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1.
Gac. méd. boliv ; 46(1)2023.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1448294

RESUMO

La nefrectomia parcial ha proporcionado múltiples beneficios principalmente en pacientes con lesiones renales de pequeño tamaño o con enfermedades que puedan afectar el funcionamiento renal a largo plazo, también en pacientes con riñón único funcional, ya sea congènita o por cirugía, enfermedad renal terminal, tumores renales bilaterales o con enfermedades cromosómicas que afecten la función renal.Se presenta el caso de un paciente de 52 años con un tumor de riñón derecho de 10 cm de diámetro en región interpolar, con riñón izquierdo sin función, por proceso obstructivo de estenosis ureteropielica congènita. Se realizó nefrectomia parcial derecha a pesar de la localización y tamaño del tumor renal, obteniendo excelentes resultados oncológicos y funcionales. Con un seguimiento a doce meses de evaluación post-operatoria sin datos de actividad tumoral, presentando una función renal con creatinina 1.6 mg/dl, con evolución satisfactoria. Conclusiones: La nefrectomia parcial es el manejo ideal para tumores renales pequeños que están localizados en la corteza renal y en los extremos polares del riñón o con un riñón contralateral sin función; pero hay el dilema cuando se presentan en pacientes con función renal baja o tumores localizados cerca del hilio renal de más de 5 cm de diámetro, se debe tomar los riesgo de intentar realizar este procedimiento, el abordaje por via laparoscópica es excelente opción con excelentes resultados, con menor riesgo de complicaciones, y menor sangrado que cirugía abierta.


Nephron-sparing surgery (partial nephrectomy) has provided multiple benefits, mainly in patients with small kidney lesions or concomitant diseases that affect overall kidney function in long term, also in patients with a single functional kidney, either congenital or by surgery, end-stage renal disease, bilateral renal tumors or with chromosomal diseases that affects the renal function. The case of a 52-years-old male patient is presented with a 10-cm right kidney tumor in the interpolar region, with not functional left kidney exclusion due to an obstructive process by congenital ureteropyelic stenosis. Right nephron-sparing nephrectomy was performed despite the location and size of the tumor, obtaining excellent oncological and functional results. Follow-up at twelve months of postoperative evolution showed no data of tumor activity, presenting renal function with creatinine of 1.6 mg/dl, with satisfactory evolution. Conclusions: Partial nephrectomy is the standard management for small-volume renal tumors located in the renal cortex and polar areas, or not functional contralateral kidney; but there is the dilemma, when patients appear with impaired renal function or tumors located near the renal hilum by > 5 cm of diameter, the risk of performs this procedure must be taken, the laparoscopic approach is an excellent option. with great results, and minor bleeding than open surgery.

2.
Arch Argent Pediatr ; 119(5): e480-e486, 2021 10.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34569748

RESUMO

A low birth weight (LBW, < 2500 g), intrauterine growth restriction (IUGR), and preterm birth (PB, < 37 weeks of gestational age) are the most common clinical factors for an altered programming of nephron number and are associated with a greater risk for hypertension, proteinuria, and kidney disease later in life. At present, an indirect assessment of total nephron number based on postnatal markers is the most important approach to evaluate the risk for future kidney disorders in newborn infants with a LBW, IUGR or PB. Here we describe advances made in animal experiments and biochemical markers in humans, and the recommendations for the prevention of preconception kidney injury, including social factors and chronic diseases. According to the evidence, IUGR and prematurity alone can modulate nephrogenesis and kidney function, and, if occurring simultaneously, their effects tend to be cumulative.


El bajo peso al nacer (BP, < 2500 g), la restricción del crecimiento intrauterino (RCIU) y el parto prematuro (PP, < 37 semanas de gestación) son los factores clínicos más habituales para la programación alterada del número de nefronas y se asocian con un mayor riesgo de hipertensión, proteinuria y enfermedad renal futura en la vida. En la actualidad la evaluación indirecta del número total de nefronas mediante el uso de marcadores en el período posnatal representa el enfoque principal para evaluar el riesgo de evolución futura de los trastornos renales en los recién nacidos con BP, RCIU o PP. Se presentan los avances en la investigación en animales y sobre marcadores bioquímicos en humanos, y recomendaciones para la prevención del daño renal preconcepcional, incluidos los factores sociales y las enfermedades crónicas. La evidencia demuestra que la restricción de crecimiento y la prematuridad solas son capaces de modular la nefrogénesis y la función renal y, cuando son concurrentes, sus efectos tienden a ser acumulativos.


Assuntos
Nefropatias , Nascimento Prematuro , Adulto , Animais , Feminino , Idade Gestacional , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Rim , Nefropatias/epidemiologia , Nefropatias/etiologia , Néfrons , Gravidez
3.
Arch. argent. pediatr ; 119(5): e480-e486, oct. 2021. ilus
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1292126

RESUMO

El bajo peso al nacer (BP, < 2500 g), la restricción del crecimiento intrauterino (RCIU) y el parto prematuro (PP, < 37 semanas de gestación) son los factores clínicos más habituales para la programación alterada del número de nefronas y se asocian con un mayor riesgo de hipertensión, proteinuria y enfermedad renal futura en la vida. En la actualidad la evaluación indirecta del número total de nefronas mediante el uso de marcadores en el período posnatal representa el enfoque principal para evaluar el riesgo de evolución futura de los trastornos renales en los recién nacidos con BP, RCIU o PP.Se presentan los avances en la investigación en animales y sobre marcadores bioquímicos en humanos, y recomendaciones para la prevención del daño renal preconcepcional, incluidos los factores sociales y las enfermedades crónicas. La evidencia demuestra que la restricción de crecimiento y la prematuridad solas son capaces de modular la nefrogénesis y la función renal y, cuando son concurrentes, sus efectos tienden a ser acumulativos.


A low birth weight (LBW, < 2500 g), intrauterine growth restriction (IUGR), and preterm birth (PB, < 37 weeks of gestational age) are the most common clinical factors for an altered programming of nephron number and are associated with a greater risk for hypertension, proteinuria, and kidney disease later in life. At present, an indirect assessment of total nephron number based on postnatal markers is the most important approach to evaluate the risk for future kidney disorders in newborn infants with a LBW, IUGR or PB.Here we describe advances made in animal experiments and biochemical markers in humans, and the recommendations for the prevention of preconception kidney injury, including social factors and chronic diseases. According to the evidence, IUGR and prematurity alone can modulate nephrogenesis and kidney function, and, if occurring simultaneously, their effects tend to be cumulative.


Assuntos
Humanos , Animais , Feminino , Gravidez , Recém-Nascido , Adulto , Nascimento Prematuro , Nefropatias/etiologia , Nefropatias/epidemiologia , Recém-Nascido de Baixo Peso , Idade Gestacional , Rim , Néfrons
4.
Hypertension ; 77(3): 759-767, 2021 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-33486988

RESUMO

The development of high blood pressure is influenced by genetic and environmental factors, with high salt intake being a known environmental contributor. Humans display a spectrum of sodium-sensitivity, with some individuals displaying a significant blood pressure rise in response to increased sodium intake while others experience almost no change. These differences are, in part, attributable to genetic variation in pathways involved in sodium handling and excretion. ENaC (epithelial sodium channel) is one of the key transporters responsible for the reabsorption of sodium in the distal nephron. This channel has an important role in the regulation of extracellular fluid volume and consequently blood pressure. Herein, we review the role of ENaC in the development of salt-sensitive hypertension, and present mechanistic insights into the regulation of ENaC activity and how it may accelerate sodium-induced damage and dysfunction. We discuss the traditional role of ENaC in renal sodium reabsorption and review work addressing ENaC expression and function in the brain, vasculature, and immune cells, and how this has expanded the implications for its role in the initiation and progression of salt-sensitive hypertension.


Assuntos
Pressão Sanguínea/fisiologia , Canais Epiteliais de Sódio/metabolismo , Hipertensão/fisiopatologia , Cloreto de Sódio na Dieta/metabolismo , Animais , Humanos , Hipertensão/etiologia , Hipertensão/metabolismo , Transporte de Íons , Rim/metabolismo , Modelos Biológicos , Néfrons/metabolismo , Cloreto de Sódio na Dieta/administração & dosagem , Cloreto de Sódio na Dieta/efeitos adversos
5.
J. bras. nefrol ; 39(4): 486-490, Oct.-Dec. 2017.
Artigo em Inglês | LILACS | ID: biblio-893790

RESUMO

ABSTRACT It is interesting that some of my predictions came true and some did not, but I think the jury is still out on many of them. I start to remind everyone on the glorious past of Nephrology, from the physiology, translational and methodological discoveries that have contributed to the development of our discipline. I predict that the Academic branch of Nephrology will continue to excel in three domains: Creative Research,Teaching (Training) and Innovative Clinical Care. I forsee dramatic changes in Nephrology practice in the short term (10 years) and I discuss which areas will have a most dramatic impact. Many developments will likely curtail the growth of CKD and decrease the burden of ESRD on society. The greatest challenge will be to ensure that what can be done to alleviate suffering and premature death from kidney disease will be done, in a cost-effective manner, and that all patients with kidney disease have reasonable and timely access to care for their illnesses. Nephrologists practicing in the second quarter of the 21st Century and beyond will be justifiably proud of their discipline, just as their predecessors have.


RESUMO É interessante que algumas de minhas previsões tenham se tornado realidade e outras não, mas acredito que algumas das que não se realizaram ainda têm chance de se concretizarem. Inicio relembrando a todos sobre o glorioso passado da Nefrologia, da fisiologia às descobertas translacionais e metodológicas que contribuíram para o desenvolvimento de nossa disciplina. Prevejo que o ramo acadêmico da Nefrologia continuará a se destacar em três domínios: Pesquisa Criativa, Ensino (Treinamento) e Cuidados Clínicos Inovadores. Vejo mudanças dramáticas na prática de Nefrologia no curto prazo (10 anos) e discuto quais áreas terão o maior impacto. Muitos acontecimentos provavelmente restringirão o crescimento da DRC e diminuirão o peso da ESRD na sociedade. O maior desafio será garantir que "o que pode ser feito" para aliviar o sofrimento e a morte prematura por doença renal "será feito", de forma economicamente viável. Outro desafio é ver que todos os nefropatas tenham acesso razoável e a tempo ao tratamento de suas doenças. Os nefrologistas praticando essa disciplina, no primeiro trimestre do século XXI e além, terão justificável orgulho de sua disciplina, da mesma forma como tiveram seus predecessores.


Assuntos
Humanos , Nefrologia/tendências , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/terapia , Previsões
6.
Acta cir. bras ; Acta cir. bras;32(7): 550-558, July 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-886220

RESUMO

Abstract Purpose: To evaluate whether low energy shock wave preconditioning could reduce renal ischemic reperfusion injury caused by renal artery occlusion. Methods: The right kidneys of 64 male Sprague Dawley rats were removed to establish an isolated kidney model. The rats were then divided into four treatment groups: Group 1 was the sham treatment group; Group 2, received only low-energy (12 kv, 1 Hz, 200 times) shock wave preconditioning; Group 3 received the same low-energy shock wave preconditioning as Group 2, and then the left renal artery was occluded for 45 minutes; and Group 4 had the left renal artery occluded for 45 minutes. At 24 hours and one-week time points after reperfusion, serum inducible nitric oxide synthase (iNOS), neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), creatinine (Cr), and cystatin C (Cys C) levels were measured, malondialdehyde (MDA) in kidney tissue was detected, and changes in nephric morphology were evaluated by light and electron microscopy. Results: Twenty-four hours after reperfusion, serum iNOS, NGAL, Cr, Cys C, and MDA levels in Group 3 were significantly lower than those in Group 4; light and electron microscopy showed that the renal tissue injury in Group 3 was significantly lighter than that in Group 4. One week after reperfusion, serum NGAL, KIM-1, and Cys C levels in Group 3 were significantly lower than those in Group 4. Conclusion: Low-energy shock wave preconditioning can reduce renal ischemic reperfusion injury caused by renal artery occlusion in an isolated kidney rat model.


Assuntos
Animais , Masculino , Ratos , Obstrução da Artéria Renal/complicações , Terapia por Ondas Curtas/métodos , Traumatismo por Reperfusão/etiologia , Traumatismo por Reperfusão/terapia , Precondicionamento Isquêmico/métodos , Rim/irrigação sanguínea , Ratos Sprague-Dawley , Modelos Animais de Doenças
7.
Acta cir. bras. ; 32(7): 550-558, July 2017. ilus, tab
Artigo em Inglês | VETINDEX | ID: vti-17587

RESUMO

Purpose: To evaluate whether low energy shock wave preconditioning could reduce renal ischemic reperfusion injury caused by renal artery occlusion. Methods: The right kidneys of 64 male Sprague Dawley rats were removed to establish an isolated kidney model. The rats were then divided into four treatment groups: Group 1 was the sham treatment group; Group 2, received only low-energy (12 kv, 1 Hz, 200 times) shock wave preconditioning; Group 3 received the same low-energy shock wave preconditioning as Group 2, and then the left renal artery was occluded for 45 minutes; and Group 4 had the left renal artery occluded for 45 minutes. At 24 hours and one-week time points after reperfusion, serum inducible nitric oxide synthase (iNOS), neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), creatinine (Cr), and cystatin C (Cys C) levels were measured, malondialdehyde (MDA) in kidney tissue was detected, and changes in nephric morphology were evaluated by light and electron microscopy. Results: Twenty-four hours after reperfusion, serum iNOS, NGAL, Cr, Cys C, and MDA levels in Group 3 were significantly lower than those in Group 4; light and electron microscopy showed that the renal tissue injury in Group 3 was significantly lighter than that in Group 4. One week after reperfusion, serum NGAL, KIM-1, and Cys C levels in Group 3 were significantly lower than those in Group 4. Conclusion: Low-energy shock wave preconditioning can reduce renal ischemic reperfusion injury caused by renal artery occlusion in an isolated kidney rat model.(AU)


Assuntos
Animais , Ratos , Ratos/anormalidades , Ratos/lesões , Traumatismo por Reperfusão/cirurgia , Isquemia
8.
Acta cir. bras ; Acta cir. bras;32(5): 334-341, May 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-837710

RESUMO

Abstract Purpose: To investigate the glomerular number after different warm ischemia times. Methods: Thirty two pigs were assigned into four groups. Three groups (G10, G20, and G30) were treated with 10, 20, and 30 minutes of left renal warm ischemia. The sham group underwent the same surgery without renal ischemia. The animals were euthanized after 3 weeks, and the kidneys were collected. Right kidneys were used as controls. The kidney weight, volume, cortical-medullar ratio, glomerular volumetric density, volume-weighted mean glomerular volume, and the total number of glomeruli per kidney were obtained. Serum creatinine levels were assessed pre and postoperatively. Results: Serum creatinine levels did not differ among the groups. All parameters were similar for the sham, G10, and G20 groups upon comparison of the right and left organs. The G30 group pigs' left kidneys had lower weight, volume, and cortical-medullar ratio and 24.6% less glomeruli compared to the right kidney. A negative correlation was found between warm ischemia time and glomerular number. Conclusions: About one quarter of glomeruli was lost after 30 minutes of renal warm ischemia. No glomeruli loss was detected before 20 minutes of warm ischemia. However, progressive glomerular loss was associated with increasing warm ischemia time.


Assuntos
Animais , Masculino , Isquemia Quente/efeitos adversos , Rim/irrigação sanguínea , Córtex Renal/irrigação sanguínea , Glomérulos Renais/irrigação sanguínea , Fatores de Tempo , Distribuição Aleatória , Creatinina/sangue , Modelos Animais , Sus scrofa , Rim/cirurgia , Rim/fisiopatologia , Córtex Renal/fisiopatologia , Glomérulos Renais/cirurgia , Glomérulos Renais/fisiopatologia
9.
Acta cir. bras. ; 32(5): 334-341, May 2017. tab, graf, ilus
Artigo em Inglês | VETINDEX | ID: vti-17636

RESUMO

Purpose: To investigate the glomerular number after different warm ischemia times. Methods: Thirty two pigs were assigned into four groups. Three groups (G10, G20, and G30) were treated with 10, 20, and 30 minutes of left renal warm ischemia. The sham group underwent the same surgery without renal ischemia. The animals were euthanized after 3 weeks, and the kidneys were collected. Right kidneys were used as controls. The kidney weight, volume, cortical-medullar ratio, glomerular volumetric density, volume-weighted mean glomerular volume, and the total number of glomeruli per kidney were obtained. Serum creatinine levels were assessed pre and postoperatively. Results: Serum creatinine levels did not differ among the groups. All parameters were similar for the sham, G10, and G20 groups upon comparison of the right and left organs. The G30 group pigs' left kidneys had lower weight, volume, and cortical-medullar ratio and 24.6% less glomeruli compared to the right kidney. A negative correlation was found between warm ischemia time and glomerular number. Conclusions: About one quarter of glomeruli was lost after 30 minutes of renal warm ischemia. No glomeruli loss was detected before 20 minutes of warm ischemia. However, progressive glomerular loss was associated with increasing warm ischemia time.(AU)


Assuntos
Animais , Suínos/anormalidades , Suínos/cirurgia , Isquemia/diagnóstico , Isquemia/veterinária , Nefrectomia/veterinária
10.
Urol Int ; 99(3): 262-266, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28355603

RESUMO

OBJECTIVE: The study aimed to evaluate the ischemic and non-ischemic areas after selective arterial occlusion by using stereological analysis of glomeruli, and to compare them with main arterial clamping and sham-operated animals. MATERIALS AND METHODS: Twenty-four male pigs were used in the study. The animals were divided into 3 groups with 8 animals in each as follows: group sham, submitted to laparoscopic dissection of the renal pedicle but not submitted to ischemia; group arterial (A), submitted to left renal artery clamping; and group selective (S), submitted to left renal artery caudal branch occlusion. Groups A and S underwent 30 min of warm ischemia. Left and right kidneys were collected after 21 days and renal fragments were processed for stereological evaluation. Glomerular volume density (Vv[glom]), mean glomerular volume (MGV), and glomerular density were measured. Serum creatinine and urea were assessed preoperatively, 10 days after surgery, and before euthanasia. RESULTS: There was no significant difference among groups with regard to renal function. Renal weight and volume were similar among groups. Also, no difference was observed between the groups with regard to Vv[glom], MGV, and glomerular density, both when compared to its right control or when left kidneys were compared. CONCLUSIONS: Selective arterial clamping technique was neither superior nor inferior to main artery clamping.


Assuntos
Rim/irrigação sanguínea , Artéria Renal/cirurgia , Isquemia Quente/métodos , Animais , Constrição , Rim/patologia , Rim/fisiopatologia , Glomérulos Renais/patologia , Masculino , Modelos Animais , Tamanho do Órgão , Artéria Renal/fisiopatologia , Circulação Renal , Sus scrofa , Fatores de Tempo , Isquemia Quente/efeitos adversos
11.
Rev. colomb. cienc. pecu ; 26(2): 127-135, jun. 2013. ilus, tab
Artigo em Inglês | LILACS | ID: lil-680509

RESUMO

Background: goliath grouper (Epinephelus itajara) is an economically valuable marine species and an excellent candidate for domestication for aquaculture purposes. If this grouper can osmoregulate in lowsalinity water, its cultivation can provide socio-economic benefits, for both coastal communities and the mainland agricultural sector. Objective: to evaluate the osmoregulatory capacity of juvenile goliath grouper when exposed to low-salinity water. Methods: juvenile goliath grouper (Epinephelus itajara) were either directly or gradually transferred from seawater to freshwater to test osmoregulatory ability. Body weight was assessed during acclimation and blood samples were taken to measure total osmolality and electrolytes. Results: all fish survived the transfer to freshwater and were maintained for up to 12 days after termination of the acclimation trials which lasted 72 hours. Juvenile goliath grouper were hyposmotic (342-462 mosmol/kg) to seawater and hyperosmotic (272-292 mosmol/kg) to freshwater. The gills and kidneys were found to have principal roles in the osmoregulatory processes. Numerous chloride cells were found on superficial regions of the gill filament epithelium, most likely serving to eliminate the excess of electrolytes while in seawater. The kidneys had numerous nephrons to make urine and retain electrolytes while in freshwater. Conclusions: these observations lead to the conclusions that juvenile goliath grouper have the ability to osmoregulate in freshwater and should be considered a marine euryhaline species. Such adaptability opens for consideration the possibility that goliath grouper could be successfully farmed in brackish water or even in freshwater.


Antecedentes: el mero guasa Epinephelus itajara es una especie marina de gran valor comercial y un excelente candidato a domesticar con fines acuícolas. Si el mero guasa puede osmoregular en agua de baja salinidad, su cultivo puede proporcionar beneficios socio económicos, tanto para las comunidades costeras, como al sector agropecuario en tierra firme. Objetivo: evaluar el efecto en la osmoregulación de juveniles de mero guasa expuestos a aguas de baja salinidad. Métodos: juveniles de mero guasa mantenidos en agua de mar fueron transferidos directamente o de manera gradual a agua dulce para poner a prueba su capacidad osmorreguladora. Durante el proceso de aclimatación se les evaluó el peso corporal y se extrajo sangre para medir la osmolalidad total y electrolitos. Resultados: todos los peces sobrevivieron la transferencia al agua dulce y durante 12 días más, después de la finalización de los ensayos de aclimatación que tuvieron una duración de 72 horas. Juveniles de mero guasa fueron hiposmóticos (342-462 mosmol/kg) respecto al agua de mar e hiperosmóticos (272-292 mosmol/kg) respecto al agua dulce. La histología de branquias y riñones reveló que estos órganos son de gran importancia en los procesos osmorregulatorios. Un gran número de células de cloruro fueron localizadas como parte del epitelio de los filamentos branquiales; estas células trabajan para librar al cuerpo del exceso de electrolitos mientras los peces se encuentran en el mar. En el riñón se observaron numerosas nefronas y túbulos colectores para la formación de orina y retención de electrolitos; tejidos esenciales si estos peces permanecen en agua dulce. Conclusión: estas observaciones llevan a la conclusión de que los juveniles de mero guasa tienen la capacidad de osmorregular en agua dulce y debe ser considerada una especie marina eurihalina. Tal adaptabilidad supone la posibilidad de que el mero guasa podría ser cultivado en agua salobre o incluso en agua dulce.


Antecedentes: o peixe garoupa Epinephelus itajara é uma espécie marinha de muito valor comercial a qual seria ótimo ter domesticada para sua produção industrial na aquicultura. Se o peixe garoupa pode osmoregular em água de baixa salinidade, sua cultura pode proporcionar benefícios socioeconômicos, tanto para as comunidades costeiras, quanto para o sector agrícola no interior do continente. Objetivo: avaliar a osmoregulação de juvenis do peixe garoupa expostos a águas de baixa salinidade. Métodos: juvenis do peixe Garoupa mantidos no mar foram transferidos direta ou gradualmente para água doce testando assim sua capacidade osmorregulatória. Durante o processo de aclimatização, foi avaliado o peso corporal e amostras de sangue foram coletadas para medir a osmolalidade total e alguns eletrólitos. Resultados: todos os peixes sobreviveram à transferência para água doce 12 dias mais após a conclusão dos estudos de aclimatação que se fizeram durante um período de 72 horas. Juvenis do peixe garupa foram hiposmoticos (342-462 mosmol/kg) com respeito à água marinha e hiperosmóticos (272-292 mosmol/kg) com respeito à água doce. Histologia das brânquias e os rins revelaram que estes órgãos são de grande importância nos processos de osmoregulaçao. Um grande número de células de cloreto foi localizado como parte do epitélio dos filamentos branquiais; estas células trabalham no organismo para livrar o corpo do excesso de eletrólitos enquanto os peixes estão no mar. Nos rins foram observados numerosos néfrons e ductos recoletores para a formação de urina e retenção de eletrólitos; tecidos essenciais no caso de que estes peixes permaneçam em água doce. Conclusão: estas observações levam à conclusão de que os juvenis do peixe garupa tem a capacidade de osmoregular em água doce e deve ser considerado uma espécie marinha eurialina. A adaptabilidade deste peixe em água doce supõe a possibilidade de que o peixe garupa poderia ser cultivado nesta água em criadouros no interior do continente.

12.
Int. braz. j. urol ; 39(2): 189-194, Mar-Apr/2013. tab, graf
Artigo em Inglês | LILACS | ID: lil-676264

RESUMO

Purpose The determination of the size of a renal tumor is important for staging, prognosis and selection of the appropriate surgical treatment. We investigated the difference of radiographic and pathologic size of renal tumors in a contemporary cohort of patients who underwent nephron sparing surgery and evaluated its clinical implications. Materials and Methods The records of 169 patients who received nephron sparing surgery for renal lesions suspicious for malignancy between January 2006 and December 2010 were reviewed retrospectively. Radiographic tumor size, defined as the largest diameter of tumor measured by CT images, and pathologic size, the largest diameter of tumor measured in the surgical specimen, were compared and analyzed. Results Among all subjects, mean radiographic and pathologic tumor size were 3.25 ± 1.78 cm and 3.03 ± 1.91 cm, respectively (P < 0.001), with a discrepancy of just 0.22 cm. When the patients were categorized according to radiographic tumor size in the 1 cm range, the mean radiographic tumor size was significantly greater than pathologic tumor size in the following groups: 2 to 3 cm (P < 0.001), 3 to 4 cm (P < 0.001), and 4 to 5 cm (P = 0.028). When radiographic and pathologic tumor sizes were compared according to the pathologic tumor subtype, a significant difference was observed only among those with clear cell renal carcinoma (P < 0.001). Conclusions Renal tumor size was overestimated by radiography as compared with pathology. The difference was just 0.22 cm with little clinical significance, suggesting that CT provides an accurate method to estimate renal tumor size preoperatively. .


Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Carcinoma de Células Renais/patologia , Carcinoma de Células Renais , Neoplasias Renais/patologia , Neoplasias Renais , Carga Tumoral , Análise de Variância , Néfrons/cirurgia , Valores de Referência , Tomografia Computadorizada por Raios X
13.
Int. braz. j. urol ; 38(3): 356-361, May-June 2012. ilus, tab
Artigo em Inglês | LILACS | ID: lil-643034

RESUMO

OBJECTIVE: Partial nephrectomy for small kidney tumors has increased in the last decades, and the approach to non-palpable endophytic tumors became a challenge, with larger chances of positive margins or complications. The aim of this study is to describe an alternative nephron-sparing approach for small endophytic kidney tumors through anatrophic nephrotomy. PATIENTS AND METHODS: A retrospective analysis of patients undergoing partial nephrectomy at our institution was performed and the subjects with endophytic tumors treated with anatrophic nephrotomy were identified. Patient demographics, perioperative outcomes and oncological results were evaluated. RESULTS: Among the partial nephrectomies performed for intraparenchymal tumors between 06/2006 and 06/2010, ten patients were submitted to anatrophic nephrotomy. The mean patient age was 42 yrs, and the mean tumor size was 2.3 cm. Mean warm ischemia time was 22.4 min and the histopathological analysis showed 80% of clear cell carcinomas. At a mean follow-up of 36 months, no significant creatinine changes or local or systemic recurrences were observed. CONCLUSION: The operative technique described is a safe and effective nephron-sparing option for complete removal of endophytic renal tumors.


Assuntos
Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Carcinoma de Células Renais/cirurgia , Neoplasias Renais/cirurgia , Nefrectomia/métodos , Néfrons/cirurgia , Tratamentos com Preservação do Órgão/métodos , Carcinoma de Células Renais/patologia , Estudos de Viabilidade , Neoplasias Renais/patologia , Estudos Retrospectivos , Resultado do Tratamento , Carga Tumoral , Isquemia Quente
14.
Int. j. morphol ; 26(1): 69-74, 2008. tab
Artigo em Inglês | LILACS | ID: lil-558575

RESUMO

The anti-inflammatory effect of dexamethasone on the irradiated kidneys of adult Wistar rats (Rattus norvegicus) was studied. Eighteen adult Wistar rats were, after acclimatization, randomly divided into 3 groups of 6 animals per group. The control group had normal saline, receiving neither drugs nor radiation. The second group received normal saline and radiation. The third group received pretreatment with dexamethasone at 1mg/kg body weight/day for 2 days followed by radiation. Radiation was delivered to the animals as a single fraction of 2.5 Gy of gamma rays from Cobalt-60 source, using an AECL Theatron 780-C Teletherapy machine. After exposure to the different interventions, the animals were sacrificed on the 14th post-irradiation day and the kidneys dissected out from each animal. The renal tissues were subjected to histological processing, and then studied using an eyepiece objective ruler calibrated with a 2mm stage micrometer for histomorphometric studies. The result of the study showed that all irradiated animals suffered weight loss by the 14th day post-irradiation (p<0.05) irrespective of the additional treatment with dexamethasone and this was statistically significant. Histomorphometry showed that the maximum width of the glomerular capsule was significantly greater in the radiation groups than in the control at p<0.05. The maximal glomerular diameter was significantly greater in irradiated animals compared with the control animals at p<0.05. The outcome of this study showed that the intraperitoneal administration of dexamethasone at 1mg/kg body weight/day for 2 days prior to treatment with irradiation did not prevent weight loss nor ameliorate the swelling of the nephrons resulting from the effect of radiation injury to the Wistar rat.


Fue estudiado el efecto anti-inflamatorio de la dexametasona en riñones irradiados de 18 ratas Wistar adultas (Rattus norvegicus). Luego de la aclimatización, aleatoriamente se dividieron en 3 grupos de 6 animales por grupo. El grupo control recibió una solución salina normal, sin recibir drogas ni radiación. El segundo grupo recibió solución salina normal y radiación. El tercer grupo recibió tratamiento previo con dexametasona con 1 mg / kg de peso corporal / día, durante 2 días, seguido de radiación. Los animales fueron expuestos a radiación con una fracción independiente de 2.5 Gy de rayos gamma por una fuente de Cobalto-60, usando una máquina de teleterapia AECL Theatron 780-C. Después de la exposición a las diferentes intervenciones, los animales fueron sacrificados el día 14 post-irradiación y los riñones de cada uno de los animales fueron disecados. Los tejidos renales fueron sometidos a procesamiento histológico, y luego se estudiaron utilizando un objetivo ocular milimetrado calibrado a 2mm para el estudio histomorfométrico. Se demostró que todos los animales irradiados sufrieron pérdida de peso 14 días después de ésta (p <0.05), independientemente de los tratamientos adicionales con dexametasona , siendo estadísticamente significativo. La histomorfometría mostró que el ancho máximo de la cápsula glomerular fue significativamente mayor en los grupos irradiados que en el control en p <0.05. El diámetro máximo del glomérulo fue significativamente mayor en los animales irradiados en comparación con los animales control p <0.05. Los resultados de este estudio mostraron que la administración intraperitoneal, de 1 mg / kg de peso corporal / día durante 2 días, de dexametasona antes de comenzar el tratamiento con irradiación, no impide la pérdida de peso ni permite aliviar el edema de los nefrones, injuria producto de la radiación a las Ratas Wistar.


Assuntos
Animais , Ratos , Anti-Inflamatórios/uso terapêutico , Dexametasona/uso terapêutico , Nefrite/tratamento farmacológico , Lesões Experimentais por Radiação/tratamento farmacológico , Nefrite/etiologia , Ratos Wistar , Rim , Rim/efeitos da radiação , Rim/patologia
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