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1.
BMC Urol ; 22(1): 163, 2022 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-36266713

RESUMO

OBJECTIVE: To evaluate and compare the outcome of ECIRS in the treatment of partial staghorn renal calculi in both prone split-leg positions versus GMSV positions with regard to; technical aspects, success rate, operative time, complications, safety, and effectiveness of both approaches. PATIENTS AND METHODS: Between October 2018 and August 2021, 66 patients with partial staghorn calculi were enrolled in this prospective comparative study. Patients were randomly divided according to a 1:1 ratio into two groups. Group A included 33 patients who were treated by (ECIRS) in the prone split-leg position, and group B included 33 patients who were treated by (ECIRS) in the Galdakao-modified supine Valdivia (GMSV) position. RESULTS: No significant statistical difference between both groups regarding the mean age (p = 0.448), mean body mass index (BMI) (p = 0.137), mean stone burden (p = 0.435), mean operative time (p = 0.541) and the number of calyces located in branched stones (p = 0.628). The mean hospital stay was 6.71 ± 1.12 days for group A and 6.66 ± 1.10 days for group B patients (p = 0.724). The final SFR was achieved in (29)87.87% and (30)90.9% of group A & B patients, respectively (p = 0.694). No significant difference was detected between both groups in perioperative complication rates. CONCLUSION: ECIRS is safe and effective in treating partial staghorn calculi either in the prone split-leg position or in the Galdakao-modified supine Valdivia position, with comparable outcomes and no statistically significant difference between both positions.


Assuntos
Cálculos Renais , Nefrostomia Percutânea , Cálculos Coraliformes , Humanos , Cálculos Coraliformes/cirurgia , Nefrostomia Percutânea/efeitos adversos , Estudos Prospectivos , Perna (Membro) , Cálculos Renais/cirurgia , Cálculos Renais/etiologia , Decúbito Dorsal , Resultado do Tratamento
2.
Adv Urol ; 2022: 9697931, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35529476

RESUMO

Objective: To study the association of the grade of vesicoureteral reflux (VUR) and urinary tract infections (UTI) with renal scarring at the first clinical presentation of patients who underwent antireflux surgery. Materials and methods. Between 2015 and 2020, 150 patients (194 units) who underwent antireflux surgery had dimercaptosuccinic acid (DMSA) renal scans preoperatively. Patients were classified into the nonscar and scar groups according to DMSA scan results. Moreover, cases were classified into afebrile UTI, febrile UTI, and antenatal hydronephrosis (ANH) according to the mode of presentation. We correlated the mode of presentation and the grade of VUR to the presence/absence of renal scars in both groups. Results: The mean follow-up was 45 months preoperatively. The mode of presentation was afebrile, febrile UTIs, and antenatal hydronephrosis in (50, 14), (20, 46), and (10, 10) patients in the nonscar and scar groups, respectively. Of the 20 patients who presented ANH, 10 (50%) had scars. Clinical presentation was correlated to the presence of renal scarring and its degree. The scar group had significantly higher grades of VUR than the nonscar group (grades I-II (50 units versus 10 units), grade III (28 units versus 40 units), and grade IV-V (22 units versus 44 units) for the nonscar versus scar groups, respectively (pvalue <0.001). Conclusion: Renal scarring is associated with higher grades of reflux and urinary tract infections. We advocate further research investigating infants who had UTIs with or without fever for early detection of reflux.

3.
J Drugs Dermatol ; 20(5): 546-549, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33938709

RESUMO

BACKGROUND: Warts, or verrucae, are mucosal human papilloma virus (HPV) infections that are very challenging to treat. OBJECTIVE: To compare the safety and efficacy of intralesional injection of vitamin D3 versus intralesional injection of candida albicans antigen for plantar warts. METHODS: Forty patients were included in the study and were divided into two groups (A&B) with 20 patients each. Group A received intralesional vitamin D3 while Group B received intralesional Candida antigen. Injection was done every 3 weeks until clearance of warts or a maximum of three treatments. RESULTS: Nine patients showed complete clearance in group A (45%), while 6 patients (30%) showed partial response and no response in 5 patients (25%) of group (A). As for group (B), complete clearance of the treated warts was observed in 8 patients (40%), partial response in 6 patients (30%) while no response was observed in 6 patients (30%). No superiority of one treatment to the other was observed nor was any statistical significance in both groups’ responses noted. CONCLUSION: Treatment of multiple warts by intralesional injection of candida antigen or vitamin D3 is safe and effective, with good cure rates, has an excellent safety profile, with minimal recurrences and statistically equivalent. J Drugs Dermatol. 2021;20(5):546-549. doi:10.36849/JDD.5264.


Assuntos
Antígenos de Fungos/administração & dosagem , Candida albicans/imunologia , Colecalciferol/administração & dosagem , Imunoterapia/métodos , Verrugas/tratamento farmacológico , Adulto , Antígenos de Fungos/efeitos adversos , Antígenos de Fungos/imunologia , Colecalciferol/efeitos adversos , Feminino , Seguimentos , Humanos , Imunoterapia/efeitos adversos , Injeções Intralesionais , Masculino , Resultado do Tratamento , Verrugas/imunologia , Adulto Jovem
4.
Urologia ; 88(4): 321-325, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33783280

RESUMO

INTRODUCTIONS: Evaluating the epidemiology, pattern, and contributing factors of sexual dysfunction in end-stage renal disease (ESRD) patients is the cornerstone in understanding and enhancing these patients' quality of life. In this study, we aimed to identify the different patterns of erectile dysfunction (ED) among 100 patients undergoing hemodialysis. MATERIALS AND METHODS: A single-center, cross-sectional, study was conducted on 100 patients with ESRD on hemodialysis. Patients were assessed using the International index of erectile dysfunction (IIEF) and Doppler assessment of the penis. RESULTS: A total of 100 patients were included in this study with a mean age of 48.77 ± 9.66 years old. The mean erectile index was 7.10 ± 4.62; while the mean free and total testosterone were 10.07 ± 7.69 and 2.93 ± 1.4 ng/dL, respectively. Overall, 67% of the patients had abnormal hormonal levels. Concerning the penile vasculature, 71% of the patients had arterogenic importance and 19% had venous impotence. The comparative analysis demonstrated that hypertensive patients had lower erectile index (p = 0.002). In addition, smokers had lower erectile index (p < 0.001). There was statistical significance between normal hormonal and abnormal hormone level according to erectile index, with lower index in patients with abnormal hormonal level (p = 0.03). CONCLUSION: In conclusion, our findings indicate that the most common causes of ED with renal failure were hormonal disturbance, including testosterone, and prolactin. Hypertension and smoking are major contributing factors that should be managed carefully to reduce the risk of ED and improve the quality of life.


Assuntos
Disfunção Erétil , Falência Renal Crônica , Adulto , Estudos Transversais , Disfunção Erétil/epidemiologia , Disfunção Erétil/etiologia , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Diálise Renal
5.
Ann Thorac Med ; 12(4): 282-289, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29118862

RESUMO

INTRODUCTION: Venous thromboembolism (VTE) during hospitalization is a serious and potentially fatal condition. Despite its effectiveness, evidence-based thromboprophylaxis is still underutilized in many countries including Saudi Arabia. OBJECTIVE OF THE STUDY: Our objectives were to determine how often hospital-acquired VTE patients received appropriate thromboprophylaxis, VTE-associated mortality, and the percentage of patients given anticoagulant therapy and adherence to it after discharged. METHODS: This study was conducted in seven major hospitals in Saudi Arabia. From July 1, 2009, till June 30, 2010, all recorded deep vein thrombosis (DVT) and pulmonary embolism (PE) cases were noted. Only patients with confirmed VTE diagnosis were included in the analysis. RESULTS: A total of 1241 confirmed VTE cases occurred during the 12-month period. Most (58.3%) of them were DVT only, 21.7% were PE, and 20% were both DVT and PE. 21.4% and 78.6% of confirmed VTE occurred in surgical and medical patients, respectively. Only 40.9% of VTE cases received appropriate prophylaxis (63.2% for surgical patients and 34.8% for medical patients; P < 0.001). The mortality rate was 14.3% which represented 1.6% of total hospital deaths. Mortality was 13.5% for surgical patients and 14.5% for medical patients (P > 0.05). Appropriate thromboprophylaxis was associated with 4.11% absolute risk reduction in mortality (95% confidence interval: 0.24%-7.97%). Most (89.4%) of the survived patients received anticoagulation therapy at discharge and 71.7% of them were adherent to it on follow-up. CONCLUSION: Thromboprophylaxis was underutilized in major Saudi hospitals denoting a gap between guideline and practice. This gap was more marked in medical than surgical patients. Hospital-acquired VTE was associated with significant mortality. Efforts to improve thromboprophylaxis utilization are warranted.

6.
Saudi Med J ; 38(1): 101-107, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28042639

RESUMO

Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a preventable disease. Long distant travelers are prone to variable degree to develop VTE. However, the low risk of developing VTE among long-distance travelers and which travelers should receive VTE prophylaxis, and what prophylactic measures should be used led us to develop these guidelines. These clinical practice guidelines are the result of an initiative of the Ministry of Health of the Kingdom of Saudi Arabia involving an expert panel led by the Saudi Association for Venous Thrombo Embolism (a subsidiary of the Saudi Thoracic Society). The McMaster University Guideline working group provided the methodological support. The expert panel identified 5 common questions related to the thromboprophylaxis in long-distance travelers. The corresponding recommendations were made following the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.


Assuntos
Guias de Prática Clínica como Assunto , Viagem , Tromboembolia Venosa/prevenção & controle , Anticoagulantes/uso terapêutico , Humanos , Arábia Saudita , Caminhada
7.
Saudi Med J ; 37(11): 1279-1293, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27761572

RESUMO

Venous thromboembolism (VTE) acquired during hospitalization is common, yet preventable by the proper implementation of thromboprophylaxis which remains to be underutilized worldwide. As a result of an initiative by the Saudi Ministry of Health to improve medical practices in the country, an expert panel led by the Saudi Association for Venous Thrombo Embolism (SAVTE; a subsidiary of the Saudi Thoracic Society) with the methodological guidance of the McMaster University Guideline working group, produced this clinical practice guideline to assist healthcare providers in VTE prevention. The expert part panel issued ten recommendations addressing 10 prioritized questions in the following areas: thromboprophylaxis in acutely ill medical patients (Recommendations 1-5), thromboprophylaxis in critically ill medical patients (Recommendations 6-9), and thromboprophylaxis in chronically ill patients (Recommendation 10). The corresponding recommendations were generated following the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach.


Assuntos
Anticoagulantes/uso terapêutico , Estado Terminal , Fidelidade a Diretrizes , Heparina/uso terapêutico , Tromboembolia Venosa/prevenção & controle , Medicina Baseada em Evidências , Humanos , Fatores de Risco , Arábia Saudita , Resultado do Tratamento
8.
Urol Ann ; 8(1): 51-5, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26834402

RESUMO

OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of ultrasound guided percutaneous sclerotherapy of symptomatic simple renal cysts with n-butyl cyanoacrylate (NBCA) and iodized oil mixture as an outpatient single session procedure. MATERIALS AND METHODS: A total of ninety two patients with 100 symptomatic simple renal cysts (larger than 5 cm) were treated by ultrasound (US)-guided percutaneous aspiration and injection of NBCA and iodized oil mixture. The patients (68 men and 24 women, mean age, 42.4 ± 10.5 years) were treated with as out-patients. The volume of the treated cysts was calculated with periodic noncontrast enhanced CT examinations 3, 6 and 9, months after the procedure. The procedure was considered successful at follow-up CT when there was total ablation or greater than 80% reduction of size with resolution of symptoms, respectively. Failure was defined as less than 80% reduction and/or persistent symptoms. RESULTS: The sclerotherapy was technically successful in all patients. The diameter of the cysts ranged between 5.5 and 13.5 cm (mean, 8.8 ± 1.4 cm), and 1.5 and 3.8 cm (mean, 2.1 ± 0.4 cm) before and after sclerotherapy, respectively (P < 0.001). Average diameter reduction was 83.7% during the follow-up period. The mean follow- up lasted 7.1 months (3-11 months). Flank pain resolved in 86 of 92 symptomatic patients (93.48%). In six patients, the symptoms decreased slightly. The procedure was successful in 98 of 100 cysts (98%), demonstrated by follow-up CT. The only two failed cyst was larger than 10 cm in diameter and don't required any further treatment. We did not observe any procedure related complications. CONCLUSION: Ultrasound guided percutaneous sclerotherapy with NBCA and iodized oil mixture for management of symptomatic simple renal cysts was found to be a real time, effective, safe, well tolerated, alternative and simple technique that can be carried out by urologists as an outpatient procedure.

9.
Saudi Med J ; 26(9): 1459-63, 2005 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16155671

RESUMO

We report a case of a 30-year-old female who had been treated periodically with steroids for idiopathic thrombocytopenic purpura ITP over the last 10 years. Recently, during the course of investigation, she was found to have incidental asymptomatic multiple pulmonary nodules on chest CT. Following a needle biopsy to exclude malignancy, 2 nodules were excised and were histologically confirmed as pulmonary hyalinizing granuloma PHG. The remaining 2 nodules regressed on increasing her dose of steroids. The case is discussed with emphasis on the histological and radiological differential diagnosis, in addition to including ITP among the spectrum of immunologic conditions associated with PHG.


Assuntos
Granuloma do Sistema Respiratório/diagnóstico , Granuloma do Sistema Respiratório/tratamento farmacológico , Hialina/metabolismo , Prednisolona/uso terapêutico , Púrpura Trombocitopênica Idiopática/diagnóstico , Púrpura Trombocitopênica Idiopática/tratamento farmacológico , Adulto , Biópsia por Agulha , Feminino , Seguimentos , Granuloma do Sistema Respiratório/complicações , Humanos , Imuno-Histoquímica , Púrpura Trombocitopênica Idiopática/complicações , Doenças Raras , Medição de Risco , Tomografia Computadorizada por Raios X , Resultado do Tratamento
10.
Scand J Infect Dis ; 36(10): 765-7, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15513406

RESUMO

A previously healthy 37-y-old male presented with community-acquired pneumonia and extensive upper limb deep vein thrombosis. The diagnosis of Legionella pneumonia was made based on a positive direct immunofluorescence of the bronchial wash. An extensive investigation for hypercoagulable states was negative. The possible association between Legionella infection and deep vein thrombosis is highlighted.


Assuntos
Infecções Comunitárias Adquiridas/diagnóstico , Doença dos Legionários/diagnóstico , Trombose Venosa/diagnóstico por imagem , Adulto , Antibacterianos , Anticoagulantes/uso terapêutico , Infecções Comunitárias Adquiridas/complicações , Infecções Comunitárias Adquiridas/tratamento farmacológico , Quimioterapia Combinada/uso terapêutico , Seguimentos , Humanos , Doença dos Legionários/complicações , Doença dos Legionários/tratamento farmacológico , Masculino , Flebografia , Medição de Risco , Índice de Gravidade de Doença , Resultado do Tratamento , Trombose Venosa/complicações , Trombose Venosa/tratamento farmacológico
11.
Hum Mutat ; 23(4): 327-33, 2004 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15024727

RESUMO

Selective intestinal malabsorption of vitamin B(12) causing juvenile megaloblastic anemia (MGA; MIM# 261100) is a recessively inherited disorder that is believed to be rare except for notable clusters of cases in Finland, Norway, and the Eastern Mediterranean region. The disease can be caused by mutations in either the cubilin (CUBN; MGA1; MIM# 602997) or the amnionless (AMN; MIM# 605799) gene. To explain the peculiar geographical distribution, we hypothesized that mutations in one of the genes would mainly be responsible for the disease in Scandinavia, and mutations in the other gene in the Mediterranean region. We studied 42 sibships and found all cases in Finland to be due to CUBN (three different mutations) and all cases in Norway to be due to AMN (two different mutations), while in Turkey, Israel, and Saudi Arabia, there were two different AMN mutations and three different CUBN mutations. Haplotype evidence excluded both CUBN and AMN conclusively in five families and tentatively in three families, suggesting the presence of at least one more gene locus that can cause MGA. We conclude that the Scandinavian cases are typical examples of enrichment by founder effects, while in the Mediterranean region high degrees of consanguinity expose rare mutations in both genes. We suggest that in both regions, physician awareness of this disease causes it to be more readily diagnosed than elsewhere; thus, it may well be more common worldwide than previously thought.


Assuntos
Anemia Megaloblástica/genética , Efeito Fundador , Mutação , Deficiência de Vitamina B 12/genética , Consanguinidade , Análise Mutacional de DNA , Feminino , Haplótipos , Humanos , Absorção Intestinal , Masculino , Proteínas de Membrana , Oriente Médio , Linhagem , Proteínas/genética , Receptores de Superfície Celular/genética , Países Escandinavos e Nórdicos , Deficiência de Vitamina B 12/diagnóstico
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