimed at identifying those patients at risk of developing renal scars or a permanent renal damage, and preventing the progression of pre-existing renal damage. Clinical data from 100 children diagnosed with urinary infection, who had been performed a renal DMSA scintigraphy, were retrospectively

  5. ESTRATÉGIAS PEDAGÓGICAS EMPREGADAS POR PROFESSORES DE EDUCAÇÃO ESPECIAL AOS SEUS ALUNOS COM DEFICIÊNCIA INTELECTUAL SEVERA: UM ESTUDO DESCRITIVO DA PRÁTICA DOCENTE

    Directory of Open Access Journals (Sweden)

    Patricia Moralis CARAMORI

    2015-12-01

    Full Text Available RESUMO Esta pesquisa aborda a temática da educação de indivíduos com deficiência intelectual severa a partir das estratégias pedagógicas utilizadas por professoras de Educação Especial. Justifica-se por abordar o processo educacional de uma população pouco investigada, além de unir dois eixos de discussão de forma inovadora: a Teoria da Modificabilidade Cognitiva Estrutural (MCE de Reuven Feuerstein e a educação de alunos severamente prejudicados. Segundo essa Teoria, o professor atua como mediador, interpondo-se entre os estímulos do ambiente e o aluno. Seu objetivo pauta-se na descrição e análise da implementação do processo educacional de alunos com deficiência intelectual severa, enfocando as estratégias pedagógicas de professoras de Educação Especial na cidade de Araraquara. Os procedimentos iniciais indicam o estabelecimento dos perfis das professoras, seu mapeamento e localização. Definidos os participantes, a coleta dos dados se deu por meio de três instrumentos: entrevista semiestruturada realizada com as professoras e observação, registrada em protocolo e em diário de campo. Os dados foram analisados qualitativamente a fim de permitir a extração de detalhes do cotidiano observado. Os resultados apresentam uma descrição do trabalho das quatro professoras participantes, evidenciando suas opiniões sobre suas práticas, além de arrolar as estratégias pedagógicas utilizadas. Oferece-se como conclusão a identificação de estratégias pedagógicas que se relacionam com os critérios que regem a mediação. Isso mostra que é possível associar as idéias de Feuerstein às práticas pedagógicas voltadas aos alunos com deficiência intelectual severa, já que determinados procedimentos empregados demonstram trazer em seu cerne alguns preceitos essenciais à mediação.

  6. Dioctofimose em cães: 16 casos Dioctophymosis in dogs: 16 cases

    Directory of Open Access Journals (Sweden)

    Glaucia Denise Kommers

    1999-09-01

    Full Text Available No período de 1978 a 1996, de um total de 3.259 cães necropsiados, 16 (0,49% apresentaram parasitismo por Dioctophyma renale. Desses, 12 (75% eram cães de rua. Em 13 cães (81, 2%, um ou vários parasitas localizavam-se no rim direito. Em 3 casos (18,7%, o parasita foi observado na cavidade abdominal. Nos casos de parasitismo renal, observou-se acentuada atrofia do parênquima, transformando o rim numa bolsa fibrosa contendo o parasita em meio a exsudato necro-hemorrágico semilíquido. Foi observada hipertrofia renal compensatória contralateral em 5 casos. O ciclo evolutivo de D. renale é complexo e incompletamente entendido. Envolve um hospedeiro intermediário e hospedeiros paratênicos. A alta ocorrência da doença em cães de rua sugere que a infecção seja relacionada aos hábitos alimentares pouco seletivos desses animais.From 1978 to 1996, out of a total of 3,259 dogs necropsied, sixteen (0.49% were parasitized by Dioctophyma renale. Twelve of those (75% were stray dogs. Thirteen dogs (81.2% presented one or more specimens of D. renale in the right kidney. In three dogs (18.7%, the parasite was observed in the abdominal cavity. In those cases of renal parasitism, there was marked atrophy of the kidney which became a fibrous-walled bag within which the parasite was found imersed in a semiliquid necro-hemorrhagic exudate. In five cases, compensatory hypertrophy of the contralateral kidney was observed. The life cycle of D. renale is complex and not fully understood. It envolves intermediate and parathenic hosts. The high incidence of the disease in stray dog suggests that the infection is related to the poor selective feeding habits of this kind of dog.

  7. 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).

  8. 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)

  9. Disappearing renal calculus.

    Science.gov (United States)

    Cui, Helen; Thomas, Johanna; Kumar, Sunil

    2013-04-10

    We present a case of a renal calculus treated solely with antibiotics which has not been previously reported in the literature. A man with a 17 mm lower pole renal calculus and concurrent Escherichia coli urine infection was being worked up to undergo percutaneous nephrolithotomy. However, after a course of preoperative antibiotics the stone was no longer seen on retrograde pyelography or CT imaging.

  10. 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)

  11. 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

  12. [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...

  13. Prototecosis Informe de tres casos

    Directory of Open Access Journals (Sweden)

    Miguel Guzmán

    1983-12-01

    Full Text Available Se presentan tres casos clínicos de prototecosis vistos y estudiados en el lnstituto Nacional de Salud. Uno corresponde a la forma tegumentaria y los otros dos a formas de bursitis del olécranon. Se discuten los aspectos biológicos, clínicos y de laboratorio de esta rara entidad causada por algas.

  14. Complex Adaptive Systems of Systems (CASoS) engineering and foundations for global design.

    Energy Technology Data Exchange (ETDEWEB)

    Brodsky, Nancy S.; Finley, Patrick D.; Beyeler, Walter Eugene; Brown, Theresa Jean; Linebarger, John Michael; Moore, Thomas W.; Glass, Robert John, Jr.; Maffitt, S. Louise; Mitchell, Michael David; Ames, Arlo Leroy

    2012-01-01

    Complex Adaptive Systems of Systems, or CASoS, are vastly complex ecological, sociological, economic and/or technical systems which must be recognized and reckoned with to design a secure future for the nation and the world. Design within CASoS requires the fostering of a new discipline, CASoS Engineering, and the building of capability to support it. Towards this primary objective, we created the Phoenix Pilot as a crucible from which systemization of the new discipline could emerge. Using a wide range of applications, Phoenix has begun building both theoretical foundations and capability for: the integration of Applications to continuously build common understanding and capability; a Framework for defining problems, designing and testing solutions, and actualizing these solutions within the CASoS of interest; and an engineering Environment required for 'the doing' of CASoS Engineering. In a secondary objective, we applied CASoS Engineering principles to begin to build a foundation for design in context of Global CASoS

  15. Complex Adaptive System of Systems (CASoS) Engineering Applications. Version 1.0.

    Energy Technology Data Exchange (ETDEWEB)

    Linebarger, John Michael; Maffitt, S. Louise (New Mexico Institute of Mining and Technology, Albuquerque, NM); Glass, Robert John, Jr.; Beyeler, Walter Eugene; Brown, Theresa Jean; Ames, Arlo Leroy

    2011-10-01

    Complex Adaptive Systems of Systems, or CASoS, are vastly complex eco-socio-economic-technical systems which we must understand to design a secure future for the nation and the world. Perturbations/disruptions in CASoS have the potential for far-reaching effects due to highly-saturated interdependencies and allied vulnerabilities to cascades in associated systems. The Phoenix initiative approaches this high-impact problem space as engineers, devising interventions (problem solutions) that influence CASoS to achieve specific aspirations. CASoS embody the world's biggest problems and greatest opportunities: applications to real world problems are the driving force of our effort. We are developing engineering theory and practice together to create a discipline that is grounded in reality, extends our understanding of how CASoS behave, and allows us to better control those behaviors. Through application to real-world problems, Phoenix is evolving CASoS Engineering principles while growing a community of practice and the CASoS engineers to populate it.

  16. Phoenix : Complex Adaptive System of Systems (CASoS) engineering version 1.0.

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Thomas W.; Quach, Tu-Thach; Detry, Richard Joseph; Conrad, Stephen Hamilton; Kelic, Andjelka; Starks, Shirley J.; Beyeler, Walter Eugene; Brodsky, Nancy S.; Verzi, Stephen J.; Brown, Theresa Jean; Glass, Robert John, Jr.; Sunderland, Daniel J.; Mitchell, Michael David; Ames, Arlo Leroy; Maffitt, S. Louise; Finley, Patrick D.; Russell, Eric Dean; Zagonel, Aldo A.; Reedy, Geoffrey E.; Mitchell, Roger A.; Corbet, Thomas Frank, Jr.; Linebarger, John Michael

    2011-08-01

    Complex Adaptive Systems of Systems, or CASoS, are vastly complex ecological, sociological, economic and/or technical systems which we must understand to design a secure future for the nation and the world. Perturbations/disruptions in CASoS have the potential for far-reaching effects due to pervasive interdependencies and attendant vulnerabilities to cascades in associated systems. Phoenix was initiated to address this high-impact problem space as engineers. Our overarching goals are maximizing security, maximizing health, and minimizing risk. We design interventions, or problem solutions, that influence CASoS to achieve specific aspirations. Through application to real-world problems, Phoenix is evolving the principles and discipline of CASoS Engineering while growing a community of practice and the CASoS engineers to populate it. Both grounded in reality and working to extend our understanding and control of that reality, Phoenix is at the same time a solution within a CASoS and a CASoS itself.

  17. 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

  18. 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.

  19. 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

  20. Renal dysplasia in a Limousin calf Displasia renal em um bezerro Limousin

    Directory of Open Access Journals (Sweden)

    M.B. Castro

    2007-04-01

    Full Text Available Descreve-se um caso de displasia renal em um bezerro Limousin, macho, de quatro meses. O animal apresentava perda de peso, baixa taxa de crescimento, anorexia, apatia, diarréia escura fétida e uremia, sem melhora apesar de tratamento. O bezerro foi sacrificado para interromper o sofrimento adicional e submetido à necropsia. Ao exame foi observado que os rins estavam pequenos, firmes, pálidos e com superfície rugosa. A cápsula estava aderida à uma superfície subcapsular irregular. O córtex tinha aparência difusamente pálida e fibrosa e apresentava múltiplos focos brancos de fibrose. A junção córtico-medular estava indistinta. O exame histologico dos rins revelou múltiplos glomérulos imaturos com núcleo periférico, capilares inaparentes e padrão arbóreo. O córtex renal apresentou túbulos primitivos com epitélio cubóide ou cilíndrico envolvido por mesênquima corado somente pelo alcian blue e não pelo tricrômico de Masson. Foi também observada leve fibrose intersticial na medula renal. Os rins mostravam estruturas em estágio inapropriado de desenvolvimento ou anômalas.

  1. Renal Branch Artery Stenosis

    DEFF Research Database (Denmark)

    Andersson, Zarah; Thisted, Ebbe; Andersen, Ulrik Bjørn

    2017-01-01

    Renovascular hypertension is a common cause of pediatric hypertension. In the fraction of cases that are unrelated to syndromes such as neurofibromatosis, patients with a solitary stenosis on a branch of the renal artery are common and can be diagnostically challenging. Imaging techniques...... that perform well in the diagnosis of main renal artery stenosis may fall short when it comes to branch artery stenosis. We report 2 cases that illustrate these difficulties and show that a branch artery stenosis may be overlooked even by the gold standard method, renal angiography....

  2. 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.

  3. Cryoablation of Renal Angiomyolipoma

    DEFF Research Database (Denmark)

    Makki, Ahmad; Graumann, Ole; Hoyer, Soren

    2017-01-01

    BACKGROUND: Small series have reported that cryoablation (CA) is a safe and feasible minimally invasive nephron-sparing alternative for the treatment of renal angiomyolipomas (renal AMLs). The aim of the present study was to investigate the safety and efficacy of CA in patients with renal AML......-guided CA. The mean patient age was 46 years [interquartile range (IQR) 30] and the mean tumor volume was 50.1 cm(3) (IQR 53.3). In all cases, the procedure was effectively conducted with no conversion to open surgery, and no major complications were experienced. The mean follow-up time was 25 months (IQR...

  4. 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.)

  5. 159. Trombectomía de Vena Cava Inferior Por Invasión de Tumor Renal

    Directory of Open Access Journals (Sweden)

    N. Miranda

    2012-04-01

    Conclusiones: en casos seleccionados, el carcinoma de célula renal extendiéndose a VCI puede ser resecado sin dificultad sin necesidad de esternotomía, CBP o PCHP, constituyendo una alternativa curativa en el tratamiento de dichos tumores.

  6. Renal tumors in infancy

    International Nuclear Information System (INIS)

    Lucaya, J.; Garcia, P.

    1997-01-01

    The classification of childhood renal masses in updated, including the clinical signs and imaging techniques currently employed to confirm their presence and type them. Several bening and malignant childhood tumors are described in substantial detail. (Author) 24 refs

  7. Renal cell carcinoma

    Science.gov (United States)

    ... kidney Patient Instructions Kidney removal - discharge Images Kidney anatomy Kidney tumor - CT scan Kidney metastases, CT scan Kidney - blood and urine flow References Campbell SC, Lane BR. Malignant renal tumors. In: Wein AJ, Kavoussi LR, Partin AW, ...

  8. 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.

  9. [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.

  10. Common paediatric renal conditions

    African Journals Online (AJOL)

    Few children in South Africa have access to dialysis or renal transplantation, so it is important to .... the chronic administration of antibiotics increases the risk of a UTI with a resistant .... factors for recurrent urinary tract infection in young women.

  11. Renal and perirenal abscesses

    International Nuclear Information System (INIS)

    Patterson, J.E.; Andriole, V.T.

    1987-01-01

    Our knowledge of the spectrum of renal abscesses has increased as a result of more sensitive radiologic techniques. The classification of intrarenal abscess now includes acute focal bacterial nephritis and acute multifocal bacterial nephritis, as well as the previously recognized renal cortical abscess, renal corticomedullary abscess, and xanthogranulomatous pyelonephritis. In general, the clinical presentation of these entities does not differentiate them; various radiographic studies can distinguish them, however. The intrarenal abscess is usually treated successfully with antibiotic therapy alone. Antistaphylococcal therapy is indicated for the renal cortical abscess, whereas therapy directed against the common gram-negative uropathogens is indicated for most of the other entities. The perinephric abscess is often an elusive diagnosis, has a more serious prognosis, and is more difficult to treat. Drainage of the abscess and sometimes partial or complete nephrectomy are required for resolution. 73 references

  12. 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...

  13. 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.

  14. OBSTETRIC RENAL FAILURE

    Directory of Open Access Journals (Sweden)

    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

  15. Insuficiencia renal aguda con necrosis tubular aguda secundaria a picadura masiva de abejas

    Directory of Open Access Journals (Sweden)

    Gustavo A. Aroca - Martínez

    2006-01-01

    Full Text Available Leñador de 46 años consulta al servicio de nefrología, de la Clínica Renal de la Costa en Barranquilla, con episodio de insuficiencia renal aguda 48 horas después de haber sufrido múltiples picaduras por abejas africanizadas. Durante su estancia hospitalaria presentó incremento de enzimas musculares (AST LDH, y de pruebas de función renal, motivo por el cual fue dializado en varias ocasiones. Con mejoría total, se decide egresar y manejar ambulatoriamente. Se concluye que el caso se trata de una insuficiencia renal por necrosis tubular aguda por rabdomiolisis debida a la picadura múltiple de abejas africanizadas.

  16. Inversión pericéntrica del cromosoma 1. Presentación de un caso

    Directory of Open Access Journals (Sweden)

    Elodia Rivas Alpízar

    2015-11-01

    Full Text Available Las alteraciones cromosómicas son más frecuentes en la pareja infértil que en la población general. Entre pacientes con infertilidad se ha descrito una incidencia global del 2,1 % y 6 % en mujeres y varones respectivamente, la mayor incidencia se observa en varones con azoospermia entre los que se alcanza hasta un 16 %. Las inversiones pericéntricas están entre los reordenamientos cromosómicos balanceados más usuales, con una frecuencia de un 1-2 %. Se presenta el caso de un paciente que fue atendido en el Centro Territorial de Reproducción Asistida de Cienfuegos, para estudio de una infertilidad de dos años de evolución. Se le realizó estudio citogenético y se diagnosticó una inversión pericéntrica del cromosoma 1 46, XY, inv (1 (p13 q32. Es indiscutible la importancia que cobra el estudio citogenético en varones con alteraciones seminales severas, porque al hacer este diagnóstico se pueden identificar los pacientes con riesgo de trasmitir esta alteración a su descendencia.

  17. 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.

  18. Uveomeningencefalites: registro de dois casos

    Directory of Open Access Journals (Sweden)

    Wilson Luiz Sanvito

    1982-03-01

    Full Text Available Após considerações a propósito das manifestações clínicas das uveomeningencefalites, são relatados dois casos com características clínicas ligeiramente diferentes. No caso 1 tratava-se da doença de Harada, tendo o paciente apresentado quadro meningítico agudo acompanhado de confusão mental. O exame do líquido cefalorraquidiano evidenciou um quadro inflamatório do tipo linfo-monocitário e o paciente evoluiu com distúrbios acentuados da memória e uveíte bilateral. Após alguns meses de evolução, a doença deixou como seqüelas uma síndrome de Korsakoff e ambliopia acentuada no olho esquerdo. No caso 2 tratava-se de doença de Behcet, tendo o paciente apresentado dois surtos de meningite do tipo linfomonocitário, lesões herpetiformes na genitalia e uveíte no olho direito que evoluiu para amaurose. São feitas considerações sobre os aspectos etiopatogênicos destas afecções e sobre o controvertido uso dos corticosteróides em seu tratamento.

  19. RENAL MALIGNANT NEOPLASMS: RENAL CELL CARCINOMA

    Directory of Open Access Journals (Sweden)

    Elisangela Giachini

    2017-06-01

    Full Text Available The aim of this study is to evaluate the incidence and prevalence of malignant kidney tumors, to contribute to identifying factors which the diagnosis of renal cell carcinomas. Through this study, we understand that kidney disease over the years had higher incidence rates, especially in adults in the sixth decade of life. The renal cell carcinoma (RCC is the third most common malignancy of the genitourinary tract, affecting 2% to 3% of the population. There are numerous ways of diagnosis; however, the most important are ultrasonography, magnetic resonance imaging and computed tomography. In general most of the patients affected by the CCR, have a good prognosis when diagnosed early and subjected to an effective treatment. This study conducted a literature review about the CCR, through this it was possible to understand the development needs of the imaging methods used for precise diagnosis and classification of RCC through the TNM system.

  20. Infección por virus BK en paciente pediátrico trasplantado renal BK virus infection in a pediatric renal transplant recipient

    Directory of Open Access Journals (Sweden)

    R. Bonaventura

    2005-09-01

    Full Text Available El poliomavirus humano BK causa infección primaria asintomática en la niñez, estableciendo latencia principalmente en el tracto urinario. En individuos con alteración en la inmunidad celular se puede producir su reactivación desencadenando patología a nivel renal. Por estas razones es particularmente importante en la población pediátrica trasplantada renal, en la que puede producir la infección primaria cuando el paciente está inmunosuprimido. En nuestro trabajo se realizó el seguimiento de un paciente de 5 años trasplantado renal en octubre de 2003 que 45 días post-trasplante sufrió un deterioro del órgano injertado. Desde la fecha del trasplante hasta junio de 2004 se produjeron 3 episodios de alteración en la función renal, durante los cuales se analizaron muestras de sangre, orina, biopsia renal y líquido de linfocele. Para el diagnóstico difererencial entre rechazo agudo versus causa infecciosa se emplearon técnicas de detección para los virus BK, CMV y ADV, además del estudio citológico del tejido renal. Los resultados obtenidos junto con la clínica del paciente indican un probable caso de infección por BK. La importancia de realizar el diagnóstico diferencial entre rechazo agudo y la infección por BK radica en que la conducta en cuanto a la terapia inmunosupresora es opuesta en cada caso.BK Human Polyomavirus causes an asymptomatic primary infection in children, then establishing latency mainly in the urinary tract. Viral reactivation can lead to renal pathology in individuals with impaired cellular immune response. This is particularly important in pediatric transplant recipients, who can suffer a primary infection when immunosupressed. We followed up the case of a 5 years old patient who received a renal transplant in October 2003, and presented damaged graft 45 days after the intervention. The patient suffered 3 episodes of renal function failure between October 2003 and June 2004. Blood, urine, renal biopsy

  1. Queilite actínica: avaliação histopatológica de 44 casos

    Directory of Open Access Journals (Sweden)

    Rachel Reinaldo Arnaud

    Full Text Available Objetivo: Descrever os aspectos epidemiológicos, clínicos e histopatológicos da queilite actínica. Material e método: Foi realizado um estudo retrospectivo a partir de casos com diagnóstico clínico de queilite actínica, registrados no arquivo histopatológico do Serviço de Cirurgia de Cabeça e Pescoço do Hospital Napoleão Laureano, Paraíba, relativos ao período de 2000 a 2007. Foram selecionados 44 blocos parafinados, que apresentavam condições de reavaliação histológica através da confecção de novas lâminas. Os novos cortes foram corados em Hematoxilina e Eosina, e a avaliação histopatológica foi realizada por dois examinadores independentes, sendo as alterações classificadas de acordo com OMS. Realizou-se análise estatística descritiva em programa SPSS for Windows versão 13. Resultado: Do total da amostra, 52,3% (23 dos casos foram diagnosticados em homens e 47,7% (21 em mulheres, com idade variando de 27 a 92 anos. A maioria dos indivíduos (81,9% tinha mais de 40 anos. Em relação às características histológicas, 68,2% (30 dos casos exibiram algum grau de displasia epitelial, sendo 36,3% (16 classificados como displasia leve, 20,4% (9 como displasia moderada e 11,3% (5, displasia severa. Em 15,9% (7, ocorreu carcinoma de células escamosas. No tecido epitelial de revestimento labial, os achados histológicos mais frequentes e identificados foram presença de degeneração hidrópica (79,5% e hipergranulose (56,8%. Infiltrado inflamatório foi observado em 88,6% dos casos e elastose solar, em 86,4%. Conclusão: Com base nos resultados da amostra estudada, podemos concluir que a maioria das lesões de queilite actínica acometeu lábio inferior de homens, com mais de 40 anos de idade. A análise histopatológica revelou displasia e atipia celular, infiltrado inflamatório e presença de elastose solar, que são características comuns em lesões de QA.

  2. 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

  3. Filosofia naturale della causalità e del caso

    CERN Document Server

    Born, Max

    1962-01-01

    Introduzione ; causalità e determinismo ; esemplificazione : l'astronomia e la meccanica delle particelle ; contiguità ; principio di antecedenza e termodinamica ; caso ; caso e antecedenza ; materia ; caso ; conclusioni metafisiche.

  4. 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....

  5. 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.

  6. 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.)

  7. PÚRPURA DE HENOCH-SCHONLEIN – O ENVOLVIMENTO RENAL PRECOCE

    Directory of Open Access Journals (Sweden)

    Inês Medeiros

    2016-07-01

    Comentários: O caso descrito ilustra um acometimento renal precoce e pouco frequente na PHS, de acordo com o descrito na literatura. A presença de proteinúria nefrótica e de síndrome nefrótica, secundárias à PHS, está associada a um prognóstico menos favorável, pelo que se ressalva a importância do seguimento a longo prazo.

  8. Eligibility for renal denervation

    DEFF Research Database (Denmark)

    Persu, Alexandre; Jin, Yu; Baelen, Marie

    2014-01-01

    -resistant hypertension (ENCOReD). The analysis included 731 patients. Age averaged 61.6 years, office blood pressure at screening was 177/96 mm Hg, and the number of blood pressure-lowering drugs taken was 4.1. Specialists referred 75.6% of patients. The proportion of patients eligible for renal denervation according...... undetected secondary causes of hypertension (11.1%). In conclusion, after careful screening and treatment adjustment at hypertension expert centers, only ≈40% of patients referred for renal denervation, mostly by specialists, were eligible for the procedure. The most frequent cause of ineligibility...... (approximately half of cases) was blood pressure normalization after treatment adjustment by a hypertension specialist. Our findings highlight that hypertension centers with a record in clinical experience and research should remain the gatekeepers before renal denervation is considered....

  9. [Renal colic in pregnancy].

    Science.gov (United States)

    Negru, Irina; Pricop, C; Costăchescu, Gh

    2010-01-01

    Renal colic in pregnant women is a serious condition, mainly when is associated with fever. Our retro-prospective study analyzes 111 cases managed conservatively or with endourological procedures for renal colic--insertion of JJ stents and percutaneous nephrostomy. Clinical evolution determined the insertion of JJ stents in 60 cases and the failure of this procedure imposed percutaneous nephrostomy in 5 cases. In 56 cases urinary tract infection was associated and in 2 cases, despite all efforts, the patients deceased due to sever sepsis. The immediate drainage of the upper urinary tract for renal colic in pregnancy is the recommended treatment, especially when the pain is associated with fever. JJ stens were well tolerated, even when they were replaced after 3 months. Pregnant women with a history of UTI or stone disease should be carefully followed-up.

  10. Renal cell karcinoma trial

    International Nuclear Information System (INIS)

    Werf-Messing, B. van der; Heul, R.O. van der; Ledeboer, R.C.

    1981-01-01

    A total of 174 patients underwent simple nephrectomy in case of clinically operable kidney cancer without demonstrable metastases. Of these 85 received preoperative irradiation to the kidney and the regional lymph nodes (3000-4000 rad in 3-4 weeks). Prognosis was not influenced by preoperative irradiation. The preoperatively assessable prognostic criteria were sex and sedimentation rate: ESR >= 30 and being male worsened prognosis. The clinical T-categories of the UICC were not related to prognosis. Of the microscopic examination of the nephrectomy specimen, renal vein invasion and to a lesser extent a low degree of differentiation appeared to worsen prognosis. The prognostic influence of the P-categories was caused by a higher incidence of renal vein involvement in case of higher P-category. The most important prognostic factors - ESR, renal vein involvement, and sex - were not interrelated. Elective chemotherapy, radiation therapy, and hormone therapy could be considered in certain high-risk groups. (orig.)

  11. Scintigraphy of renal transplant

    International Nuclear Information System (INIS)

    Ramackers, J.M.; Marrast, A.C.; Touraine, J.L.; Peyrin, J.O.

    1995-01-01

    Scintigraphy is useful for monitoring perfusion and function of renal transplant, as well as for diagnosing miscellaneous surgical. This non-invasive imaging technique, which uses no deleterious products, is an attractive alternative for patients. This is especially true for those patients in early post-transplant course, with immunity depression and often impairment of renal function. Otherwise, multiple indices with a large range of inter-patient values has not favoured a methodological and interpretative consensus. Furthermore, the poor specificity of renogram patterns does not allow for discrimination of all etiologies with only one scintigraphy. Nevertheless, follow-up with iterative scintigraphy may be helpful due to the high intra-patient reproducibility and to the early appreciate change of parameters, according to clinical and histological renal post-transplant outcome. (authors). 43 refs., 8 figs

  12. Drug-induced renal injury

    African Journals Online (AJOL)

    The kidney receives a rich blood flow of 25% of resting cardiac output ... Drugs can cause acute renal failure by causing pre-renal, intrinsic or .... tubular epithelial cells causing cell swelling ... the dose as required or prescribe alternative drugs.

  13. Leiomyosarcoma of the renal pelvis

    Directory of Open Access Journals (Sweden)

    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.

  14. Análise da rejeição nos pacientes transplantados por anemia aplástica severa condicionados com ciclofosfamida ou a associação desta ao bussulfano Analysis of rejection in transplanted patients suffering severe aplastic anemia conditioned with cyclophosphamide alone or associated with busulfan

    Directory of Open Access Journals (Sweden)

    Lídice C. Lenz e Silva

    2005-03-01

    Full Text Available O transplante de medula óssea é um tratamento eficaz para pacientes com anemia aplástica severa (AAS e é a modalidade terapêutica de escolha para pacientes jovens com doador aparentado HLA idêntico. A rejeição é uma importante complicação do transplante de medula, que, independentemente do tipo de tratamento imunossupressor pré e pós-transplante, ocorre em 55% a 60% dos pacientes. O serviço de TMO da Universidade Federal do Paraná (UFPR acumula a experiência de 178 casos de AAS transplantados no período de 1993 a 2001, usando como condicionamento tanto a ciclofosfamida (CFA como a combinação desta ao bussulfano (CFA + BU. Dentre eles, 39 apresentaram rejeição ou falha de pega. Dos pacientes condicionados com ciclofosfamida, 24 (46% apresentaram rejeição, sendo 3 (6% com falha primária de pega (FPP e 21 (40% com pega transitória (PT. Entre os pacientes condicionados com BU+CFA, 15 (12% apresentaram rejeição, sendo 4 (3% com FPP e 11 (9% com pega transitória. Os pacientes condicionados com ciclofosfamida (200 mg/kg que apresentaram rejeição tiveram uma sobrevida global alta (aproximadamente 80%, pois conseguiram ser resgatados por um novo transplante ou pelo tratamento imunossupressor com ciclosporina. A sobrevida dos pacientes politransfundidos condicionados com a associação de ciclofosfamida e bussulfano foi de aproximadamente 35%.Bone marrow transplantation is an effective therapy for severe aplastic anemia and is generally considered the preferable treatment for young patients who have an HLA (Human Leukocyte Antigen identical sibling donor. Recent studies report 55% to 80% extended survival. Graft failure owing to rejection or others causes remains an important life-threatening complication following allogeneic bone marrow transplantation for aplastic anemia. It occurs in 55% to 60% of patients receiving HLA identical transplants, using different immunosuppressive therapies before and after transplant. The BMT

  15. Renal denervation and hypertension.

    Science.gov (United States)

    Schlaich, Markus P; Krum, Henry; Sobotka, Paul A; Esler, Murray D

    2011-06-01

    Essential hypertension remains one of the biggest challenges in medicine with an enormous impact on both individual and society levels. With the exception of relatively rare monogenetic forms of hypertension, there is now general agreement that the condition is multifactorial in nature and hence requires therapeutic approaches targeting several aspects of the underlying pathophysiology. Accordingly, all major guidelines promote a combination of lifestyle interventions and combination pharmacotherapy to reach target blood pressure (BP) levels in order to reduce overall cardiovascular risk in affected patients. Although this approach works for many, it fails in a considerable number of patients for various reasons including drug-intolerance, noncompliance, physician inertia, and others, leaving them at unacceptably high cardiovascular risk. The quest for additional therapeutic approaches to safely and effectively manage hypertension continues and expands to the reappraisal of older concepts such as renal denervation. Based on the robust preclinical and clinical data surrounding the role of renal sympathetic nerves in various aspects of BP control very recent efforts have led to the development of a novel catheter-based approach using radiofrequency (RF) energy to selectively target and disrupt the renal nerves. The available evidence from the limited number of uncontrolled hypertensive patients in whom renal denervation has been performed are auspicious and indicate that the procedure has a favorable safety profile and is associated with a substantial and presumably sustained BP reduction. Although promising, a myriad of questions are far from being conclusively answered and require our concerted research efforts to explore the full potential and possible risks of this approach. Here we briefly review the science surrounding renal denervation, summarize the current data on safety and efficacy of renal nerve ablation, and discuss some of the open questions that need

  16. Imaging of Renal Leiomyomas

    Energy Technology Data Exchange (ETDEWEB)

    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

  17. Renal lithiasis and nutrition

    Directory of Open Access Journals (Sweden)

    Prieto Rafel M

    2006-09-01

    Full Text Available Abstract Renal lithiasis is a multifactorial disease. An important number of etiologic factors can be adequately modified trough diet, since it must be considered that the urine composition is directly related to diet. In fact, the change of inappropriate habitual diet patterns should be the main measure to prevent kidney stones. In this paper, the relation between different dietary factors (liquid intake, pH, calcium, phosphate, oxalate, citrate, phytate, urate and vitamins and each type of renal stone (calcium oxalate monohydrate papillary, calcium oxalate monohydrate unattached, calcium oxalate dihydrate, calcium oxalate dihydrate/hydroxyapatite, hydroxyapatite, struvite infectious, brushite, uric acid, calcium oxalate/uric acid and cystine is discussed.

  18. Hepatite infecciosa canina: 62 casos Infectious canine hepatitis: 62 cases

    Directory of Open Access Journals (Sweden)

    Maria A. Inkelmann

    2007-08-01

    Full Text Available Os protocolos de necropsias realizadas em 5.361 cães durante um período de 43 anos (1964-2006 foram revisados em busca de casos de hepatite infecciosa canina (HIC e sessenta e dois (1,2% casos foram encontrados. A maioria dos 62 cães afetados tinha dois anos de idade ou menos (91,9%. Os sinais clínicos foram anotados nos protocolos de necropsia de 45 cães afetados por HIC e incluíam anorexia (55,6%, apatia (35,6%, diarréia (35,6%, freqüentemente com sangue (43,8% dos casos de diarréia, distúrbios neurológicos (33,3%, vômito (26,7%, petéquias e equimoses nas membranas mucosas e/ou pele (24,4%, hipotermia (20,0%, dor abdominal (15,6%, icterícia (13,3%, aumento de volume e congestão das tonsilas (11,1%, febre (11,1% e ascite (6,7%. A duração do curso clínico variou de poucas horas a 15 dias. Os principais achados de necropsia incluíram alterações hepáticas (87,1%, linfonodos edematosos, congestos e hemorrágicos (51,6%, líquido sanguinolento, líquido claro ou sangue na cavidade abdominal (35,5%, víbices, sufusões e petéquias sobre a pleura visceral (27,4% e superfície serosa das vísceras gastrintestinais (24,2%. Em 12,9% dos casos a serosa do intestino tinha aspecto granular. Hemorragias cerebrais nas leptomeninges e na substância do encéfalo foram observadas em 9,7% dos casos. As alterações hepáticas macroscópicas incluíam fígados moderadamente aumentados de volume, mais friáveis, com acentuação do padrão lobular, congestos e com múltiplos focos de necrose pálidos ou hemorrágicos. Películas e filamentos de fibrina cobriam a superfície hepática em 20,4% dos casos e em 27,8% dos casos a parede da vesícula biliar estava espessada por edema. Necrose hepática zonal ou aleatória (93,5% dos casos associada a corpúsculos de inclusão intranucleares foi a lesão histológica mais regularmente encontrada. Os corpúsculos de inclusão intranucleares ocorreram no fígado em todos os casos e esse foi o crit

  19. 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

  20. Pulmão e transplante renal

    Directory of Open Access Journals (Sweden)

    Patrícia Caetano Mota

    2009-11-01

    Full Text Available Resumo: O transplante renal é o transplante de órgãos sólidos mais frequente, sendo os transplantados renais alvo de complicações pulmonares inerentes à própria terapêutica imunossupressora, as quais constituem, por vezes, um desafio diagnóstico e terapêutico.Objectivo: Avaliar os doentes admitidos na Unidade de Transplante Renal (UTR do Hospital de S. João com o diagnóstico de patologia respiratória.Material e métodos: Estudo retrospectivo de todos os doentes admitidos na UTR por doença respiratória, durante um período de 12 meses.Resultados: Foram incluídos 36 doentes, com uma média de idades de 55,2 (±13,4 anos; 61,1% do sexo masculino. Os esquemas imunossupressores mais utilizados foram: prednisolona e micofenolato mofetil com ciclosporina (38,9% ou tacrolimus (22,2% ou rapamicina (13,9%. Trinta e um doentes (86,1% apresentaram doença infecciosa respiratória. Neste grupo destacaram-se: 23 casos (74,2% de pneumonia, 5 casos (16,1% de infecção oportunista, 2 (6,5% de traqueobronquite, e 1 (3,2% de abcessos pulmonares. O agente etiológico foi identificado em 7 casos (22,6%. Cinco doentes (13,9% apresentaram doença pulmonar iatrogénica pela rapamicina. Em 15 doentes (41,7% foi necessário recorrer à realização de broncofibroscopia, diagnóstica em 10 casos (66,7%. O tempo médio de internamento foi de 17,1 (±18,5 dias, e não se verificou nenhum óbito.Conclusão: A infecção constituiu a principal complicação pulmonar no grupo de doentes estudado. O diagnóstico de doença pulmonar induzida por fármacos implica reconhecimento das suas características e monitorização rigorosa dos níveis séricos dos mesmos. O recurso a técnicas de diagnóstico invasivas contribuiu para maior precocidade e especificidade terapêuticas.Rev Port Pneumol 2009; XV (6: 1073-1099 Abstract: Renal transplantation is the most common type of solid organ transplantation and kidney transplant recipients are susceptible to pulmonary

  1. 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...

  2. Descripción paso a paso de la técnica transaórtica para el tratamiento transcatéter de la estenosis aórtica severa

    Directory of Open Access Journals (Sweden)

    Omar A. Araji

    2016-07-01

    Full Text Available El tratamiento transcatéter de la estenosis aórtica severa se encuentra en continua evolución desde que se describió por Cribier por primera vez en 2002. Se han estandarizado la vía transfemoral retrógrada y la vía transapical, y con la mejora de los dispositivos, se está empleando cada vez con más frecuencia la vía transaórtica. Esta vía puede suponer muchas ventajas para el tratamiento de los pacientes con un alto riesgo quirúrgico y rechazados para los otros abordajes. Nuestro grupo comenzó a emplearla a finales del 2013 y se ha convertido en la vía preferida por delante de la transapical. En este artículo describimos nuestra técnica transaórtica paso a paso, sus ventajas e inconvenientes.

  3. Insulinoma canino: relato de caso

    Directory of Open Access Journals (Sweden)

    L. Padovani

    Full Text Available RESUMO O insulinoma é um tumor das células β do pâncreas, que têm a função de produzir e secretar insulina e, geralmente são malignos em cães. O presente trabalho descreve o diagnóstico e o manejo terapêutico de três casos de insulinoma. Os sinais clínicos dos animais relatados variaram de acordo com a severidade e a duração da hipoglicemia. O diagnóstico presuntivo se deu através dos sinais clínicos e da dosagem de insulina sérica no momento de mais intensa hipoglicemia e, o diagnóstico definitivo foi obtido por meio de exame histopatológico nos três casos relatados. O tratamento realizado variou de acordo com a intensidade dos sinais clínicos.

  4. Costos de intervenciones para pacientes con insuficiencia renal crónica Costs of intervention for patients with chronic renal disease

    Directory of Open Access Journals (Sweden)

    Armando Arredondo

    1998-06-01

    Full Text Available INTRODUCCIÓN: Se presentan resultados sobre un estudio que pretendió identificar los costos de intervenciones en salud en el manejo de pacientes con insuficiencia renal crónica. MATERIAL Y MÉTODO: El método de costeo se basó en técnicas de consenso y de instrumentación de manejo de caso a través de la identificación de insumos y funciones de producción para la demanda de cada servicio solicitado. Las intervenciones costeadas incluyeron: diálisis peritoneal, hemodiálisis y trasplante renal. RESULTADOS: El costo por evento en US dóllares fué de $3.71, $57.95 y $ 8,778.32 respectivamente. En cuanto al costo de manejo anual de caso los resultados fueron: diálisis peritoneal $5,643.07, hemodiálisis $9,631.60 y trasplante $3,021.67. CONCLUSIONES: La información generada a partir de los costos de eventos difiere considerablemente de la información generada a partir del costo de manejo anual de caso. Estas diferencias resultan significativas para el diseño y evaluación de patrones de asignación de recursosINTRODUÇÃO: Apresentam-se os resultados sobre estudo que pretendeu identificar os custos de intervenções em saúde no manejo de pacientes com insuficiência renal crônica. MATERIAL E MÉTODO: O método de custeio teve como base técnicas de consenso e de instrumentação de manejo de caso a partir da identificação de insumos e funções de produção na demanda de cada serviço solicitado. As intervenções avaliadas nos seus custos foram: diálise peritoneal, hemodiálise e transplate renal. RESULTADOS: O custo por evento (diálise, hemodiálise e transplante em dólares foi de US$3.71, US$57.95 e US$8,778.32, respectivamente. Quanto ao custo do manejo anual de caso os resultados foram: diálise peritoneal US$5,643.07, hemodiálise US$9,631.60 e transplate renal de US$3,021.63. CONCLUSÕES: A informação gerada a partir dos custos de eventos difere consideravelmente do custo de manejo anual de caso.. Essas diferen

  5. Angiography for renal hypertension

    International Nuclear Information System (INIS)

    Chuang, V.P.; Ernst, C.B.

    1985-01-01

    As angioplasty and operative techniques have become more precise and successful, so have evaluation techniques. Preoperative arteriography is indispensible for deciding on the appropriate treatment modality and the specifics of the procedure. Arteriography, therefore, remains the cornerstone in managing renovascular hypertension and renal arterial disease

  6. Dopamins renale virkninger

    DEFF Research Database (Denmark)

    Olsen, Niels Vidiendal

    1990-01-01

    is frequently employed in cases of acute oliguric renal failure but the results available concerning the therapeutic effect are frequently retrospective and uncontrolled. The results suggest that early treatment with 1-3 micrograms/kg/min dopamine combined with furosemide can postpone or possibly render...

  7. Primary renal graft thrombosis

    NARCIS (Netherlands)

    Bakir, N; Sluiter, WJ; Ploeg, RJ; van Son, WJ; Tegzess, Adam

    Background. Renal allograft thrombosis is a serious complication of kidney transplantation that ultimately leads to graft loss. Its association with acute and hyperacute rejection is well documented; however, in a large proportion of patients the precise cause remains obscure. The exact incidence

  8. Paniculite criptocócica em transplantado renal Cryptococcal panniculitis in a renal transplant recipient

    Directory of Open Access Journals (Sweden)

    Beatriz M. Trope

    2008-06-01

    Full Text Available Os autores relatam um caso de paniculite criptocócica em paciente transplantado renal inicialmente tratado como celulite bacteriana. O diagnóstico definitivo só foi possível pela impressão clínica dermatológica confirmada pelo exame micológico. O tratamento foi realizado a princípio com anfotericina B e posteriormente com fluconazol, considerando-se as interações das drogas imunossupressoras utilizadas para evitar rejeição. A regressão clínica foi alcançada no sexto mês de tratamento, que, no entanto, foi mantido por 12 meses. São feitas considerações a respeito dessa forma rara de criptococose cutânea em transplantado de órgão sólido e suas implicações diagnósticas e terapêuticas.The authors report a case of cryptococcal panniculitis in a renal transplant recipient,which was initially mistaken for bacterial cellulitis. Dermatological evaluation and laboratory studies led to the definitive diagnosis. Treatment was started with amphotericin B, followed by oral fluconazol, taking into consideration their interactions with the immunossupressive drugs. Even though clinical improvement was attained after six months, treatment was maintained during a whole year. We discuss this rare presentation of cutaneous cryptococcosis in a solid organ transplant recipient, as well as its diagnosis and therapy.

  9. Ascite meconial - relato de caso

    Directory of Open Access Journals (Sweden)

    Celeste Gomez Sardinha Oshiro

    2016-10-01

    Full Text Available INTRODUÇÃO: A ascite meconial resultante da perfuração intestinal fetal tem baixa incidência (1:30.000 nascimentos e elevada mortalidade (50%. Os achados ecográficos fetais incluem ascite e calcificações intra-abdominais. OBJETIVO: Relatar um caso de ascite meconial neonatal no Conjunto Hospitalar de Sorocaba. METODOLOGIA: Descrição do referido caso e revisão de literatura. RELATO DE CASO: Recém-nascido de J.A.P., masculino, de parto cesáreo por iteratividade em 12/05/2016, cuja mãe com 44 anos, sem intercorrências no pré-natal, negou consanguinidade, vícios e infecções; ultrassonografia obstétrica evidenciou ascite moderada, circunferência abdominal >p95, hepatomegalia e hidrocele. Ao nascimento, idade gestacional 3 8 2 /7 semanas, peso=3630g, comprimento=49 cm, Apgar 8/9. Apresentava abdome globoso, fígado a 4 cm do rebordo costal direito e hidrocele volumosa. Realizada paracentese com saída de 310 ml de líquido esverdeado (meconial. No 5o dia de vida, durante laparotomia, observou-se aderência de alças intestinais, perfuração de íleo terminal a 8 cm da vávula íleo-cecal, sendo realizada ileostomia. O anátomo-patológico de apêndice cecal evidenciou processo inflamatório crônico, neovascularização e fibrose. Paciente recebeu nutrição parenteral por 14 dias; houve progressão da dieta do 6o ao 36o dia de vida, recebendo alta em aleitamento materno e boa recuperação clínica. CONCLUSÃO: A ascite meconial por perfuração intestinal deve ser considerada no diagnóstico diferencial de ascite fetal. O diagnóstico ecográfico pré-natal é fundamental para o prognóstico pós-natal.

  10. Características clínicas y diagnósticas en infarto renal agudo en una serie clínica

    Directory of Open Access Journals (Sweden)

    C. Juan Alberto Fierro, Dr.

    2010-07-01

    Full Text Available El infarto renal agudo constituye un diagnóstico infrecuente. Ello puede deberse a que sus síntomas son similares a los de los cálculos renales o la pielonefritis aguda. Por esa razón, el síntoma cardinal de dolor de flanco debe ser investigado en forma muy acabada. Esta serie clínica revisa seis casos de infarto renal agudo vistos en esta institución durante el año 2007.

  11. Complex Adaptive Systems of Systems (CASOS) engineering environment.

    Energy Technology Data Exchange (ETDEWEB)

    Detry, Richard Joseph; Linebarger, John Michael; Finley, Patrick D.; Maffitt, S. Louise; Glass, Robert John, Jr.; Beyeler, Walter Eugene; Ames, Arlo Leroy

    2012-02-01

    Complex Adaptive Systems of Systems, or CASoS, are vastly complex physical-socio-technical systems which we must understand to design a secure future for the nation. The Phoenix initiative implements CASoS Engineering principles combining the bottom up Complex Systems and Complex Adaptive Systems view with the top down Systems Engineering and System-of-Systems view. CASoS Engineering theory and practice must be conducted together to develop a discipline that is grounded in reality, extends our understanding of how CASoS behave and allows us to better control the outcomes. The pull of applications (real world problems) is critical to this effort, as is the articulation of a CASoS Engineering Framework that grounds an engineering approach in the theory of complex adaptive systems of systems. Successful application of the CASoS Engineering Framework requires modeling, simulation and analysis (MS and A) capabilities and the cultivation of a CASoS Engineering Community of Practice through knowledge sharing and facilitation. The CASoS Engineering Environment, itself a complex adaptive system of systems, constitutes the two platforms that provide these capabilities.

  12. 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...

  13. 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.)

  14. Criptococose palpebral: relato de caso

    OpenAIRE

    Souza,Murilo Barreto; Melo,Carlos Sergio Nascimento; Silva,Cristiana Silveira; Santo,Ruth Miyuki; Matayoshi,Suzana

    2006-01-01

    Relata-se o caso de uma paciente portadora de síndrome da imunodeficiência adquirida empiricamente tratada com esquema tríplice para tuberculose miliar. Durante a evolução clínica a paciente cursou com lesões comprometendo a pálpebra e conjuntiva tarsal à direita. A hipótese diagnóstica inicial foi de tuberculose ocular com comprometimento conjuntival e palpebral. A biópsia da lesão conjuntival mostrou presença do Criptococcus neoformans. Após o início do tratamento específico com anfotericin...

  15. El caso de Buzios - Brasil

    Directory of Open Access Journals (Sweden)

    Juana A. Norrild

    2007-01-01

    Full Text Available La relación entre sexo y turismo ha seguido diferentes caminos, desde el turismo para GLS hasta el turismo nudista o la prostitución. No obstante aún son pocas las iniciativas que tienden a interrumpir el flagelo, que deja grandes secuelas sociales y escandaliza a la opinión pública. Probablemente por el tabú que históricamente ha significado el sexo, suele ser problemática toda relación en la que esté implicado. Este artículo describe un estudio de caso realizado en el centro turístico de Buzios, en Brasil, donde se aplicaron tres variables en las cuales se encuentra involucrada la mujer, el turismo aparece como revelador del sexismo existente en la sociedad y queda manifiesta la eficacia de una política social de concientización en dos de las variables.

  16. Un caso inusual de rabdomiosarcoma

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    Caridad Verdecia Cañizares

    2011-09-01

    Full Text Available Los sarcomas de partes blandas aparecen a cualquier edad, aunque son más frecuentes en la cuarta década de la vida. Se denominan así a aquellos tumores que se originan en las estructuras que soportan el cuerpo o envuelven los órganos y tejidos, y es el rabdomiosarcoma el tumor de partes blandas más frecuente en edad pediátrica. Es rara la condición de intratabilidad, mientras que son frecuentes las recaídas tempranas y tardías después del tratamiento. Presentamos un caso de una paciente diagnosticada en etapa de recién nacida con una mala respuesta al tratamiento, con progresión en el curso de este (algo no habitual, pues, generalmente, existe una buena respuesta inicial y después puede haber recaídas.

  17. DEGENERACIÓN COMBINADA SUBAGUDA, ANEMIA MEGALOBLÁSTICA Y MANIFESTACIONES NEUROPSIQUIÁTRICAS Caracterización clínica de catorce casos con deficiencia de cianocobalamina

    Directory of Open Access Journals (Sweden)

    Tomás Omar Zamora Bastidas

    2012-04-01

    Full Text Available La degeneración combinada subaguda es un desorden neurológico que afecta los cordones posteriores de la médula y se manifiesta precozmente con disestesia, parestesias y astenia severa. En pacientes de riesgo, es la manifestación inicial (y a veces única de una deficiencia de vitamina B12. El cerebro, el nervio óptico y los nervios periféricos pueden afectarse igualmente. Presentamos catorce casos de degeneración combinada subaguda por deficiencia de vitamina B12, con niveles bajos y anemia en la mayor parte de pacientes. Una revisión de la literatura muestra también estados carenciales en grupos poblacionales pobres de adultos mayores con otros factores de riesgo; y deficiencias subclínicas con depósitos hepáticos de vitamina B12 casi exhaustos. Puede haber clínica neuropsiquiátrica en casos sin niveles bajos de vitamina B12 ni anemia.

  18. 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

  19. Bilateral renal calculi

    Science.gov (United States)

    Sreenevasan, G

    1974-01-01

    Bilateral renal calculi were present in 114 (10.7%) of 1,070 cases of proved urinary calculus admitted to the Urological Department of the General Hospital, Kuala Lumpur, during the period November 1968—May 1973. The management of bilateral renal calculi is discussed with reference to the first 100 cases in this series. The introduction of renography has greatly facilitated the decision as to which kidney should be operated on first. The management of patients with and without uraemia is discussed and the use of the modified V and V—Y incisions for the removal of staghorn calculi is described. Complications and results are briefly reviewed. ImagesFig. 1Fig. 4Fig. 6Fig. 7 PMID:4845653

  20. Renal protection in diabetes

    DEFF Research Database (Denmark)

    Parving, H H; Tarnow, L; Rossing, P

    1996-01-01

    BACKGROUND: The combination of diabetes and hypertension increases the chances of progressive renal disorder and, ultimately, renal failure. Roughly 40% of all diabetics, whether insulin-dependent or not, develop diabetic nephropathy. Diabetic nephropathy is the single most important cause of end...... function in diabetic patients with incipient diabetic nephropathy. There are still no long-term trials using the new long-acting dihydropyridine calcium antagonists to treat patients with incipient nephropathy. A recent, 1-year, randomized, double-blind study in hypertensive insulin-dependent diabetic...... identical in both treatment groups, at 103 (SD 9) and 101 (SD 11) mmHg, respectively. Furthermore, a recent 5-year randomized open study in hypertensive non-insulin-dependent patients with diabetic nephropathy has revealed the same beneficial effect of a calcium antagonist and of ACE inhibition...

  1. Efeito da estimulação elétrica nervosa transcutânea no tratamento da dor no ombro de pacientes com doença renal crônica: relato de casos Effect of transcutaneous electrical nerve stimulation in the treatment of pain in the shoulder of patients with chronic kidney disease: a two-case report

    Directory of Open Access Journals (Sweden)

    Patrícia Ribeiro Bertoli

    2009-09-01

    Full Text Available A doença renal crônica (DRC pode causar muitas complicações clínicas associadas ao tempo de diálise. A amiloidose é uma dessas complicações e pode levar à dor no ombro, comum em pacientes com DRC. Só foram encontrados na literatura relatos de tratamento cirúrgico e/ou medicamentoso para esse tipo de dor. O objetivo aqui foi avaliar o benefício da estimulação elétrica nervosa transcutânea (TENS no tratamento da dor no ombro devida à amiloidose em pacientes com DRC. Duas pacientes foram avaliadas quatro vezes num período de três meses. Na avaliação inicial as pacientes foram orientadas e receberam um aparelho de TENS para uso domiciliar (10Hz, 150 µs, duas vezes por dia, por 40 minutos durante três meses. A dor foi avaliada utilizando-se uma escala visual analógica e o questionário de dor de Wisconsin. Os resultados mostram que o tratamento com TENS reduziu a dor no ombro em ambas as pacientes. O tratamento com a TENS pode pois ser eficaz em reduzir a dor no ombro em pacientes com DRC.Chronic kidney disease (CKD may bring about several clinical complications associated to long-term dialysis. Amyloidosis is one of such complications and may lead to shoulder pain, common among CKD patients, for which no studies could be found in literature on the use of transcutaneous electrical nerve stimulation (TENS - only surgical and medicine treatments are reported. The purpose here was to assess benefits of TENS in treating shoulder pain due to amyloidosis in patients with CKD. Two female patients were assessed four times in a three-month period. At the initial evaluation, patients were guided as to its use and given a TENS device for use at home (10 Hz, 150 µs, twice a day, for 40 minutes for three months. Pain was assessed by means of a visual analog scale and of the Wisconsin brief pain questionnaire. Results show that TENS reduced shoulder pain in both patients. Treatment with TENS may hence be effective in reducing shoulder

  2. 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)

  3. Renal phosphate handling: Physiology

    Directory of Open Access Journals (Sweden)

    Narayan Prasad

    2013-01-01

    Full Text Available Phosphorus is a common anion. It plays an important role in energy generation. Renal phosphate handling is regulated by three organs parathyroid, kidney and bone through feedback loops. These counter regulatory loops also regulate intestinal absorption and thus maintain serum phosphorus concentration in physiologic range. The parathyroid hormone, vitamin D, Fibrogenic growth factor 23 (FGF23 and klotho coreceptor are the key regulators of phosphorus balance in body.

  4. Factores contextuales en la percepción de la enfermedad mental severa en México, pautas para el cambio Contextual factors in the perception of severe mental illness in Mexico, guidelines for change

    Directory of Open Access Journals (Sweden)

    Maribel Cruz Ortiz

    2011-12-01

    Full Text Available Bajo la perspectiva del interaccionismo simbólico se analiza como influyen los factores del entorno en la relación de cuidado establecida por cuidadores primarios de personas con enfermedad mental severa en México. El cuidado se encuentra circunscrito al ámbito familiar dado el escaso desarrollo de una red social que proporcione los apoyos necesarios para favorecer la integración social. A esta situación han contribuido la naturalización cultural de los roles que desempeñan las mujeres como cuidadoras natas y las personas con enfermedad mental como dependientes, favoreciendo de esta forma la aceptación de alternativas como la institucionalización. La visualización del cuidado como responsabilidad individual favorece la situación de vulnerabilidad social, emocional y económica en la que se encuentran los cuidadores primarios y personas con enfermedad mental de este estudio.Under the perspective of symbolic interactionism analyzes how environmental factors influence the relationship of care provided by primary caregivers of people with severe mental illness in Mexico. The care is restricted to the family given the limited development of a social network to provide the necessary support to promote social integration. This situation has contributed the cultural naturalization of the roles that women plays as natural born caregivers and people with mental illness as a dependent person, consequently, encouraging the acceptance of alternatives such as institutionalization. The display of care as individual responsibility benefits the vulnerable social, emotional and economic situation, in which are the primary caregivers and people with mental illness in this study.

  5. Carambola como causa de lesão renal aguda

    Directory of Open Access Journals (Sweden)

    Karilla Lany Scaranello

    2014-04-01

    Full Text Available A carambola pertence à família das Oxalidáceas, espécie Averrhoa carambola. É rica em sais minerais, vitaminas A, C, complexo B e ácido oxálico. Estudos recentes demonstram que a toxicidade da fruta difere entre os indivíduos e pode ser explicada pelas respostas biológicas individuais como idade, quantidade da ingestão, neurotoxinas em cada tipo de fruta. Adicionalmente, a nefrotoxicidade causada pela fruta é dose dependente, podendo levar ao desenvolvimento de lesão renal aguda pela deposição de cristais de oxalato de cálcio intratubular, assim como por lesão direta das células epiteliais tubulares, levando à apoptose das mesmas. Relatamos o caso de uma paciente que, após a ingestão do suco da fruta e fruta in natura, desenvolveu lesão renal aguda, necessitando de terapia dialítica, evoluindo com desfecho favorável e recuperação da função renal.

  6. Injúria renal aguda: um alerta global Acute kidney injury: a global alert

    Directory of Open Access Journals (Sweden)

    Philip Kam Tao Li

    2013-03-01

    Full Text Available A Injúria Renal Aguda (IRA é cada vez mais prevalente nos países desenvolvidos e nos em desenvolvimento, e está associada com morbidade e mortalidade severas. A maioria das causas da IRA pode ser evitada por meio de intervenções em nível individual, comunitário, regional e intra-hospitalar. Medidas efetivas devem incluir, em toda a comunidade, os esforços para aumentar a consciência dos efeitos devastadores do IRA e fornecer orientações sobre as estratégias de prevenção, bem como o reconhecimento e tratamento precoces. Os esforços devem ser focados em minimizar as causas de IRA, aumentando a consciência da importância de medidas seriadas de creatinina sérica em pacientes de alto risco para IRA, e documentar o volume de urina em pessoas gravemente doentes para obtenção de diagnóstico precoce; até o momento, não há ainda um papel definitivo para outros biomarcadores. Há a necessidade de protocolos para sistematizar a conduta em condições de IRA pré-renal e em infecções específicas. Dados mais precisos sobre a verdadeira incidência e o impacto clínico da IRA ajudarão a melhor conhecer a importância desta doença, a aumentar o conhecimento de IRA por parte dos governantes, dos médicos em geral e de outros profissionais de saúde para ajudar na prevenção da doença. A prevenção é a chave para evitar a pesado ônus de mortalidade e morbidade associada com IRA.

  7. 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.

  8. Immunological response in cases of complicated and uncomplicated bartonellosis during pregnancy Respuesta inmunologica en casos de bartonelosis con y sin complicaciones durante el embarazo

    Directory of Open Access Journals (Sweden)

    Erick Huarcaya

    2007-10-01

    Full Text Available Bartonellosis (Carrion's Disease during pregnancy is associated with high rates of maternal and perinatal mortality. We report the immunological patterns in two cases of human bartonellosis during pregnancy. One patient had an uncomplicated course while the second patient developed life threatening anasarca and cardiac tamponade. The patient with a complicated course had a Th1 response with a higher elevation of IL-10. This elevation has been associated with poor outcome pregnancies during bacterial infections.Bartonelosis (Enfermedad de Carrión durante el embarazo esta asociado a una alta tasa de mortalidad maternal y perinatal. Reportamos el perfil inmunológico de dos casos de Bartonelosis humana en el embarazo. Una paciente tuvo un curso sin complicaciones, mientras la segunda presento complicaciones severas de anasarca y tamponamiento cardiaco. La paciente con curso complicado tuvo un patrón de repuesta Th1, con una elevación de IL-10, que se ha asociado a mal pronóstico en infecciones durante embarazo.

  9. Neurofibromatosis tipo I con manifestaciones en el periodonto y lengua: presentación de un caso Type I neurofibromatosis with periodontal and lingual manifestations: a case report

    Directory of Open Access Journals (Sweden)

    M.C. Negreiros Lyrio

    2008-06-01

    Full Text Available La enfermedad de Von Recklinghausen o Neurofibromatosis Tipo I (NF1 es una condición autosómica dominante que presenta una variada expresión clínica, con manifestaciones que van desde manchas tipo café con leche en piel a severas complicaciones estéticas y funcionales afectando los tejidos óseos y nerviosos. Las manifestaciones orales de la NF1 son comunes, afectando aproximadamente al 72% de los pacientes. Presentamos un caso de NF1 con lesiones neurofibromatosas afectando al reborde alveolar inferior y lengua, con indicación de excisión quirúrgica debido a la dificultad de higiene local.Von Recklinghausen’s disease, or type I neurofibromatosis (NF-1, is an autosomal dominant condition with a varied clinical expression. Disease manifestations may range from café au lait spots of the skin to severe cosmetic and functional complications that affect bone and nervous tissues. Oral manifestations of NF-1 are common, affecting approximately 72% of patients. We report a case of NF-1 with neurofibromatous lesions of the lower alveolar bridge and tongue. Resection was indicated due to the difficulty of maintaining oral hygiene.

  10. Renal angiomyoadenomatous tumour: Imaging features

    Science.gov (United States)

    Sahni, V. Anik; Hirsch, Michelle S.; Silverman, Stuart G.

    2012-01-01

    Renal angiomyoadenomatous tumour is a rare, recently described neoplasm with a distinctive histological appearance. Although reported in the pathology literature, to our knowledge, no prior reports have described its imaging appearance. We describe the computed tomography and magnetic resonance imaging features of an incidentally detected renal angiomyoadenomatous tumour that appeared as a well-marginated, solid T2-hypointense enhancing mass, in a 50-year-old woman. It is indistinguishable from a variety of benign and malignant renal neoplasms. PMID:23093565

  11. Multiple oncocytomas and renal carcinoma

    International Nuclear Information System (INIS)

    Velasquez, G.; Glass, T.A.; D'Souza, V.J.; Formanek, A.G.

    1984-01-01

    Renal oncocytoma, although rare, is being diagnosed more frequently, and criteria to differentiate it from other tumors have been described. Multiple oncocytomas have been reported, but an association between multiple oncocytomas and renal carcinoma in the same kidney has not been described. The authors report a case with two oncocytomas and a renal carcinoma in the right kidney as well as a right adrenal adenoma

  12. Applicability of the Spanish Version of the Supports Intensity Scale (SIS, in the Mexican Population with Severe Mental Illness Aplicabilidad de la escala de intensidad de apoyos (SIS, en población mexicana con enfermedad mental severa Aplicabilidade da versão espanhola da escala de intensidade de apoio, na população mexicana com doença mental severa

    Directory of Open Access Journals (Sweden)

    Maribel Cruz Ortiz

    2010-10-01

    Full Text Available This study presents the results obtained from the evaluation, by specialist judges, of the Supports Intensity Scale (SIS, Spanish version, to determine its suitability for the Mexican population with severe mental illness (SMI. The instrument, originally designed for people with intellectual disabilities, is consistent with the multidimensional concept of quality of life and the social model of disability. The semantic equivalence of the items adjusted by specialist judges, the reliability of the subscales, using Cronbach’s alpha, and the concurrent validity between the SIS and the Global Functioning Assessment (GAF were analyzed. The mean similarity to the original was 9.91 from a total of 10 (sd=0.14. The reliability coefficients were above 0.95 and the correlations between the SIS and the GAF were medium to high and significant. In conclusion, in the Mexican context, the SIS scale can be used to understand the needs and expectations of people with mental illness.Mostramos resultados obtenidos en la evaluación de jueces expertos en la Escala de Intensidad de Apoyos (SIS, versión española, para determinar su adecuación a la población mexicana con Enfermedad Mental Severa (EMS. El instrumento, originalmente diseñado para personas con discapacidad intelectual, es congruente con el concepto multidimensional de calidad de vida y el modelo social de discapacidad. Se analizó la equivalencia semántica de los ítems adaptados a través de jueces expertos, la fiabilidad de las subescalas mediante el coeficiente Alfa de Cronbach y la validez concurrente entre la SIS y la GAF. El promedio de semejanza con el original fue 9,91 sobre 10 (DE=0,14. Los coeficientes de fiabilidad fueron superiores a 0,95 y las correlaciones entre la SIS y la GAF fueron entre medias y altas y significativas. Los resultados confirman que la escala SIS, con mínimas adecuaciones de forma, puede usarse para conocer las necesidades y expectativas en personas con

  13. Endocarditis infecciosa activa: 152 casos

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    Lucía R. Kazelian

    2012-04-01

    Full Text Available La endocarditis infecciosa es una enfermedad de baja incidencia que en las últimas décadas mostró modificaciones respecto de su presentación, posibilidad diagnóstica y tratamiento. A pesar de estos avances, la mortalidad hospitalaria sigue siendo muy elevada. Nuestro objetivo fue analizar las características de los pacientes con endocarditis infecciosa activa y su relación con la mortalidad hospitalaria a lo largo de 16 años. Se realizó un registro prospectivo entre 1994 y 2010 de pacientes ingresados con endocarditis. Se analizaron características clínicas, evolución y tratamiento y se registraron los eventos intrahospitalarios. Ingresaron 152 pacientes, 64.5% varones, edad 45 ± 16 años, las causas más frecuentes de cardiopatía de base fueron: congénita 32 (21% y reumática 20 (13.2%. Los motivos de internación fueron síndrome febril 116 (76.3% e insuficiencia cardíaca 61 (40.1%. Se identificó el agente infeccioso en 106 (69.7% de los casos, el más frecuente fue Streptococcus viridans. El ecocardiograma mostró vegetaciones en 123 (80.9% de los pacientes y 88 (57.8% presentaron complicaciones durante su internación, siendo la más frecuente la insuficiencia cardíaca. Se indicó tratamiento quirúrgico en 96 (63.1% de los casos, fundamentalmente por insuficiencia cardíaca en 66. La mortalidad hospitalaria global fue 46 (30.2%. El desarrollo de complicaciones en la internación, la indicación de cirugía y la presencia de insuficiencia cardíaca refractaria al tratamiento fueron predictores independientes de mortalidad hospitalaria, mientras que la presencia de vegetaciones resultó un predictor independiente de mejor supervivencia. La identificación temprana de estos predictores descriptos podría ayudar a mejorar los resultados.

  14. 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

  15. Sporotrichosis in Renal Transplant Patients

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    Paulo Gewehr

    2013-01-01

    Full Text Available The current report describes two renal transplant recipients who presented with sporotrichosis. In addition, the authors review the general aspects of sporotrichosis in renal transplant recipients reported in the literature. Sporotrichosis is a rare fungal infection in transplant patients and has been reported primarily in renal transplant recipients not treated with antifungal prophylaxis. Extracutaneous forms of sporotrichosis without skin manifestations and no previous history of traumatic injuries have been described in such patients and are difficult to diagnose. Renal transplant recipients with sporotrichosis described in the present report were successfully treated with antifungal therapy including amphotericin B deoxycholate, lipid amphotericin B formulations, fluconazole and itraconazole.

  16. Renal myxoma: a case report

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    Carlos Henrique C Souza

    2015-04-01

    Full Text Available Myxomas are rare tumors that can appear in many anatomical locations. There are only 14 cases of renal involvement documented in the literature. This article reports a case of renal myxoma in an elderly woman with recurrent cystitis. After five years of follow-up, the computed tomography (CT revealed a large solid tumor mass in the left kidney. Tumor resection was performed preserving the affected kidney with histopathological diagnosis of renal myxoma. The objective of this study is to report a rare case of renal myxoma, emphasizing the importance of the differential diagnosis from other benign and malignant mesenchymal tumors.

  17. 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)

  18. General Information about 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 ...

  19. Treatment Option Overview (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 ...

  20. Cell therapy in renal and cardiovascular disease Terapia celular en enfermedades renales y cardiovasculares

    Directory of Open Access Journals (Sweden)

    Juan Manuel Senior Sánchez

    2006-01-01

    Full Text Available Although there have been important advances in the field of molecular biology, the mechanisms responsible for nephrogenesis and the factors that modulate the process of development, proliferation, growth, and maturation during fetal and adult life have not been thoroughly explained. Animals, including mammals, share the intrinsic ability to regenerate tissues and organs as an important biological defense mechanism. In the case of the kidney, after tissue damage secondary to injury, anatomical and functional recovery of integrity is achieved, accompanied by the activation of a complex, poorly understood process, leading to the replacement of damaged tubular cells by functional ones that reorganize tubular architecture. This regeneration and repair process is produced by somatic, exogenous, adult stem cells, and probably by intrinsic renal stem cells, that are responsible for maintaining renal homeostasis Aunque se han logrado grandes avances en el campo de la biología molecular, todavía no se han esclarecido completamente los mecanismos responsables de la organogénesis y los factores que modulan el proceso de desarrollo, proliferación, crecimiento y maduración celulares durante la vida fetal y adulta. Los animales comparten la capacidad de regenerar tejidos y órganos, como un mecanismo biológico importante de defensa. En el caso del riñón, luego del daño tisular secundario a una noxa, se produce recuperación anatómica y funcional de la integridad, acompañada por la activación de un proceso sofisticado, mal comprendido, que lleva al reemplazo de las células tubulares dañadas por otras funcionalmente normales que reorganizan la arquitectura tubular. Este fenómeno de recambio se produce gracias a la presencia de células madre adultas somáticas exógenas, responsables del proceso de mantenimiento de la homeostasis renal, y posiblemente por células renales intrínsecas.

  1. Epilepsia e síndrome de turner apresentação de um caso e revisão da literatura

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    P. C. Trevisol-Bittencourt

    1990-09-01

    Full Text Available Henry Turner descreveu, em 1938, síndrome caracterizada por infantilismo sexual, pescoço alado e cubitus valgus. Disgenesia gonadal foi acrescentada à síndrome nos anos subsequentes e o critério exigido para sua confirmação diagnostica é a demonstração de cariótipo anormal, no qual é inexistente uma porção ou todos os de um cromossoma X. Ainda que nos dias atuais haja muita informação geral disponível sobre a síndrome de Turner, em relação a suas possíveis complicações neurológicas há inexplicável negligência. Nesta comunicação revemos o caso de uma paciente com esta síndrome, que desenvolveu epilepsia severa a partir dos 16 anos de idade. Em complementação, revisão das publicações sobre o assunto nos últimos 20 anos, com ênfase às alterações neurológicas associadas à condição, é apresentada. O constante aparecimento de malformações extracranianas, muitas das quais estando empírica e freqüentemente combinadas a anomalias no SNC, bem como a incidência relativamente alta de deficits nestas pacientes, parecem justificar a hipótese de que em certa porcentagem de casos, uma malformação do SNC, não necessariamente de tipo vascular, poderá ser parte ainda não descrita da síndrome.

  2. 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

  3. Hipernefroma gigante: a propósito de un caso Giant hypernephroma: apropos of a case

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    Rafael Pinilla González

    2008-03-01

    Full Text Available El hipernefroma constituye el 3 % de todos los tumores malignos y es el tumor renal más frecuente del adulto. Se sospechaba la existencia de un carcinoma renal ante la presencia de hematuria, lumbalgia y tumor abdominal palpable. En la actualidad, el empleo sistemático de la ultrasonografía y la tomografía axial computarizada ha posibilitado la detección de masas renales incidentales y mejorado el pronóstico de estos pacientes. Se describe el caso de un paciente del sexo masculino, de 45 años de edad, con dolor en el lado izquierdo del abdomen y tumoración de crecimiento rápido, que se hizo muy dolorosa en los dos días previos a la operación. Por incremento notable del dolor y por no tener la posibilidad de realizar estudios imaginológicos, se decide operar de urgencia. Se diagnosticó un hipernefroma izquierdo con sangrado intratumoral y se realizó nefrectomía izquierda. El informe histológico confirmó un carcinoma de células renales del tipo de células claras. El paciente fue valorado antes del alta por el oncólogo, quien propuso seguimiento solamenteThe hypernephroma accounts for 3 % of all the malignant tumors and it is the most frequent renal tumor in adults. It was suspected the existence of a renal carcinoma in the presence of haematuria, low back pain and palpable abdominal tumor. Nowadays, the systematic use of ultrasonography and computerized axial tomography has made possible the detection of incidental renal masses, and has improved the prognosis of these patients. The case of a 45-year-old patient with pain on the left side of the abdomen and tumor of fast growth that became very painful 2 days before the operation was described. Due to a marked increase of pain and to the impossibility of carrying out imaging studies, it was decided to perform emergency surgery. A left hypernephroma with intratumoral bleeding was diagnosed and left nephrectomy was performed. The histological report confirmed a clear-cell renal

  4. Renal posttransplant's vascular complications

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    Bašić Dragoslav

    2003-01-01

    Full Text Available INTRODUCTION Despite high graft and recipient survival figures worldwide today, a variety of technical complications can threaten the transplant in the postoperative period. Vascular complications are commonly related to technical problems in establishing vascular continuity or to damage that occurs during donor nephrectomy or preservation [13]. AIM The aim of the presenting study is to evaluate counts and rates of vascular complications after renal transplantation and to compare the outcome by donor type. MATERIAL AND METHODS A total of 463 kidneys (319 from living related donor LD and 144 from cadaveric donor - CD were transplanted during the period between June 1975 and December 1998 at the Urology & Nephrology Institute of Clinical Centre of Serbia in Belgrade. Average recipients' age was 33.7 years (15-54 in LD group and 39.8 (19-62 in CD group. Retrospectively, we analyzed medical records of all recipients. Statistical analysis is estimated using Hi-squared test and Fischer's test of exact probability. RESULTS Major vascular complications including vascular anastomosis thrombosis, internal iliac artery stenosis, internal iliac artery rupture obliterant vasculitis and external iliac vein rupture were analyzed. In 25 recipients (5.4% some of major vascular complications were detected. Among these cases, 22 of them were from CD group vs. three from LD group. Relative rate of these complications was higher in CD group vs. LD group (p<0.0001. Among these complications dominant one was vascular anastomosis thrombosis which occurred in 18 recipients (17 from CD vs. one from LD. Of these recipients 16 from CD lost the graft, while the rest of two (one from each group had lethal outcome. DISCUSSION Thrombosis of renal allograft vascular anastomosis site is the most severe complication following renal transplantation. In the literature, renal allograft thrombosis is reported with different incidence rates, from 0.5-4% [14, 15, 16]. Data from the

  5. Citrato y litiasis renal

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    Elisa E. Del Valle

    2013-08-01

    Full Text Available El citrato es un potente inhibidor de la cristalización de sales de calcio. La hipocitraturia es una alteración bioquímica frecuente en la formación de cálculos de calcio en adultos y especialmente en niños. El pH ácido (sistémico, tubular e intracelular es el principal determinante de la excreción de citrato en la orina. Si bien la mayoría de los pacientes con litiasis renal presentan hipocitraturia idiopática, hay un número de causas para esta anormalidad que incluyen acidosis tubular renal distal, hipokalemia, dietas ricas en proteínas de origen animal y/o dietas bajas en álcalis y ciertas drogas, como la acetazolamida, topiramato, IECA y tiazidas. Las modificaciones dietéticas que benefician a estos pacientes incluyen: alta ingesta de líquidos y frutas, especialmente cítricos, restricción de sodio y proteínas, con consumo normal de calcio. El tratamiento con citrato de potasio es efectivo en pacientes con hipocitraturia primaria o secundaria y en aquellos desordenes en la acidificación, que provocan un pH urinario persistentemente ácido. Los efectos adversos son bajos y están referidos al tracto gastrointestinal. Si bien hay diferentes preparaciones de citrato (citrato de potasio, citrato de sodio, citrato de potasio-magnesio en nuestro país solo está disponible el citrato de potasio en polvo que es muy útil para corregir la hipocitraturia y el pH urinario bajo, y reducir marcadamente la recurrencia de la litiasis renal.

  6. Síndrome de Lowe: reporte de caso

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    Nadia Luz Casillas-Chavarín

    2016-11-01

    Full Text Available El síndrome de Lowe es un trastorno raro con afectación multiorgánica y herencia recesiva ligada a X. Presenta repercusión a nivel de sistema nervioso central, riñones y ojos, siendo las manifestaciones más frecuentes el retraso del desarrollo psicomotor, síndrome de Fanconi, cataratas y glaucoma congénito. Los estudios enzimáticos y moleculares son de ayuda en el diagnóstico. El tratamiento incluye: cirugía de catarata, control de glaucoma, terapia física y de lenguaje, medicamentos para manejo de la conducta y la corrección de la acidosis tubular y alteraciones óseas mediante la utilización de bicarbonato, fosfato y potasio. El pronóstico para la función y la vida es malo, presentando una supervivencia alrededor de los 40 años. Presentamos el caso de un síndrome de Lowe con afectación renal, cataratas y glaucoma bilateral que fueron intervenidos quirúrgicamente mediante trabeculectomía con mitomicina C y lensectomía con vitrectomía anterior. Es importante conocer las repercusiones potencialmente mortales de este síndrome para iniciar manejo multidisciplinario de manera oportuna.

  7. Colgajo deltopectoral bilateral para el tratamiento de úlceras por radionecrosis en el cuello: Caso clínico

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    P. Benito Duque

    2006-09-01

    Full Text Available Bakamjian describió el colgajo deltopectoral en 1965, recibiendo inicialmente una gran aceptación en cirugía de cabeza y cuello. Sin embargo, un porcentaje de fallos del 10%-25% descrito por varios autores motivó su progresivo abandono y su sustitución por otras alternativas. Los autores hacen una revisión de la bibliografía, analizando las modificaciones técnicas que han mejorado la viabilidad de este colgajo y describen la capacidad del colgajo deltopectoral elevado bilateralmente para aportar suficiente tejido en el caso de un paciente con defecto bilateral en el cuello secundario a radiodermitis severa. En la actualidad, el colgajo deltopectoral, teniendo en consideración las aportaciones técnicas descritas, puede seguir considerándose como una fuente de tejido con la calidad y fiabilidad idóneas para técnicas de reconstrucción superficial en cabeza y cuello.Bakamjian introduced the deltopectoral skin flap en 1965, and there after it was used extensively for reconstructive surgery of the head and neck. Within the next years, flap failure rates of 20% to 25% were reported, and several alternative methods of reconstruction have supplanted the preeminent position of the deltopectoral flap. This work is a review of the reconstructive experience afforded by several authors and evaluates the technical modifications used to enhance the reliability of this flap. The authors describe the ability of the deltopectoral flap raised bilaterally to provide tissue enough for an extensive irradiated neck, allowing resurfacing a bilateral cutaneous defect after radiation therapy. The deltopectoral flap remains a useful and reliable tissue source for superficial neck reconstruction by implementing several technical modifications.

  8. Síndrome de Rendu-Osler-Weber: presentación de un caso clínico

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    Freyli Bustamante

    2016-08-01

    Full Text Available El síndrome de Rendu-Osler-Weber (SROW, conocido también como Telangiectasia Hemorrágica Hereditaria (THH, es un desorden vascular infrecuente. Se trata de una alteración vascular displásica multisistémica de carácter autosómico dominante, con diversas complicaciones, siendo las malformaciones arterio-venosas (MAV responsables de la morbi-mortalidad de los pacientes cuando no son diagnosticadas ni tratadas a tiempo. Muchas veces este síndrome presenta síntomas sutiles, por lo que puede pasar desapercibida clínicamente. Presentamos un caso de una paciente femenina de 51 años, con historia de epistaxis frecuentes quien acude a nuestro hospital por presentar cefalea de fuerte intensidad, meningismo y pérdida de la consciencia. La tomografía axial computada (TAC de cráneo identificó hemorragia sub aracnoidea (HSA difusa. La angiografía cerebral permitió identificar aneurisma arteria comunicante anterior (AcoA roto que fue tratado por vía endovascular, sin eventualidades. Además, se observó telangectasias mucosas nasales múltiples y fistula arterio-venosa (FAV dural occipital izquierda. Estudios ulteriores permitieron identificar MAV pulmonares múltiples. Se confirmó el diagnóstico de SROW, con criterios de diagnóstico vigentes (criterios de Curazao. Durante los tres meses posteriores a su egreso el paciente presentó hemoptisis severa y disnea, que no pudo ser tratada a tiempo por lo que falleció.

  9. Hiperoxaluria primaria con pancitopenia: a propósito de un caso

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    Jessica Bravo Zuñiga

    2005-06-01

    Full Text Available Se presenta el caso de un varón, de 15 años de edad, con diagnóstico de litiasis renal desde la infancia que evolucionó a Insuficiencia Renal Crónica, requiriendo hemodiálisis. Seis meses antes del reporte se agregan dolores articulares, con signos flogósicos en rodilla derecha, compromiso progresivo del estado general, pérdida de peso y anemia. Al examen físico se encuentra a un paciente emaciado, pálido, con múltiples adenopatías cervicales, y presencia de hepato-esplenomegalia. Se realizan exámenes evidenciándose: pancitopenia, con mayor compromiso de la serie roja (hemoglobina 7,3mg/dL, leucocitos 2 600/µL, y plaquetas 123 000/µL.. Los valores de transaminasas y bilirrubinas fueron normales así como los dosajes de Fierro, Transferrina, Ácido Fólico y Vitamina B12. La ecografía abdominal revela riñones calcificados y atróficos y los Rx de abdómen demuestran nefrocalcinosis y litiasis renal. La biopsia de medula ósea evidenció un extenso depósito de cristales de oxalato de calcio, dispuestos en forma radiada, con casi completa obliteración de la medula ósea con un número variable de células multinucleadas y fibrosis moderada. El aspirado de medula ósea no mostró cristales de oxalato de calcio. Este reporte hace una revisión sobre hiperoxaluria primaria, y resalta la importancia de reconocer la enfermedad como causa de falla renal en un paciente con historia clínica de litiasis renal y nefrocalcinosis. (Rev Med Hered 2004;16:148-156

  10. Automatic quantitative renal scintigraphy

    International Nuclear Information System (INIS)

    Valeyre, J.; Deltour, G.; Delisle, M.J.; Bouchard, A.

    1976-01-01

    Renal scintigraphy data may be analyzed automatically by the use of a processing system coupled to an Anger camera (TRIDAC-MULTI 8 or CINE 200). The computing sequence is as follows: normalization of the images; background noise subtraction on both images; evaluation of mercury 197 uptake by the liver and spleen; calculation of the activity fractions on each kidney with respect to the injected dose, taking into account the kidney depth and the results referred to normal values; edition of the results. Automation minimizes the scattering parameters and by its simplification is a great asset in routine work [fr

  11. Imaging of renal metastases

    International Nuclear Information System (INIS)

    Bruneton, J.N.; Normand, F.; Balu-Maestro, C.; Rogopoulos, A.; Drouillard, J.; Laurent, F.

    1988-01-01

    Metastases are the most frequent malignant tumors of the kidney, but these lesions are of late onset in neoplastic disease. The 19 cases reported here were all investigated with various imaging techniques (CT 12 cases, ultrasonography 12 cases, urography 8 cases, angiography 2 cases, MRI 1 case). The most common primary malignancies were lung cancer, melanoma and cancer of the controlateral kidney. In this series, 8 of the lesions were solitary, and 9 were unilateral. Tumor vascularity was evaluated in 15 cases: 14 of these lesions were hypovascular. The differential diagnosis includes small cysts, lymphoma, bilateral renal cancer, multiple small abscesses and multiple small infarcts [fr

  12. Infarto renal agudo: características clínicas y factores pronósticos

    Directory of Open Access Journals (Sweden)

    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.

  13. Trece tratamientos de la insuficiencia renal aguda secundaria a mieloma múltiple con filtros de high cut off

    Directory of Open Access Journals (Sweden)

    Ana Berni Wennekers

    2016-07-01

    Conclusiones: El tratamiento combinado con quimioterapia más diálisis largas con filtros de HCO resultó eficaz para reducir el nivel de CLLs y recuperar un nivel de función renal suficiente en el 77% de los casos. Con filtros de HCO se consigue un ahorro significativo, en contraposición a lo descrito previamente en la literatura.

  14. Pregnancy after kidney transplantation: when is the best time? = Gravidez após transplante renal: qual o momento ideal?

    Directory of Open Access Journals (Sweden)

    Gustavo Falcão Gama

    2012-10-01

    Full Text Available The authors report a case of a patient underwent kidney transplantation that went through an unplanned pregnancy, at 41 years old, as well as the implications for both mother and fetus.Os autores relatam o caso de uma paciente submetida à transplante renal que evoluiu com uma gravidez não planejada, aos 41 anos de idade, bem como suas implicações para o binômio mãe e feto.

  15. Influencia del tratamiento quirúrgico de la próstata sobre la función renal en pacientes con insuficiencia renal crónica secundaria a hiperplasia prostática benigna

    Directory of Open Access Journals (Sweden)

    Roxana Aguirre Castañeda

    2002-07-01

    Full Text Available Objetivo: Evaluar la influencia del tratamiento quirúrgico sobre la función renal en pacientes con Insuficiencia Renal Crónica (IRC causada por Hiperplasia Prostática Benigna (HPB. Material y métodos: Es un estudio descriptivo, retrospectivo y analítico de series de casos; cuya variable resultado principal fue el delta de creatinina (creatinina post cirugía - creatinina pre-cirugía, los deltas de creatinina negativos se categorizaron como mejoría de la función renal y los deltas de creatinina positivos como deterioro de la función renal. Resultados: De 40 casos, 24 cumplían con los criterios de inclusión. La edad promedio fue de 67.2 ± 6.8 años. El síntoma más frecuente fue el chorro urinario delgado presentándose en 20 (83.3% pacientes. Trece(54.17% pacientes tuvieron una próstata mediana, quienes con los pacientes de próstata grande refirieron con mayor frecuencia el síntoma de polaquiuria (p=0.03. El tratamiento quirúrgico de pacientes con IRC por HPB produjo una mejoría de la función renal en el 83% de los casos. Solo 4(16.67% pacientes tuvieron delta de creatinina positivo con disminución de la función renal post-cirugía. Se encontró una correlación directa entre la edad y el delta de creatinina (r=0.55 (p=0.004 traduciendo una asociación del deterioro de la función renal post-cirugía con la edad. Conclusiones: El tratamiento quirúrgico de pacientes con IRC por HPB produjo una mejoría de la función renal en la mayoría de los pacientes evaluados en este estudio. No se identificó factores de riesgo relacionados con un deterioro o mejoría de la función renal post-cirugía. (Rev Med Hered 2002; 13: 99-104.

  16. 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)

  17. Leiomyosarcoma of the renal vein

    Directory of Open Access Journals (Sweden)

    Lemos Gustavo C.

    2003-01-01

    Full Text Available Leiomyosarcoma of the renal vein is a rare tumor of complex diagnosis. We presented a case of renal vein leiomyosarcoma detected in a routine study. The primary treatment was complete surgical removal of the mass. In cases where surgical removal is not possible the prognosis is poor, with high rates of local recurrence and distant spread.

  18. 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

  19. Sepsis severa postaborto secundaria a tuberculosis miliar

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    Edith Angel Müller

    1995-10-01

    Mujer de 24 años de edad, natural y procedente de Bogotá, de nivel socio-económico medio-bajo, sin antecedentes medico quirúrgicos importantes y con historia obstétrica: G2 P1 A1 VI. Esta paciente ingresó al Hospital del Guavio el día 1-05- 95, con diagnósticos de embarazo de 18 semanas, amenaza de aborto e infección de vías urinarias altas. Presenta expulsión espontanea del feto y se le realiza legrado uterino en el cual se encuentran restos ovulares fétidos, La paciente además presentaba fiebre y taquicardia por lo cual le diagnosticaron infección postaborto y le comenzaron tratamiento con penicilina cristalina y gentamicina. EI10-05-95 la paciente persistió con fiebre y taquicardia y comenzó a presentar dificultad respiratoria, se le realizo un segundo legrado en el cual extrajeron escasos restos, no fétidos. En vista del deterioro, el 11-05-95 es remitida al Instituto Materno Infantil (lMI.

  20. Acute renal failure after rifampicin

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    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.

  1. Fetal programming of renal function.

    Science.gov (United States)

    Dötsch, Jörg; Plank, Christian; Amann, Kerstin

    2012-04-01

    Results from large epidemiological studies suggest a clear relation between low birth weight and adverse renal outcome evident as early as during childhood. Such adverse outcomes may include glomerular disease, hypertension, and renal failure and contribute to a phenomenon called fetal programming. Other factors potentially leading to an adverse renal outcome following fetal programming are maternal diabetes mellitus, smoking, salt overload, and use of glucocorticoids during pregnancy. However, clinical data on the latter are scarce. Here, we discuss potential underlying mechanisms of fetal programming, including reduced nephron number via diminished nephrogenesis and other renal (e.g., via the intrarenal renin-angiotensin-aldosterone system) and non-renal (e.g., changes in endothelial function) alterations. It appears likely that the outcomes of fetal programming may be influenced or modified postnatally, for example, by the amount of nutrients given at critical times.

  2. Renal manifestations of primary hyperparathyroidism

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    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.

  3. Renal replacement therapy in Europe

    DEFF Research Database (Denmark)

    Pippias, Maria; Stel, Vianda S; Abad Diez, José Maria

    2015-01-01

    BACKGROUND: This article summarizes the 2012 European Renal Association-European Dialysis and Transplant Association Registry Annual Report (available at www.era-edta-reg.org) with a specific focus on older patients (defined as ≥65 years). METHODS: Data provided by 45 national or regional renal...... disease (ESRD) receiving renal replacement therapy (RRT) and renal transplantation rates for 2012 are presented. RESULTS: In 2012, the overall unadjusted incidence rate of patients with ESRD receiving RRT was 109.6 per million population (pmp) (n = 69 035), ranging from 219.9 pmp in Portugal to 24.2 pmp...... to 32% between countries. The overall renal transplantation rate in 2012 was 28.3 pmp (n = 15 673), with the highest rate seen in the Spanish region of Catalonia. The proportion of patients ≥65 years receiving a transplant ranged from 0 to 35%. Five-year adjusted survival for all RRT patients was 59...

  4. Magnification renal arteriography

    International Nuclear Information System (INIS)

    Carr, D.; Davidson, J.K.; McMillan, M.; Davison, M.

    1979-01-01

    Magnification selective renal arteriograms were performed on 24 patients, 12 of whom were hypertensive, and compared with non-magnification arteriograms by two observers independently. The magnification angiograms were performed on a Siemens Microfocus Bi 125/3/50 RG tube with a 0.1 mm focal spot. Of the 24 patients examined, information crucial to the diagnosis was found only on the magnification films in three patients (12.5%). Extra information compared with the non-magnification films was found in the magnification films in 12 patients (50%). No additional information was discovered in the remaining nine patients (37.5%). The magnification angiograms enabled the interlobular vessels to be visualised - this was not possible on the non-magnification films. Against the additional information gained must be weighed the disadvantages of magnification arteriography which include increased radiation dose and lengthening of procedure time plus additional injections of contrast. In conclusion, there is a place for magnification renal arteriography and the advantages seem to outweigh the disadvantages. (author)

  5. Renal complications of anaesthesia.

    Science.gov (United States)

    McKinlay, J; Tyson, E; Forni, L G

    2018-01-01

    Peri-operative acute kidney injury is common, accounting for 30-40% of all in-hospital cases of acute kidney injury. It is associated with clinically significant morbidity and mortality even with what was hitherto regarded as relatively trivial increases in serum creatinine, and carries over a 12-fold relative risk of death following major abdominal surgery. Comorbid conditions such as diabetes, hypertension, liver disease and particularly pre-existing chronic kidney disease, as well as the type and urgency of surgery, are major risk factors for the development of postoperative acute kidney injury. As yet, there are no specific treatment options for the injured kidney, although there are several modifiable risk factors of which the anaesthetist should be aware. As well as the avoidance of potential nephrotoxins and appropriate volume balance, optimal anaesthetic management should aim to reduce the risk of postoperative renal complications. This may include careful ventilatory management and blood pressure control, as well as appropriate analgesic strategies. The choice of anaesthetic agent may also influence renal outcomes. Rather than concentrate on the classical management of acute kidney injury, this review focuses on the potential development of acute kidney injury peri-operatively, and the means by which this may be ameliorated. © 2018 The Association of Anaesthetists of Great Britain and Ireland.

  6. Angiography in renal tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Doo Suk [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1974-10-15

    Angiographies on forty cases of renal tuberculosis performed at the National Medical Center during a period 1960 through 1970 were reviewed. Abdominal angiography was performed via the femoral route. Some were followed by selective nephroangiography. All patients were subjected to urographyior to angiography. The results of X-ray findings in the forty cases with renal tuberculosis were follows. 1. The age varied 18 to 57 years, average 30.5 years. Twenty one patients were male, and nineteen were female. 2. The right kidney was involved in 17 cases and the left in 15 cases. Both kidneys were involved in 8 cases. 3. Urographic examination revealed pathologic changes in all patients. 4. Focal destruction in the collecting system was the most common finding in the urography of 16 patients. 5. A varying degree of hydronephrosis was present in 15 patients, of whom nine had complained of palpable mass due to hydronephrosis. 6. In the 7 patients with extensive destruction there was no observable excretion contrast medium from the diseased kidney. 7. Angiographic examination was normal in 6 of the 40 patients. 8. Decreased vascularity in the subsegmental or smaller arteries of the affected kidney was the most frequent finding, being found in 34 patients. 9. Occlusion or abrupt termination of the subsegmental arteries was present in 4 patients. 10. Eighteen of the patients had signs of an expansive process within the cavity, the vessels being displaced and stretched around the lesions.

  7. Bartonelosis aguda en niños: Estudio de 32 casos en el Instituto Especializado de Salud del Niño y el Hospital Nacional Cayetano Heredia (Período 1993-2003.

    Directory of Open Access Journals (Sweden)

    Judith Patricia BREÑA CHÁVEZ

    2006-07-01

    Full Text Available Objetivos: Determinar las características epidemiológicas, clínicas, datos de laboratorio y tratamiento de la Bartonelosis aguda en niños. Materiales y métodos: Se revisaron las historias clínicas de 32 niños con Bartonelosis aguda, internados en el Hospital Nacional Cayetano Heredia y en el Instituto Especializado de Salud del Niño entre 1993 y 2003. Resultados: La edad promedio fue 9,8 años, 72% fueron varones, los lugares de exposición probable fueron principalmente las zonas endémicas de los valles interandinos de Perú, pero hubieron pacientes procedentes de zonas no endémicas de la selva alta; fueron nativos de éstas zonas el 72%. Los síntomas principales fueron fiebre (97%, hiporexia (91%, síntomas gastrointestinales (66% y malestar general (53%; los signos principales fueron palidez (97%, hepatomegalia (78%, taquicardia (75% y linfadenomegalia (72%. El promedio de hematocrito fue 18,8 %, 63% cursaron con anemia severa, leucocitosis 63%, hiperbilirrubinemia a predominio indirecto 45% de casos e hipoalbuminemia el 68%. Las complicaciones fueron frecuentes (78%, siendo las infecciosas 25%, no infecciosas 22%, infecciosas y no infecciosas 31%. De las infecciosas destacan las respiratorias (25%, fiebre tifoidea / salmonelosis (19%, un caso de endocarditis infecciosa y otro de probable púrpura fulminans. De las complicaciones no infecciosas desatacan las complicaciones cardiovasculares (34% y la neurobartonelosis (34%; hubo un caso de anemia hemolítica autoinmune. El 72% recibió transfusiones sanguíneas; el 97% recibió antibiótico, utilizando cloranfenicol (56% y ciprofloxacino (34%. La letalidad fue de 6%. Conclusiones: La Bartonelosis aguda en esta serie tuvo gran morbilidad, siendo frecuentes las complicaciones cardiovasculares, neurológicas y respiratorias. (Rev Med Hered 2006;17:122-131.

  8. Estudio REHASE (Relevamiento de Hipertensión Arterial Severa en Servicios de Emergencia: características de la población y respuesta a una estrategia de manejo

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    Pablo Rodriguez

    2006-01-01

    Full Text Available Objetivos Determinar la prevalencia de consultas por HTA severa (HTS en los servicios de emergencia (SE, caracterizar esa población y evaluar la eficacia de una guía de práctica clínica (GPC basada en las Normas para el Manejo de la HTS del Consejo Argentino de Hipertensión Arterial, Sociedad Argentina de Cardiología. Material y métodos Se incluyeron pacientes con HTS que consultaron en SE de 31 centros participantes. Se distinguieron dos fases: I o de relevamiento de datos epidemiológicos de toda la población y II o de intervención que sólo incluyó a aquellos pacientes con HTS sin daño agudo de órgano blanco (DAOB. En esta última fase se aplicó una GPC que incluía en forma secuencial reposo y la aleatorización a drogas antihipertensivas de diferente mecanismo y velocidad de acción (amlodipina 10 mg o labetalol 200 mg o perindopril 4 mg. Resultados Se incluyeron 816 pacientes (60,4 ± 14,7 años, el 50,4% de sexo masculino, el 87,4% sin DAOB; la prevalencia de HTS fue del 9%. En el 83,4% ya se conocía la presencia de hipertensión y de ellos, el 86,2% recibía tratamiento pero mantenía una PAS > 150 mm Hg. Se observó el 32% de respuesta al reposo y entre los no respondedores, el 79,1% respondió al tratamiento farmacológico. Los parámetros de seguridad considerados fueron: reducción £ 20% de la presión arterial media (PAM basal y ausencia o número reducido de eventos en el SE. La PAM se redujo > 20% en el 5,6% de respondedores al reposo y en el 15,9% de los que requirieron drogas, sin que se observaran eventos. Conclusiones El presente relevamiento proporciona datos para caracterizar clínicamente a los pacientes con HTS y sugiere que la GPC propuesta podría constituir una alternativa eficaz y segura para su manejo en el SE.

  9. Análisis comparativo de la aplicación de protocolos de evaluación de conductores con discapacidades severas que conducen con Joysticks de 4 vías entre los simuladores de conducción SERCO y UPV-DGT

    OpenAIRE

    ALAGARDA CONTRERAS, RAIMON

    2016-01-01

    [ES] El presente TFG tiene por objeto el análisis inter-comparativo entre los procedimientos de evaluación de conductores con discapacidades severas que conducen con la ayuda de adaptaciones del tipo Joystick de 4 vías, y que se implementan en los simuladores de conducción SERCO y UPV-DGT. Ambos simuladores se encuentran ubicados actualmente en las instalaciones del Instituto de Diseño y Fabricación (IDF). Se ha estudiado el comportamiento de diferentes tipos de conductores (co...

  10. Acute cervical epidural hematoma: case report Hematoma epidural cervical agudo: relato de caso

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    GUILHERME BORGES

    2000-09-01

    Full Text Available A 74 year-old patient with a nocturnal onset of neck and chest pain was brought to an emergency clinic. Physical examination and cardiac assessment were normal. Three hours after the addmittance, a flaccid paralysis of the four limbs supervened. Suspecting of an unusual onset of central nervous system infection, a lumbar puncture was performed, yielding 20 ml of normal cerebrospinal fluid. Thirty oinutes after the puncture, the patient completely regained neurological funcion. He was then referred to a General Hospital where a computed tomography (CT scan was done showing a large cervical epidural bleeding in the posterolateral region of C4/C5 extending to C7/Th1, along with a C6 vertebral body hemangioma. A magnetic resonance imaging revealed the same CT findings. A normal selective angiography of vertebral arteries, carotid arteries and thyreocervical trunk was carried out. Spontaneous spinal epidural hematoma (ASSEH is a rare but dramatic cause of neurological impairment. In this article we report a fortunate case of complete recovery after an unusual spine cord decompression. We also review the current literature concerning diagnosis and treatment of ASSEH.Paciente de 74 anos acordou à noite sentindo fortes dores na região da nuca acompanhadas de ansiedade e desconforto torácico e respiratório. A internação emergencial em clinica cardiológica não demonstrou problemas cardíacos. Com a progressão do quadro neurológico traduzida por quadriplegia severa foi realizada uma punção lombar para afastar hipótese de meningite, sendo retirados cerca de 20 ml de liquor. Trinta minutos imediatamente após a punção lombar foi observada completa remissão do déficit neurológico. Transferido para um hospital geral a tomografia computadorizada demonstrou extenso hematoma epidural espinal em nivel C4/C5 com extensão a C7/Th1, bem como hemangioma do sexto corpo vertebral (C6. A ressonância magnética demonstrou as mesmas lesões. Observando

  11. Teratocarcinosarcoma rinosinusal: Reporte de un caso

    OpenAIRE

    González G,Claudia; Iñiguez,Rodrigo; Aranís Jiménez,Carolina; Castiblanco Galvis,Adriana

    2008-01-01

    Teratocarcinosarcoma rinosinusal es una neoplasia maligna infrecuente y rara, que combina elementos de teratoma y carcinosarcoma. Se compone de epitelio benigno o maligno (fibroblastos), mesénquima (cartílago, hueso o músculo liso) y elementos neurales. Hasta el año 2008 se han reportado un total de 63 casos de ubicación rinosinusal. Presentamos el caso de un teratocarcinosarcoma de fosa nasal, en un hombre de 67 años de edad, que consultó por obstrucción nasal rápidamente progresiva. La lesi...

  12. Afasia global sem hemiparesia: relato de caso

    OpenAIRE

    SILVA,MARCUS TULIUS TEIXEIRA DA; CAVALCANTI,JOSÉ LUÍS DE SÁ; MOREIRA,DENISE MADEIRA

    2000-01-01

    Afasia global geralmente é acompanhada por hemiparesia direita devido à extensão da lesão subjacente. Recentemente têm sido registrados na literatura casos em que tal síndrome ou não se acompanha do déficit motor ou este é apenas transitório, sendo esta condição conhecida como afasia global sem hemiparesia (AGSH). Relatamos caso de AGSH devido a infarto cerebral embólico cardiogênico, corroborando a tese de que esta condição pode ter valor preditivo para o diagnóstico de infartos embólicos....

  13. Sangrado de angiomiolipoma renal en paciente con síndrome de genes contiguos (TSC2/PKD1 tras 17 años de tratamiento renal sustitutivo

    Directory of Open Access Journals (Sweden)

    Mónica Furlano

    2017-01-01

    Full Text Available Presentamos el caso de un varón de 32 años, con síndrome de genes contiguos TSC2/PKD1, que le ocasiona esclerosis tuberosa (ET y poliquistosis renal autosómica dominante simultáneamente. Evolucionó a enfermedad renal terminal y se realizó trasplante renal a los 12 años. Los riñones presentaban angiomiolipomas (AML, que son tumores benignos frecuentes en pacientes con ET. A los 17 años postrasplante, presentó un cuadro de dolor abdominal, anemización y hematoma retroperitoneal. Dicho hematoma se produjo por el sangrado de los AML. Como tratamiento se realizó embolización selectiva. Nuestro paciente podría haberse beneficiado en el momento del trasplante renal del tratamiento con inhibidores de mTOR. Este fármaco actúa como inmunosupresor y reductor tumoral en la ET, al disminuir el riesgo de rotura y hemorragia. En este paciente no se administró porque cuando se trasplantó no se conocía la relación de los inhibidores de mTOR con la ET. Este caso confirma que, a pesar de tratarse de pacientes trasplantados o en diálisis, el riesgo de sangrado por los AML persiste, por lo cual se propone realizar controles periódicos de los riñones propios y valorar la nefrectomía.

  14. Relato de caso: esclerose tuberosa

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    Samuel Simis

    2016-10-01

    Full Text Available Introdução: O Complexo de Esclerose Tuberosa (CET é uma síndrome neurocutânea transmitida hereditariamente, de traço autossômico dominante e que se manifesta por uma tríade clássica: deficiência mental, convulsões e adenoma sebáceo. A mutação responsável pela síndrome está presente em até 85% dos portadores de CET e.ocorre nos genes supressores tumorais TSC1 e TSC2, que produzem hamartina e tuberina, respectivamente.A prevalência do CET é de 1:10.000 a 1:170.000, atinge mais indivíduos do sexo masculina e é rara em negros. Relato de Caso: R.C.S.B., paciente do sexo feminino, 16 anos, vem encaminhada ao ambulatório de neurologia devido a quadro de convulsões tônico-clônicas generalizadas e crises de ausência diárias há 1 ano, mas com história de convulsões aos 2 anos que cessaram espontaneamente. Está em tratamento com fenitoína 200mg/dia e carbamazepina 800mg/dia, mas ainda apresenta crises de ausência. A paciente apresenta as lesões cutâneas típicas do CET: adenomas sebáceos (angiofibroma em face distribuídos simetricamente entre nariz e bochechas, envolvendo ainda fronte e queixo. Não há sinais de retardo mental. A ressonância nuclear magnética revelou imagens com padrão compatível com áreas de desmielinização. O eletroencefalograma encontrava-se normal. Conclusão: O tratamento do CET ainda é um desafio para muitos neurologistas, uma vez que não há tratamento específico para doença. A paciente deve contar com equipe multidisciplinar, por vezes é necessário acompanhamento com neurologista, dermatologista, geneticista, psicólogos e outros, dependendo das manifestações do CET. A finalidade terapêutica é a qualidade de vida da paciente, que pode ser prejudicada pelas várias convulsões ou alterações estéticas da doença.

  15. RENAL DAMAGE WITH MALIGNANT NEOPLASMS

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    I. B. Kolina

    2015-01-01

    Full Text Available The relationship between renal damage and malignant neoplasms is one of the most actual problems of the medicine of internal diseases. Very often, exactly availability of renal damage determines the forecast of cancer patients. The range of renal pathologies associated with tumors is unusually wide: from the mechanical effect of the tumor or metastases on the kidneys and/or the urinary tract and paraneoplastic manifestations in the form of nephritis or amyloidosis to nephropathies induced with drugs or tumor lysis, etc. Thrombotic complications that develop as a result of exposure to tumor effects, side effects of certain drugs or irradiation also play an important role in the development of the kidney damage. The most frequent variants of renal damage observed in the practice of medical internists (therapists, urologists, surgeons, etc., as well as methods of diagnosis and treatment approaches are described in the article. Timely and successful prevention and treatment of tumor-associated nephropathies give hope for retaining renal functions, therefore, a higher life standard after completion of anti-tumor therapy. Even a shortterm episode of acute renal damage suffered by a cancer patient must be accompanied with relevant examination and treatment. In the caseof transformation of acute renal damage into the chronic kidney disease, such patients need systematic and weighted renoprotective therapy and correct dosing of nephrotoxic drugs.

  16. Feocromocitoma. Presentación de un caso clínico. Pheochromocytoma. A clinical case report.

    Directory of Open Access Journals (Sweden)

    Maité Cabrera Gámez

    2008-08-01

    Full Text Available El feocromocitoma es un tumor de células cromafines, que puede localizarse en los territorios derivados de la cresta neural, o en el trayecto que siguen estas células hasta su localización definitiva. Por lo general se ubican en el abdomen (90 % de los casos particularmente en las glándulas suprarrenales y en el órgano de Zuckerkandl. Pueden causar una amplia variedad de síntomas, dada su capacidad de secretar catecolaminas, particularmente noradrenalina y adrenalina, en cantidades variables e intermitentes. Clínicamente pueden ser asintomáticos o presentarse con hipertensión arterial paroxística, o permanente con o sin paroxismos, acompañados de la triada clásica de cefalea, hiperhidrosis y taquicardia. Teniendo en cuenta lo anterior decidimos presentar un caso clínico de un paciente de sexo masculino, de 40 años de edad, con antecedentes de hipertensión arterial controlada, aparentemente de tipo esencial de varios años de evolución, con el diagnóstico de tumoración suprarrenal derecha incidental, aparentemente no funcionante, y que después de la palpación abdominal pre-quirúrgica, comienza con una crisis paroxística hipertensiva severa. Se prepara con alfa bloqueador y se interviene con informe anatomopatológico de feocromocitoma de suprarrenal derecha.The pheochromocytoma is a tumor of the chromaffin cells that may be located in territories derived from the neural crest or in the way these cells follow to their definitive localization. Generally, they are located in the abdomen (90 % of the cases, particularly in the suprarenal glands and in Zuckerkandl's organ. They may cause a wide variety of symptoms due to their capacity for secreting catecholamine, specifically noradrenalin and adrenaline in variable and intermittent amounts. Clinically, they may be asymptomatic or appear with paroxistic arterial hypertension, or permanent with or without paroxisms, accompanied with the classic triad of headache, hyperhydrosis and

  17. Da lesão à disfunção: um caso invulgar de hipertensão renovascular

    OpenAIRE

    Pimentel, Ana; Cabrita, Ana; Jeronimo, Teresa; Ministro, Augusto; Bernardo, Idalecio; Neves, Pedro Leao

    2014-01-01

    A hipertensão arterial resistente e uma condição clinica que carece de investigação etiológica, cujo objectivo e identificar causas secundarias passiveis de serem corrigidas. Os autores descrevem uma apresentação rara de hipertensão secundaria. O caso consiste num doente que e seguido em consulta externa desde Janeiro de 2012 por insuficiência renal e hipertensão diagnosticadas ha um ano. Foi realizado um estudo etiológico no qual constou um estudo endocrinológico que demonstrou um hiperaldos...

  18. Peritonitis fúngica en diálisis peritoneal continua ambulatoria: descripción de 10 casos

    OpenAIRE

    García Martos, P.; Gil de Sola, F.; Marín, P.; García-Agudo, L.; García-Agudo, R.; Tejuca, F.; Calle, L.

    2009-01-01

    Antecedentes: La peritonitis fúngica es una complicación infrecuente pero grave en pacientes en diálisis peritoneal continua ambulatoria (DPCA). Métodos: Durante un período de 10 años (1999-2008), de un total de 175 pacientes con insuficiencia renal crónica en tratamiento con DPCA, estudiamos retrospectivamente 10 casos de peritonitis fúngica, analizando los factores predisponentes, aspectos clínicos, agentes etiológicos y tratamiento. El diagnóstico se estableció por la presencia de efluente...

  19. Alterações morfológicas da glândula supra-renal na síndrome da imunodeficiência adquirida

    Directory of Open Access Journals (Sweden)

    Duch Francisco Moretti

    1998-01-01

    Full Text Available Na síndrome da imunodeficiência adquirida (AIDS pode-se verificar o acometimento da supra-renal por efeito citopático direto pelo HIV, por infecções oportunistas ou neoplasias. Estes achados poderiam variar de acordo com a procedência do paciente, devido às doenças peculiares à região. Neste trabalho avaliou-se o comprometimento da supra-renal em quatorze pacientes que morreram de AIDS no Hospital Escola, em Uberaba. Treze eram do sexo masculino e treze brancos. A idade foi de 29,9 ± 7,8 anos e o índice de massa corporal foi de 19 ± 4,1kg/m2. Os fragmentos de supra-renal obtidos nas necropsias foram analisados em microscópio de luz. Encontramos inflamação em 100% dos casos, identificando-se o agente etiológico em oito (58,1% casos. O Citomegalovírus foi identificado em sete casos, o Cryptococcus sp e o Herpes simplex em dois e o Histoplasma sp em um caso, estes achados são semelhantes aos da literatura. Em um caso, encontramos calcificação do parênquima e em outro, flebite da veia central. Em alguns casos que apresentavam lesão não foi possível identificar o agente etiológico, talvez em decorrência do efeito citopático direto pelo HIV ou devido a toxicidade das drogas utilizadas no tratamento da AIDS e das infecções oportunistas.

  20. Renal acidification defects in medullary sponge kidney

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F

    1988-01-01

    Thirteen patients with medullary sponge kidney underwent a short ammonium chloride loading test to investigate their renal acidification capacity. All but 1 presented with a history of recurrent renal calculi and showed bilateral widespread renal medullary calcification on X-ray examination. Nine...... of renal calculi in medullary sponge kidney, have considerable therapeutic implications....

  1. Cólica renal

    OpenAIRE

    Pinheiro, JC

    1999-01-01

    Os aspectos práticos de actuação na cólica renal são abordados nesta apresentação, que o médico de família, a quem os doentes primeiro recorrem, deve conhecer em pormenor.É referida a incidência da afecção num serviço de urgência dum grande hospital e descreve-se, ainda que sumariamente, a fisiopatologia da dor, o quadro clínico mais frequente e a conveniente actuação terapêutica para o imediato alívio da dor intensa que estes doentes apresentam. Nas conclusões sublinha-se que a cólica ...

  2. Mature Cystic Renal Teratoma

    International Nuclear Information System (INIS)

    Yavuz, Alpaslan; Ceken, Kagan; Alimoglu, Emel; Akkaya, Bahar

    2014-01-01

    Teratomas are rare germline tumors that originate from one or more embryonic germ cell layers. Teratoma of the kidney is extremely rare, and less than 30 cases of primary intrarenal teratomas have been published to date. We report the main radiologic features of an unusual case of mature cystic teratoma arising from the left kidney in a two-year-old boy. A left-sided abdominal mass was detected on physical examination and B-Mod Ultrasound (US) examination revealed a heterogeneous mass with central cystic component. Computed tomography (CT) demonstrated a lobulated, heterogeneous, hypodense mass extending craniocaudally from the splenic hilum to the level of the left iliac fossa. Nephrectomy was performed and a large, fatty mass arising from the left kidney was excised. The final pathologic diagnosis was confirmed as cystic renal teratoma

  3. Hyperparathyroidism of Renal Disease.

    Science.gov (United States)

    Yuen, Noah K; Ananthakrishnan, Shubha; Campbell, Michael J

    2016-01-01

    Renal hyperparathyroidism (rHPT) is a common complication of chronic kidney disease characterized by elevated parathyroid hormone levels secondary to derangements in the homeostasis of calcium, phosphate, and vitamin D. Patients with rHPT experience increased rates of cardiovascular problems and bone disease. The Kidney Disease: Improving Global Outcomes guidelines recommend that screening and management of rHPT be initiated for all patients with chronic kidney disease stage 3 (estimated glomerular filtration rate, < 60 mL/min/1.73 m(2)). Since the 1990s, improving medical management with vitamin D analogs, phosphate binders, and calcimimetic drugs has expanded the treatment options for patients with rHPT, but some patients still require a parathyroidectomy to mitigate the sequelae of this challenging disease.

  4. Characterization of complex renal cysts

    DEFF Research Database (Denmark)

    Graumann, Ole; Osther, Susanne Sloth; Osther, Palle Jörn Sloth

    2010-01-01

    Abstract Objective. Complex renal cysts represent a major clinical problem, since it is often difficult to exclude malignancy. The Bosniak classification system, based on computed tomography (CT), is widely used to categorize cystic renal lesions. The aim of this study was to evaluate critically...... available data on the Bosniak classification. Material and methods. All publications from an Entrez Pubmed search were reviewed, focusing on clinical applicability and the use of imaging modalities other than CT to categorize complex renal cysts. Results. Fifteen retrospective studies were found. Most...

  5. Renal rickets-practical approach

    Science.gov (United States)

    Sahay, Manisha; Sahay, Rakesh

    2013-01-01

    Rickets/osteomalacia is an important problem in a tropical country. Many cases are due to poor vitamin D intake or calcium deficient diets and can be corrected by administration of calcium and vitamin D. However, some cases are refractory to vitamin D therapy and are related to renal defects. These include rickets of renal tubular acidosis (RTA), hypophosphatemic rickets, and vitamin D dependent rickets (VDDR). The latter is due to impaired action of 1α-hydroxylase in renal tubule. These varieties need proper diagnosis and specific treatment. PMID:24251212

  6. Renal epithelioid angiomyolipoma presenting clinically as renal cell ...

    African Journals Online (AJOL)

    M.S. Johnson

    a Detroit Medical Center, Michigan State University School of Osteopathic Medicine, Detroit, MI, USA .... Immunohistochemically, the tumor cells stained strongly positive .... [10] Cao Q, Liu F, Xiao P, Tian X, Li B, Li Z. Coexistence of renal.

  7. 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.

  8. Cisto cisticercótico incluido em adenona da supra-renal

    Directory of Open Access Journals (Sweden)

    Ehrenfried O. Wittig

    1969-09-01

    Full Text Available Os autores fazem o registro de um caso anátomo-patológico de cisto cis-ticercótico incluído em adenoma de supra-renal. O caráver apresentava cis-ticercose no cérebro, na musculatura estriada e no coração. Na literatura compulsada não foi encontrada referência a caso semelhante. Em virtude da falta de informações quanto aos antecedentes não foi possível fazer correlação anátomo-clínica. É admitida a hipótese de que o parasita tenha se alojado no tumor pré-formado.

  9. 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....

  10. 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...

  11. Perfil morfofuncional de pacientes com retinopatia diabética sem baixa acuidade visual severa em hospital público de referência em diabetes no Brasil Morpho-functional profile of patients with diabetic retinopathy without severe loss of visual acuity in a public hospital of reference in diabetes in Brazil

    Directory of Open Access Journals (Sweden)

    Alípio de Sousa Neto

    2010-02-01

    Full Text Available OBJETIVO: Demonstrar o perfil morfofuncional da avaliação de pacientes com retinopatia diabética sem baixa acuidade visual severa em hospital público de referência em endocrinologia, determinando nesta amostra, a relação entre o tempo de diabetes, idade e acuidade visual com a espessura retiniana medidas pela tomografia de coerência óptica (OCT e retinografia (RET. MÉTODOS: Foi realizado estudo prospectivo, linear, em corte transversal de 61 pacientes consecutivos com retinopatia diabética registrados no Hospital Regional de Taguatinga (HRT, e encaminhados pelos serviços de oftalmologia e endocrinologia. Pacientes foram submetidos à avaliação oftalmológica completa, incluindo história clínica, aferição da acuidade visual com correção e com buraco estenopeico. 109 olhos de 55 pacientes foram então submetidos à OCT e RET para avaliação da presença ou ausência de edema macular pela RET e da avaliação quantitativa (medidas da espessura retiniana das 9 regiões classificadas pelo Early Tratment Diabetic Retinophaty Study - ETDRS e da avaliação qualitativa (presença ou ausência de edema retiniano pela fenda central, número 1. RESULTADOS: O tempo médio de diabetes entre os sujeitos da pesquisa foi de 12 anos, com idade variando de 23 a 86 anos; 51% eram do gênero feminino, e 49% do masculino. A avaliação da acuidade visual melhorou em 47% (51/109 dos pacientes com buraco estenopeico. Somente 22% (24/109 dos olhos apresentavam acuidade visual corrigida de 20/20 com correção e sem edema macular diabético (EMD. Em 83% (91/109 dos casos havia concordância e em 17% (18/109 olhos havia discordância em relação à presença/ausência de EMD no perfil da avaliação morfológica realizada pela OCT e pela RET nos olhos do grupo amostral. CONCLUSÃO: Não houve correlação estatística significante entre a espessura retiniana e o tempo de diabetes. O grupo da oftalmologia teve 5 vezes mais chance de apresentar EMD do

  12. Aneurisma y fístula arterio-venosa renal: manejo quirúrgico laparoscópico asistido por robot

    OpenAIRE

    CASTILLO C,OCTAVIO A; CUENTAS J,MARIANO; VIDANGOS V,RUBÉN; GUTIÉRREZ,RODRIGO; PALAVECINO R,PATRICIO

    2013-01-01

    Introducción: Los aneurismas de la arteria renal constituyen una patología infrecuente, y plantean dificultades en la decisión terapéutica. Objetivo: Presentar un caso de un aneurisma complejo intrarenal, asociado a una fístula arterio-venosa de alto flujo, el cual fue resuelto con asistencia robótica. Caso clínico: Paciente de 51 años, con historia prolongada de hipertensión arterial, al cual, en estudio radiológico de rutina, se le diagnostica 3 aneurismas intrarenales derechos, asociado a ...

  13. Pulmão e transplante renal Lung and renal transplantation

    Directory of Open Access Journals (Sweden)

    Patrícia Caetano Mota

    2009-11-01

    Full Text Available O transplante renal é o transplante de órgãos sólidos mais frequente, sendo os transplantados renais alvo de complicações pulmonares inerentes à própria terapêutica imunossupressora, as quais constituem, por vezes, um desafio diagnóstico e terapêutico. Objectivo: Avaliar os doentes admitidos na Unidade de Transplante Renal (UTR do Hospital de S. João com o diagnóstico de patologia respiratória. Material e métodos: Estudo retrospectivo de todos os doentes admitidos na UTR por doença respiratória, durante um período de 12 meses. Resultados: Foram incluídos 36 doentes, com uma média de idades de 55,2 (±13,4 anos; 61,1% do sexo masculino. Os esquemas imunossupressores mais utilizados foram: prednisolona e micofenolato mofetil com ciclosporina (38,9% ou tacrolimus (22,2% ou rapamicina (13,9%. Trinta e um doentes (86,1% apresentaram doença infecciosa respiratória. Neste grupo destacaram-se: 23 casos (74,2% de pneumonia, 5 casos (16,1% de infecção oportunista, 2 (6,5% de traqueobronquite, e 1 (3,2% de abcessos pulmonares. O agente etiológico foi identificado em 7 casos (22,6%. Cinco doentes (13,9% apresentaram doença pulmonar iatrogénica pela rapamicina. Em 15 doentes (41,7% foi necessário recorrer à realização de broncofibroscopia, diagnóstica em 10 casos (66,7%. O tempo médio de internamento foi de 17,1 (±18,5 dias, e não se verificou nenhum óbito. Conclusão: A infecção constituiu a principal complicação pulmonar no grupo de doentes estudado. O diagnóstico de doença pulmonar induzida por fármacos implica reconhecimento das suas características e monitorização rigorosa dos níveis séricos dos mesmos. O recurso a técnicas de diagnóstico invasivas contribuiu para maior precocidade e especificidade terapêuticas.Renal transplantation is the most common type of solid organ transplantation and kidney transplant recipients are susceptible to pulmonary complications of immunosuppressive therapy, which are a

  14. 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)

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

    Directory of Open Access Journals (Sweden)

    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.

  16. 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

  17. Nefrolitiasis de infección: caso clínico Nephrolithiasis of infection: clinical case

    Directory of Open Access Journals (Sweden)

    Nadienka Rodríguez Ramos

    2010-03-01

    Full Text Available Se presenta un caso de litiasis de infección, conocida con el nombre de cálculos de estruvita y asociado a una enfermedad metabólica subyacente y diabetes mellitus tipo 2 de reciente debut, el cual se manifestó con oliguria e infección, como resultado de una obstrucción urinaria bilateral parcial. El paciente de 48 años de edad, con antecedentes de cardiopatía isquémica, hipertensión arterial y de expulsar cálculos de riñón, consultó su caso el 21 de enero de 2009. Manejaba cifras de creatinina, glicemia y acido úrico normales anterior al ingreso y estas tuvieron un comportamiento ascendente durante la obstrucción, excepto el ácido úrico. En el diagnóstico aportaron datos de interés la ecografía renal y de próstata, la Uro-TAC y gammagrafía renal con MAG-3. El diagnóstico diferencial incluyó toda causa extrínseca e intrínseca, esta última relacionada con cálculos, coágulos o papila renal necrosada, que provocaran alteración al libre flujo urinario. Se estableció como patrones de buena evolución, la recuperación del volumen urinario, la normalización de la glucemia y creatinina, así como la permanencia del urocultivo negativo. El manejo terapéutico motivó a la utilización de la nefrolitotomía percútanea como una de las opciones que ofrecen los procederes endorulógicos, además del control de las enfermedades de base, lo que resultó una favorable evolución del caso.A clinical case of lithiasis of infection is presented, known as calculi of struvite associated to an underlying metabolic disease and diabetes mellitus type-2 of recent onset, with oliguria and infection as a result of a partial bilateral urinary infection. A 48 years-old patient having medical records of ischemic heart disease, hypertension and expulsion of kidney stones attended to the office in January 21, 2009 presenting normal values of creatinine, glycemia and uric acid before the admission; these values increased during the obstruction

  18. HIPOTIROIDISMO CANINO, PRESENTACION DE UN CASO ATIPICO

    Directory of Open Access Journals (Sweden)

    Juan Carlos Ballut P

    2004-12-01

    Full Text Available Este trabajo describe las características clínicas de un caso de hipotiroidismo atípico, catalogado como de presentaciónoculta, caracterizado por signos relacionados con miopatía, neuropatía, deterioro del estado mental, sangrado

  19. Transcatheter embolisation of renal angiomyolipoma.

    LENUS (Irish Health Repository)

    Leong, S

    2010-06-01

    Angiomyolipomas (AML) are rare benign renal tumours which are associated with aneurysms that can cause haemorrhage. Embolisation of AML greater than 4 cm with a variety of embolic agents is now the first-line treatment in these cases.

  20. Renal cell carcinoma in childhood

    International Nuclear Information System (INIS)

    Zanier, J.F.C.; Ramos, C.O.P.; Pereira, A.A.

    1990-01-01

    The authors present five cases of renal cell carcinoma in children, describing its aspects on excretory urography, ultra-sonography and computerized tomography. The clinical, pathological and radiological features are compared with those of the literature. (author)

  1. Antibiotic managment in renal failure.

    Science.gov (United States)

    Winter, R E

    1976-06-01

    This is a brief compilation of the work of many investigators. It includes facts about toxicity and recommendations about antibiotic management in patients with renal failure. As new data are accrued, changes in these recommendations will be necessary.

  2. Bone scintigraphy in renal osteodystrophy

    International Nuclear Information System (INIS)

    de Graaf, P.; Schicht, I.M.; Pauwels, E.K.J.; te Velde, J.; de Graeff, J.

    1978-01-01

    Bone scintigraphy with Tc-99m HEDP was performed in 30 patients on maintenance hemodialysis, and the results of quantitative analysis were compared wth those of a normal group. To permit this comparison, elevated background activity due to the absence of renal radiotracer excretion was reduced by hemodialysis to levels found in the normals. Histologic proof of renal osteodystrophy had been obtained in all patients. the incidence of radiographic abnormalities was 46%, whereas abnormal scans were found in 25 patients (83%); skeletal lesions were also more pronounced and detected earlier. However, even when the scans appeared normal, the quantitative analysis showed increased skeletal activity in all patients. The total skeletal activity proved to be a good index of the severity of renal osteodystrophy and appeared dependent on both osteomalacia and hyperparathyroidism. These findings show that bone scintigraphy is a sensitive method to detect skeletal involvement in renal osteodystrophy

  3. Prolonged Intermittent Renal Replacement Therapy.

    Science.gov (United States)

    Edrees, Fahad; Li, Tingting; Vijayan, Anitha

    2016-05-01

    Prolonged intermittent renal replacement therapy (PIRRT) is becoming an increasingly popular alternative to continuous renal replacement therapy in critically ill patients with acute kidney injury. There are significant practice variations in the provision of PIRRT across institutions, with respect to prescription, technology, and delivery of therapy. Clinical trials have generally demonstrated that PIRRT is non-inferior to continuous renal replacement therapy regarding patient outcomes. PIRRT offers cost-effective renal replacement therapy along with other advantages such as early patient mobilization and decreased nursing time. However, due to lack of standardization of the procedure, PIRRT still poses significant challenges, especially pertaining to appropriate drug dosing. Future guidelines and clinical trials should work toward developing consensus definitions for PIRRT and ensure optimal delivery of therapy. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  4. Mucormycosis (zygomycosis) of renal allograft

    Science.gov (United States)

    Gupta, Krishan L.; Joshi, Kusum; Kohli, Harbir S.; Jha, Vivekanand; Sakhuja, Vinay

    2012-01-01

    Fungal infection is relatively common among renal transplant recipients from developing countries. Mucormycosis, also known as zygomycosis, is one of the most serious fungal infections in these patients. The most common of presentation is rhino-cerebral. Isolated involvement of a renal allograft is very rare. A thorough search of literature and our medical records yielded a total of 24 cases with mucormycosis of the transplanted kidney. There was an association with cytomegalovirus (CMV) infection and anti-rejection treatment in these patients and most of these transplants were performed in the developing countries from unrelated donors. The outcome was very poor with an early mortality in 13 (54.5%) patients. Renal allograft mucormycosis is a relatively rare and potentially fatal complication following renal transplantation. Early diagnosis, graft nephrectomy and appropriate antifungal therapy may result in an improved prognosis for these patients. PMID:26069793

  5. Fibromuscular dysplasia of renal arteries

    International Nuclear Information System (INIS)

    Akhtar, N.; Ahmed, T.M.

    2007-01-01

    This case reports a young child having uncontrolled hypertension, resulting from bilateral renal artery stenosis due to fibromuscular dysplasia presenting with abdominal pain, headache and visual disturbance. Diagnostic features and management is discussed. (author)

  6. Cancer - renal pelvis or ureter

    Science.gov (United States)

    ... ureter; Kidney cancer - renal pelvis; Ureter cancer Images Kidney anatomy References National Cancer Institute website. Transitional cell cancer (kidney/ureter) treatment (PDQ) - health professional version. www.cancer. ...

  7. Radiological evaluation of renal transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Dorph, S [Herlev University Hospital, Copenhagen (Denmark). Dept. of Radiology

    1996-12-31

    Briefly discussed the nephrologic complications, episodes of rejection, acute tubular necrosis, cyclosporine, urologic complications, perirenal fluid collections, small asymptomatic hematomas, urinomas, abscesses, lymphocele, ureteral obstruction, cascular complications, imaging of the renal allograft, radionuclide imaging, ultrasonography, conventional radiography, cystograhy (8 refs.).

  8. Radiological evaluation of renal transplantation

    International Nuclear Information System (INIS)

    Dorph, S.

    1995-01-01

    Briefly discussed the nephrologic complications, episodes of rejection, acute tubular necrosis, cyclosporine, urologic complications, perirenal fluid collections, small asymptomatic hematomas, urinomas, abscesses, lymphocele, ureteral obstruction, cascular complications, imaging of the renal allograft, radionuclide imaging, ultrasonography, conventional radiography, cystograhy (8 refs.)

  9. Inflammation in renal atherosclerotic disease.

    Science.gov (United States)

    Udani, Suneel M; Dieter, Robert S

    2008-07-01

    The study of renal atherosclerotic disease has conventionally focused on the diagnosis and management of renal artery stenosis. With the increased understanding of atherosclerosis as a systemic inflammatory process, there has been increased interest in vascular biology at the microvasculature level. While different organ beds share some features, the inflammation and injury in the microvasculature of the kidney has unique elements as well. Understanding of the pathogenesis yields a better understanding of the clinical manifestations of renal atherosclerotic disease, which can be very subtle. Furthermore, identifying the molecular mechanisms responsible for the progression of kidney damage can also direct clinicians and scientists toward targeted therapies. Existing therapies used to treat atherosclerotic disease in other vascular beds may also play a role in the treatment of renal atherosclerotic disease.

  10. Renal Ammonia Metabolism and Transport

    Science.gov (United States)

    Weiner, I. David; Verlander, Jill W.

    2015-01-01

    Renal ammonia metabolism and transport mediates a central role in acid-base homeostasis. In contrast to most renal solutes, the majority of renal ammonia excretion derives from intrarenal production, not from glomerular filtration. Renal ammoniagenesis predominantly results from glutamine metabolism, which produces 2 NH4+ and 2 HCO3− for each glutamine metabolized. The proximal tubule is the primary site for ammoniagenesis, but there is evidence for ammoniagenesis by most renal epithelial cells. Ammonia produced in the kidney is either excreted into the urine or returned to the systemic circulation through the renal veins. Ammonia excreted in the urine promotes acid excretion; ammonia returned to the systemic circulation is metabolized in the liver in a HCO3−-consuming process, resulting in no net benefit to acid-base homeostasis. Highly regulated ammonia transport by renal epithelial cells determines the proportion of ammonia excreted in the urine versus returned to the systemic circulation. The traditional paradigm of ammonia transport involving passive NH3 diffusion, protonation in the lumen and NH4+ trapping due to an inability to cross plasma membranes is being replaced by the recognition of limited plasma membrane NH3 permeability in combination with the presence of specific NH3-transporting and NH4+-transporting proteins in specific renal epithelial cells. Ammonia production and transport are regulated by a variety of factors, including extracellular pH and K+, and by several hormones, such as mineralocorticoids, glucocorticoids and angiotensin II. This coordinated process of regulated ammonia production and transport is critical for the effective maintenance of acid-base homeostasis. PMID:23720285

  11. Novel genes in renal aging

    OpenAIRE

    Noordmans, Gerda Anke

    2015-01-01

    Renal aging is characterized by structural changes and functional decline. These changes make the elderly more vulnerable to chronic kidney disease, hypertension, and cardiovascular disease. Furthermore, they also make it more difficult to cope with stress factors, such as dehydration, toxicity, and obstruction. These stress factors can lead to acute kidney injury and reduced recovery from acute kidney injury and may result in chronic kidney disease or even end-stage renal disease. The rate o...

  12. Parasites and chronic renal failure

    OpenAIRE

    Mohammadi Manesh, Reza; Hosseini Safa, Ahmad; Sharafi, Seyedeh Maryam; Jafari, Rasool; Bahadoran, Mehran; Yousefi, Morteza; Nasri, Hamid; Yousofi Darani, Hossein

    2014-01-01

    Suppression of the human immune system results in an increase in susceptibility to infection by various infectious agents. Conditions such as AIDS, organ transplantation and chronic renal insufficiency (CRI) are the most important cause of insufficient immune response against infections. Long term renal disorders result in uremia, which can suppress human immune system. Parasitic infections are one of the most important factors indicating the public health problems of the societies. These inf...

  13. CASO AlbAm S.A.

    Directory of Open Access Journals (Sweden)

    Ricardo Goulart Serra

    2015-12-01

    Full Text Available RESUMO Os analistas financeiros da AlbAm, uma empresa do setor de autopeças, devem avaliar duas opções de aquisições (Cardblue e Garciadores. O objetivo do caso é servir de oportunidade para os alunos vivenciarem uma decisão de investimentos por meio do lucro econômico. Uma análise superficial certamente levará a decisão equivocada. Levando-se todos os aspectos do caso em consideração, chegar-se-á a uma solução que pode surpreender alguns alunos, uma vez que a empresa melhor gerida não será a melhor oportunidade de investimento. Também se pode aproveitar o caso para discutir a superficialidade da adoção do EBITDA como métrica de gestão comparativamente a uma métrica de valor agregado (lucro econômico - a melhor solução também não é aquela que gera o maior aumento em EBITDA. O caso pode ser usado em disciplinas de finanças (finanças corporativas ou avaliação de empresas em cursos de graduação, pós-graduação ou especialização. Todas as empresas e pessoas relatadas neste caso são fictícias.

  14. MR Imaging of renal transplants

    International Nuclear Information System (INIS)

    Gremo, L.; Avataneo, T.; Potenzoni, F.; Colla, L.; Segoloni, G.

    1988-01-01

    The authors report their experience in the study of renal transplant recipients by MR, in order to determine its clinical potentials. The main purpose of this work is to focus on MR patterns in relation to clinical findings of rejector or normally fuctioning kidney. Twenty-four patients were examined with a 0.5 T superconductive magnete, body coil, spin-echo pulse sequence (SE) and inversion-recovery (IR). MRI patterns could be seen in normally functioning kidneys and transplant rejections, while variable MRI findings were observed in transplants with acute tubular necrosis (ATN). In the normally functioning transplanted kidney there is a clear corticomedullary differentiation (CMD), and the extent of vascular penetration into the renal parenchyma is clearly seen. In transplant rejection, CMD is either diminished or absent, and there is no vascular penetration into the parenchyma; to differentiate acute from chronic rejections, the increase/decrease in renal size and the change in renal shape (spherical shape in acute transplant rejection) respectively must be observed. MRI proves thus to be useful in the study of renal transplants, even in case of questionable clinical findings, and in patients in whom renal biopsy is contraindicated

  15. Renal transplant scintigraphy (Part 1)

    International Nuclear Information System (INIS)

    Chew, Ghee

    2005-01-01

    Renal transplantation is the most effective mode of renal replacement therapy for correction of renal failure. Renal donors can either be: a. a deceased person - the kidneys being removed when brain death or absence of cerebral cortical function / perfusion is confirmed - the cadaveric kidney is packed in ice and nutrient solution and transplanted within 24 hours of removal ('cold ischemia') ob. a living donor - the donor may or may not be related to the recipient. Due to the limited length of the renal vessels and ureter of the donor kidney, it is implanted close to the bladder of the recipient. The donor vessels are anastomosed to the iliac artery and vein of the recipient. Transplant variants: a. 2 kidneys maybe transplanted because: - an old donor with less kidney reserve from atrophy due to age or disease (e.g. hypertension) - an infant donor when both kidneys are removed en bloc, b. Donor kidneys with more than 1 artery, vein or ureter. c. Donor horse shoe kidney d. Combined renal and pancreas transplant for type I diabetics -a short segment of duodenum transplanted with the pancreas maybe implanted into the bladder. Copyright (2005) The Australian and New Zealand Society of Nuclear Medicine

  16. O desempenho na pré-escola de crianças portadoras de cárie severa - DOI: 10.4025/actascihealthsci.v25i2.2164 School performance of pre-school children with severe caries - DOI: 10.4025/actascihealthsci.v25i2.2164

    Directory of Open Access Journals (Sweden)

    Viviane Colares

    2003-04-01

    Full Text Available O objetivo desta pesquisa foi o de avaliar o desempenho na escola de crianças de quatro anos de idade portadoras de cárie severa. Foram examinadas 101 pré-escolares pertencentes a 4 escolas municipais da cidade do Recife, estado de Pernambuco, Brasil, no ano de 2002. Os exames clínicos foram realizados por 3 pesquisadoras (Kappa inter-examinador = 0,89 e intra-examinador = 0,91, com o objetivo de selecionar crianças livres de cárie (grupo A e portadoras de cárie severa (grupo B, compondo a amostra final de 41 crianças selecionadas A avaliação do desempenho das crianças na escola foi obtida por meio da aplicação de um questionário com as professoras. Verificou-se que o grupo dos alunos livres de cárie apresentou-se, em geral, mais atento às explicações das professoras em sala de aula e com menor dificuldade na realização das tarefas escolares, bem como não apresentaram faltas à escola por motivos relacionados aos dentes, o que não ocorreu com os alunos do grupo B. Quanto à participação oral em sala de aula e a pronúncia das palavras, não se observaram diferenças significativas entre os dois grupos, de acordo com as informações fornecidas pelas professoras. No grupo A, não foi relatado apelido constrangedor relacionado aos dentes, fato que foi verificado em 11% das crianças do grupo B. As professoras consideraram que 22% das crianças portadoras de cárie severa apresentavam prejuízos em suas atividades escolares devido às condições de sua saúde bucal. Concluiu-se que o desempenho das crianças portadoras de cárie severa na escola pode ser prejudicado por sua saúde bucal. Outras pesquisas devem ser desenvolvidas para melhor avaliar o impacto da cárie severa no desempenho da criança na escola.The study evaluated and compared school performance of caries-free and severe caries of 4-year-old children by their teachers’ perception. The selected group consisted of 101 preschoolers from 4 randomly chosen

  17. Aplicación de un programa de ejercicio físico para niños con obesidad infantil severa. [Application of physical exercise program for children with severe obese

    Directory of Open Access Journals (Sweden)

    Antonio García-Hermoso

    2009-12-01

    Full Text Available Resumen La obesidad es una enfermedad compleja y multifactorial que puede iniciarse en la infancia, y se caracteriza por un exceso de grasa corporal que coloca al individuo en una situación de riesgo para la salud. La práctica regular de actividad física/ejercicio físico se ha convertido en uno de los objetivos principales de los planes de salud pública, debido a su relación con la prevención y tratamiento de la obesidad. En población infantil europea, el hábito de ejercicio físico es bajo y disminuye al aumentar la edad. Los objetivos del estudio fueron: (i mostrar la metodología de las sesiones desarrolladas en un programa de ejercicio físico dirigido en niños con obesidad severa, y (ii describir las ventajas e inconvenientes de las sesiones desarrolladas en el día a día con esta población. Las conclusiones que se pueden extraer de este trabajo son: (a en esta población resulta importante plantear actividades cooperativas, en el que todos tengan posibilidades de participar independientemente de sus características y habilidades individuales y (b en ocasiones y debido a la heterogeneidad observada durante las sesiones, es importante plantear y establecer varias actividades paralelas, aunando más si cabe las motivaciones y gustos de los participantes. Palabras clave: juego, actividad física, habilidad, cooperación. Abstract Obesity is a complex multifactorial disease that can begin in childhood, and is characterized by excess body fat that puts the individual's health at risk.  The regular practice of physical activity / physical exercise has become one of the main objectives of public health plans due to its relationship with the prevention and treatment of obesity.  In the European child population, the habit of physical activity is low and decreases with increasing age.  The objectives of the study were: (i to show "type sessions" used in physical exercise program in targeted at children with severe obesity, and (ii to

  18. Aplicación de un programa de ejercicio físico para niños con obesidad infantil severa. [Application of physical exercise program for children with severe obese

    Directory of Open Access Journals (Sweden)

    Antonio García-Hermoso

    2009-12-01

    Full Text Available Resumen La obesidad es una enfermedad compleja y multifactorial que puede iniciarse en la infancia, y se caracteriza por un exceso de grasa corporal que coloca al individuo en una situación de riesgo para la salud. La práctica regular de actividad física/ejercicio físico se ha convertido en uno de los objetivos principales de los planes de salud pública, debido a su relación con la prevención y tratamiento de la obesidad. En población infantil europea, el hábito de ejercicio físico es bajo y disminuye al aumentar la edad. Los objetivos del estudio fueron: (i mostrar la metodología de las sesiones desarrolladas en un programa de ejercicio físico dirigido en niños con obesidad severa, y (ii describir las ventajas e inconvenientes de las sesiones desarrolladas en el día a día con esta población. Las conclusiones que se pueden extraer de este trabajo son: (a en esta población resulta importante plantear actividades cooperativas, en el que todos tengan posibilidades de participar independientemente de sus características y habilidades individuales y (b en ocasiones y debido a la heterogeneidad observada durante las sesiones, es importante plantear y establecer varias actividades paralelas, aunando más si cabe las motivaciones y gustos de los participantes. Palabras clave: juego, actividad física, habilidad, cooperación. Abstract Obesity is a complex multifactorial disease that can begin in childhood, and is characterized by excess body fat that puts the individual's health at risk.  The regular practice of physical activity / physical exercise has become one of the main objectives of public health plans due to its relationship with the prevention and treatment of obesity.  In the European child population, the habit of physical activity is low and decreases with increasing age.  The objectives of the study were: (i to show "type sessions" used in physical exercise program in targeted at children with severe obesity, and (ii to

  19. Hallazgos electroencefalográficos e hipoglucemia severa en niños con diabetes mellitus tipo 1 Electroencephalographic findings and severe hypoglycemia in children with type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Pedro González Fernández

    2003-08-01

    Full Text Available Los episodios de hipoglucemia severa (HS constituyen un riesgo por ocasionar alteraciones de la función cerebral y del trazado electroencefalográfico (EEG en pacientes con diabetes. El presente estudio tiene como objetivo determinar la frecuencia de alteraciones del EEG después del diagnóstico de diabetes en un grupo de niños y su posible relación con HS, edad, control metabólico y tiempo de evolución de la diabetes. Se estudiaron retrospectivamente 40 niños con edades comprendidas entre 1 y 17 años (media de 12 años con diagnóstico de diabetes mellitus tipo 1 atendidos en el servicio de endocrinología del Hospital Pediátrico Docente "William Soler", en el período comprendido entre abril de 1990 y abril de 1998. Se tomaron los resultados de la hemoglobina glucosilada, así como los episodios referidos de HS. Se realizó EEG al diagnóstico de la diabetes y anualmente. Se clasificaron los EEG anormales de acuerdo con el tipo de trazado. Se encontraron EEG anormales en aproximadamente la mitad de los pacientes (45 % con predominio del trazado con descargas focales, los que fueron significativamente mayor en los pacientes con 2 ó más HS y con una edad menor al diagnóstico de la diabetes. No se encontró relación entre el EEG anormal y el control metabólico ni con el tiempo de evolución de la diabetes. La frecuencia hallada en este estudio enfatiza la importancia de realizar EEG al diagnóstico de DM y posteriormente, sobre todo en aquellos pacientes con HS y edad menor de 6 años.Episodes of severe hypoglycemia (SH constitute a risk because it causes brain function and electroencephalographic recording (EEG disturbances in patients with diabetes. This study was aimed at determining the frequency of EEG alterations after the diagnosis of diabetes in a group of children and their possible relation with SH, age, metabolic control and progression of diabetes. Forty children aged 1 to 17 years (average 12 years diagnosed with type 1

  20. Changes in renal function after discontinuation of vitamin D analogues in advanced chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Francisco Caravaca

    2018-03-01

    mainly associated with baseline total serum calcium. Resumen: Antecedentes: En la práctica clínica habitual la prescripción de análogos de vitamina D (AVD en la enfermedad renal crónica (ERC se asocia con frecuencia a un descenso de la función renal estimada cuyo origen no es bien conocido. Objetivos: Analizar el efecto de la suspensión de un tratamiento previo con AVD en ERC avanzada, y determinar los factores asociados con los cambios de función renal. Material y métodos: Estudio de cohorte retrospectivo en pacientes adultos incidentes con ERC avanzada. El subgrupo caso estaba siendo tratado con AVD y esta medicación fue suspendida en la primera visita. El subgrupo control no había sido tratado con AVD y fueron elegidos por criterios de coincidencia para datos relevantes relacionados con la progresión de la ERC. La variable de resultado principal fue el cambio de filtrado glomerular, tanto el estimado (FG-MDRD como el medido (media del aclaramiento de creatinina y urea, con respecto al siguiente control analítico. Parámetros basales relacionados con el metabolismo mineral y la generación de creatinina fueron analizados como determinantes potenciales de los cambios de la función renal. Resultados: Se incluyeron 67 pacientes casos y otros 67 controles. El 67% de los casos mejoró la función renal, mientras que el 72% de los controles empeoró (p < 0,0001. El cambio FG-MDRD en casos y controles fue +0,455 ± 0,997 vs. −0,436 ± 1,103 ml/min/1,73 m2/mes (p < 0,0001, respectivamente. La excreción total de creatinina era ligeramente superior en los casos, pero la diferencia con respecto a los controles no fue significativa.Por regresión logística y lineal multivariante, el calcio sérico total basal fue uno de los principales determinantes tanto de la recuperación de la función renal (odds ratio = 3,49; p = 0,001, como de la magnitud de esta recuperaci

  1. Astragalectomía. Evaluación funcional y radiográfica. Reporte de 5 casos. [Talectomy. Functional and radiographic evaluation. Report of 5 cases

    Directory of Open Access Journals (Sweden)

    Ruben David Radkievich

    2015-11-01

    Full Text Available Objetivos Analizar las indicaciones de la astragalectomía y evaluar resultados radiográficos y funcionales de la técnica en cuatro pacientes. Materiales y Métodos Se evaluaron funcional (Score AOFAS y radiológicamente (Rx y RMI 5 astragalectomías en 4 pacientes con diferentes etiologías. Caso 1 y 4 osteonecrosis infectada secundario a fracturas expuestas de astrágalo, caso 2 osteonecrosis asociada a equino varo y retropié rígido, secuela de fractura expuesta grave de tibia y caso 3, equino varo y retropié rígido neurológico bilateral .Todos los  pacientes del sexo masculino. Edad promedio 32.5 años (19 a 56. Abordaje anteroexterno en pié y tobillo .Astragalectomía y fijación en posición de corrección con 2 clavos de Steinmann de3 mm. Tenotomía del Aquiles u otros procedimientos según necesidad. Resultados Seguimiento de 38 meses (15 A 84, sin signos de osteoartrosis, o signos leves y sin dolor. Score AOFAS de 81,4 puntos (prequirúrgico de 17, una discrepancia de longitud del miembro inferior de2 cm, y un rango de flexo-extensión de 18° en promedio (variancia entre 10° y 45°. Dos varo leves del retropié y tres alineaciones neutras asintomáticos. Conclusión Se observa una buena correlación entre la sintomatología de los pacientes, la alineación adecuada y los escasos signos imagenológicos de artrosis tibiocalcánea o en el resto del pié. Ante la imposibilidad técnica de artrodesis o artroplastía de tobillo como método de tratamiento, la astragalectomía es un método de salvataje para pacientes con deformidades muy severas, o déficit de stock óseo e infecciones recalcitrantes de la articulación del tobillo.

  2. Nueva indicación de implantes cigomáticos para la rehabilitación fija de desdentados parciales: reporte de un caso A new indication for Zygomatic implants for the fixed rehabilitation of the partially edentulous patient: Case report

    Directory of Open Access Journals (Sweden)

    M.F. Pintor Willcock

    2007-08-01

    Full Text Available Los implantes cigomáticos están indicados en casos de reabsorciones maxilares severas. Esto permitiría eliminar la necesidad de injertos óseos o levantamientos de seno de manera de recuperar el volumen óseo necesario para rehabilitar en base a implantes convencionales, disminuyendo así la morbilidad y el tiempo de tratamiento. A continuación presentamos caso de paciente desdentado parcial superior, clase I de Kennedy, en el cual se utilizaron dos implantes cigomáticos a cada lado, emergiendo sobre el reborde, a través de una modificación de la técnica.Zygomatic Implants are used in the rehabilitation of severely resorbed maxillas. This eliminates the necessity of bone grafting or sinus augmentation to restore the osseous volume necessary for conventional implant rehabilitation. This also minimizes morbidity and treatment times. We present the case of a patient with a partially edentulous upper ridge, Kennedy class I, in whom two zygomatic implants were placed in each side, that emerged over the alveolar ridge crest as a result of a technique modification.

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

    Science.gov (United States)

    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.

  4. Sarcoma de Kaposi en un adulto con trasplante renal Kaposi's sarcoma in an adult with renal transplantation

    Directory of Open Access Journals (Sweden)

    Enrique Emilio Jiménez López

    2010-07-01

    Full Text Available Se presenta el caso clínico de un paciente con trasplante renal, atendido en el Hospital Provincial Docente "Saturnino Lora Torres" de Santiago de Cuba, que a los 12 meses de operado comenzó a presentar lesiones eritematosas en la piel. Los resultados de los exámenes complementarios, incluida la biopsia, confirmaron que se trataba de un sarcoma de Kaposi. El afectado egresó y continuó su seguimiento por consulta externa. A los 3 meses, la dermatopatía había desaparecido totalmente y disminuido a 50 % el índice de filtración glomerular.The case report of a patient with renal transplantion, attended in the «Saturnino Lora Torres» Teaching Provincial Hospital from Santiago de Cuba who, after 12 months of his surgery, began to present erythematous lesions in the skin is presented. The results of the additional tests, including the biopsy, confirmed that it was a Kaposi's sarcoma. He was discharged and continued his follow up through the out patient department. After 3 months, the dermatopathy had totally disappeared and the glomerular filtration index decreased to 50%.

  5. Dioctophyma renale in maned wolf in the geoeconomic region of Jatai, GO, Brazil - Case report

    OpenAIRE

    Valcinir Aloisio Scalla Vulcani; Vanessa Sobue Franzo; Diego Pereira de Araújo; Felipen Roncatto Vicenti; Otávio Marins da Costa; Aynna Silva Rangel; Luanna Alves Gomes

    2015-01-01

    ABSTRACT. Vulcani V.A.S., Franzo V.S., de Araújo D.P., Vicentin F.R., da Costa O.M., Rangel A.S. & Gomes L.A. [Dioctophyma renale in maned wolf in the geoeconomic region of Jatai, GO, Brazil - Case report.] Dioctophyma renale em Lobo-Guará na região geoeconômica de Jataí, GO, Brasil - Relato de caso. Revista Brasileira de Medicina Veterinária, 37(2):149-152, 2015. Laboratório de Anatomia, Curso de Medicina Veterinária, Universidade Federal de Goiás, Campus de Jataí, BR 364 Km 192, 3800, Setor...

  6. Reemplazo renal continuo en eclampsia y síndrome de HELLP. Reporte de un caso

    Directory of Open Access Journals (Sweden)

    L.A. Ramírez Palacios

    2017-03-01

    Conclusiones: El uso de TRRC es novedoso en pacientes embarazadas o puérperas que desarrollan LRA, coexistiendo con sobrecarga de líquidos en presencia de anuria e inestabilidad hemodinámica, incrementado la morbimortalidad materna.

  7. 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.

  8. Renal manifestations in children with Alagille syndrome.

    Science.gov (United States)

    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.

  9. 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.

  10. 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.

  11. Pielonefritis xantogranulomatosa en la infancia: A propósito de un caso

    OpenAIRE

    González Resina, R.; Barrero Candau, R.; Argüelles Salido, E.; Campoy Martínez, P.; Rodríguez Pérez, A.; Pérez Pérez, M.

    2005-01-01

    La pielonefritis xantogranulomatosa es una rara inflamación crónica del parénquima renal. Predomina en mujeres de edad media y es extremadamente rara en niños. Presentamos el caso de una niña de 4 años de edad, con infecciones del tracto urinario de repetición y mala respuesta a tratamiento médico. La paciente tenía retraso pondo-estatural y una masa en hemiabdomen izquierdo a la exploración y en las pruebas de imagen. Se realizó heminefrectomía superior izquierda, con posterior confirmación ...

  12. 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

  13. 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)

  14. CT imaging spectrum of infiltrative renal diseases.

    Science.gov (United States)

    Ballard, David H; De Alba, Luis; Migliaro, Matias; Previgliano, Carlos H; Sangster, Guillermo P

    2017-11-01

    Most renal lesions replace the renal parenchyma as a focal space-occupying mass with borders distinguishing the mass from normal parenchyma. However, some renal lesions exhibit interstitial infiltration-a process that permeates the renal parenchyma by using the normal renal architecture for growth. These infiltrative lesions frequently show nonspecific patterns that lead to little or no contour deformity and have ill-defined borders on CT, making detection and diagnosis challenging. The purpose of this pictorial essay is to describe the CT imaging findings of various conditions that may manifest as infiltrative renal lesions.

  15. 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

  16. Hyperhomocyst(einemia in chronic stable renal transplant patients

    Directory of Open Access Journals (Sweden)

    David José de Barros Machado

    2000-10-01

    prednisona; grupo III (n=7 doadores de rim para pacientes dos grupos I e II, constituíram o grupo controle. O nível sérico de creatinina e o clearance estimado de creatinina, o nível sérico de ciclosporina, o perfil de lipídeos, a concentração de ácido fólico e vitamina B12 e as características clínicas dos indivíduos foram avaliados na procura de determinantes da homocisteinemia. A concentração sérica de homocisteína foi medida através da cromatografia de alta resolução e a concentração de ácido fólico e vitamina B12 por radio-imunoensaio. RESULTADOS: Os pacientes tinham 48.8 ± 15.1 aa e 43.3 ± 11.3 aa respectivamente, nos grupos I e II e os doadores 46.5 ± 14.8 aa. A homocisteinemia sérica média dos pacientes transplantados renais foi de 18.07 ± 8.29 mmol/l. No grupo de pacientes em uso de ciclosporina foi de 16.55 ± 5.6 mmol/l e no grupo sem ciclosporina foi de 21.44 ± 12.1 mmol/l (NS. No grupo de doadores foi significativamente menor (9.07 ± 3.06 mmol/l; grupo I + grupo II vs. grupo III, p<0.008, não tendo sido encontrado nenhum caso de hiper-homocisteinemia. Houve correlação entre idade (r=0.427; p<0.005, peso corpóreo (r=0.412; p<0.05, creatinina sérica (r=0.427; p<0.05, clearance estimado de creatinina (r=0.316; p<0.10 e tHcy nos pacientes transplantados renais. Porém no modelo de regressão múltipla, só foram significativos idade (coeficiente = 0.253; p=0.009 e creatinina sérica (coeficiente =8.07; p=0.045. No grupo de transplantados renais encontramos 38% de casos com hiper-homocist(einemia sendo sete casos (35% do grupo I e quatro casos (45% do grupo II, baseado nos níveis séricos normais. CONCLUSÕES: Os pacientes transplantados renais apresentam hiper-homocisteinemia independente do esquema de imunossupressão que estejam utilizando. A hiper-homocisteinemia após o transplante renal tem como determinantes a idade do receptor e o seu nível de creatinina sérica.

  17. 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

  18. [Renal hemorrhage after ESWL: From small hematoma to renal blowout].

    Science.gov (United States)

    Panach-Navarrete, Jorge; Palmero Martí, Jose Luis; Ganau Ituren, Amparo; Pastor Lence, Juan Carlos; Benedicto Redón, Antonio

    2016-04-01

    To report two cases of renal hemorrhage after extracorporeal shock wave lithotripsy (ESWL) and their therapeutic management. Description of the clinical cases, together with the diagnosis and therapeutic management of these complications. We present two cases of patients with renal hemorrhage after ESWL, which were performed without immediate complications. One of the cases, after detecting an important laceration of the renal parenchyma, needed two embolization sessions for its short-term resolution; however, the patient finally passed away due to the complications derived from hemorrhage. The other case was solved through conservative management. Even though hemorrhage is an infrequent complication after ESWL, it should be suspected when the patient presents compatible clinical symptoms, since even though most cases are resolved in a conservative manner, on some occasions specific treatments for the hemorrhage are necessary. Old age and the presence of vascular comorbidities seem to be related to a higher risk of hemorrhage after ESWL.

  19. 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.

  20. Acute renal failure in rats

    International Nuclear Information System (INIS)

    Cederholm, C.; Almen, T.; Bergquist, D.; Golman, K.; Takolander, R.; Malmoe Allmaenna Sjukhus

    1989-01-01

    It was demonstrated in rats that renal injury which follows transient renal hypoxia is potentiated by the contrast media metrizoate, ioxaglate, iopamidol and iohexol. Intravenous injection of 1 g I/kg of all four media alone to 82 rats caused no significant increase in serum urea 1, 3 and 7 days later. The percentage increase of serum urea is given in median values and interquartile range (in parentheses). Bilateral renal arterial occlusion alone for 40 minutes in 42 rats increased serum urea one day later by 40% (20-130). Intravenous injection of the media followed in one hour by bilateral renal arterial occlusion for 40 minutes in 104 rats caused serum urea to increase one day later by 130% (70-350) after metrizoate, by 220% (50-380) after ioxaglate, by 290 % (60-420) after iopamidol and by 160% (50-330) after iohexol. There were no significant differences between the potentiating effects of the various media on ischemic renal failure. (orig.)

  1. Paralisia periodica tireotoxica: registro de um caso

    Directory of Open Access Journals (Sweden)

    Athos Scherer Torres

    1979-06-01

    Full Text Available É relatado um caso de paralisia periódica tireotóxica. Os autores chamam a atenção para o fato de não haver registro de publicações semelhantes na literatura brasileira nos 10 últimos anos. São abordados diversos aspectos do diagnóstico diferencial com outros tipos de paralisia periódica.

  2. Picnodistosis: El caso de Toulouse-Lautrec

    Directory of Open Access Journals (Sweden)

    Gabriel Alcalá-Cerra

    2006-01-01

    Full Text Available El pintor francés Henri de Toulouse-Lautrec fue el primer caso de picnodisostosis reconocido a nivel mundial. En este texto se analizan las distintas manifestaciones de la picnodisostosis y se hace énfasis en las que el artista presentó y se detallan desde el punto de vista que brindan los conocimientos surgidos a través del tiempo sobre la fisiopatología de esta enfermedad.

  3. Micetoma por Nocardia brasiliensis: reporte de caso

    Directory of Open Access Journals (Sweden)

    Miriam Guevara R

    2003-07-01

    Full Text Available Se presenta el caso de un paciente peruano, agricultor, con una infección cutánea de origen traumático causada por Nocardia brasiliensis, que evolucionó hacia la amputación del miembro inferior afectado. El diagnóstico se realizó por examen directo y cultivo del espécimen.

  4. Distrofia neuroaxonal infantil: relato de dois casos

    Directory of Open Access Journals (Sweden)

    SCOLA ROSANA HERMINIA

    1999-01-01

    Full Text Available Descrevemos dois casos de distrofia neuroaxonal infantil ou doença de Seitelberger, que é doença rara, neurodegenerativa, com herança autossômica recessiva. O primeiro caso, sexo masculino, com 8 anos de idade, apresentava atraso do desenvolvimento psicomotor, ataxia e fraqueza muscular. Ao exame físico foi encontrado nistagmo horizontal e vertical com palidez do disco óptico, hipotonia e arreflexia profunda. O segundo caso, sexo masculino, com 1 ano e 6 meses de idade, apresentava atraso do desenvolvimento psicomotor e convulsões. No exame físico, apresentava atrofia de nervo óptico, hipertonia e hiperreflexia. A biópsia de nervo sural de ambos os pacientes mostrou aumento dos axônios, compatível com distrofia neuroaxonal. As características clínicas pleomórficas, bem como os achados neurofisiológicos variáveis tornam difícil firmar o diagnóstico, o qual é ajudado pela confirmação anatomopatológica dos esferóides neuroaxonais.

  5. Anemia aplástica severa: análise dos pacientes pediátricos atendidos pelo serviço de transplante de medula óssea do Hospital de Clínicas de Curitiba no período de 1979-1993

    Directory of Open Access Journals (Sweden)

    FONSECA TERESA CRISTINA CARDOSO

    2002-01-01

    Full Text Available A anemia aplástica severa é uma doença rara que acomete pessoas de todas as regiões do mundo. Devido a sua raridade, existem dificuldades em se caracterizar o perfil dos pacientes acometidos pela doença, assim como identificar possíveis fatores implicados na sua etiologia. OBJETIVO: Descrever o perfil dos pacientes pediátricos atendidos com anemia aplástica severa, analisando variáveis como distribuição de idade, sexo, local de habitação, etiologia e nível socioeconômico. MÉTODOS: FOI realizada uma análise descritiva das características encontradas em todos os pacientes com idade inferior a 18 anos, encaminhados no período de 1979-1993 com diagnóstico da doença, conforme classificação proposta por Camitta et al. As informações foram obtidas através do prontuário médico e de um questionário aplicado pela pesquisadora em 79 das 134 famílias. RESULTADOS: A média das idades foi de 10,89 anos. Houve leve predominância do sexo feminino. A maioria dos pacientes residia na zona urbana da região sul do país. 34% das famílias não identificaram um fator causal. Os pesticidas agrícolas e os derivados de benzeno foram os fatores causais mais relatados no questionário. Das 79 famílias que responderam ao questionário, 83,5% tinham renda familiar inferior a 1 salário mínimo " per capita" e 70,9% das mães tinham nível de escolaridade inferior o primeiro grau completo. CONCLUSÃO: O perfil da população pediátrica com anemia aplástica severa atendida no Serviço de Transplante de Medula Óssea de Curitiba é formado predominantemente por crianças de 11 anos, do sexo feminino, provenientes da zona urbana da região sul do país, com baixo nível socioeconômico, que relataram os pesticidas agrícolas e derivados de benzeno como possíveis fatores etiológicos.

  6. Massive postpartum right renal hemorrhage.

    Science.gov (United States)

    Kiracofe, H L; Peterson, N

    1975-06-01

    All reported cases of massive postpartum right renal hemorrhage have involved healthy young primigravidas and blacks have predominated (4 of 7 women). Coagulopathies and underlying renal disease have been absent. Hematuria was painless in 5 of 8 cases. Hemorrhage began within 24 hours in 1 case, within 48 hours in 4 cases and 4 days post partum in 3 cases. Our first case is the only report in which hemorrhage has occurred in a primipara. Failure of closure or reopening of pyelovenous channels is suggested as the pathogenesis. The hemorrhage has been self-limiting, requiring no more than 1,500 cc whole blood replacement. Bleeding should stop spontaneously, and rapid renal pelvic clot lysis should follow with maintenance of adequate urine output and Foley catheter bladder decompression. To date surgical intervention has not been necessary.

  7. Renal Myxoma, an Incidental Finding

    Directory of Open Access Journals (Sweden)

    Parth Thakker

    2017-07-01

    Full Text Available Myxomas are mesenchymal tumors commonly found in the heart and skin. Renal myxomas are rare, having only been documented 14 times. Our case is a 55-year-old woman who presented to our clinic after a right renal mass was incidentally found on CT. Evaluation with MRI showed a mass that appeared to arise from the supero-medial cortex of the right kidney. As the imaging was concerning for renal cell carcinoma, the patient underwent a partial nephrectomy. Microscopic examination showed a well-circumscribed mass with polygonal to spindle-shaped cells in a granular eosinophilic cytoplasm. Immunohistochemical staining for CD-10, Desmin, HMB-45, and Pankeratin were negative.

  8. Renal diseases in AIDS patients

    OpenAIRE

    Álvarez Escobar, María del Carmen; Alfonso de León, José Alberto; Lima Gutiérrez, Héctor; Torres Álvarez, Armella; Torres Álvarez, Arling Yuliett

    2009-01-01

    La afectación renal en el SIDA es un tema poco abordado a pesar de su frecuencia, la misma depende de la acción directa e indirecta del virus, así como de las complicaciones y del tratamiento. La más frecuente de las complicaciones es la Insuficiencia Renal Aguda. La forma más típica de nefropatía asociada al VIH (NAVIH) se caracteriza por alto grado de proteinuria con progresión rápida a Insuficiencia Renal Terminal. En el SIDA se presentan diversas formas de glomerulopatías cuya expresión c...

  9. CT of the renal infarction

    International Nuclear Information System (INIS)

    Tazawa, Satoru; Ito, Hisao; Tange, Isamu

    1984-01-01

    We have five cases of the global renal infarction, four of which resulted from post-transarterial embolization(TAE) of the hypernephroma, the remaining one was probably caused by the cardiac disease. Generally speaking, CE-CT is useful for the diagnosis of the acute renal infarction, because the ''rim sign'' which represents viable subcapsular parenchyma is helpful for the diagnosis. It seems that band-like enhancement from the renal sinus to the periphery in the low-attenuation-parenchyma on CE-CT, named as ''band sign'', is useful for the diagnosis. ''Band sign'' may also be valuable for distinguishing the neoplastic area from the non-neoplastic one after TAE of the hypernephroma. (author)

  10. Radiologic observation of renal tuberculosis

    International Nuclear Information System (INIS)

    Kim, S. W.; Ra, Y. W.; Kim, Y. J.

    1981-01-01

    Radiographic findings of thirty eight cases of renal tuberculosis treated at this hospital during last 4 years were analysed with following results. The cases examined were 24 male and 14 female patients. Age distribution was broad and evenly distributed ranging from 2nd decades to 5th decades. Main symptoms complained were urinary frequency, hematuria, dysuria and flank pain. Findings of physical examination revealed tenderness of costovertebral angle, palpable mass on flank area and epididymal indutration. The simple chest films showed pulmonary tuberculosis in 22 cases including 6 cases of active military type. Thirty one cases showed increased ESR, 8 cases showed AFB positive in urine and 12 cases showed bilateral renal tuberculosis. Through urographic findings nonvisualization, cyceopelviectasis, motheaten appearance of minor calyx, contracted bladder, delayed visualization, ureteral stricture and beading were observed in order of frequency. Five cases with miliary tuberculosis showed advanced renal lesion on urogram

  11. Renal replacement therapy in Europe

    DEFF Research Database (Denmark)

    Noordzij, Marlies; Kramer, Anneke; Abad Diez, José M

    2014-01-01

    the Mediterranean Sea were used. From 27 registries, individual patient data were received, whereas 17 registries contributed data in aggregated form. We present the incidence and prevalence of RRT, and renal transplant rates in 2011. In addition, survival probabilities and expected remaining lifetimes were....... The overall unadjusted prevalence of RRT for ESRD on 31 December 2011 was 692 pmp (n = 425 824). The highest prevalence was reported by Portugal (1662 pmp) and the lowest by Ukraine (131 pmp). Among all registries, a total of 22 814 renal transplantations were performed (37 pmp). The highest overall.......6-47.0], and on dialysis 39.3% (95% CI 39.2-39.4). The unadjusted 5-year patient survival after the first renal transplantation performed between 2002 and 2006 was 86.7% (95% CI 86.2-87.2) for kidneys from deceased donors and 94.3% (95% CI 93.6-95.0) for kidneys from living donors....

  12. 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)

  13. Drugs Approved for Kidney (Renal Cell) Cancer

    Science.gov (United States)

    ... Your Treatment Research Drugs Approved for Kidney (Renal Cell) Cancer This page lists cancer drugs approved by the ... not listed here. Drugs Approved for Kidney (Renal Cell) Cancer Afinitor (Everolimus) Aldesleukin Avastin (Bevacizumab) Axitinib Bevacizumab Cabometyx ( ...

  14. 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

  15. 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

  16. 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....

  17. Bumetanide kinetics in renal failure

    International Nuclear Information System (INIS)

    Pentikaeinen, P.J.P.; Pasternack, A.; Lampainen, E.; Neuvonen, P.J.; Penttilae, A.

    1985-01-01

    To study the effects of renal failure on bumetanide kinetics, the authors administered single intravenous doses of 1.0 mg/3.08 microCi 14 C-bumetanide to six healthy subjects and 22 patients with variable degrees of renal failure. The kinetics of 14 C-bumetanide and total 14 C were adequately described by a two-compartment open model in the control subjects and in the patients. The volume of the central compartment and the distribution t1/2 were of the same order in both groups, whereas the mean (+/- SE) volume at steady state was larger (22.1 +/- 1.6 and 16.9 +/- 1.0 L) and the elimination t1/2 was longer (1.9 +/- 0.2 and 1.4 +/- 0.1 hours) in patients with renal failure than in healthy controls. Bumetanide renal clearance was lower (10 +/- 3 and 90 +/- 13 ml/min) in patients than in subjects and correlated with creatinine clearance (r = 0.784) and log serum creatinine level (r = -0.843), whereas nonrenal clearance was significantly higher in the patients (153 +/- 14 and 99 +/- 6 ml/min). Bumetanide total plasma clearance did not significantly change. The non-protein-bound, free fraction of bumetanide was higher in patients and correlated with plasma albumin levels (r = -0.777). The kinetics of total 14 C showed similar but greater changes than those of 14C-bumetanide. Thus the most important changes in bumetanide kinetics in patients with renal failure are low renal clearance and a high free fraction, with a consequent increase in nonrenal clearance, volume of distribution, and elimination t1/2

  18. Molecular mechanisms of renal aging.

    Science.gov (United States)

    Schmitt, Roland; Melk, Anette

    2017-09-01

    Epidemiologic, clinical, and molecular evidence suggest that aging is a major contributor to the increasing incidence of acute kidney injury and chronic kidney disease. The aging kidney undergoes complex changes that predispose to renal pathology. The underlying molecular mechanisms could be the target of therapeutic strategies in the future. Here, we summarize recent insight into cellular and molecular processes that have been shown to contribute to the renal aging phenotype.The main clinical finding of renal aging is the decrease in glomerular filtration rate, and its structural correlate is the loss of functioning nephrons. Mechanistically, this has been linked to different processes, such as podocyte hypertrophy, glomerulosclerosis, tubular atrophy, and gradual microvascular rarefaction. Renal functional recovery after an episode of acute kidney injury is significantly worse in elderly patients. This decreased regenerative potential, which is a hallmark of the aging process, may be caused by cellular senescence. Accumulation of senescent cells could explain insufficient repair and functional loss, a view that has been strengthened by recent studies showing that removal of senescent cells results in attenuation of renal aging. Other potential mechanisms are alterations in autophagy as an important component of a disturbed renal stress response and functional differences in the inflammatory system. Promising therapeutic measures to counteract these age-related problems include mimetics of caloric restriction, pharmacologic renin-angiotensin-aldosterone system inhibition, and novel strategies of senotherapy with the goal of reducing the number of senescent cells to decrease aging-related disease in the kidney. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  19. Renal dysplasia in a Rhodesian Ridgeback dog

    International Nuclear Information System (INIS)

    Lobetti, R.G.; Pearson, J.; Jimenez, M.

    1996-01-01

    A six-month-old Rhodesian ridgeback dog was presented for evaluation of facial swelling. Chronic renal failure was clinically diagnosed based on urinalysis, biochemical changes and ultrasonography. The facial swelling was due to fibrous osteodystrophy, which was evident on survey radiographs of the skull. On post mortem examination, chronic renal failure as a result of renal dysplasia was confirmed. This is the first reported case of renal dysplasia in this breed of dog

  20. 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

  1. 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)

  2. 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....

  3. Sonographic findings of renal tuberculosis

    International Nuclear Information System (INIS)

    Yoon, Chong Hyun; Lee, Chang Joon; Kim, Seung Hyun

    1990-01-01

    In order to determine sonographic characteristic of renal tuberculosis, we retrospectively collected 27 cases during a 5 year period. Infected kidneys showed large size (52%) and lobulating contour (76%). In 19 cases of increased parenchymal echogenicity, most of them (16 cases) showed decreased parenchymal thickness. We divided hydronephrotic patterns into 4 categories; predominant calyceal dilatation with mild or no pelvic dilatation (67%), focal calyectasis without pelvic dilation (15%), parenchymal cavitation without hydronephrosis (11%) and proportional hydronephrosis with calyceal deformity (7%). Our findings suggest that disproportional hydronephrosis would be the characteristic finding of renal tuberculosis

  4. Pseudoaneurisma de artéria ilíaca comum como complicação de cirurgia para hérnia discal lombar: relato de caso

    Directory of Open Access Journals (Sweden)

    HANEL RICARDO A.

    1999-01-01

    Full Text Available A cirurgia para tratamento da doença discal lombo-sacra pode cursar com complicações severas, iatrogênicas incluindo-se as neurológicas, vasculares, entéricas, ureterais e disfunção sexual podendo levar o paciente à morte dependendo da extensão da lesão. Abramovitz relata que as complicações vasculares do acesso posterior para o tratamento hérnia discal lombo-sacra ocorrem em menos de 0,1% dos casos As lesões vasculares podem manifestar-se de maneira imediata como hemorragia arterial levando a choque hipovolêmico no per ou pós-operatório imediato, devendo ser diagnosticadas e tratadas prontamente. Sinais precoces de hemorragia retroperitoneal se manifestam na vigência de lesões traumáticas, sendo os pseudoaneurismas e as fístulas arteriovenosas diagnosticados tardiamente, semanas ou mesmo após anos. Descrevemos o caso de uma paciente de 39 anos que foi submetida a tratamento cirúrgico de hérnia discal no espaço L4-L5, à direita, em outro serviço. Devido ao fato de persistirem os sintomas dolorosos, foi encaminhada ao nosso serviço. Na investigação a ressonância magnética mostrou lesão paravertebral sugestiva de abscesso. A angiografia aorto-ilíaca revelou a presença de pseudoaneurisma na artéria ilíaca comum esquerda, o qual foi reparado cirurgicamente com sucesso. Discutimos os mecanismos das lesões vasculares e as precauções para evitá-las.

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

    Science.gov (United States)

    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.

  6. Salvageability of renal function following renal revascularisation in ...

    African Journals Online (AJOL)

    reported on the outcome of hypertension in a cohort of patients with Takayasu's ... Against Rheumatism/Paediatric Rheumatology European Society ... Association guidelines for reporting of renal artery revascularisation .... reversing the dialysis dependence of 2 of the 3 patients who were .... Clinical Practice Guidelines.

  7. Maternal drugs and neonatal renal failure

    Directory of Open Access Journals (Sweden)

    M Sahay

    2014-01-01

    Full Text Available Maternal use of drugs during pregnancy may cause irreversible renal failure in the newborn. This report highlights the adverse effect of telmisartan during the last trimester of pregnancy. The neonate presented with oliguric renal failure and the renal histology showed proximal tubular dysgenesis.

  8. Hypogonadism and renal failure: An update.

    Science.gov (United States)

    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.

  9. Relationship Between Adult Renal Dimensions and Biometric ...

    African Journals Online (AJOL)

    We measured renal dimensions sonographically and correlated the values obtained with some anthropometric parameters in order to identify the best estimate of renal size in a clinical setting. The renal dimensions of 200 adult subjects referred for abdomino-pelvic scan at University of Nigeria Teaching Hospital, Enugu ...

  10. Protein restriction in chronic renal failure

    NARCIS (Netherlands)

    ECHTEN, JEKT; NAUTA, J; HOP, WCJ; de Jong, MCJ; REITSMABIERENS, WCC; VANAMSTEL, SLBP; VANACKER, KJ; NOORDZIJ, CM; WOLFF, ED

    The aim of the study was to investigate the effect of a protein restricted diet on renal function and growth of children with chronic renal failure. In a multicentre prospective study 56 children (aged 2-18 years) with chronic renal failure were randomly assigned to the protein restricted (0.8-1.1

  11. Primary Renal Carcinoid - A Case Report

    LENUS (Irish Health Repository)

    O’Sullivan, M

    2018-01-01

    Carcinoid tumours in the abdomen are uncommon, but typically occur in the gastrointestinal tract. Primary renal carcinoid is an extremely rare tumour, poorly described in the literature. We describe an unusual case where an atypical renal mass on imaging led to a preoperative diagnosis of renal carcinoid on imaging guiding biopsy.

  12. 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)

  13. Insuficiência renal aguda associada ao uso de aciclovir endovenoso Acute renal failure related to intravenous acyclovir

    Directory of Open Access Journals (Sweden)

    Leonardo R. Pacheco

    2005-10-01

    Full Text Available OBJETIVO: Avaliar a incidência e evolução da IRA em pacientes que utilizaram aciclovir por via intravenosa. MÉTODOS: Foram revisados, durante um período de sete meses consecutivos, os prontuários médicos de pacientes acima de 13 anos de idade que usaram aciclovir endovenoso (EV por cinco dias ou mais. A IRA foi considerada quando a creatinina sérica, previamente normal, aumentava acima de 2 mg/dl. Foi analisado o tipo de tratamento instituído nos casos de IRA e sua evolução. RESULTADOS: Oitenta e cinco pacientes receberam aciclovir por via endovenosa durante o período estudado. Foram incluídos no estudo 41 pacientes. A IRA desenvolveu-se em 8 dos 41 pacientes estudados (19,5%. O tempo médio para o início do aumento dos níveis séricos da creatinina, após o início do uso da droga, foi de 4,2 dias, com o pico dos níveis da creatinina sérica aparecendo entre 3 a 14 dias (média 7,1 dias. A recuperação da função renal, avaliada pela queda dos níveis da creatinina, variou de 1 a 7 dias ( média de 3,6 dias. A resolução da IRA ocorreu após medidas gerais de hidratação, aumento do tempo de infusão e ajuste da dose do aciclovir. CONCLUSÃO: O aciclovir provocou IRA em 19,5% dos pacientes, que evoluíram bem em todos os casos observados, com retorno da função renal pré-tratamento após medidas de hidratação, reajuste da dose e aumento do tempo de infusão. Não houve necessidade de hemodiálise em nenhum paciente. A droga apresenta segurança de uso, desde que cuidados sejam implementados durante sua administração.OBJECTIVE: The aim of this study was to evaluate the incidence and outcome of acute renal failure (ARF in patients submitted to intravenous (IV acyclovir treatment. METHODS: All patients over 13 years of age that used intravenous acyclovir for 5 or more days were retrospectively analyzed. When serum creatinine levels, previously in the normal range, increased above 2 mg/dl, the case was considered an ARF

  14. Reporte de insuficiencia renal producida por Leptospira Interrogans Serovar Pomona en Colombia

    Directory of Open Access Journals (Sweden)

    Fortunato Ospino

    1988-06-01

    Full Text Available Se describe la presentación de un caso de leptospirosis producida por L. pomona en un paciente de 20 años de edad, trabajadora habitual en un molino de arroz y caracterizado por un síndrome de insuficiencia renal y hepática. El cuadro clínico consistió principalmente en malestar general, anorexia, vómito, fiebre, diarrea, ictericia y hemorragias subconjuntivales. Los exámenes de laboratorio mostraron alteraciones, en los niveles de nitrógeno ureico, creatinina, depuración de creatinina, concentración de cloro, fosfatasa alcalina y bilirrubina directa lo cual podría indicar un daño en el funcionamiento hepático y renal. Las alteraciones en la velocidad de sedimentación, hemoglobina, hematocrito y leucocitos (Tabla 1 explican la anemia e infección ocasionada por la L. pomona en la paciente. El diagnóstico de leptospirosis fue confirmado por el aislamiento del microorganismo de la orina a pesar de no haber detectado anticuerpos en el suero de la paciente. Se pone en evidencia la necesidad de realizar siempre el diagnóstico diferencial con leptospirosis en todo síndrome hepatorrenal, especialmente en los casos con antecedentes epidemiológicos o que por la sintomatología clínica se sospeche la infección.

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

    Science.gov (United States)

    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

  16. 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...

  17. TORSIÓN LOBAR PULMONAR ESPONTÁNEA EN UN CANINO MESTIZO Y POSTERIOR DESARROLLO DE UNA NEOPLASIA ÓSEA APENDICULAR: REPORTE DE CASO

    Directory of Open Access Journals (Sweden)

    J.L. Granados

    2013-01-01

    Full Text Available Se describe el caso de un canino mestizo hembra de ocho años de edad que presentó historia de diez días de letargia, anorexia, pérdida de peso, vómito ocasional, tos esporádica y dificultad respiratoria; los hallazgos clínicos, radiográficos y ultrasonográficos sugirieron como diagnóstico diferencial más probable torsión lobar pulmonar del lóbulo medio derecho, lo cual se confirmó mediante toracotomía exploratoria. el manejo terapéutico incluyó resección del lóbulo afectado; no se identificó ninguna etiología subyacente. La paciente tuvo una recuperación completa de la torsión lobar; sin embargo, dos se-manas después de la cirugía presentó claudicación severa del miembro anterior derecho y se encontraron hallazgos radiográficos compatibles con neoplasia ósea en la epífisis proximal del húmero. Por decisión de los propietarios sólo se realizó manejo analgésico y un mes después se practicó eutanasia debido a una posible metástasis pulmonar. es posible que la neoplasia y posible metástasis se tratasen de eventos concomitantes sin relación causa-efecto; sin embargo, pudo haber existido una asociación entre un proceso estresante y traumático (la torsión pulmonar con el desarrollo y manifestación de una patología oncológica subyacente.

  18. Parálisis periódica hipokalémica tirotóxica: reporte de un caso y revisión del tema

    Directory of Open Access Journals (Sweden)

    Sandra Milena Acevedo Rueda

    2013-07-01

    Full Text Available Se expone el caso de un hombre de 20 años, que consultó a urgencias por cuadro de 2 horas de parestesias y pérdida de la fuerza muscular en miembros inferiores, hasta incapacidad completa para incorporarse desde una silla. Cinco episodios similares, matutinos, leves, de corta duración, con resolución espontánea, durante los últimos dos meses. Cuatro meses antes había estado presentando palpitaciones, pérdida de 12 kilos de peso con polifagia, sensibilidad al calor, hiperdefecación y temblor fino en manos. Se documentó y corrigió hipokalemia. Se confirmó enfermedad de Graves dando tratamiento con propanolol y 20mCi de I131. La parálisis periódica hipokalémica tirotóxica (PPHT es una emergencia y puede presentarse desde debilidad muscular de predominio proximal hasta una parálisis completa con riesgo de muerte secundario a hipokalemia severa. El diagnóstico se confirma con la presencia de signos clínicos y/ó bioquímicos de tirotoxicosis asociados a hipokalemia. En la PPHT, hay un incremento de actividad de la bomba Na K – ATPasa dado por un aumento en la estimulación beta adrenérgica asociado a un exceso de hormona tiroidea. Los factores precipitantes de crisis de PPHT mas frecuentes son la alta ingesta de carbohidratos y el ejercicio extenuante, aunque existen muchos otros más. Es importante la pesquisa de hipertiroidismo en individuos con parálisis ó debilidad muscular e hipokalemia. Ésta condición se ha descrito principalmente en hombres asiáticos, pero debe ser considerada también en nuestro medio.

  19. Osteorradionecrose resultando em fratura patológica de mandíbula: relato de caso clínico = Osteoradionecrosis resulting in pathological fracture of jaw: relate of clinical case

    Directory of Open Access Journals (Sweden)

    Gomes, Ana Claudia Amorim

    2007-01-01

    Full Text Available Introdução: A osteorradionecrose (ORN é uma severa complicação da radioterapia em pacientes portadores de câncer de cabeça e pescoço. Dependendo da localização e extensão da lesão osteorradionecrótica, pode trazer sinais e sintomas como dor, odor fétido, disgeusia, disestesia ou anestesia, trismo, dificuldade de mastigação, deglutição e fonação, formação de fístula, fratura patológica e infecção local ou sistêmica. Objetivo: O presente trabalho teve como objetivo relatar um caso clínico de um paciente portador de osteorradionecrose em corpo mandibular, com presença de infecção, e que resultou em fratura patológica mandibular. Desenvolvimento do caso: Foram realizados esquemas rigorosos de antibioticoterapia, associados a oxigenoterapia hiperbárica para permitir o tratamento da fratura mandibular com fixação interna rígida, após o tratamento da infecção secundária, na intenção de eliminar a osteorradionecrose, a qual no caso em questão houve reparação e ausência de qualquer sinal clínico radiográfico de recidiva, num acompanhamento de um ano de pós-operatório. Conclusão: Diante da severidade da doença, esgotadas as possibilidades conservadoras e diante de uma necessidade cirúrgica pela fratura patológica, pôde-se observar que o uso da oxigenoterapia hiperbárica resultou em uma satisfatória cicatrização da ferida cirúrgica, bem como a manutenção da saúde dos tecidos no caso em questão

  20. DIOCTOFIMOSE EM UM CÃO PROVENIENTE DO MUNICÍPIO DE VALENÇA, RJ: RELATO DE CASO

    Directory of Open Access Journals (Sweden)

    Laís Zacaron MARQUES

    2016-12-01

    Full Text Available Dioctophyma renale é o maior nematóide conhecido. Seu parasitismo tem sido descrito em várias espécies animais e no homem. Este helminto localiza-se preponderantemente no rim direito ou livre na cavidade abdominal de seus hospedeiros. Sinais clínicos como abatimento, inapetência e emagrecimento podem estar associados à dioctofimose, apesar do curso da parasitose ser muitas vezes assintomático nos animais e pessoas infectadas. O único tratamento eficaz é a remoção cirúrgica do parasito e, em alguns casos, do rim afetado. O presente trabalho teve como objetivo relatar um caso de parasitismo por Dioctophyma renale em um cão no município de Valença/RJ. O animal foi resgatado por apresentar um tumor na pata e também hérnia perianal, mas ao caminho da policlínica veterinária apresentou também uma urina de odor fétido, que através da urinálise observou-se presença de ovos compatíveis com os de Dioctophyma renale.Dado o diagnóstico e localização do parasito, o animal foi encaminhado para a Policlínica de Pequenos Animais, da Faculdade de Medicina Veterinária de Valença, onde optou-se pela nefrectomia do rim afetado. 

  1. CASO DE PRIMARIA: REZAGO EDUCATIVO POR FALTA DE DESARROLLO DE COMPETENCIAS

    OpenAIRE

    Saucedo, Gerardo

    2012-01-01

    Párrafo de inicio, explicación del caso, explicación de un ejercicio tanto individual como grupal para un debate referente al caso,los objetivos del caso, soluciones propuestas por el autor y conclusiones

  2. Evaluación nutricional de niños con insuficiencia renal aguda que reciben diálisis Nutritional assessment of children presenting with acute renal insufficiency and underwent to dialysis

    Directory of Open Access Journals (Sweden)

    Jorge Silva Ferrera

    2010-03-01

    Full Text Available INTRODUCCIÓN. La insuficiencia renal aguda se produce en horas o en algunos días, y durante su evolución se produce un deterioro del estado nutricional del paciente. El objetivo de este estudio fue caracterizar el estado nutricional de niños con esta enfermedad que requirieron terapias de reemplazo renal. MÉTODOS. Se realizó un estudio retrospectivo y transversal que incluyó a los pacientes ingresados por insuficiencia renal aguda en dos hospitales pediátricos de Santiago de Cuba entre diciembre de 2006 y diciembre de 2008. Se analizó edad, sexo, etiología, terapia de reemplazo renal, causa del uso de nutrición parenteral, evaluación nutricional según tablas cubanas de percentiles y parámetros antropométricos (edad, peso, talla y aporte de nutrientes parenterales. RESULTADOS. Eventos prerrenales fueron la causa de la insuficiencia renal aguda en el 44,4 % de los casos, y renales y posrenales, en el 33,4 y 22,2 %, respectivamente. Como método de depuración renal se utilizó la diálisis peritoneal en el 66,6 % de los casos y la hemodiálisis en los restantes pacientes. Las principales causas que motivaron la nutrición parenteral fueron las afecciones quirúrgicas, los estados hipercatabólicos, la hemorragia digestiva y la pancreatitis, en orden decreciente. Cuatro pacientes fueron evaluados como de bajo peso. CONCLUSIONES. El aporte promedio de proteínas y lípidos estuvo por debajo de los aportes nutricionales establecidos, y el aporte de kilocalorías fue superior a lo recomendado. Se deben mejorar estos parámetros en el tratamiento de estos pacientes.INTRODUCTION: Acute renal insufficiency appears in hours or in a few days and during its course there is a deterioration of patient nutritional status. The aim of present study was to characterize the nutritional status of children with this disease requiring renal replacement therapies. METHODS: A crossed-sectional and retrospective study was conducted including the patients

  3. 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.

  4. 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

  5. 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.

  6. Sequential Scintigraphy in Renal Transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Winkel, K. zum; Harbst, H.; Schenck, P.; Franz, H. E.; Ritz, E.; Roehl, L.; Ziegler, M.; Ammann, W.; Maier-Borst, W. [Institut Fuer Nuklearmedizin, Deutsches Krebsforschungszentrum, Heidelberg, Federal Republic of Germany (Germany)

    1969-05-15

    Based on experience gained from more than 1600 patients with proved or suspected kidney diseases and on results on extended studies with dogs, sequential scintigraphy was performed after renal transplantation in dogs. After intravenous injection of 500 {mu}Ci. {sup 131}I-Hippuran scintiphotos were taken during the first minute with an exposure time of 15 sec each and thereafter with an exposure of 2 min up to at least 16 min.. Several examinations were evaluated digitally. 26 examinations were performed on 11 dogs with homotransplanted kidneys. Immediately after transplantation the renal function was almost normal arid the bladder was filled in due time. At the beginning of rejection the initial uptake of radioactive Hippuran was reduced. The intrarenal transport became delayed; probably the renal extraction rate decreased. Corresponding to the development of an oedema in the transplant the uptake area increased in size. In cases of thrombosis of the main artery there was no evidence of any uptake of radioactivity in the transplant. Similar results were obtained in 41 examinations on 15 persons. Patients with postoperative anuria due to acute tubular necrosis showed still some uptake of radioactivity contrary to those with thrombosis of the renal artery, where no uptake was found. In cases of rejection the most frequent signs were a reduced initial uptake and a delayed intrarenal transport of radioactive Hippuran. Infarction could be detected by a reduced uptake in distinct areas of the transplant. (author)

  7. Contemporary treatment of renal tumors

    DEFF Research Database (Denmark)

    Nisen, Harry; Järvinen, Petrus; Fovaeus, Magnus

    2017-01-01

    Objective: The five Nordic countries comprise 25 million people, and have similar treatment traditions and healthcare systems. To take advantage of these similarities, a collaborative group (Nordic Renal Cancer Group, NORENCA) was founded in 2015. Materials and methods: A questionnaire of 17...

  8. Novel genes in renal aging

    NARCIS (Netherlands)

    Noordmans, Gerda Anke

    2015-01-01

    Renal aging is characterized by structural changes and functional decline. These changes make the elderly more vulnerable to chronic kidney disease, hypertension, and cardiovascular disease. Furthermore, they also make it more difficult to cope with stress factors, such as dehydration, toxicity, and

  9. Renal involvement in Gaucher's disease.

    Science.gov (United States)

    Siegal, A.; Gutman, A.; Shapiro, M. S.; Griffel, B.

    1981-01-01

    A patient with chronic Gaucher's disease is described who developed glomerulopathy 24 years after splenectomy terminating in renal failure. The pathological changes of this very rare complication of Gaucher's disease are described. The few similar cases reported in the literature are reviewed and the possible pathogenetic pathways discussed. Images Fig. 1 Fig. 2 Fig. 3 PMID:7301691

  10. The Radiology of Renal Trauma

    African Journals Online (AJOL)

    1974-05-15

    May 15, 1974 ... Retrograde pyelography was performed in 3 patients and renal angio- graphy in 22. Of the 210 cases referred, abnormal radio- logical signs were observed in 112. All the radiological in- vestigations were reviewed to assess the frequency of the various findings. RESULTS. The Plain Film of the Abdomen.

  11. Renal sympathetic denervation in hypertension.

    Science.gov (United States)

    Doumas, Michael; Faselis, Charles; Papademetriou, Vasilios

    2011-11-01

    Despite the abundance of antihypertensive drugs, resistant hypertension remains a major clinical problem. Recent technological advances render interventional management of resistant hypertension one of the hottest topics in the hypertension field. The aim of this review is to present the pathophysiologic background and the mechanisms mediating blood pressure reduction after renal sympathetic denervation, to analyze recent findings with this fascinating approach and to critically suggest future research directions. Catheter-based, ablation-induced renal sympathetic denervation was initially studied in 45 patients with resistant hypertension in a proof-of-concept study. Impressive blood pressure reductions of about 30/15  mmHg were achieved at 6 months, without serious complications. A second, controlled, randomized (but not blinded) study confirmed the results, verifying the efficacy and safety of the procedure. A recent report revealed the 2-year durability of blood pressure reduction. Data published so far indicate that ablation-induced renal denervation is a feasible, effective, and well tolerated interventional approach for the management of resistant hypertension. The groundbreaking studies of renal denervation in drug-resistant hypertension pave the way for further research in other disease conditions in which sympathetic overactivity seems to play a critical role. This initial wave of enthusiasm needs to be followed by rigorous investigation, for the proper identification of the potential and the limitations, indications, and contraindications of this approach.

  12. More about... renal and urology

    African Journals Online (AJOL)

    [3,4]. Although the incidence of ESRD is high in the elderly, progression to renal failure tends to be low.[3[. The Kidney Disease .... to loosely it will fall off. • When ulceration occurs, the patient needs to stop using the urinary sheath .... If the patient has a history of retrograde ejaculation, it is necessary to prepare the bladder by ...

  13. Metastatic renal cell carcinoma management

    Directory of Open Access Journals (Sweden)

    Flavio L. Heldwein

    2009-06-01

    Full Text Available PURPOSE: To assess the current treatment of metastatic renal cell carcinoma, focusing on medical treatment options. MATERIAL AND METHODS: The most important recent publications have been selected after a literature search employing PubMed using the search terms: advanced and metastatic renal cell carcinoma, anti-angiogenesis drugs and systemic therapy; also significant meeting abstracts were consulted. RESULTS: Progress in understanding the molecular basis of renal cell carcinoma, especially related to genetics and angiogenesis, has been achieved mainly through of the study of von Hippel-Lindau disease. A great variety of active agents have been developed and tested in metastatic renal cell carcinoma (mRCC patients. New specific molecular therapies in metastatic disease are discussed. Sunitinib, Sorafenib and Bevacizumab increase the progression-free survival when compared to therapy with cytokines. Temsirolimus increases overall survival in high-risk patients. Growth factors and regulatory enzymes, such as carbonic anhydrase IX may be targets for future therapies. CONCLUSIONS: A broader knowledge of clear cell carcinoma molecular biology has permitted the beginning of a new era in mRCC therapy. Benefits of these novel agents in terms of progression-free and overall survival have been observed in patients with mRCC, and, in many cases, have become the standard of care. Sunitinib is now considered the new reference first-line treatment for mRCC. Despite all the progress in recent years, complete responses are still very rare. Currently, many important issues regarding the use of these agents in the management of metastatic renal cancer still need to be properly addressed.

  14. Urolitiasis obstructiva en ovinos: estudio de caso Urolitiasis obstructiva en ovinos: estudio de caso

    Directory of Open Access Journals (Sweden)

    Abner Josué Gutiérrez Chávez

    2012-02-01

    Full Text Available A 5-months-old, commercial-crossbreed male lamb was remitted to post-morten study. The clinical history about of animal included: signs of severe abdominal distension, anorexia, poliaquiuria, straguria and prolonged urination posture, urine dribbling and blood-tinged urine. Necropsy revealed ascitis and a hemorrhagic fibrine membrane floating in approximately 8 litres of urine caused by a rupture of the urinary bladder in consequence of a total blockage of urethral lumen by multiple small stones localized in the sigmoid flexure of the animal. Obstructive urolithiasis is a common problem in the fed-flocks affecting between 20 % and 30 % of the animals. A diet with adequate mineral balance could reduce the health risk of formation of urinary stones. Un ovino macho de 5 meses de edad fue presentado para su estudio patológico. La historia clínica del animal incluía: postración, dificultad para incorporarse, distensión abdominal severa, pérdida de apetito, estranguria, poliaquiuria y hematuria. A la necropsia se observó la presencia de 8 litros aproximadamente de orina en cavidad abdominal y una membrana fibrino-hemorrágica flotante adherida a la vejiga a nivel de la lesión de ruptura, por una sobre distensión provocada por la presencia obstructiva total de cálculos urinarios localizados en la luz de la uretra a nivel de la flexura sigmoidea del animal. La urolitiasis obstructiva es una patología que se presenta en el 20 % - 30 % de los animales en engorda. Un adecuado balance mineral de la dieta rica en concentrados puede reducir el riesgo de la formación de urolitos.

  15. Babesiose cerebral em bovinos: 20 casos

    Directory of Open Access Journals (Sweden)

    Rodrigues Aline

    2005-01-01

    Full Text Available Num estudo retrospectivo de 1.071 necropsias de bovinos, foram encontrados 20 casos de babesiose cerebral confirmados pelo exame de esfregaços do córtex telencefálico. A maioria desses casos ocorreu no verão, em bovinos adultos de raças européias ou suas cruzas. Além dos sinais clínicos neurológicos, observou-se hemoglobinúria, anorexia, febre, taquicardia, taquipnéia e queda na produção de leite. O hemograma realizado em cinco bovinos afetados revelou acentuada anemia regenerativa; em média, 20% dos eritrócitos estavam parasitados por Babesia bovis. Na necropsia de todos os casos, a substância cinzenta dos córtices telencefálico e cerebelar e dos núcleos da base era consistente e caracteristicamente róseo-cereja. Essa coloração devia-se ao seqüestro de eritrócitos nos capilares encefálicos. Nesses eritrócitos, podiam-se observar, tanto em esfregaços do córtex como em preparações histológicas do encéfalo, microorganismos com morfologia compatível com B. bovis. Outros achados de necropsia incluíam hemoglobinúria, rins vermelho-escuros, hepatoesplenomegalia, fígado vermelho-alaranjado, icterícia, hemorragias epicárdicas e endocárdicas e edema e congestão dos linfonodos mesentéricos.

  16. Leiomioma perianal. Reporte de un caso

    Directory of Open Access Journals (Sweden)

    Yorlenis C Uzcátegui R

    2014-09-01

    Full Text Available Los leiomiomas perianales son tumoraciones derivadas de células mesenquimales distribuidas por todo el cuerpo. Histológicamente se han clasificado en tres subtipos: vascular, no vascular y epiteloide. El subtipo vascular puede ser sólido, cavernoso o venoso. Los leiomiomas son raros en adultos, con incidencia de 0,1 %, generalmente se presentan entre la cuarta a sexta década de la vida con predominio en mujeres en caso de ser benignos. La forma de presentación más frecuente es un nódulo palpable, próximo al ano e indoloro. El diagnóstico se realiza según criterios histológicos e inmunohistoquímicos, además son útiles la ecografía endoanal y RMN. La exéresis es la primera opción terapéutica. Se presenta caso de paciente femenino de 41 años de edad, quien consulta por presentar nódulo palpable perianal derecho, con dolor a la palpación, de ocho meses de evolución, con valores normales de marcadores tumorales, el ultrasonido revela a nivel perianal derecho imagen sólida, hipocrómica (con tejido lineal fibroso, mide 4.82x 6.7x 6.87cm, la RMN muestra lesión ocupante de espacio en la misma ubicación, Doppler Color sin vascularización. Se efectuó exéresis de leiomioma en fosa isquiorectal derecha de 4x6 cm. El estudio anatomopatológico reportó leiomioma perianal subtipo epitelial. En el presente estudio se reporta un caso muy poco frecuente de leiomioma perianal doloroso, exponiendo las características clínicas e histológicas del mismo

  17. estadounidense: el caso de la berenjena mexicana

    Directory of Open Access Journals (Sweden)

    Carlos Javier Maya Ambía

    2004-01-01

    Full Text Available El mercado hortÌcola de Estados Uni- dos es el escenario de una din·mica competencia en la que se enfrentan empresas productoras-distribuidoras de naciones con muy dispares grados de desarrollo. Este artÌculo se enfoca al caso de la berenjena mexicana exportada hacia dicho paÌs, consi- derando que, a partir de su estudio, es posible repensar una serie de conceptos empleados en la inves- tigaciÛn sobre el tema. En particular, se propone, si- guiendo una idea expuesta por Van Sickle y otros autores, tomar el segmento del mercado como indi- cador de la competitividad de los oferentes. De acuerdo con este indi- cador, se trata de ubicar el posicio- namiento actual de las hortalizas mexicanas en el mercado de los Estados Unidos, comparando la berenjena con las otras hortalizas m·s importantes exportadas por MÈxico. Se busca explicar esta participaciÛn a partir de una serie de elementos, como son innovaciones tecnolÛgicas, rendimientos, costos, estrategias de comercializaciÛn y, de especial im- portancia, la atenciÛn a las normas para preservar la inocuidad alimen- taria. El caso estudiado viene a con- firmar la hipÛtesis de autores como Friedland y Bonanno, quienes sos- tienen el car·cter global de la com- petencia en los mercados hortÌcolas. El artÌculo concluye con algunas reflexiones derivadas del estudio de caso, mismas que apuntan hacia el cuestionamiento del concepto de divisiÛn internacional del trabajo.

  18. 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.

  19. Microwave treatment of renal cell carcinoma adjacent to renal sinus

    International Nuclear Information System (INIS)

    Gao, Yongyan; Liang, Ping; Yu, Xiaoling; Yu, Jie; Cheng, Zhigang; Han, Zhiyu; Duan, Shaobo; Huang, Hui

    2016-01-01

    Highlights: • This study shows US-guided microwave ablation appears to be a promising method to treat renal cell carcinoma adjacent to renal sinus. • The estimated 1-, 3- and 5-year RCC-related survival were 100%, 93.3% and 93.3%, respectively. • The estimated 1-, 3- and 5-year overall survival were 97.1%, 87.8%, 83.6%, respectively. • For patients with RCC ≤4 cm, initial ablation success was 100% (29/29) and the estimated 5-year disease-free survival were 81.5%. - Abstract: Purpose: To evaluate the efficacy and safety of ultrasound (US)-guided percutaneous microwave ablation (MWA) for renal cell carcinoma (RCC) adjacent to renal sinus. Materials and methods: This retrospective study included 41 patients who underwent US-guided percutaneous MWA of 41 RCCs adjacent to the renal sinus from April 2006 to December 2015. Contrast-enhanced images of US and computed tomography (CT) or magnetic resonance (MR) imaging were performed at pre-ablation and 1 day, 1 month, 3 months, and every 6 months after ablation. Initial ablation success (IAS), disease-free survival (DFS), RCC-related survival (RRS), and overall survival (OS) were recorded at the follow-up visits. Results: IAS was achieved in 92.7% (38/41) of the study subjects. The IAS significantly differed between patients with RCCs ≤4 cm (100%, 29/29) and RCCs >4 cm (75%, 9/12, p = 0.021). During the median follow-up of 37.6 (range, 3.0–97.3) months, the estimated 1-, 3-, and 5-year DFS of patients with an initial tumor of ≤4 cm were 100%, 89.7%, and 81.5%, respectively. The 1-, 3-, and 5-year RRS were 100%, 93.3%, and 93.3%, respectively. The 1-, 3-, and 5-year OS were 97.1%, 87.8%, and 83.6%, respectively. The multivariate analysis using the Cox proportional hazard model revealed no independent predictor of recurrence among all the variables. There were no MWA-related deaths among the study subjects. One patient developed a retroperitoneal abscess after ablation. Conclusion: US-guided percutaneous MWA

  20. Microwave treatment of renal cell carcinoma adjacent to renal sinus

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Yongyan, E-mail: gaoyongyan7@163.com [Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 (China); Department of Ultrasound, The General Hospital of Chinese People’s Armed Police Forces, 69 Yongding Road, Beijing, 100039 (China); Liang, Ping, E-mail: liangping301@hotmail.com [Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 (China); Yu, Xiaoling, E-mail: 784107477@qq.com [Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 (China); Yu, Jie, E-mail: 1411495161@qq.com [Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 (China); Cheng, Zhigang, E-mail: 13691367317@163.com [Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 (China); Han, Zhiyu, E-mail: hanzhiyu122@163.com [Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 (China); Duan, Shaobo, E-mail: Dustin2662@163.com [Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 (China); Huang, Hui, E-mail: 309hh@sina.com [Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 (China)

    2016-11-15

    Highlights: • This study shows US-guided microwave ablation appears to be a promising method to treat renal cell carcinoma adjacent to renal sinus. • The estimated 1-, 3- and 5-year RCC-related survival were 100%, 93.3% and 93.3%, respectively. • The estimated 1-, 3- and 5-year overall survival were 97.1%, 87.8%, 83.6%, respectively. • For patients with RCC ≤4 cm, initial ablation success was 100% (29/29) and the estimated 5-year disease-free survival were 81.5%. - Abstract: Purpose: To evaluate the efficacy and safety of ultrasound (US)-guided percutaneous microwave ablation (MWA) for renal cell carcinoma (RCC) adjacent to renal sinus. Materials and methods: This retrospective study included 41 patients who underwent US-guided percutaneous MWA of 41 RCCs adjacent to the renal sinus from April 2006 to December 2015. Contrast-enhanced images of US and computed tomography (CT) or magnetic resonance (MR) imaging were performed at pre-ablation and 1 day, 1 month, 3 months, and every 6 months after ablation. Initial ablation success (IAS), disease-free survival (DFS), RCC-related survival (RRS), and overall survival (OS) were recorded at the follow-up visits. Results: IAS was achieved in 92.7% (38/41) of the study subjects. The IAS significantly differed between patients with RCCs ≤4 cm (100%, 29/29) and RCCs >4 cm (75%, 9/12, p = 0.021). During the median follow-up of 37.6 (range, 3.0–97.3) months, the estimated 1-, 3-, and 5-year DFS of patients with an initial tumor of ≤4 cm were 100%, 89.7%, and 81.5%, respectively. The 1-, 3-, and 5-year RRS were 100%, 93.3%, and 93.3%, respectively. The 1-, 3-, and 5-year OS were 97.1%, 87.8%, and 83.6%, respectively. The multivariate analysis using the Cox proportional hazard model revealed no independent predictor of recurrence among all the variables. There were no MWA-related deaths among the study subjects. One patient developed a retroperitoneal abscess after ablation. Conclusion: US-guided percutaneous MWA

  1. Caso de miiasis orbitaria severa humana por Cochliomyia hominivorax (Diptera: Calliphoridae asociada con carcinoma espinocelular en el estado Falcón, Venezuela | A case of human severe orbital myiasis by Cochliomyia hominivorax (Diptera: Calliphoridae associated with spinocellular carcinoma in Falcón state, Venezuela

    Directory of Open Access Journals (Sweden)

    Leonardo Tortolero Low

    2017-11-01

    Full Text Available Myiasis is the parasitism of organs and tissues due to fly larvae of the order Diptera. A report is made of a case in a 70 years old man from La Vela, Falcon State, Venezuela, with severe orbital myiasis associated to a spinocellular carcinoma. The patient attended the emergency room of the Universitary Hospital of Coro, Falcon State, with a cavitary tumor with perforations in the right eyeball with suppurative and foul-smelly discharge. 160 larvae instars II and III were collected, and identified as Cochliomyia hominivorax (“screwworm” (Diptera: Calliphoridae. The patient was treated with debridement and intravenous antibiotic therapy (Ampicillin/Sulbactam; Clindamycin. Myiasis should be considered potentially when the patient has open extensive lesions such as malignant wounds.

  2. Hidrocefalia multiloculada: relato de dois casos

    Directory of Open Access Journals (Sweden)

    Marilisa M. Guerreiro

    1988-09-01

    Full Text Available Hidrocefalia multiloculada é conceituada como quadro clínico-patológico que consiste de ventrículos aumentados e loculados e de cavidades porencefálicas paraventriculares. Apresentamos dois casos de hidrocefalia multiloculada, um provavelmente conseqüente a processo infeccioso do sistema nervoso central e outro em decorrência de malformação congênita. Aspectos tomográficos compatíveis ao diagnóstico são ressaltados. A etiopatogenia, o tratamento e o prognóstico são discutidos em face da literatura compulsada.

  3. Estrabismo sensorial: estudo de 191 casos

    OpenAIRE

    Oliveira,Bráulio Folco Telles de; Bigolin,Silvane; Souza,Murilo Barreto; Polati,Mariza

    2006-01-01

    OBJETIVO: Avaliar os prontuários dos pacientes com estrabismo sensorial em aspectos variados, como etiologia, tipo e medida do desvio, correlação do tipo do desvio com a idade de aparecimento da doença de base, e resultado cirúrgico dos casos operados. MÉTODOS: Avaliação dos prontuários médicos dos pacientes com estrabismo sensorial atendidos no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - USP - no setor de Motilidade Ocular Extrínseca, no período de setembro ...

  4. Anartria Pura: Estudo de Dois Casos

    OpenAIRE

    Lecours,André Roch; Parente,Maria Alice de Mattos Pimenta; Feijó,Adriana Vélez; Maia,Alberto

    2001-01-01

    O marco do nascimento da neurolingüística é considerado a publicação do livro A síndrome de Desintegração Fonética, em 1939, que teve como autores: um neurologista, um psicólogo e uma lingüista. Dez anos mais tarde foi publicado, pela mesma equipe de pesquisadores franceses, o distúrbio de fala do paciente portador de anartria pura. No presente artigo, situaremos as polêmicas históricas a respeito de um distúrbio seletivo de fala de origem telencefálica, apresentaremos o primeiro caso descrit...

  5. Hiperekplexia: Um Caso Raro de Hipertonia Neonatal

    OpenAIRE

    Alegria, Artur; Santos, Manuela; Coelho, Elisabete; Cardoso, Maria Luís

    2014-01-01

    A hiperekplexia ou «doença do sobressalto» é um síndroma clínico muito raro caracterizado por uma resposta de sobressalto exagerada a estímulos sensoriais inesperados e hipertonia generalizada neonatal transitória, resultante de um defeito genético dos receptores da glicina. Descrevemos um novo caso clínico desta doença, num recém-nascido cuja história familiar era negativa. Após o nascimento apresentou-se com hipertonia e rigidez muscular generalizadas, agravadas em resposta a estímulos táct...

  6. Enanismo pituitario canino: reporte de dos casos

    OpenAIRE

    Corrada, Yanina; Humbert Lan, Analia; Dragonetti, Ana; Goya, Rodolfo; Gobello, Cristina

    2009-01-01

    El enanismo pituitario es una endocrinopatía ocasionada por la deficiencia de hormona de crecimiento. La imposibilidad de medir esta hormona en los caninos ha ocasionado que, muchas veces, no se considere al enanismo pituitario entre los diagnósticos diferenciales de retraso del crecimiento y dermatopatía en el cachorro. En el presente trabajo se describen dos casos clínicos de esta enfermedad en caninos, los cuales una vez referidos a la Facultad de Ciencias Veterinarias de La Plata, Argenti...

  7. Larva migrans visceral: relato de caso

    OpenAIRE

    Machado Alexandre Bortoli; El Achkar Marice Emanuela

    2003-01-01

    Larva migrans visceral é doença infecciosa, adquirida por ingestão de ovos provenientes dos vermes Toxocara canis e/ou Toxocara cati que infestam cães e gatos; as larvas penetram a parede intestinal e migram através dos tecidos levando a alterações diversas, conseqüentes a uma resposta inflamatória imune.¹ Os autores descrevem um caso clínico de larva migrans visceral com apresentação clínica atípica.

  8. Hemangioma de úvula: relato de um caso

    Directory of Open Access Journals (Sweden)

    G. Sobrinho Fernando P.

    2003-01-01

    Full Text Available O hemangioma é o mais comum tumor de origem vascular, benigno, freqüentemente diagnosticado em crianças, e com predileção pela cabeça e pescoço, mas que raramente tem origem na úvula. Neste órgão, apresenta risco de traumatismo local e sangramento. Este artigo relato um caso de hemangioma de úvula num adulto jovem com disfagia orofaríngea progressiva e sensação de corpo estranho na garganta, tratado com sucesso por ressecção cirúrgica do tumor com bisturi de radiofreqüência.

  9. Funciones sociales del consumo: un caso extremo

    OpenAIRE

    JOSÉ CASTILLO CASTILLO

    1994-01-01

    El consumo religioso de reliquías de santos durante la edad media cumple semejantes funciones sociales para su época que el consumo economico de objetos para la nuestra: El de reforzar real y simbólicamente las estructuras de prestigio, riqueza y poder de sus respectivas sociedades. El ámbito de la sociología del consumo no se circunscribe a los estrechos límites de las llamadas sociedades de consumo de masas. en el presente caso, el estudio del pasado ilumina procesos sociales propios de nue...

  10. Funciones sociales del consumo: un caso extremo

    Directory of Open Access Journals (Sweden)

    JOSÉ CASTILLO CASTILLO

    1994-01-01

    Full Text Available El consumo religioso de reliquías de santos durante la edad media cumple semejantes funciones sociales para su época que el consumo economico de objetos para la nuestra: El de reforzar real y simbólicamente las estructuras de prestigio, riqueza y poder de sus respectivas sociedades. El ámbito de la sociología del consumo no se circunscribe a los estrechos límites de las llamadas sociedades de consumo de masas. en el presente caso, el estudio del pasado ilumina procesos sociales propios de nuestros días.

  11. Enfermedad de Pompe: reporte de caso

    OpenAIRE

    Arias, Sara; G?mez, Mariana; Fern?ndez, Isabel; Celis, Luis Gustavo

    2016-01-01

    Se describe el caso de un paciente masculino de siete meses de edad, evaluado por cardiolog?a a los quince d?as de vida por antecedente de muerte s?bita card?aca de hermana a los cuatro meses, no se sospech? nada pese a consanguinidad de padres y diagn?stico temprano del paciente de cardiomiopat?a. Evoluciona con un cuadro cl?nico de infecciones respiratorias a repetici?n desde los tres meses (bronquiolitis recurrente), falla de medro y cuadro de neumon?a reciente y fallece a los ocho d?as de...

  12. Anorexia nervosa: un estudio de casos

    OpenAIRE

    Zusman, Lillyana

    2013-01-01

    La Anorexia Nervosa es un trastorno de alimentación que se define (etimológicamente) como una "pérdida nerviosa del apetito". Se caracteriza por la actitud consciente, voluntaria y rotunda de los sujetos  de tener un exceso de peso que intentan modificar por vía de la inanición. A partir del estudio de casos, se propone la distinción entre una Anorexia Nervosa Estructural -aquella en la que predomina el conflicto intrapsíquico primario y arcaico, y que manifiesta una conducta aislada y retraí...

  13. Hepatocarcinoma fibrolamelar: relato de um caso

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    Martins Rogéria de Castro

    2001-01-01

    Full Text Available O hepatocarcinoma fibrolamelar é neoplasia hepatocelular rara, diagnosticada por tomografia computadorizada e confirmada pelo exame anatomopatológico. O caso relatado foi atendido no Hospital Mater Dei de Belo Horizonte, MG. Os aspectos clínicos, radiológicos e patológicos discutidos reforçam a importância das imagens radiológicas na detecção e caracterização das neoplasias focais hepáticas.

  14. Implante coclear en enfermedad de Ménière bilateral. Descripción de un caso

    Directory of Open Access Journals (Sweden)

    Ainhoa MORENO-BRAVO

    2017-03-01

    Full Text Available Introducción: La enfermedad de Ménière se caracteriza por síntomas cocleares y vestibulares. Puede ser unilateral o bilateral. Cuando la pérdida de audición asociada es severa-profunda de forma bilateral o unilateral pero con problemas de audición en el otro oído, dicha audición puede beneficiarse de un implante coclear. Si además, presenta crisis de vértigo y Tumarkin refractarias al tratamiento médico, se puede plantear la realización simultánea de una laberintectomía quirúrgica y colocación de un implante coclear. Descripción: Se describe el caso de un paciente con enfermedad de Ménière bilateral con hipoacusia neurosensorial profunda de oído derecho con fluctuaciones auditivas izquierdas que asocia crisis vertiginosas y de Tumarkin sin respuesta a corticoides orales e intratimpánicos ni a gentamicina intratimpánica. Se le realizó una laberintectomía quirúrgica con implante coclear en el mismo acto quirúrgico anticipándonos al probable deterioro auditivo contralateral. Posteriormente presenta buen rendimiento del implante y desaparición de las crisis del oído intervenido. Discusión: El objetivo del tratamiento es controlar las crisis preservando la función, pero en pacientes en los que las medidas conservadoras fallan, se han de considerar otras más destructivas como es la laberintectomía química, que consigue altas tasas de control de las crisis, y el implante coclear, indicado para restaurar la audición en el oído afectado por enfermedad de Ménière. Si ambas se realizan en un mismo tiempo quirúrgico, se consigue reducir riesgos asociados con otros procedimientos quirúrgicos y anestésicos y evitar las modificaciones histológicas tras una laberintectomía química que dificultarían la posterior colocación del implante colear.

  15. INSUFICIENCIA RENAL AGUDA CON UREMIA NORMAL EN PACIENTE MONO-RENO SECUNDARIA A PIELONEFRITIS AGUDA

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    Musso CG

    2006-03-01

    Full Text Available RESUMEN:La insuficiencia renal aguda es un sindrome que característicamente cursa con niveles plasmáticos elevados de urea y creatinina. Sin embargo, hay situaciones clínicas en las cuales este sindrome puede cursar con un incremento de la creatininemia sin presentar elevación de la uremia.En este reporte presentamos un caso clínico de una insuficiencia renal aguda con uremia normal secundaria a una pielonefritis aguda en un paciente con riñón único. El paciente presentaba una elevada excreción fraccional de urea lo cual podía explicar su uremia normal pese a estar cursando una caída del filtrado gomerular. Dicha excreción de urea elevada fue interpretada como secundaria a una diabetes insipida nefrogénica y una alteración en el recirculado intra-renal de la urea ambos producto de la pielonefritis aguda. Concluimos que la pielonefritis aguda en un paciente mono-reno puede presentarse con un patrón de insuficiencia renal aguda con uremia normal. SUMMARYAcute renal failure is a syndrome that usually runs with an increase in creatinine and urea plasma levels. However, there are clinical situations in which this syndrome may run with an increase in plasma creatinine keeping normal the urea one.In this report we present a case of acute renal failure with normal plasma urea level secondary to an acute pyelonephritis in a single kidney patient. The patient had an increased fractional excretion of urea which could explain the normal plasma urea levels found despite of his reduced glomerular filtration. This increased urea excretion state was interpreted as a consequence of the nephrogenic diabetes insipidus and alteration of the intra-renal urea reciclying process that the acute pyelonephritis induced. In conclusion: Acute pyelonephritis in a single kidney patient can appear as a pattern of acute renal failure with normal plasma urea levels.

  16. INSUFICIENCIA RENAL AGUDA CON UREMIA NORMAL EN PACIENTE MONO-RENO SECUNDARIA A PIELONEFRITIS AGUDA

    Directory of Open Access Journals (Sweden)

    Musso CG

    2007-04-01

    Full Text Available RESUMENLa insuficiencia renal aguda es un sindrome que característicamente cursa con niveles plasmáticos elevados de urea y creatinina. Sin embargo, hay situaciones clínicas en las cuales este sindrome puede cursar con un incremento de la creatininemia sin presentar elevación de la uremia. En este reporte presentamos un caso clínico de una insuficiencia renal aguda con uremia normal secundaria a una pielonefritis aguda en un paciente con riñón único. El paciente presentaba una elevada excreción fraccional de urea lo cual podía explicar su uremia normal pese a estar cursando una caída del filtrado gomerular. Dicha excreción de urea elevada fue interpretada como secundaria a una diabetes insipida nefrogénica y una alteración en el recirculado intra-renal de la urea ambos producto de la pielonefritis aguda. Concluimos que la pielonefritis aguda en un paciente mono-reno puede presentarse con un patrón de insuficiencia renal aguda con uremia normal.SUMMARYAcute renal failure is a syndrome that usually runs with an increase in creatinine and urea plasma levels. However, there are clinical situations in which this syndrome may run with an increase in plasma creatinine keeping normal the urea one. In this report we present a case of acute renal failure with normal plasma urea level secondary to an acute pyelonephritis in a single kidney patient. The patient had an increased fractional excretion of urea which could explain the normal plasma urea levels found despite of his reduced glomerular filtration. This increased urea excretion state was interpreted as a consequence of the nephrogenic diabetes insipidus and alteration of the intra-renal urea reciclying process that the acute pyelonephritis induced. In conclusion: Acute pyelonephritis in a single kidney patient can appear as a pattern of acute renal failure with normal plasma urea levels.

  17. “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.

  18. Supervivencia prolongada en el síndrome de Casamassima-Morton- Nance. Reporte de caso y revisión de la literatura

    Directory of Open Access Journals (Sweden)

    Nidia Huerta-Uribe

    2015-03-01

    Full Text Available El síndrome de Casamassima-Morton-Nance es una entidad rara, de etiología desconocida y mal pronóstico, que pertenece al grupo heterogéneo de las disostosis espondilocostales. Este síndrome, además de defectos vertebrales y arcos costales, comprende atresia anal y anormalidades genitourinarias como criptorquidia, hidrocele, hidronefrosis, agenesia renal, cloaca y fístulas urinarias, entre otras. En este trabajo informamos el caso de una niña de seis años de edad, sin historia de consanguinidad y con cariotipo normal, que presenta alteraciones congénitas, costovertebrales, anales y urogenitales compatibles con el síndrome de Casamassima-Morton-Nance. En su evolución se agregaron retraso psicomotor grave, epilepsia y litiasis renal recidivante, hallazgos no reportados en los casos previos, posiblemente por el fallecimiento temprano. Se han propuesto como mecanismos causales la herencia autosómica recesiva, mutaciones de novo y al menos dos casos han presentado rearreglos cromosómicos. Este reporte propone la posibilidad de supervivencia hasta la etapa escolar a partir de un abordaje multidisciplinario temprano; aunque el síndrome puede condicionar retraso psicomotor importante. La etiología permanece desconocida y no se descarta que sea heterogénea, por lo que los casos son candidatos a hibridación genómica comparativa en microarreglos o a secuenciación exómica.

  19. Comprometimento medular por linfoma tipo Burkitt: relato de um caso

    Directory of Open Access Journals (Sweden)

    Murillo Côrtes Drummond

    1985-06-01

    Full Text Available Registro de caso de linfoma tipo Burkitt com comprometimento intrarraqueano em criança de três anos de idade. Considerações sobre esse tipo de tumor são feitas em função do caso observado e de dados da literatura.

  20. Multiple infestation of Dioctophyme renale in dogs with leishmaniasis in Uruguaiana, RS - Report of five cases

    Directory of Open Access Journals (Sweden)

    Maria Lígia de Arruda Mistieri

    2014-06-01

    Full Text Available ABSTRACT. Mistieri M.L. de A., Pascon J.P. da E. & dos Santos F.P. [Multiple infestation of Dioctophyme renale in dogs with leishmaniasis in Uruguaiana, RS - Report of five cases.] Infestação múltipla de Dioctophyme renale em cães portadores de leishmaniose em Uruguaiana, RS - Relato de cinco casos. Revista Brasileira de Medicina Veterinária, 36(2:195-198, 2014. Universidade Federal do Pampa, BR 472, Km 592, Caixa Postal 118, Uruguaiana, RS 97500-970, Brasil. Email: mariamistieri@unipampa.edu.br Dioctophyme renale is a parasite of different animal species, including human beings. The parasite life cycle can be complex, involving intermediate hosts, definitive hosts and paratenic hosts, represented by different species of frog, rat and fish, specially. The domestic dogs are considered unusual and terminal hosts because they commonly present single parasite, enabling its reproduction and the cycle maintenance. This report presents a multiple infestation of D. renale (male and female specimens in five of nine dogs that underwent to euthanasia due to leishmaniasis. It was noticed two to eight parasites in each affected dog, summing 27 specimens, 12 males measuring between 9.0 and 21.5 cm in length and 15 females with 23.5 to 42.0 cm. In all dogs, the right kidney was completely destroyed. Actual epidemiological studies are necessary to check the real prevalence of the dioctophimosis in the region of Uruguaiana and the determination of the local parasite cycle. Deficient sanitary and hygiene conditions are commonly observed in the progression of D. renale and Leishmania sp. infections. It is possible that those conditions are the link between both disorders in the studied dogs.

  1. 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)

  2. Renal replacement therapy in sepsis-induced acute renal failure

    Directory of Open Access Journals (Sweden)

    Rajapakse Senaka

    2009-01-01

    Full Text Available Acute renal failure (ARF is a common complication of sepsis and carries a high mortality. Renal replacement therapy (RRT during the acute stage is the mainstay of therapy. Va-rious modalities of RRT are available. Continuous RRT using convective methods are preferred in sepsis-induced ARF, especially in hemodynamically unstable patients, although clear evidence of benefit over intermittent hemodialysis is still not available. Peritoneal dialysis is clearly inferior, and is not recommended. Early initiation of RRT is probably advantageous, although the optimal timing of dialysis is yet unknown. Higher doses of RRT are more likely to be beneficial. Use of bio-compatible membranes and bicarbonate buffer in the dialysate are preferred. Anticoagulation during dialysis must be carefully adjusted and monitored.

  3. 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)

  4. Viabilidad Celular in Vitro de tejido renal neonatal postmortem: Sus aplicaciones futuras.

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    Alvaro Dueñas L.

    2001-04-01

    Full Text Available

    La importancia de los cultivos celulares humanos continúa expandiéndose, en especial en el campo de la bioingeniería de tejidos. Con el fin de establecer mejores criterios de selección en la obtención de tejido renal postmortem, se estudiaron 111 neonatos de < 3 días de edad, fallecidos en la sala de Cuidados Intensivos del Recién Nacido (CIRENA y 22 mortinatos de la sala de partos del Hospital Universitario del Valle (HUV en Cali, Colombia, entre enero 1 y diciembre 31 de 1995. Se consideraron los antecedentes maternos y fetales, en busca de variables que determinen una mejor viabilidad celular renal postmortem (VCRP. Además, se hizo un estudio del estado microbiológico de los neonatos postmortem y de los mortinatos mediante el examen de sangre y células para conocer la incidencia en estos de infecciones bacterianas y virales.

    De los 133 casos estudiados, 115 (86% fueron de bajo peso al nacer (BPN, vgr. 500 a 2,500 gramos y los 18 (14% restantes fueron de peso adecuado al nacer (PAN >2,500 gramos. De 13 clases de diagnóstico registrados como antecedentes maternos, los seis más frecuentes fueron: ruptura prematura de membranas (RPM – 20%, PRE-eclampsia/eclampsia (PE – 13%, corioamnionitis (CA – 11%, infección urinaria (IU – 11%, placenta previa (PP – 9% y vaginitis (V – 8%. De los ocho diagnósticos registrados en los neonatos, los dos más frecuentes fueron el síndrome de dificultad respiratoria (SDR y la enfermedad de membrana hialina (ME -73%.

    Se pudo observar que la VCRP total fue de 65%, siendo mayor en los casos con BPN (69% que en los de PAN (39%. Independientemente de los antecedentes maternos se observó una VCRP de 70% y 77% en los casos con diagnóstico de SDR y EMH, respectivamente. Por otra parte, se obtuvo la mayor VCRP en los casos con diagnóstico materno de PP (83%. Aunque por el bajo número de casos expuestos en el presente estudio estas diferencias no demostraron significancia estad

  5. Microwave treatment of renal cell carcinoma adjacent to renal sinus.

    Science.gov (United States)

    Gao, Yongyan; Liang, Ping; Yu, Xiaoling; Yu, Jie; Cheng, Zhigang; Han, Zhiyu; Duan, Shaobo; Huang, Hui

    2016-11-01

    To evaluate the efficacy and safety of ultrasound (US)-guided percutaneous microwave ablation (MWA) for renal cell carcinoma (RCC) adjacent to renal sinus. This retrospective study included 41 patients who underwent US-guided percutaneous MWA of 41 RCCs adjacent to the renal sinus from April 2006 to December 2015. Contrast-enhanced images of US and computed tomography (CT) or magnetic resonance (MR) imaging were performed at pre-ablation and 1day, 1 month, 3 months, and every 6 months after ablation. Initial ablation success (IAS), disease-free survival (DFS), RCC-related survival (RRS), and overall survival (OS) were recorded at the follow-up visits. IAS was achieved in 92.7% (38/41) of the study subjects. The IAS significantly differed between patients with RCCs ≤4cm (100%, 29/29) and RCCs >4cm (75%, 9/12, p=0.021). During the median follow-up of 37.6 (range, 3.0-97.3) months, the estimated 1-, 3-, and 5-year DFS of patients with an initial tumor of ≤4cm were 100%, 89.7%, and 81.5%, respectively. The 1-, 3-, and 5-year RRS were 100%, 93.3%, and 93.3%, respectively. The 1-, 3-, and 5-year OS were 97.1%, 87.8%, and 83.6%, respectively. The multivariate analysis using the Cox proportional hazard model revealed no independent predictor of recurrence among all the variables. There were no MWA-related deaths among the study subjects. One patient developed a retroperitoneal abscess after ablation. US-guided percutaneous MWA appears to be a promising method for RCCs adjacent to renal sinus, especially for tumors ≤4cm. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Does Renal Artery Supply Indicate Treatment Success of Renal Denervation?

    International Nuclear Information System (INIS)

    Schmid, Axel; Ditting, Tilmann; Sobotka, Paul A.; Veelken, Roland; Schmieder, Roland E.; Uder, Michael; Ott, Christian

    2013-01-01

    PurposeRenal denervation (RDN) emerged as an innovative interventional antihypertensive therapy. With the exception of pretreatment blood pressure (BP) level, no other clear predictor for treatment efficacy is yet known. We analyzed whether the presence of multiple renal arteries has an impact on BP reduction after RDN.MethodsFifty-three patients with treatment-resistant hypertension (office BP ≥ 140/90 mmHg and 24-h ambulatory BP monitoring (≥130/80 mmHg) underwent bilateral catheter-based RDN. Patients were stratified into one-vessel (OV) (both sides) and at least multivessel (MV) supply at one side. Both groups were treated on one vessel at each side; in case of multiple arteries, only the dominant artery was treated on each side.ResultsBaseline clinical characteristics (including BP, age, and estimated glomerular filtration rate) did not differ between patients with OV (n = 32) and MV (n = 21). Office BP was significantly reduced in both groups at 3 months (systolic: OV −15 ± 23 vs. MV −16 ± 20 mmHg; diastolic: OV −10 ± 12 vs. MV −8 ± 11 mmHg, both p = NS) as well as 6 months (systolic: OV −18 ± 18 vs. MV −17 ± 22 mmHg; diastolic: OV −10 ± 10 vs. −10 ± 12 mmHg, both p = NS) after RDN. There was no difference in responder rate (rate of patients with office systolic BP reduction of at least 10 mmHg after 6 months) between the groups.ConclusionIn patients with multiple renal arteries, RDN of one renal artery—namely, the dominant one—is sufficient to induce BP reduction in treatment-resistant hypertension

  7. Does Renal Artery Supply Indicate Treatment Success of Renal Denervation?

    Energy Technology Data Exchange (ETDEWEB)

    Schmid, Axel, E-mail: axel.schmid@uk-erlangen.de [University of Erlangen-Nuremberg, Department of Radiology (Germany); Ditting, Tilmann, E-mail: tilmann.ditting@uk-erlangen.de [University of Erlangen-Nuremberg, Department of Nephrology and Hypertension (Germany); Sobotka, Paul A., E-mail: sobotka@alumni.stanford.edu [Ohio State University (United States); Veelken, Roland, E-mail: roland.veelken@uk-erlangen.de; Schmieder, Roland E., E-mail: roland.schmieder@uk-erlangen.de [University of Erlangen-Nuremberg, Department of Nephrology and Hypertension (Germany); Uder, Michael, E-mail: michael.uder@uk-erlangen.de [University of Erlangen-Nuremberg, Department of Radiology (Germany); Ott, Christian, E-mail: christian.ott@uk-erlangen.de [University of Erlangen-Nuremberg, Department of Nephrology and Hypertension (Germany)

    2013-08-01

    PurposeRenal denervation (RDN) emerged as an innovative interventional antihypertensive therapy. With the exception of pretreatment blood pressure (BP) level, no other clear predictor for treatment efficacy is yet known. We analyzed whether the presence of multiple renal arteries has an impact on BP reduction after RDN.MethodsFifty-three patients with treatment-resistant hypertension (office BP {>=} 140/90 mmHg and 24-h ambulatory BP monitoring ({>=}130/80 mmHg) underwent bilateral catheter-based RDN. Patients were stratified into one-vessel (OV) (both sides) and at least multivessel (MV) supply at one side. Both groups were treated on one vessel at each side; in case of multiple arteries, only the dominant artery was treated on each side.ResultsBaseline clinical characteristics (including BP, age, and estimated glomerular filtration rate) did not differ between patients with OV (n = 32) and MV (n = 21). Office BP was significantly reduced in both groups at 3 months (systolic: OV -15 {+-} 23 vs. MV -16 {+-} 20 mmHg; diastolic: OV -10 {+-} 12 vs. MV -8 {+-} 11 mmHg, both p = NS) as well as 6 months (systolic: OV -18 {+-} 18 vs. MV -17 {+-} 22 mmHg; diastolic: OV -10 {+-} 10 vs. -10 {+-} 12 mmHg, both p = NS) after RDN. There was no difference in responder rate (rate of patients with office systolic BP reduction of at least 10 mmHg after 6 months) between the groups.ConclusionIn patients with multiple renal arteries, RDN of one renal artery-namely, the dominant one-is sufficient to induce BP reduction in treatment-resistant hypertension.

  8. Renal oncocytoma in a cat with chronic renal failure

    OpenAIRE

    Sora Lee; Hyun-Ji Choi; Han-Byul Lee; Sung-Min Jo; Ji-hye Mun; Woo-Chan Son

    2017-01-01

    Case summary A 9-year-old male neutered domestic shorthair cat presented with anorexia. Ultrasonography showed an irregularly shaped hypoechoic mass in the cranial pole of the right kidney. Ultrasound-guided fine-needle aspiration of the renal mass was performed. Cytology revealed moderate cellularity smears composed of epithelial cell clusters, which consisted of an exclusive population of oncocytic cells seen in sheets and papillary clusters along with abundant single cells. A moderate-to-a...

  9. [Orthotopic renal transplant: our experience].

    Science.gov (United States)

    De Gracia, R; Jiménez, C; Gil, F; Escuin, F; Tabernero, A; Sanz, A; Hidalgo, L

    2007-01-01

    Orthotopic renal transplant (ORT) is useful in cases of severe atherosclerosis, heterotopic bilateral transplant, unsuitable pelvic vessels and in aortic thrombosis, but it is not available in all the institutions and it is only realized of exceptional form. To review the indication, surgical technique and outcome of the ORT at our hospital. The studied included five cases between January 1990 and December 2005. We analyzed several variables: demographic characteristics, characteristics of the donor, ischemia times, evolution of renal function and morbi-mortality associated. Left ORT was performed in three men and two women. Mean patient age was 52+/-5 years, all the patients received kidneys from cadaveric donors. Mean creatinine and urea one month postoperative were 2.2+/-0.72 mg/dl and 103+/-17.2 mg/dl and at 6 months postoperative were 1.8+/-0.59 mg/dl and 78+/-14 mg/dl respectively. Immediately all patients received prophylaxis with low molecular weight heparin but it was indicated antiaggregation to two patients when they left the hospital, anticoagulation to two patients and to one of them was decided to anticoagulation nor antiagregation for history of bled digestive. A patient died for bleeding episode at level of the renal graft six months after the transplant, she was in treatment with dicumarinics, they were indicated by venous deep thrombosis in right leg. The survival a year is 80 % of the graft and the patient. Only two patients returned to hospital later, one of them for presenting an episode of diverticulitis and the other one for renal obstructive failure that needed laying of catheter pig-tail. Four patients presented stenosis of renal native vassels detected in control magnetic nuclear resonance, not symptomatic. There are two patients who take more than three years transplanted with renal stable function (creatinina 1.3 mg/dl and 1.4 mg/dl respectively). ORT is an excellent option in patients with co-morbidity increased for atherosclerosis and

  10. Supervivencia prolongada en el síndrome de Casamassima-Morton- Nance. Reporte de caso y revisión de la literatura

    OpenAIRE

    Nidia Huerta-Uribe

    2015-01-01

    El síndrome de Casamassima-Morton-Nance es una entidad rara, de etiología desconocida y mal pronóstico, que pertenece al grupo heterogéneo de las disostosis espondilocostales. Este síndrome, además de defectos vertebrales y arcos costales, comprende atresia anal y anormalidades genitourinarias como criptorquidia, hidrocele, hidronefrosis, agenesia renal, cloaca y fístulas urinarias, entre otras. En este trabajo informamos el caso de una niña de seis años de edad, sin historia de consanguinida...

  11. Leiomiosarcoma de mesenterio. Reporte de un caso

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    Miguel Ángel Serra Valdés

    2014-11-01

    Full Text Available Los tumores sólidos primitivos son generalmente de origen mesenquimático, y dentro de estos predominan los derivados del músculo liso, constituyendo un capítulo de gran interés por su carácter excepcional y por su dificultad diagnóstica. Se presenta el caso de una paciente de 50 años de edad, con molestias en flanco derecho, donde se notaba un aumento de volumen, desde hacía algunos meses, que ya causaba dolor. Al examen físico se constató una tumoración abdominal gigante que ocupaba todo el flanco derecho y se proyectaba a mesogastrio. Se realizaron estudios imagenológicos, que incluyeron tomografía axial computarizada contrastada de abdomen, y se sometió a laparotomía exploradora con diagnóstico preoperatorio de tumor abdominal. Se realizó exéresis tumoral y estudio histológico, concluyendo un leiomiosarcoma de mesenterio. Se puso tratamiento con quimioterapia y la evolución clínica fue favorable. El objetivo de esta presentación es comunicar a la comunidad médica este caso por el insuficiente reporte encontrado en la literatura.

  12. Cistos de Tarlov: relato de quatro casos

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    Sá Márcia Cristina da Paixão Rodrigues Miranda de

    2004-01-01

    Full Text Available São relatados quatro casos de cistos perineurais sacrais, conhecidos por cistos de Tarlov, e é feita revisão da literatura. A partir de amostra de 88 pacientes com queixas de radiculopatia em membros inferiores, e/ ou dor lombar ou sacral que foram submetidos à ressonância magnética de coluna lombossacra quatro (4.5% tiveram o diagnóstico de cisto de Tarlov. O diagnóstico foi feito através de ressonância magnética de coluna vertebral lombossacra. Os quatro casos foram submetidos a laminectomia sacral. Todos evoluíram assintomáticos sem défices motores ou sensitivos. Os cistos de Tarlov podem apresentar manifestações clínicas semelhantes às provocadas por hérnia discal lombossacra embora, nem sempre sejam citados nos diagnósticos diferenciais. O tratamento clínico é basicamente fisioterápico. O tratamento cirúrgico visa sanar o efeito compressivo em estruturas ósseas e/ ou nervosas através de punção do cisto ou retirada dele através de laminectomia sacral.

  13. 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...

  14. Manifestações renais na síndrome de Joubert Renal symptoms in the Joubert syndrome

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    Ana Paula Weiss

    2009-06-01

    Full Text Available OBJETIVO:Descrever o caso clínico de paciente com Síndrome de Joubert associada a alterações renais. DESCRIÇÃO DO CASO: Paciente de dois meses de idade admitida com quadro hipotonia e hiperpneia. Ao exame físico, observaram-se, além da respiração irregular, movimentos oculares anormais e hipertensão arterial; não se evidenciaram alterações na ausculta cardíaca e pulmonar. Durante investigação clínico-laboratorial inicial, as causas cardíacas e pulmonares foram descartadas. Aventaram-se hipóteses diagnósticas de patologias neurológicas com doença renal. Os exames laboratoriais mostraram presença de alcalose respiratória, acidose metabólica e hipercalemia, com função renal normal. A ressonância magnética evidenciou alterações neurológicas compatíveis com "sinal do dente molar", quadro frequentemente associada à Sindrome de Joubert. Levando-se em consideração a associação dessa síndrome com alterações renais, a investigação nefrológica demonstrou imagens císticas em parênquima renal. COMENTÁRIOS: Patologias cardíacas e pulmonares estão frequentemente associadas a manifestações clínicas como taquipneia e distúrbios metabólicos. Entretanto, pode ser necessária uma investigação neurológica porque diversas doenças que acometem o sistema nervoso central apresentam tais alterações. A associação entre alterações renais e malformações de sistema nervoso central é frequente em diversos processos sindrômicos, justificando-se a sua investigação. A Síndrome de Joubert e as desordens a ela relacionadas caracterizam-se por aplasia do vermix cerebelar, ataxia, movimentos oculares anormais, respiração irregular e retardo do desenvolvimento neuropsicomotor. As alterações renais mais comuns são os cistos renais e a nefronoftise, que pode progredir para doença renal terminal.OBJECTIVE:To describe the case of a patient with Joubert syndrome associated with renal impairments. CASE

  15. Focus on renal congestion in heart failure.

    Science.gov (United States)

    Afsar, Baris; Ortiz, Alberto; Covic, Adrian; Solak, Yalcin; Goldsmith, David; Kanbay, Mehmet

    2016-02-01

    Hospitalizations due to heart failure are increasing steadily despite advances in medicine. Patients hospitalized for worsening heart failure have high mortality in hospital and within the months following discharge. Kidney dysfunction is associated with adverse outcomes in heart failure patients. Recent evidence suggests that both deterioration in kidney function and renal congestion are important prognostic factors in heart failure. Kidney congestion in heart failure results from low cardiac output (forward failure), tubuloglomerular feedback, increased intra-abdominal pressure or increased venous pressure. Regardless of the cause, renal congestion is associated with increased morbidity and mortality in heart failure. The impact on outcomes of renal decongestion strategies that do not compromise renal function should be explored in heart failure. These studies require novel diagnostic markers that identify early renal damage and renal congestion and allow monitoring of treatment responses in order to avoid severe worsening of renal function. In addition, there is an unmet need regarding evidence-based therapeutic management of renal congestion and worsening renal function. In the present review, we summarize the mechanisms, diagnosis, outcomes, prognostic markers and treatment options of renal congestion in heart failure.

  16. 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.

  17. Renal aneurysm and arteriovenous fistula

    International Nuclear Information System (INIS)

    Savastano, S.; Feltrin, G.P.; Miotto, D.; Chiesura-Corona, M.; Padua Univ.

    1990-01-01

    Embolization was performed in six patients with renal artery aneurysms (n=2) and arteriovenous fistulas (AVF) (n=5). The aneurysms were observed in one patient with fibromuscular dysplasia and in another with Ehlers-Danlos syndrome. All the AVFs were intraparenchymal and secondary to iatrogenic trauma. Elective embolization was performed in five patients with good clinical results at follow-up between 1 and 9 years. Because of rupture of the aneurysm emergency embolization was attempted without success in the patient with Ehlers-Danlos syndrome, and nephrectomy was carried out. A postembolization syndrome complicated three procedures in which Gelfoam and polyvinyl alcohol were used; in two of these cases unexpected reflux of the particulate material occurred, resulting in limited undesired ablation of the ipsilateral renal parenchyma. Embolization is the most reliable and effective treatment for intrarenal vascular abnormalities since it minimizes the parenchymal damage. (orig.)

  18. Bone scintigraphy in renal osteopathy

    International Nuclear Information System (INIS)

    Hermann, H.J.; Gahl, G.; Freie Univ. Berlin

    1976-01-01

    25 patients with chronic renal disease are investigated. In 16 cases with conservative treatment the bone scintigram showed pathological uptake according to the creatinine level, mainly in the joints of iliosacrum, hip, knee and ankles. In three patients increased uptake in the skull was found. The bone uptake found by scintigraphy was highly pronounced in the patients treated by dialysis. The most frequently involved regions were the joints of iliocacrum and hip, facial cranium, skull, pelvis and metatarsus. The count-rate ratio of cranium to chest was significantly increased in 6 patients. The investigations 6 months later showed in 4 cases a further increase compared with the first values. Count-rates of the skull were found to be comparable to the highly increased uptake in Paget's disease. Bone scintigraphy is a suitable method to estimate semiquantitatively the bone turnover in renal disease. (orig.) [de

  19. Dynamic renal scintigraphy at hydronephrosis

    International Nuclear Information System (INIS)

    Petrov, T.; Chukov, I.; Svrakova, E.

    1998-01-01

    The aim of the study was to estimate the clinical relevance and accuracy of dynamic renal scintigraphy (DRS) in case of obstructed kidneys as hydronephrosis is among the complications at different renal diseases, like nephrolithiasis and urolithiasis. Twenty-one patients mainly with unilateral hydronephrosis were studied. DRS with 99m Tc-MAG3 or 99m Tc-EC was done and quantitative parameters of the morphological and functional status of every kidney were assessed. At 24 % of the patients accumulation curves typical for obstructed by hydronephrosis kidneys were obtained. At 38 % the type of renograms of the affected kidneys was intermediate one, closer to that at the cases with nephrosclerosis, with lower uptake and severe parenchymal changes. The rest 38 % of the cases showed normal renograms or slightly delayed downslope. DRS is a very precise and sensitive method for evaluation of the degree of kidney damage in cases with hydronephrosis

  20. Renal allograft rupture: US diagnosis

    International Nuclear Information System (INIS)

    Maklad, N.F.

    1987-01-01

    The US appearances in seven pathologically and/or surgically proved cases of renal allograft rupture are presented. These include a triangular or amorphous echogenic area in the cortex and medulla in a polar location, an echogenic band or wavy, branching anechoic lines in the hyperechoic region, a subcapsular hematoma, and an extrarenal hematoma in direct continuity with the echogenic area. Duplex Doppler examination in renal allograft rupture shows marked reduction of absence of the diastolic component of the velocity waveform in the arcuate and interlobar arteries, with reduction in amplitude of the systolic wave form. Correlation of the US appearances with gross and microscopic pathologic findings indicates that the echogenic area is due to an intrarenal hematoma, while the echogenic band represents the cortical laceration with adherent blood clots. The US-duplex Doppler examination should be the primary diagnostic modality in this life-threatening condition

  1. 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.

  2. [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.

  3. 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.

  4. Costo-efectividad de intervenciones para insuficiencia renal crónica terminal

    Directory of Open Access Journals (Sweden)

    Armando Arredondo

    1998-12-01

    Full Text Available OBJETIVO: Analisó el costo-efectividad en intervenciones para pacientes con insuficiencia renal crónica terminal (IRCT en términos de los costos económicos de cada intervención, los años de vida ganados y la calidad de vida que generan tres alternativas comparables y mutuamente excluyentes: diálisis peritoneal contínua ambulatoria (DPCA, la hemodiálisis (HD y el trasplante renal (TR. MÉTODO: El diseño del estudio fue de tipo longitudinal. Los costos de cada intervención se determinaron mediante la técnica de manejo de caso promedio. Las medidas para evaluar los criterios de efectividad elegidos fueron la probabilidad de sobrevida y el Año de Vida Ajustado por Calidad (QALY, Quality Adjusted Life Year medido por el Indice de Rosser. RSULTADOS: Los costos de manejo anual de caso fueron: diálisis peritoneal $5,643.07, hemodiálisis $9,631.60 y trasplante $3,021.63. En cuanto a la efectividad, la sobrevida del injerto de trasplante renal resultó de 89,9% y 79,6% a uno y tres años respectivamente, mientras que los pacientes sometidos a DPCA tienen una sobrevida de 86,2% y 66,9% a un año y a tres años respectivamente. En cuanto a los QALY's, los resultados para cada intervención fueron: DPCA 0,879; HD 0,864; y para el TR 0,978. CONCLUSIÓN: La intervención más costo-efectiva resultó el trasplante renal con un coeficiente de 3,088.69, seguido de la DPCA y la hemodiálisis, cuyos coeficientes fueron de 6,416.95 y 11,147.68 respectivamente. Por lo tanto se recomienda promover y utilizar el trasplante renal como la intervención más costo-efectiva para pacientes con IRCT.

  5. GENERACIÓN DE CASOS DE PRUEBA A PARTIR DE CASOS DE USO EN LAS PRUEBAS DE SOFTWARE

    Directory of Open Access Journals (Sweden)

    Orelvis Vázquez Ruiz

    2006-04-01

    Full Text Available

    Los casos de uso son utilizados para expresar la funcionalidad requerida en un sistema. Los casos de prueba derivados directamente de casos de uso aprovechan la ventaja que constituye contar con la especificación existente de estos últimos, para garantizar un basamento sólido para las pruebas a realizar sobre el sistema. La capacidad para crear casos de prueba a partir de los casos de uso, y hacer la traza de unos a otros, es una habilidad vital para asegurar un producto de calidad.

  6. Leiomyoma in a Renal Allograft

    Directory of Open Access Journals (Sweden)

    Yan Jun Li

    2016-01-01

    Full Text Available Leiomyomas are smooth muscle tumours that are rarely found in the kidney. There is one report of a leiomyoma in a kidney transplant in a paediatric recipient. Here, we report an adult renal transplant recipient who developed an Epstein-Barr virus-positive leiomyoma in his allograft 15 years after transplantation. The patient was converted to everolimus for posttransplant immunosuppression management and there was no sign of progression over a year.

  7. Congenital hypopituitarism and renal failure

    Directory of Open Access Journals (Sweden)

    Gaurav Atreja

    2011-01-01

    Full Text Available Congenital hypopituitarism is potentially fatal in the newborn period but treatable if the diagnosis is made early. We report a neonate who presented with hypothermia and severe hypoglycemia. He also had undescended testis and micropenis. Initial screening revealed panhypopituitarism, which was corrected promptly. He developed renal failure due to initial cardiovascular compromise related to hypotension but recovered quickly with standard management. Magnetic resonance imaging revealed absent stalk of anterior pituitary.

  8. Renal manifestations of primary hyperparathyroidism

    OpenAIRE

    Lila, Anurag Ranjan; Sarathi, Vijaya; Jagtap, Varsha; Bandgar, Tushar; Menon, Padma S.; Shah, Nalini Samir

    2012-01-01

    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 decli...

  9. Fonoterapia em glossectomia total: estudo de caso Speech therapy in total glossectomy: case study

    Directory of Open Access Journals (Sweden)

    Camila Alves Vieira

    2011-12-01

    Full Text Available A cirurgia curativa do câncer de língua ocasiona sequelas que prejudicam o bom funcionamento das funções estomatognáticas. O objetivo do trabalho é descrever, por meio de estudo de caso, os achados da avaliação e a evolução da reabilitação fonoaudiológica das funções de deglutição e fala de um indivíduo de 58 anos, gênero masculino, submetido à glossectomia total em junho de 2009. Após a avaliação diagnosticou-se disfagia orofaríngea mecânica severa e alteração na articulação da fala. Na reabilitação fonoaudiológica foram utilizadas, como formas de atuação, as terapias direta e indireta. Na terapia indireta trabalhou-se controle motor oral, sensibilidade, mobilidade, motricidade, tônus e postura das estruturas adjacentes da língua resseccionada. Na terapia direta empregou-se a manobra de postura de cabeça para trás para auxiliar na ejeção de alimentos para a faringe. O paciente passou a alimentar-se exclusivamente por via oral, com a restrição de sólidos, após dez meses em tratamento. No que se refere à fala, foram utilizados exercícios de sobrearticulação, velocidade e ritmo para melhorar a sua inteligibilidade. Dessa forma, considerou-se os resultados da intervenção fonoaudiológica positivos e o paciente recebeu alta após um ano em tratamento. Conclui-se que as ressecções de língua apresentam sequelas significativas nas funções de deglutição e fala, assim sendo, é imprescindível a atuação fonoaudiológica para modificar e adaptar essas funções, além de proporcionar melhor qualidade de vida ao paciente.Curative surgery for tongue cancer results in sequelae that harm the good functioning of the stomatognathic system. The aim of the present study is to describe a case study, reporting the evaluation and evolution findings of the speech-language pathology rehabilitation of the swallowing and speech functions of a 58-year-old man submitted to total glossectomy in June 2009. After

  10. Hiperoxalúria primária com insuficiência renal crônica terminal em lactente Primary hyperoxaluria with endstage renal failure in an infant

    Directory of Open Access Journals (Sweden)

    Célia S. Macedo

    2002-04-01

    Full Text Available Objetivo: descrever caso clínico de um lactente com insuficiência renal crônica terminal, causada por hiperoxalúria primária.Método: após revisão da literatura, verifica-se a raridade da doença; na França, a prevalência é de 1,05/milhão, com taxa de incidência de 0,12/milhão/ano. Pesquisa abordando centros especializados mundiais detectou, em 1999, 78 casos em lactentes; destes, em 14% o quadro inicial foi de uremia. A gravidade e a raridade da doença sugerem o relato deste caso.Resultados: criança de sexo feminino, com quadro de vômitos e baixo ganho de peso desde os primeiros meses de vida, desenvolveu insuficiência renal terminal aos 6 meses de idade, sendo mantida em tratamento dialítico desde então. Aos 8 meses, foi encaminhada para esclarecimento diagnóstico, apresentando déficit pôndero-estatural grave e os seguintes exames laboratoriais: uréia= 69 mg/dl, creatinina=2,2 mg/dl e clearance de creatinina= 12,5 ml/min/1.73m²SC. O exame de urina foi normal, a ultra-sonografia renal revelou tamanho normal e hiperecogenicidade de ambos os rins. A dosagem de oxalato urinário foi de 9,2mg/kg/dia ou 0,55 mmol/1.73m²SC, e a relação oxalato:creatinina, de 0,42. A biópsia renal diagnosticou presença de grande quantidade de depósitos de cristais de oxalato de cálcio no parênquima renal. A radiografia de ossos longos evidenciou sinais sugestivos de osteopatia oxalótica, e a fundoscopia indireta, sinais de retinopatia por oxalato. A criança foi mantida em diálise peritoneal ambulatorial contínua, tendo sido iniciado tratamento com piridoxina.Conclusões: a hiperoxalúria primária deve ser considerada como um dos diagnósticos diferenciais de insuficiência renal crônica em lactentes, especialmente na ausência de história sugestiva de outras patologias.Objective: to report a case of an infant with endstage renal failure caused by primary hyperoxaluria. Methods: the review of the literature showed the rarity of

  11. Pulmonary complications in renal transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jung Bin; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Lee, Seung Rho; Hahm, Chang Kok; Joo, Kyung Bin [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2003-04-01

    To evaluate the radiographic and CT findings of pulmonary complications other than pulmonary edema arising from renal transplantation. Among 393 patients who had undergone renal transplantation at our hospital during a previous ten-year period, 23 with pulmonary complications other than pulmonary edema were included in this study. The complications involved were infection caused by CMV (n=6), bacteria (n=4), fungus (n=4), tuberculosis (n=2), varicella (n=1) or chlamydia (n=1), and malignancy involving lung cancer (n=4) or Kaposi's sarcoma (n=1). Two chest radiologists reviewed all images. The complications manifesting mainly as pulmonary nodules were lung cancer (4/4), tuberculosis (1/2), and Kaposi's sarcoma (1/1). Pulmonary consolidation was a main feature in bacterial infection (4/4), fungal infection (3/4), tuberculosis (1/2), chlamydial infection (1/1), and varicellar pneumonia (1/1). Ground-glass attenuation was a main CT feature in CMV pneumonia (4/6), and increased interstitial making was a predominant radiographic feature in CMV pneumonia (2/6). The main radiologic features described above can be helpful for differential diagnosis of the pulmonary complications of renal transplantation.

  12. Pregnancy in renal transplant recipients.

    Science.gov (United States)

    Bouattar, T; Hakim, H; Rhou, H; Benamar, L; Bayahia, R; Ouzeddoun, N

    2009-06-01

    Renal transplantation with a well-functioning graft leads to a rapid restoration of endocrine and sexual functions. The aim of this study was to examine our experience with pregnancies among renal transplant patients, particularly with regard to their impact on graft function. We analyzed 10 pregnancies in 7 renal transplant recipients for long-term graft outcomes in terms of clinical and biological data. The mean patient age was 28.5 +/- 4 years. They all received a living donor kidney. The time between transplantation and the onset of pregnancy was 33.4 +/- 23.2 months. Regarding the immunosuppressive therapy, all patients received steroids and cyclosporine; 4 patients received in addition azathioprine and 2 received mycophenolate mofetil that was changed at 1 month before conception to azathioprine. There was no significant difference between the serum creatinine before and during pregnancy. We did not observe any acute rejection episode. Pregnancy complications were preclampsia in 1 case, hypertension in 1 case, urinary tract infection in 2 cases, and anemia in 80% of patients during the third trimester. Premature rupture of membranes occurred in 1 case and preterm delivery in 2 cases. Two cases of neonatal death were registered. Cesarean section was performed in 50% of cases. The follow-up revealed 2 cases of chronic rejection. A multidisciplinary approach is necessary for pregnancy which generally occurs at 2 years after kidney transplantation.

  13. Renal disease and mitochondrial genetics.

    Science.gov (United States)

    Rötig, Agnès

    2003-01-01

    Respiratory chain (RC) deficiencies have long been regarded as neuromuscular diseases mainly originating from mutations in the mitochondrial DNA. Oxidative phosphorylation, i.e. adenosine triphosphate (ATP) synthesis-coupled electron transfer from substrate to oxygen through the RC, does not occur only in the neuromuscular system. Therefore, a RC deficiency can theoretically give rise to any symptom, in any organ or tissue, at any age and with any mode of inheritance, owing to the dual genetic origin of RC enzymes (nuclear DNA and mitochondrial DNA). Mitochondrial diseases can give rise to various syndromes or association, namely, neurologic and neuromuscular diseases, cardiac, renal, hepatic, hematological and endocrin or dermatological presentations. The most frequent renal symptom is proximal tubular dysfunction with a more or less complete de Toni-Debre-Fanconi Syndrome. A few patients have been reported with tubular acidosis, Bartter Syndrome, chronic tubulointerstitial nephritis or nephrotic syndrome. The diagnosis of a RC deficiency is difficult when only renal symptoms are present, but should be easier when another, seemingly unrelated symptom is observed. Metabolic screening for abnormal oxidoreduction status in plasma, including lactate/pyruvate and ketone body molar ratios, can help to identify patients for further investigations. These include the measurement of oxygen consumption by mitochondria and the assessment of mitochondrial respiratory enzyme activities by spectrophotometric studies. Any mode of inheritance can be observed: sporadic, autosomal dominant or recessive, or maternal inheritance.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Inhibición de la acumulación de Rojo Fenol por sulfametoxipiridazina en cortes de tejido renal

    Directory of Open Access Journals (Sweden)

    Jorge Sarmiento M.

    1962-10-01

    Full Text Available En relación con un trabajo anterior, en el cual se comprobó en el animal intacto la elevación de la concentración plasmática de penicilina cuando se había inyectado media hora antes sulfametoxipiridazina, el presente trabajo demuestra, en cortes de tejido renal adecuadamente conservados, que la capacidad de transporte del epitelio tubular renal para el rojo de fenol se inhibe en proporción a la concentración de sulfametoxipiridazina presente. Como el sistema enzimático responsable de la secreción tubular de la penicilina es idéntico al de la secreción del Rojo Fenol, se concluye que los resultados obtenidos son aplicables al caso de la penicilina.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Endovascular repair of an aorto-iliac aneurysm succeeded by kidney transplantation Tratamento endovascular de aneurisma aorto-ilíaco sucedido por transplante renal

    Directory of Open Access Journals (Sweden)

    Marcelo Bellini Dalio

    2010-09-01

    Full Text Available We present the case of aorto-iliac aneurysm in a patient with chronic renal failure requiring dialysis who were treated with an endovascular stent graft and, later on, submitted to kidney transplantation. A 53-year-old male with renal failure requiring dialysis presented with an asymptomatic abdominal aorto-iliac aneurysm measuring 5.0cm of diameter. He was treated with endovascular repair technique, being used an endoprosthesis Excluder®. After four months, he was successfully submitted to kidney transplantation (dead donor, with anastomosis of the graft renal artery in the external iliac artery distal to the endoprosthesis. The magnetic resonance imaging, carried out 30 days after the procedure, showed a good positioning of the endoprosthesis and adequate perfusion of the renal graft. In the follow-up, the patient presented improvement of nitrogenous waste, good positioning of the endoprosthesis without migration or endoleak. The endovascular repair of aorto-iliac aneurysm in a patient with end-stage renal failure under hemodialysis treatment showed to be feasible, safe and efficient, as it did not prevent the success of the posterior kidney transplantation.Apresentamos o caso de aneurisma aortoilíaco em um paciente com insuficiência renal crônica dialítica tratado com uma endoprótese vascular, sendo, após, submetido a transplante renal. Um homem de 53 anos com insuficiência renal dialítica apresentava um aneurisma abdominal aortoilíaco assintomático com 5,0cm de diâmetro. Foi tratado com técnica endovascular com uma endoprótese Excluderâ. Após quatro meses, foi submetido a transplante renal (doador cadáver com sucesso, com anastomose da artéria renal do enxerto na artéria ilíaca externa distal à endoprótese. A ressonância magnética 30 dias após o procedimento mostrou a endoprótese bem posicionada e o enxerto renal bem perfundido. No seguimento, o paciente evoluiu com melhora das escórias nitrogenadas, bom

  18. 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....

  19. Changing spectrum of renal disease in HIV

    Directory of Open Access Journals (Sweden)

    R. Sunil

    2016-12-01

    Full Text Available The study was done to evaluate the spectrum of various renal histopathological lesions in patients infected with HIV (Human Immunodeficiency Virus.32 HIV positive patients underwent Renal biopsy over a period of 3 years from October 2013 to September 2016 who had presented with renal dysfunction and urine sediment abnormalities. Out of 32 patients, 24 were males and 8 were females. The mode of transmission of disease was sexual in 25 patients.14 patients presented with Nephrotic range proteinuria and 11 patients underwent RRT (renal replacement therapy. Majority of patients had tubulointerstitial lesions (18 patients followed by glomerular lesions (14 patients.24 patients were receiving HAART (Highly active antiretroviral therapy and majority of them had tubulointerstitial lesions. Hence Renal biopsy is indicated in HIV patients presenting with renal failure to arrive at proper diagnosis and treatment.

  20. Renal Artery Stenosis (RAS) Case study

    International Nuclear Information System (INIS)

    Zaater, M.K.

    2012-01-01

    Renal Artery Stenosis (RAS), is one of the causes of secondary hypertension; there are many causes of renal artery stenosis, as atherosclerosis of the renal artery which account for 90% of cases of RAS; fibromuscular dysplasia accounts for 10% of RAS. Various causes of thrombophilia either due congenital causes or acquired causes and can lead to RAS. Our patient was presented by acute attack of epistaxis and hypertension. Angiography of the Renal Arteries,are showed no sign of renal artery stenosis. However, the right kidney showed upper pole infarction, and the left kidney showed evidence of functional lower pole renal artery stenosis, although there is no anatomical stenosis detected in angiography. Work up for the cause of thrombophilia did not help in the diagnosis, which may be due to an undiscovered cause of thrombophilia