Navegando por Palavras-chave "Lithiasis"

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    Anxiety and depression symptoms in recurrent painful renal lithiasis colic
    (Associação Brasileira de Divulgação Científica, 2007-07-01) Diniz, Denise Helena de Madureira Pará [UNIFESP]; Blay, Sergio Luis [UNIFESP]; Schor, Nestor [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Several studies have reported that symptoms of anxiety and depression are significantly associated with diseases characterized by painful crises. However, there is little information about the psychological aspects of recurrent painful episodes of renal stone disease. Our objective was to evaluate the association of symptoms of anxiety, depression and recurrent painful renal colic in a case-control study involving 64 subjects (32 cases/32 controls) matched for age and sex. Cases were outpatients with a confirmed diagnosis of nephrolithiasis as per their case history, physical examination, image examination and other laboratory exams. Patients had a history of at least two episodes within a 3-year period, and were currently in an intercrisis interval. The control group consisted of subjects seen at the Ophthalmology Outpatient Clinic of this University Hospital with only eye refraction symptoms, and no other associated disease. Symptoms of anxiety were evaluated by the State-Trait Anxiety Inventory and symptoms of depression by the Beck Depression Inventory. Statistically significant differences were observed between patients with nephrolithiasis and controls for anxiety state (P = 0.001), anxiety trait (P = 0.005) and symptoms of depression (odds ratio = 3.74; 95%CI = 1.31-10.62). The Beck Depression Inventory showed 34.5% of respondents with moderate and 6% with severe levels of depression. There was a significant linear correlation between symptoms of anxiety (P = 0.002) and depression (P < 0.001) and the number of recurrent colic episodes (anxiety-state: P = 0.016 and anxiety-trait: P < 0.001). These data suggest an association between recurrent renal colic and symptoms of both anxiety and depression.
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    Avaliação da concordância interobservador na análise da tomografia computadorizada sem contraste no diagnóstico da urolitíase em pacientes com cólica renal aguda
    (Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2006-10-01) Souza, Luís Ronan Marquez Ferreira De [UNIFESP]; Faintuch, Salomão [UNIFESP]; Bekhor, Daniel [UNIFESP]; Tiferes, Dario Ariel [UNIFESP]; Goldman, Suzan Menasce [UNIFESP]; Szejnfeld, Jacob [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Colégio Brasileiro de Radiologia e Diagnóstico por Imagem
    OBJECTIVE: To evaluate the interobserver agreement on non-contrast computed tomography interpretation by a group of experienced abdominal radiologists, for the study of urolithiasis in patients presenting acute flank pain. MATERIALS AND METHODS: Prospective study of 52 patients submitted to non-contrast enhanced helical computed tomography. The images were subsequently analyzed by three independent observers, with the interobserver agreement assessed by means of the kappa (kappa) statistical method. The following parameters were analyzed: a) presence, localization and measurement of ureteral calculi; b) intrarenal calyceal system dilatation; c) perirenal fat heterogeneity; d) ureteral dilatation; e) ureteral wall edema (halo sign). RESULTS: Ureteral calculi were found in 40 of 52 patients (77%). The interobserver agreement was almost perfect as regards identification of ureteral calculi (kappa = 0.89) and ureteral dilatation (kappa = 0.87), substantial for calyceal system dilatation (kappa = 0.77), and moderate for perirenal fat heterogeneity (kappa = 0.55) and ureteral wall edema (kappa = 0.56). CONCLUSION: Non-contrast-enhanced abdominal computed tomography presents high reproducibility in the evaluation of urolithiasis and secondary signs of the calyceal system obstruction.
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    Comparison between ultrasound and noncontrast helical computed tomography for identification of acute ureterolithiasis in a teaching hospital setting
    (Associação Paulista de Medicina - APM, 2007-03-01) Souza, Luís Ronan Marquez Ferreira de [UNIFESP]; Goldman, Suzan Menasce [UNIFESP]; Faintuch, Salomão [UNIFESP]; Faria, Juliano Ferreira [UNIFESP]; Bekhor, Daniel [UNIFESP]; Tiferes, Dario Ariel [UNIFESP]; Ortiz, Valdemar [UNIFESP]; Choyke, Peter [UNIFESP]; Szejnfeld, Jacob [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    CONTEXT AND OBJECTIVE: Recent studies have shown noncontrast computed tomography (NCT) to be more effective than ultrasound (US) for imaging acute ureterolithiasis. However, to our knowledge, there are few studies directly comparing these techniques in an emergency teaching hospital setting. The objectives of this study were to compare the diagnostic accuracy of US and NCT performed by senior radiology residents for diagnosing acute ureterolithiasis; and to assess interobserver agreement on tomography interpretations by residents and experienced abdominal radiologists. DESIGN AND SETTING: Prospective study of 52 consecutive patients, who underwent both US and NCT within an interval of eight hours, at Hospital São Paulo. METHODS: US scans were performed by senior residents and read by experienced radiologists. NCT scan images were read by senior residents, and subsequently by three abdominal radiologists. The interobserver variability was assessed using the kappa statistic. RESULTS: Ureteral calculi were found in 40 out of 52 patients (77%). US presented sensitivity of 22% and specificity of 100%. When collecting system dilatation was associated, US demonstrated 73% sensitivity, 82% specificity. The interobserver agreement in NCT analysis was very high with regard to identification of calculi, collecting system dilatation and stranding of perinephric fat. CONCLUSIONS: US has limited value for identifying ureteral calculi in comparison with NCT, even when collecting system dilatation is present. Residents and abdominal radiologists demonstrated excellent agreement rates for ureteral calculi, identification of collecting system dilatation and stranding of perinephric fat on NCT.
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    Definição do nível da junção ureterovesical pela tomografia computadorizada
    (Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2006-12-01) Freire Filho, Edison de Oliveira [UNIFESP]; Leão, Alberto Ribeiro de Souza [UNIFESP]; Capobianco, Júlia [UNIFESP]; Szejnfeld, Jacob [UNIFESP]; D'Ippolito, Giuseppe [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To define, by means of computed tomography, the level of ureteral implantation into de bladder. MATERIALS AND METHODS: We have measured the distances from the ureteral meatus to the acetabulum, and to the superior margin of the pubic symphysis, as well as the bladder volume, using contrast enhanced computed tomography of the pelvis in 46 patients (31 male and 15 female) in the age range between 18 and 45 years, with at least one of the ureteres filled with excreted contrast material. The Student t test has been applied to determine eventual statistically significant differences between groups. RESULTS: The level of ureteral implantation into the bladder was, on average, 10.6 ± 8.1 mm below the acetabular roof, and 29.7 ± 9.5 mm above the superior margin of the pubic symphysis. In patients with bladder repletion volume of < 200 ml and > 200 ml, the level of ureteral implantation into the bladder was, respectively, on average, 11.6 ± 7.3 mm and 10.2 ± 8.4 mm below the acetabular roof (p = 0.61), and 28.3 ± 7.3 mm and 30.3 ± 10.2 mm above the superior margin of the pubic symphysis (p = 0.52), and in male and female men patients, respectively, on average, 11.8 ± 8.0 mm and 8.3 ± 8.0 mm below the acetabular roof (p = 0.17), and 27.7 ± 9.2 mm and 33.9 ± 8.8 mm above the superior margin of the pubic symphysis (p = 0.34). CONCLUSION: Calcifications located < 3 cm below the acetabular roof and < 1.5 cm above the superior margin of the pubic symphysis probably do not represent ureteral calculi. Vesical repletion or sex have no significant influence on the ureteral meatus position.
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    Efeitos do timol sobre os parâmetros urinários envolvidos na formação de cálculos
    (Sociedade Brasileira de Patologia ClínicaSociedade Brasileira de PatologiaSociedade Brasileira de Citopatologia, 2009-08-01) Ferraz, Renato Ribeiro Nogueira [UNIFESP]; Moreira, Silvia Regina Da Silva; Heilberg, Ita Pfeferman [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Fundação Oswaldo Ramos Laboratório Central
    INTRODUCTION: In a previous study, we demonstrated that acidification or alkalinization of urine samples upon delivery of the material to the laboratory in comparison with samples with preservatives did not alter the results of urinary parameters related to the metabolic investigation into renal lithiasis such as oxalate (OxU), calcium (CaU), magnesium (MgU), uric acid (AcUrU) and creatinine (CreatU), with the exception of citrate (CitU), whose value was slightly lower. OBJECTIVE: To evaluate if the addition of thymol, through its antibacterial effect, is able to prevent the reduction of CitU observed in samples acidified 24 hs after collection in comparison with pre-acidified ones without interfering in the determination of other urinary parameters. METHODS: Forty (40) healthy volunteers collected a single spot urine sample, which was divided into four aliquots of 10 ml containing thymol (1 g/l). In the first sample, the acid preservative (HCl6N, 20 ml/l) was added immediately after collection and in the second, only after 24hs. OxU, CaU, CitU and MgU were determined. In the third and fourth aliquots, an alkali preservative (NaHCO3,5 g/l) was added immediately or 24 hs after collection for AcUrU determination. RESULTS: In the presence of thymol, there was no significant variation in CitU values between pre-or post-acidified samples (577±490 mg/l vs. 575±501 mg/l). The values of other parameters also remained unchanged. CONCLUSION: The prior addition of thymol to urine samples allows the determination of all lithogenic urinary parameters in the same sample, reducing the cost and inconvenience of multiple 24-hour urine collections.
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    Effects of repeated extracorporeal shock wave in urinary biochemical markers of rats
    (Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2009-12-01) Carvalho, Márcio [UNIFESP]; Freitas Filho, Luiz Gonzaga De [UNIFESP]; Carvalho, Maurício; Fagundes, Djalma José [UNIFESP]; Ortiz, Valdemar [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); State University of Maringa Department of Medicine
    PURPOSE: To access the effect of repeated extracorporeal shock wave (ESW) on urinary biochemical markers METHODS: 20 rats were assigned for ESW (Direx Tripter X1® - 14 KV) to one of two groups: G1 (n=10) one ESW; G2 (n=10) two ESWs within a 14-day interval. Within the twenty-four hour period before and after the application of shock waves, the animals were placed in metabolic cages for 24 hour urine collection. The ph, creatinine, sodium, potassium, chlorides, calcium, magnesium, phosphorus, oxalates, alkaline phosphatase and citrates were measured. Twenty-four hours after the material was collected for urinary determination, the animals underwent nephrectomy of the kidney submitted to the ESW applications and were, then, sacrificed. The kidneys were processed for hispatological examination. RESULTS: Small variations in the biochemical markers were found in both groups, with no significant differences between the values obtained either prior to or following the ESW applications, except for citrate and alkaline phosphatase. Citraturia decreased significantly in group 2, following the second ESWL application (24.8 ± 3.0 mg/day after the first ESWL vs. 15.3 ± 2.2 mg/day after the second ESWL; p < 0.05). Alkaline phosphatase increased significantly following ESWL in group I (0.57 ± 0.02 vs. 0.79 ± 0.04 µmol/mg creatinine; p < 0.01) and also in group 2 (0.69 ± 0.05 vs. 0.83 ± 0.03 µmol/mg creatinine; p < 0.05). Glomerular, interstitial and sub-capsular hemorrhage with perivascular edema was found in the animals in both groups studied. CONCLUSIONS: A significant increase in urinary alkaline phosphatase was found in both groups studied, suggesting a proximal tubule lesion. In the group of rats undergoing more than one ESWL application, a smaller urinary citrate excretion was noticed, which may be a factor contributing for the formation of new calculi.
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    Intestinal metaplasia in gallbladders: prevalence study
    (Associacao Paulista Medicina, 2008-07-03) Fernandes, Jose Eduardo Vasconcelos; Franco, Maria Isete Fares; Suzuki, Reinaldo Kenji; Tavares, Nelson Mattos; Bromberg, Sansom Henrique [UNIFESP]; Hosp Serv Publ Estadual Sao Paulo; Univ Metropolitana Santos; Universidade de São Paulo (USP); Univ Lusiada; Santa Casa Misericordia Santos; Universidade Federal de São Paulo (UNIFESP)
    CONTEXT AND OBJECTIVE: Gallbladder cancer is usually diagnosed at a late stage and generally results in death. Discovery of predisposing factors for this neoplasia could prevent this outcome. In this study, we assess the presence of one of these factors: intestinal metaplasia in gallbladders with stones and inflammatory processes.DESIGN AND SETTING: Cross-sectional study in Hospital do Servidor Publico Estadual de Sao Paulo.METHOD: The first 80 gallbladders from patients who underwent elective cholecystectomy between April and August 2002, presenting stones and chronic inflammation, were studied. The patients were divided into groups according to their age: CC 1, from 15 to 40 years; CC2, from A I to 60 years; and CC3, from 61 to 85 years.RESULTS: Twenty-one patients (26%) were male, while 59 (74%) were female. In the group CC 1, intestinal metaplasia was present in 85.71% of the 21 patients studied; in CC2, in 79.41% of 34 patients; and in CC3, in 56.00% of 25 patients. These differences presented statistical significance (p = 0.04542).CONCLUSION: Intestinal metaplasia is extremely frequent in gallbladders with inflammation and lithiasis, especially in younger patients.