RESUMO
OBJECTIVE: The objective of our study was to systematically summarize the published evidence of demographic, clinical, diagnostic imaging, and therapeutic characteristics of patients with multilocular cystic nephroma (MLCN). CONCLUSION: Cross-sectional imaging evaluation is important for suggesting the diagnosis of MLCN but has several limitations. The number of radical nephrectomies reported for MLCN encourages discussion concerning the utility of percutaneous presurgical biopsy and frozen-section intraoperative biopsy as a more conservative diagnostic approach.
Assuntos
Doenças Renais Císticas/diagnóstico por imagem , Neoplasias Renais/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Tumor de Wilms/diagnóstico por imagem , Biópsia , Meios de Contraste , Humanos , Doenças Renais Císticas/patologia , Doenças Renais Císticas/cirurgia , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Nefrectomia , Tumor de Wilms/patologia , Tumor de Wilms/cirurgiaRESUMO
BACKGROUND: Plasmodium vivax, the most geographically distributed cause of malaria, accounts for more than 70% of cases in the Americas. In Colombia, P. vivax was responsible for 67.3% of cases in the last five years. Despite vivax malaria impact worldwide, historically it has been neglected and considered to be a benign disease. In the last decade medical literature reports have emerged countering this benign outlook. This study pretends to describe the clinical and paraclinical profile of severe vivax malaria cases hospitalized in Tumaco, Cali, Buenaventura between 2009 and 2013, to contribute to the knowledge regarding the behaviour and clinical expression of this disease. METHODS: This is a descriptive, retrospective case-series study of 16 severe malaria vivax cases, hospitalized between 2009 and 2013, in Colombian municipalities of Tumaco, Buenaventura and Cali. Severe malaria vivax cases were defined using criteria adapted from the national guidelines. Descriptive analyses of reason for consultation, signs and symptoms, diagnosis, treatment, paraclinical characteristics, complications, and time hospitalized, were conducted. RESULTS: Sixteen cases of severe P. vivax were analysed. Fever, chills and headache were shown to be the main admission symptoms. Elevation of total bilirubin levels in 18.75%, and severe thrombocytopaenia in 25% of cases were the main complications presented during hospitalization. All cases responded to treatment, there were no deaths. CONCLUSIONS: The following questions derived from this study could be the basis for future research: 1) Does the time to consultation have an impact on the number of days hospitalized and how cases progress during hospitalization, 2) Are the severity criteria in WHO guidelines sensitive enough to be used in clinical practice compared to national guidelines, and 3) How does malnutrition contribute to anaemia in malaria-endemic regions.