RESUMEN

We report a case of an African patient with sickle cell trait who was diagnosed in Spain with B-cell lymphoma. Blood smears were negative for malaria, and no plasmodium antigens were detected in the blood. To treat his lymphoma, the patient underwent chemotherapy and autologous stem cell transplantation. Following a splenectomy due to a worsening condition, he developed clinical malaria with detectable parasitemia. This case suggests that the humoral response and parasite removal by the spleen may afford protection from overt disease and may even help maintain subclinical human reservoirs of the disease.

Asunto(s)

RESUMEN

PURPOSE: The purpose of this study is to describe the clinical characteristics of patients diagnosed with renal trauma at Hospital Universitario Del Valle (HUV) in Cali, Colombia. MATERIAL AND METHODS: This is a descriptive study of patients diagnosed with renal trauma (ICD 10) at HUV between 1 January 2003 and 31 December 2007. We gathered such variables as age, sex, haemodynamic stability, type of trauma, location and effect of injury, clinical examination findings at admission, presence of renal failure, need for transfusion, diagnostic method, accompanying injuries, required treatment, duration of hospital stay and complications. Statistical analysis was performed using SPSS v. 15. RESULTS: 106 patients were evaluated, 78.3% of whom were male; mean age was 30.5 years. The majority were admitted for blunt trauma (73.6%) mainly due to motorcycle accidents and falls from heights. Minor trauma (Grades 1-3) was found in 77.3% of cases, haematuria in 90% and flank pain in 64%. A CT scan was used in 69.8% of all cases. Conservative treatment was employed in 77.4% of the cases, mainly for minor trauma (P < .0001); of these, 12% subsequently required surgery. Acute abdominal pain was the main surgical indication. Procedures were as follows: Nephropexy (32%) nephrectomy (38%) and conservative treatment (26%). The main complication was rebleeding (3.8%). CONCLUSIONS: Minor trauma is the most frequent kind of kidney injury, and is usually present with associated injuries. Conservative treatment was administered to most patients, but the failure rate was 12% and the frequency of overall complications was 10%.

Asunto(s)

RESUMEN

Objetivo: Describir las características clínicas de los pacientes con diagnóstico de traumatismo renal en el Hospital Universitario del Valle (HUV) en Cali, Colombia. Materiales y métodos: Se realizó un estudio descriptivo de pacientes con diagnóstico de traumatismo renal (CIE 10) en el HUV entre el 1 de enero de 2003 y el 31 de diciembre de 2007. Se recolectaron variables como: edad, sexo, estabilidad hemodinámica, tipo de traumatismo, sitio y mecanismo de la lesión, hallazgos al examen físico de ingreso, fallo renal, requerimiento de transfusión, método del diagnóstico, lesiones asociadas, manejo del traumatismo, tiempo de hospitalización y complicaciones. El análisis estadístico se realizó en SPSS v. 15.Resultados: Se evaluó a 106 pacientes, el 78,3% varones, con un promedio de edad de 30años. La mayoría ingresó por traumatismo cerrado (73,6%), principalmente por accidente en moto y caídas de altura. Se encontró traumatismo menor (grado 1-3) en el 77,3% de los casos, hematuria (90%) y dolor en el flanco (64%). La tomografía computarizada se utilizó en el 69,8% de los casos. Se realizó un manejo conservador (77,4%) principalmente en traumatismo menor (p < 0,0001); de éstos un 12% requirió cirugía posteriormente. El abdomen agudo fue la indicación quirúrgica más frecuente. Se realizó: nefrorrafia (32%), nefrectomía (38%) y manejo conservador (26%). La complicación más frecuente fue el resangrado (3,8%).Conclusiones: El traumatismo renal menor es más frecuente y usualmente se presenta con lesiones asociadas. Se hace un manejo conservador en la mayoría de los pacientes; sin embargo, la tasa de fallo es del 12% y la frecuencia de complicaciones es del 10% (AU)

Purpose: The purpose of this study is to describe the clinical characteristics of patients diagnosed with renal trauma at Hospital Universitario Del Valle (HUV) in Cali, Colombia. Material and methods: This is a descriptive study of patients diagnosed with renal trauma (ICD 10) at HUV between 1 January 2003 and 31 December 2007. We gathered such variables as age, sex, haemodynamic stability, type of trauma, location and effect of injury, clinical examination findings at admission, presence of renal failure, need for transfusion, diagnostic method, accompanying injuries, required treatment, duration of hospital stay and complications. Statistical analysis was performed using SPSS v. 15.Results: 106 patients were evaluated, 78.3% of whom were male; mean age was 30.5 years. The majority were admitted for blunt trauma (73.6%) mainly due to motorcycle accidents and falls from heights. Minor trauma (Grades 1-3) was found in 77.3% of cases, haematuria in 90% and flank pain in 64%. A CT scan was used in 69.8% of all cases. Conservative treatment was employed in 77.4% of the cases, mainly for minor trauma (P <0.0001); of these, 12% subsequently required surgery. Acute abdominal pain was the main surgical indication. Procedures were as follows: Nephropexy (32%) nephrectomy (38%) and conservative treatment (26%). The main complication was rebleeding (3.8%).Conclusions: Minor trauma is the most frequent kind of kidney injury, and is usually present with associated injuries. Conservative treatment was administered to most patients, but the failure rate was 12% and the frequency of overall complications was 10% (AU)

Asunto(s)