ABSTRACT
Objetivo: Determinar la frecuencia, la evolución clínica, el tratamiento y el desenlace de la lesión renal aguda (LRA) en pacientes embarazadas con preeclampsia severa (PS) menores de 20años de edad. Material y método: Estudio observacional, transversal, retrospectivo y analítico en una serie de 23 pacientes embarazadas menores de 20años de edad con PS atendidas en la UCI de un hospital de alta especialidad de la ciudad de México durante los años 2018 y 2019. Se consultaron los expedientes para conocer la frecuencia de enfermas que desarrollaron LRA (creatinina sérica ≥1,1mg/dl), complicaciones, diuresis, tratamiento con fármacos, terapia de reemplazo, desenlace (recuperación, hemodiálisis) y mortalidad. Los resultados se compararon con los de enfermas de la serie que no presentaron LRA. Se utilizó estadística descriptiva, prueba U de Mann Whitney y prueba exacta de Fisher con el programa SPSS versión 20. Resultados: Veintidós enfermas tenían riñones nativos y una portaba injerto renal. La frecuencia de pacientes con LRA fue del 43,47% (n=10) con media de la creatinina sérica de 1,59±0,63mg/dl (límites 1,1 a 3,2) y diuresis de 0,91±0,74ml/kg/h. Las 23 enfermas recibieron furosemida como fármaco individual intravenoso (60,87%; n=14) o posterior a la infusión de solución NaCl 0,9% (39,13%; n=9). La LRA se recuperó en el 39,13% (n=9) y se precisó hemodiálisis en la paciente trasplantada (4,34%), con muerte materna del 0%. Conclusiones: La frecuencia de LRA fue elevada, con un solo caso que requirió hemodiálisis, sin mortalidad materna. El uso irrestricto de furosemida en todos los casos resultó relevante.(AU)
Objective: To determine the frequency, clinical course, treatment and outcome of acute kidney injury (AKI) in pregnant patients under 20years of age with severe preeclampsia (SP). Material and method: Observational, cross-sectional, retrospective and analytical study in a series of 23 pregnant patients under 20years of age with SP attended in the Intensive Care Unit (ICU) of a high specialty hospital in Mexico City during the years 2018 and 2019. Records were consulted to determine the frequency of patients that developed AKI (serum creatinine ≥1.1mg/dL), complications, diuresis, drug treatment, replacement therapy, outcome (recovery, haemodialysis), and mortality. The results were compared with those of the patients in the series that did not present with an AKI. Descriptive statistics, Mann Whitney U test and Fisher's exact test, using SPSS version 20, were used. Results: Twenty-two patients had native kidneys and one had a kidney graft. The frequency of patients with AKI was 43.47% (n=10) with mean serum creatinine 1.59±0.63mg/dL (range 1.1 to 3.2) and urine volume 0.91±0.74ml/kg/hour. All 23 patients received furosemide, as an individual drug intravenously 60.87% (n=14), and 39.13% (n=9) after the infusion of 0.9% NaCl solution. AKI recovered in 39.13% (n=9), and haemodialysis was performed in the transplanted patient (4.34%), with 0% maternal death. Conclusions: The frequency of AKI was high with only one case requiring haemodialysis, and no maternal mortality. The unrestricted use of furosemide in all cases was relevant.(AU)
Subject(s)
Humans , Female , Adult , Pregnant Women , Pre-Eclampsia , Gynecology , Acute Kidney Injury , HELLP Syndrome , Eclampsia , Renal Dialysis , Cross-Sectional Studies , Retrospective Studies , MexicoABSTRACT
OBJETIVO: Presentar dos casos de masas renales infrecuentes, intentando llegar a su diagnóstico preoperatoriamente. MÉTODOS: Describimos un caso remitido por Hematología por hallazgos en TAC de masas perirrenales bilaterales, que al biopsiar refieren hematopoyesis extramedular. El otro caso se estudió por disnea, apreciando en el TAC pulmones con múltiples quistes y en abdomen, masa quístico sólida perirrenal izquierda. La biopsia pulmonar nos informó de Linfangiomatosis pulmonar, con lo que obviamos la biopsia renal. RESULTADOS: La mayoría de las masas renales sólidas son hipernefromas (85%). El resto de las masas son sarcomas, linfomas, tumores de vías infiltrantes y tumores benignos. Para su diagnóstico disponemos de la clínica y las pruebas radiológicas (ecografía, TAC, RNM y PET-TAC); pero ante hallazgos inespecíficos el diagnóstico se basará en el estudio histológico. CONCLUSIONES: La hematopoyesis renal extramedular y el Linfangioma perirrenal son tumores raros y su diagnóstico preoperatorio es difícil
OBJETIVE: To present two cases of infrequent renal masses, trying to achieve the diagnosis before surgery. METHODS: We describe a case referred from the Department of Hematology in which bilateral perirrenal masses were described in the CT scan; after biopsy they where classified as extramedullary hematopoietic tissue. The other case was a patient presenting to the emergency room with dyspnea. CT Scan showed lungs with multiple cysts, chylothorax and a cystic-solid mass in the left perirenal space. In the lung biopsy they reported lung lymphangiomatosis, so we didn't perform renal biopsy. RESULTS: Most renal masses are renal carcinomas (85%). The less common diagnosis are sarcomas, lymphomas, upper urinary tract transitional cell carcinomas, metastases of other primary tumors, the Erdheim-Chester disease, the Castleman disease and benign tumors. All these diseases might show similar images in the CT scan and MRI, being the biopsy and histological study necessary for the diagnosis CONCLUSION: Perirenal extramedullary hematopoiesis and perirenal lymphangioma are rare diseases that need a pathologic study for their diagnosis
Subject(s)
Humans , Male , Female , Adult , Hematopoiesis/genetics , Lymphangioma, Cystic/complications , Lymphangioma, Cystic/diagnosis , Blood Platelets/cytology , Blood Platelets/pathology , Nephrectomy , Nephrectomy/instrumentation , Hematopoiesis/physiology , Lymphangioma, Cystic/chemistry , Lymphangioma, Cystic/chemically induced , Blood Platelets/classification , Nephrectomy/methods , NephrectomyABSTRACT
OBJECTIVE: To present two cases of infrequent renal masses, trying to achieve the diagnosis before surgery. METHODS: We describe a case referred from the Department of Hematology in which bilateral perirrenal masses were described in the CT scan; after biopsy they where classified as extramedullary hematopoietic tissue. The other case was a patient presenting to the emergency room with dyspnea. CT Scan showed lungs with multiple cysts, chylothorax and a cystic-solid mass in the left perirenal space. In the lung biopsy they reported lung lymphangiomatosis, so we didn't perform renal biopsy. RESULTS: Most renal masses are renal carcinomas (856%). The less common diagnosis are sarcomas, lymphomas, upper urinary tract transitional cell carcinomas, metastases of other primary tumors, the Erdheim-Chester disease, the Castleman disease and benign tumors. All these diseases might show similar images in the CT scan and MRI, being the biopsy and histological study necessary for the diagnosis CONCLUSIONS: Perirenal extramedullary hematopoiesis and perirenal lymphangioma are rare diseases that need a pathologic study for their diagnosis.
Subject(s)
Hematopoiesis, Extramedullary , Kidney Neoplasms/surgery , Lymphangioma/surgery , Adult , Aged , Biopsy , Fatal Outcome , Female , Humans , Kidney Neoplasms/pathology , Lung Diseases/complications , Lung Diseases/congenital , Lung Diseases/surgery , Lung Neoplasms/complications , Lung Neoplasms/surgery , Lymphangiectasis/complications , Lymphangiectasis/congenital , Lymphangiectasis/surgery , Lymphangioma/pathology , Male , Thoracic Surgery, Video-AssistedABSTRACT
The aim of this paper was to investigate the feasibility of using gamma irradiation to inhibit the microbial activity of biological powder activated carbon (PAC) without impacting its adsorptive properties. First of all, the range of dose of gamma rays required to produce abiotic PAC was selected on the basis of heterotrophic plate counts (HPC) inactivation and methylene blue (MB) adsorption kinetics. Doses inferior to 10 kGy were not sufficient to inhibit the culture of heterotrophic bacteria. On the other hand, doses superior to 15 kGy were demonstrated to affect the adsorption rate of MB. Consequently, a dose comprised between 10 and 15 kGy was selected for further investigation. In order to validate the adequacy of the range of dose (i.e. 10-15 kGy), adsorption characteristics were tested by monitoring the removal kinetics of refractory dissolved organic carbon (RDOC). No significant differences were observed between irradiated and non-irradiated biological PAC for the adsorption of RDOC. Irradiated, non-irradiated and virgin PAC were also evaluated in terms of abundance of viable (using the LIVE/DEAD BacLight method) bacteria and in terms of heterotrophic biomass activity. The results of the BacLight method demonstrated that attachment of the biofilm on the PAC was not impacted by the irradiation and heterotrophic activity measurements demonstrated that the latter could be radically reduced in the range of dose selected. In conclusion, when using a proper dose, the gamma irradiation of colonized activated carbon drastically reduced the heterotrophic activity on activated carbon without significantly impacting its adsorptive behaviour.
Subject(s)
Biofilms/radiation effects , Charcoal/chemistry , Charcoal/radiation effects , Organic Chemicals/isolation & purification , Sterilization/methods , Ultrafiltration/instrumentation , Ultrafiltration/methods , Absorption/radiation effects , Dose-Response Relationship, Radiation , Equipment Contamination/prevention & control , Feasibility Studies , Gamma Rays , Materials Testing , Organic Chemicals/chemistry , Organic Chemicals/radiation effects , Radiation DosageABSTRACT
Results of ready biodegradability tests (RBT) are barely reproducible owing to a well-known lack of definition in inoculum source and quality. In this study, the degree of variability expected when only activated sludges are used as inoculum source was investigated. For this, the characteristics of activated sludges collected in municipal wastewater treatment plants operating at various massic loading rates (MLR; 0.1, 0.5 and 0.9 kgBOD5 kgVSS(-1) d(-1)) were compared. In order to provide suitable cellular densities for RBT, inocula were obtained after settling of activated sludges and analyzed in terms of active and cultivable cell densities, dehydrogenasic activity, BOD5 and a general profile of hydrolytic enzymes. In our analysis, biomass obtained from the High-MLR treatment plant constituted the inoculum having the highest biodegradation potential both with respect to microbial densities and to enzyme activities. This biomass also yielded the fastest biodegradation kinetics in dodecyl benzene sulfonate RBT. An attempt of biomass homogenization of inocula on the basis of cultivable cell density and dehydrogenasic activity gave negative results with this chemical compound. Since, in practice, restriction of activated sludge sources may be difficult, our results emphasize the importance of further studies aimed at homogenization of inoculum quality and quantity.