Ensayo clínico piloto para evaluar las características, preferencia de producto y calidad de vida de usuarios de cateterismo vesical intermitente: testando un nuevo set / No disponible

Teniendo en cuenta que el cateterismo intermitente es el tratamiento de primera elección para el manejo de la vejiga neurógena, quisimos estudiar si un nuevo set aportaría ventajas al usuario en su sondaje, tanto en el manejo como en sus relaciones sociales y su calidad de vida

We wanted to research if a new set would offer advantages to the catheter user taking into account that intermittent catheterization becomes the method of choice for neurogic bladder management. For that reason, we included social relationship domains and quality of life in patients with stoma in the study

Fast-track access to urologic care for patients with macroscopic haematuria is efficient and cost-effective: results from a prospective intervention study.

BACKGROUND: The delay between onset of macroscopic haematuria and diagnosis of bladder cancer is often long. METHODS: We evaluated timely diagnosis and health-care costs for patients with macroscopic haematuria given fast-track access to diagnostics. During a 15-month period, a telephone hotline for fast-track diagnostics was provided in nine Swedish municipalities for patients aged ⩾50 years with macroscopic haematuria. The control group comprised 101 patients diagnosed with bladder cancer in the same catchment area with macroscopic haematuria who underwent regular diagnostic process. RESULTS: In all 275 patients who called 'the Red Phone' hotline were investigated, and 47 of them (17%) were diagnosed with cancer and 36 of those had bladder cancer. Median time from patient-reported haematuria to diagnosis was 29 (interquartile range (IQR) 14-104) days and 50 (IQR 27-165) days in the intervention and the control group, respectively (P=0.03). The median health-care costs were lower in the intervention group (655 (IQR 655-655) EUR) than in the control group (767 (IQR 490-1096) EUR) (P=0.002). CONCLUSIONS: Direct access to urologic expertise and fast-track diagnostics is motivated for patients with macroscopic haematuria to reduce diagnostic intervals and lower health-care expenditures.

Biopsia renal en receptores de transplante renal: cuidados de enfermería y complicaciones / Renal biopsy in renal transplant recipients: nursing care and complications

Introducción: La biopsia renal percutánea es una herramienta fundamental para el manejo del paciente trasplantado renal. La prueba es primordial para detectar y/o prevenir cualquier disfunción en el injerto, siendo un procedimiento tanto diagnóstico como preconizador. Objetivo: Describir los cuidados de enfermería e identificar las complicaciones derivadas de la biopsia renal en los receptores de Trasplante Renal. Material y métodos: Estudio cuantitativo, descriptivo y transversal realizado en la Unidad de Trasplante Renal, Servicio de Nefrología, del 2008 al 2014. La población objeto de estudio son los receptores de Trasplante Renal (TR). La muestra está compuesta por 368 biopsias renales de seguimiento que ingresan para someterse a una biopsia renal. Los criterios de inclusión son ser mayores de 18 años, trasplantados y que han firmado el consentimiento informado. Se recogen datos sociodemográficos, clínico-asistenciales y complicaciones post-biopsia renal. Resultados: Desde 1980 hasta el 2014 se han llevado a cabo 1868 TR, de 2008 a 2014 se estudiaron 368 biopsias de seguimiento. Se monitoriza la Tensión Arterial y la coagulación pre biopsia. Tras el procedimiento, se controla la presencia de sangrado por micción y constantes vitales. Inicialmente el reposo absoluto era de 24 h, a partir de 2014 se reduce a 6 horas, recomendando reposo relativo al alta, las complicaciones fueron mínimas. Conclusiones: Los resultados indican que la biopsia renal es un procedimiento eficaz, con escasas complicaciones. Destacar el papel de enfermería en la detección precoz de complicaciones (AU)

Introduction: Percutaneous Renal Biopsy is an essential tool for the management of renal transplant patients. The test is essential to detect and / or prevent any graft dysfunction, being both a diagnostic and preconizador procedure. Objective is to describe nursing care and identify complications of renal biopsy in renal transplant recipients. Methods: A quantitative, descriptive and transversal study was carried out in the Renal Transplantation Unit, Nephrology Department of Puigvert Foundation, from 2008 to 2014. The study population is kidney transplant recipients (TR). The sample consists of 368 kidney biopsies follow-up. Inclusion criteria are being over 18 years, transplanted, and signed informed consent. Sociodemographic data, clinical care and complications after renal biopsy are collected. Results: From 1980 to 2014 were carried out 1868 TR of 2008-2014 368 follow-up biopsies were studied. Blood Pressure and pre biopsy coagulation were monitored. After the procedure, the presence of bleeding urination and vital signs monitored. Initially absolute rest was 24 h, since 2014 was reduced to 6 hours, recommending rest relative to high, complications were minimal. Conclusions: The results indicate that renal biopsy is an effective procedure with few complications. The nursing role in the early detection of complications is important (AU)

Haematuria: from identification to treatment.

Haematuria has a prevalence of 0.1% to 2.6%. Potential diagnoses may include infection, kidney stones, trauma, exercise or spurious causes, such as foods, drugs or menstruation, and a tumour. Approximately 20% of patients with haematuria have a urological tumour, with a further 20% found to have a significant underlying pathology. Haematuria is subsequently known as the 'classic presentation' of bladder cancer with 70-80% of patients experiencing painless, gross (visible) haematuria. However, in all cases of visible haematuria, a tumour should be suspected until proven otherwise. A patient with visible haematuria requires urgent, stringent investigation, warranting specialist assessment and subsequent selective referral through a series of patient-centred investigations at a haematuria clinic. One-stop clinics have been shown to improve the patient experience in early diagnosis of potentially life-threatening conditions. Yet despite morbidity and mortality from bladder cancer increasing, the haematuria service has remained largely unchanged for several decades. This paper will discuss the tests and investigations that need to be undertaken in an individual with either visible or non-visible haematuria, and outline the care that is needed to support patients through the investigation process, with special focus on bladder tumour.

Schistosomiasis.

Schistosomiasis is a parasitic infection caused by flatworms (trematodes). It is second only to malaria in public health significance, with over 200 million people infected worldwide, leading to severe consequences in 20 million persons and 100,000 deaths, annually. There are four species that cause intestinal schistosomiasis: Schistosoma mansoni; Schistosoma japonicum, Schistosoma mekongi, and Schistosoma intercalatum. Schistosoma haematobium causes urinary schistosomias, and is endemic in Africa and the Middle East, with the greatest prevalence in poor rural areas. Fibrotic changes in the urinary tract can lead to hydroureter, hydronephrosis, bacterial urinary infections, and ultimately, kidney disease or eventually bladder cancer. A rare lesion can also arise in patients infected with Schistosomiasis haematobium, resulting in squamous and adenosquamous prostate cancers. Imported diseases, such as schistosomiasis, are entering the United States through immigration via illegal aliens, refugees, and travelers. Schistosomiasis is a neglected tropical disease, and its global health impact is grossly underestimated.

Creation and validation of a visual macroscopic hematuria scale for optimal communication and an objective hematuria index.

PURPOSE: Macroscopic hematuria is a common symptom and sign that is challenging to quantify and describe. The degree of hematuria communicated is variable due to health worker experience combined with lack of a reliable grading tool. We produced a reliable, standardized visual scale to describe hematuria severity. Our secondary aim was to validate a new laboratory test to quantify hemoglobin in hematuria specimens. MATERIALS AND METHODS: Nurses were surveyed to ascertain current hematuria descriptions. Blood and urine were titrated at varying concentrations and digitally photographed in catheter bag tubing. Photos were processed and printed on transparency paper to create a prototype swatch or card showing light, medium, heavy and old hematuria. Using the swatch 60 samples were rated by nurses and laymen. Interobserver variability was reported using the generalized kappa coefficient of agreement. Specimens were analyzed for hemolysis by measuring optical density at oxyhemoglobin absorption peaks. RESULTS: Interobserver agreement between nurses and laymen was good (kappa = 0.51, p <0.001). Subgroup analysis showed substantial agreement for light hematuria (kappa = 0.71). Overall agreement improved when the moderate (kappa = 0.28) and heavy (kappa = 0.53) hematuria categories were combined (kappa = 0.70). Compared to known blood concentrations the assay of optical density at oxyhemoglobin absorption peaks showed a linear trend. CONCLUSIONS: A simple visual scale to grade and communicate hematuria with adequate interobserver agreement is feasible. The test for optical density at oxyhemoglobin absorption peaks is a new method, validated in our study, to quantify hemoglobin in a hematuria specimen.

Haematuria: causes and management.

Most nurses are familiar with testing urine and many do so daily. The urine dipstick can reveal many abnormalities. The purpose of this article is to ensure that nurses are aware of the possible significance of finding blood in a patient's urine.

Advanced practice nursing in pediatric nephrology.

This article provides the nurse practitioner with a concise and accurate reference for the evaluation of children with hematuria, proteinuria, and hypertension. Although the incidence of these disorders in children is lower than in adults, they are not uncommon. The nurse practitioner must be able to accurately assess the results of a urinalysis and measure and interpret blood pressure readings in children. A discussion of when to refer children with signs and symptoms of serious disease; and how to educate patients and families in order to promote children's health is also provided.