Asunto(s)
Cistitis/diagnóstico , Enfisema/diagnóstico , Anciano , Antibacterianos/administración & dosificación , Cistitis/tratamiento farmacológico , Cistitis/microbiología , Diagnóstico Diferencial , Enfisema/tratamiento farmacológico , Enfisema/microbiología , Escherichia coli/aislamiento & purificación , Infecciones por Escherichia coli/diagnóstico , Infecciones por Escherichia coli/tratamiento farmacológico , Infecciones por Escherichia coli/microbiología , Femenino , Humanos , Inyecciones Intravenosas , Radiografía Abdominal , UrinálisisRESUMEN
Renal arteriovenous fistulae (AVF) are a rare condition that can be acquired, congenital, or idiopathic. Idiopathic AVF are the rarest type of renal AVF. Traditionally, renal AVF were treated with surgery, but the mainstay of treatment has shifted to an endovascular approach by coil embolization. Embolization procedures are often difficult secondary to the "high flow" of the AVF, and there is the substantial risk of distal embolization of coils. We present a case in which an idiopathic renal AVF was successfully embolized with an Amplatzer vascular plug.
Asunto(s)
Fístula Arteriovenosa/cirugía , Embolización Terapéutica/instrumentación , Arteria Renal/cirugía , Venas Renales/cirugía , Anciano , Fístula Arteriovenosa/diagnóstico por imagen , Velocidad del Flujo Sanguíneo , Embolización Terapéutica/métodos , Femenino , Humanos , Flujo Pulsátil , Arteria Renal/diagnóstico por imagen , Venas Renales/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Management of renal trauma has become more conservative as newer techniques evolve. In 2004, the Renal Trauma Subcommittee modified their algorithms for the management of renal injuries to include selective angiography and embolization for grade III and IV lacerations for both blunt and penetrating renal lacerations. These algorithms are based on the renal organ injury scale defined by The American Association for the Surgery of Trauma (AAST) and whether the patient is hemodynamically stable or unstable (Table 1). Historically, grade III and IV renal injuries would have been managed by renal exploration. The goals of treating patients with severe renal injuries are to prevent significant hemorrhage and retain sufficient functional nephrons to prevent end-stage kidney failure. Selective arterial embolization provides a minimally invasive treatment option for renovascular injuries and potentially obviates the need for surgical exploration with its higher incidence of nephrectomy. We present a case of grade IV renal laceration following blunt renal trauma, which was successfully treated with selective renal arterial embolization.
Asunto(s)
Embolización Terapéutica , Laceraciones/terapia , Arteria Renal/lesiones , Esquí/lesiones , Heridas no Penetrantes/terapia , Humanos , Masculino , Heridas y Lesiones/clasificación , Adulto JovenRESUMEN
Encrusted cystitis is a subtype of chronic cystitis characterized by multiple calcifications in the form of plaques located in the interstitium of the urinary bladder mucosa and frequently associated with mucosal ulcers. It is a very rare disease of controversial etiology. Our transmission electron microscopy of the calcified plaques of encrusted cystitis has revealed that the smallest formed particles (elementary units) of these calcifications are electron-dense shells surrounding an electron lucent core, diagnostic of calcifying nanoparticles (previously called nanobacteria). We pioneer the notion that calcifying nanoparticles are the causative agents of encrusted urinary bladder cystitis.
Asunto(s)
Calcinosis/patología , Cistitis/patología , Nanopartículas/ultraestructura , Vejiga Urinaria/ultraestructura , Adulto , Humanos , MasculinoRESUMEN
OBJECTIVES: To determine the feasibility of laboratories to use an instrument's Hemolytic Index (HI) to determine if a test result would be accurate in the presence of hemoglobin-based oxygen carrier HBOC-201. DESIGN AND METHODS: HI values from the Roche Hitachi Modular P800 for samples containing HBOC-201 were determined. HI limits for 24 tests determined by addition of RBC lysate hemoglobin to serum and the instrument manufacturer's HI limits were compared to HI limits for reporting the same tests determined by adding HBOC-201 to plasma. RESULTS: There is a linear relationship (R(2)=0.99) between the HI value on the Modular P800 and HBOC-201 concentrations. Twenty-one of 24 HI limits for reporting results as determined by the manufacturer or adding RBC lysate to serum were more conservative or equal to the limit determined by HBOC-201 interference testing. HBOC-201 interference testing was more conservative for albumin, creatinine, and uric acid. CONCLUSION: For most analytes, the Modular P800 HI provides an accurate, conservative and automated method to determine whether laboratory results should be reported or suppressed when samples contain HBOC-201.
Asunto(s)
Análisis Químico de la Sangre/instrumentación , Sustitutos Sanguíneos/metabolismo , Hemoglobinas/metabolismo , Hemólisis , Análisis Químico de la Sangre/métodos , HumanosRESUMEN
Laparoscopic radical prostatectomy (LARP) has been accepted as first line therapy for clinically localized prostate cancer. Complications have been low and outcomes are comparable to that of open surgery with potential benefits including shorter hospital stay, less pain and quicker return to normal activity. Unexplained paralysis following LARP is a rare entity with no reported cases in the current literature. We report a case of complete motor paralysis following LARP. An extensive multidisciplinary evaluation did not definitively establish a diagnosis. Aggressive multimodality treatment led to a complete recovery. Our understanding of this phenomena with the possible etiology and treatment is discussed.