Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 576
Filtrar
1.
Medicine (Baltimore) ; 99(9): e19339, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118768

RESUMO

Ageing people with hemophilia (PWH) have a higher prevalence of hypertension than the general population. This study aimed to determine whether macroscopic hematuria was associated with hypertension in PWH in a post hoc analysis using data from a cross-sectional study conducted by the ADVANCE Working Group (the H3 study), which included PWH ≥ 40 years of age. Data from 16 contributing centers, located in 13 European countries and Israel, were analyzed using logistic regression models. Of 532 recruited PWH in the H3 study, 117 had hypertension and a positive family history of hypertension (hypertension FH+), 75 had hypertension and a negative family history of hypertension (hypertension FH-), 290 had no diagnosis of hypertension, and the remaining 50 had missing hypertension data. Logistic regressions showed that macroscopic hematuria was associated with hypertension FH+, both in the univariate (OR = 1.84 [1.17-2.90], P = .01) and in the multivariate model (OR = 1.80 [1.03-3.16], P = .04). Macroscopic hematuria was not associated with hypertension FH-. Moreover, in a multivariate logistic regression the odds of hypertension FH+ were increased with the number of macroscopic hematuria episodes. The association between macroscopic hematuria and hypertension was significant for PWH with a family history of hypertension.


Assuntos
Hematúria/etiologia , Hemofilia A/complicações , Hipertensão/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Estudos Transversais , Feminino , Hematúria/epidemiologia , Hematúria/fisiopatologia , Hemofilia A/epidemiologia , Hemofilia A/fisiopatologia , Humanos , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Israel/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
2.
Pan Afr Med J ; 33: 321, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692795

RESUMO

Introduction: The burden of chronic kidney disease (CKD) is increasing worldwide. Few studies in low and low-middle income countries have estimated the prevalence of CKD. We aimed to estimate prevalence and factors associated with CKD among medical inpatients at the largest referral hospital in Kenya. Methods: We conducted a cross-sectional study among medical inpatients at the Kenyatta National Hospital. We used systematic sampling and collected demographic information, behavioural risk factors, medical history, underlying conditions, laboratory and imaging workup using a structured questionnaire. We estimated glomerular filtration rate (GFR) in ml/min/1.73m2 classified into 5 stages; G1 (≥ 90), G2 (60-89), G3a (45-59), G3b (30-44), G4 (15-29) and G5 (<15, or treated by dialysis/renal transplant). Ethical approval was obtained from Kenyatta National Hospital-University of Nairobi Ethics and Research Committee (KNH-UoN ERC), approval number P510/09/2017. We estimated prevalence of CKD and used logistic regression to determine factors independently associated with CKD diagnosis. Results: We interviewed 306 inpatients; median age 40.0 years (IQR 24.0), 162 (52.9%) were male, 155 (50.7%) rural residents. CKD prevalence was 118 patients (38.6%, 95% CI 33.3-44.1); median age 42.5 years (IQR 28.0), 74 (62.7%) were male, 64 (54.2%) rural residents. Respondents with CKD were older than those without (difference 4.4 years, 95% CI 3.7-8.4 years, P = 0.032). Fifty-six (47.5%) of the patients had either stage G1 or G2, 17 (14.4%) had end-stage renal disease; 64 (54.2%) had haemoglobin below 10g/dl while 33 (28.0%) had sodium levels below 135 mmol/l. ). History of unexplained anaemia (aOR 1.80, 95% CI 1.02-3.19), proteinuria (aOR 5.16, 95% CI 2.09-12.74), hematuria (aOR 7.68, 95% CI 2.37-24.86); hypertension (aOR 2.71, 95% CI 1.53-4.80) and herbal medications use (aOR 1.97, 95% CI 1.07-3.64) were independently associated with CKD. Conclusion: Burden of CKD was high among this inpatient population. Haematuria and proteinuria can aid CKD diagnosis. Public awareness on health hazards of herbal medication use is necessary.


Assuntos
Hematúria/epidemiologia , Falência Renal Crônica/epidemiologia , Proteinúria/epidemiologia , Insuficiência Renal Crônica/epidemiologia , Adulto , Estudos Transversais , Feminino , Taxa de Filtração Glomerular , Humanos , Pacientes Internados , Quênia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Diálise Renal/estatística & dados numéricos , Insuficiência Renal Crônica/diagnóstico , Fatores de Risco , Inquéritos e Questionários
3.
BMC Urol ; 19(1): 76, 2019 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-31387648

RESUMO

BACKGROUND: Microscopic hematuria is a common incidental finding on routine urinalysis. Although there are no clear recommendations to perform routine urinalysis, some studies have shown that up to 50% of general practitioners continue to perform annual routine urinalysis regardless of age or risk factors. The aim of this study was to identify associated factors and prevalence of dipstick microscopic hematuria in the general male population presenting to an annual public men's health fair. METHOD: We conducted a retrospective analysis of prospectively collected data at an annual Men's Health fair from 2008 to 2013. Patient reported health questionnaires, basic physical exam including digital rectal exam, basic bloodwork and dipstick urinalysis data was examined. RESULTS: A total of 979 patients were reviewed. Of these, 850 provided a urine sample and were included in the final analysis. Seventy-three (8.6%) patients had positive hematuria on urinalysis. Average age in both groups was 55 years. Presence of microscopic hematuria was correlated with presence of diabetes and proteinuria with odds-ratio of 2.8 (1.3-5.8) and 2.9 (1.7-5.0) respectively on multivariate analysis. There was no significant correlation identified with age, hypertension, coronary artery disease, body-mass index, smoking, prostate specific antigen (PSA) or International Prostate Symptom Score (IPSS). Limitation of this study is the lack of follow-up and knowledge of subsequent investigations of patients. CONCLUSION: Microscopic hematuria is a prevalent condition in the male population presenting to a health fair. The only factors associated with microscopic hematuria were diabetes and proteinuria. No association was found between hematuria and smoking, age, or lower urinary tract symptoms.


Assuntos
Hematúria/diagnóstico , Hematúria/epidemiologia , Hematúria/urina , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores de Risco , Urinálise/métodos
4.
J Urol ; 202(5): 899-904, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31188730

RESUMO

PURPOSE: Computerized tomography urography is used to evaluate patients with gross or microscopic hematuria. Computerized tomography urography is a high radiation dose scan and, thus, it confers a higher risk of secondary malignancy. A computerized tomography urography split bolus protocol reduces radiation exposure but it may reduce sensitivity. In this study we used a theoretical cohort of patients with hematuria in which to model the risk of missing malignancies against the benefit of averting secondary malignancies. MATERIALS AND METHODS: We calculated the prevalence of renal cell carcinoma and upper tract urothelial carcinoma in patients with hematuria by pooled analysis of cohort studies, which in conjunction with split bolus sensitivity allows for the estimation of missed malignancies. The number of prevented secondary malignancies was calculated from lifetime attributable risk estimates. Sensitivity analyses were run to determine the minimum sensitivity required for a net population benefit. RESULTS: Estimates of split bolus computerized tomography urography sensitivity ranged from 80% to 100% (mean 95.2%). At the low estimate of 80% sensitivity split bolus computerized tomography urography was beneficial in men and women with microscopic hematuria at ages less than 50 and less than 60 years, respectively. An increase in sensitivity to 90% improved the benefit 1 decade in each gender, representing 68.8% of patients with microscopic hematuria. The overall population of patients with microscopic hematuria benefited from split bolus computerized tomography urography at 91.1% sensitivity. However, in patients with gross hematuria the threshold for an overall population benefit was high at 98.4% sensitivity. CONCLUSIONS: Exposure to ionizing radiation risks causing secondary malignancy. These data indicate that split bolus computerized tomography urography may be performed safely in 70% of the population of patients with microscopic hematuria. However, it is not currently advisable in patients with gross hematuria or in other patients at high risk.


Assuntos
Hematúria/diagnóstico , Modelos Teóricos , Medição de Risco/métodos , Tomografia Computadorizada por Raios X/métodos , Urografia/métodos , Neoplasias Urológicas/complicações , Adulto , Idoso , Feminino , Seguimentos , Hematúria/epidemiologia , Hematúria/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Exposição à Radiação , Tennessee/epidemiologia , Neoplasias Urológicas/diagnóstico
5.
Saudi J Kidney Dis Transpl ; 30(2): 394-400, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31031376

RESUMO

Dengue-related renal manifestations such as proteinuria, hematuria in the absence of thrombocytopenia, rhabdomyolysis, and acute kidney injury (AKI) are not uncommon. There is relatively sparse data on the renal manifestations of dengue viral infection (DVI). Hence, a retrospective study was conducted to investigate the incidence, characteristics, and clinical outcome of DVI with renal manifestations. A total of 2416 patients were admitted to our hospital with the diagnosis of dengue fever during the study period from 2012 to 2015. Data were collected from the electronic medical records and were analyzed retrospectively. The disease severity was classified according to the World Health Organization criteria. The renal manifestations were divided into AKI and non-AKI groups using AKI Network (AKIN) criteria. Proteinuria was defined as urinary protein >1+ (30 mg/dL) by dipstick test. A total of 218 patients were found to have proteinuria (9.56%). Most of the patients [135 (58.44%) with renal manifestations] were aged between 15 and 30 years. Comorbid conditions including diabetes mellitus, hypertension, and ischemic heart disease were seen in 10 (4.31%), 11 (4.76%), and six (2.59%) patients, respectively. Nephrotic-range proteinuria was seen in five patients (2.16%). AKI was seen in 82 patients (3.4%); 58 (70.73%) had AKIN-I, 19 (23.17%) had AKIN-II, and five patients (6.09%) had AKIN-III. Death occurred in 11 patients (39.28%) with AKI. The incidence of renal manifestations (proteinuria, hematuria, and AKI) is high at 9.59% among patients with dengue, and those with AKI had significant morbidity, mortality, longer hospital stay, and poor renal outcomes. Our findings suggest that AKI in dengue is likely to increase health-care burden that underscores the need for clinician's alertness to this highly morbid and potentially fatal complication for optimal prevention and management.


Assuntos
Lesão Renal Aguda/epidemiologia , Dengue/complicações , Diabetes Mellitus/epidemiologia , Hematúria/epidemiologia , Hipertensão/epidemiologia , Proteinúria/epidemiologia , Lesão Renal Aguda/fisiopatologia , Lesão Renal Aguda/virologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Hematúria/virologia , Humanos , Incidência , Índia/epidemiologia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/epidemiologia , Proteinúria/virologia , Recuperação de Função Fisiológica , Estudos Retrospectivos , Índice de Gravidade de Doença , Adulto Jovem
6.
BMC Public Health ; 19(1): 392, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30971223

RESUMO

BACKGROUND: In 2014, a study in Munyenge revealed a high prevalence of urogenital schistosomiasis (UGS) among pregnant women. This study investigated he prevalence and risk factors of UGS in pregnancy following scale-up of piped water sources from 2014 to 2017. Secondly, we compared stream usage, stream contact behaviour, infection rate and intensity with the findings of 2014. METHODS: Consenting pregnant women reporting for antenatal care (ANC) in the different health facilities were enrolled consecutively between November 2016 and January 2018. Information on age, gravidity status, residence, marital status, educational level, occupation, household water source, frequency of contact with water and stream activities were obtained using a semi-structured questionnaire. Urine samples were examined for the presence of microhaematuria and S. haematobium ova using test strip and filtration/microscopy methods respectively. Data were analysed using univariate and multivariate regression analyses and relative risk reductions calculated. RESULTS: Of the 368 women enrolled, 22.3% (82) were diagnosed with UGS. Marital status (single) (aOR = 2.24, 95% CI: 1.04-4.79), primary - level of education (aOR = 2.0; 95% CI: 1.04-3.85) and domestic activity and bathing in the stream (aOR = 3.3; 95% CI: 1.83-6.01) increased risk of S. haematobium infection. Meanwhile, fewer visits (< 3 visits/week) to stream (aOR = 0.35, 95% CI = 0.17-0.74) reduced exposure to infection. Piped water usage was associated with reduced stream usage and eliminated the risk of infection among women who used safe water only. Compared with the findings of 2014, stream usage (RRR = 23 95% CI: 19-28), frequency (≥ 3 visits) (RRR = 69 95% CI: 59-77) and intensity of contact with water (RRR = 37 95% CI = 22-49) has reduced. Similarly, we observed a decrease in infection rate (RRR = 52, 95% CI = 40-62) and prevalence of heavy egg intensity (RRR = 71, 95% CI = 53-81). CONCLUSION: Following increased piped water sources in Munyenge, S. haematobium infection has declined due to reduced stream contact. This has important implication in the control of UGS in pregnancy.


Assuntos
Complicações Parasitárias na Gravidez/epidemiologia , Schistosoma haematobium , Esquistossomose Urinária/epidemiologia , Abastecimento de Água/métodos , Água/parasitologia , Adolescente , Adulto , Animais , Camarões/epidemiologia , Estudos Transversais , Feminino , Filtração , Hematúria/epidemiologia , Hematúria/parasitologia , Humanos , Microscopia , Gravidez , Complicações Parasitárias na Gravidez/etiologia , Complicações Parasitárias na Gravidez/parasitologia , Cuidado Pré-Natal , Prevalência , Fatores de Risco , Rios/parasitologia , Esquistossomose Urinária/etiologia , Esquistossomose Urinária/parasitologia , Inquéritos e Questionários , Adulto Jovem
7.
Arch Ital Urol Androl ; 91(1): 11-15, 2019 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-30932423

RESUMO

OBJECTIVE: Urinoma is a rare entity and mainly occurs due to acute obstruction such as ureteral stone. We aimed to demonstrate factors associated with urinoma accompanied by ureteral calculi. MATERIAL AND METHODS: Data of 550 patients who were diagnosed with ureteral stone by computed tomography (CT) were analyzed retrospectively. In 20 patients perirenal urinoma was associated with ureteral calculi (group I), whereas in other 530 patients no urinoma was detected (group II). Gender, age, size, side and localization of the stone, hydronephrosis, fever, sepsis, urinary tract infections (UTIs), hematuria, serum creatinine, blood urea nitrogen (BUN), white blood cell (WBC), C-reactive protein (CRP), presence of diabetes mellitus (DM), hypertension (HT) and cronic kidney disease (CKD) of the two groups were compared. RESULTS: The average age of the patients were 46.2 (20-71) and 44.9 (10-82) years in group I and group II, respectively (p > 0.05). According to our results leukocytosis, microscopic and macroscopic hematuria, UTIs, increase of serum creatinine, BUN and CRP, diagnosis of DM and HT were significantly associated with urinoma (p < 0.05). In addition, patients with distal ureteral stones are more prone to urinoma (p = 0.001). An interesting finding of the study was that the stone size in group I (median 5 mm [range 3-8]) was significantly smaller than in group II (9.3 mm [4-25]; p = 0.001). CONCLUSIONS: Small stone size, distal localisation of the stone in ureter, leukocytosis, hematuria, UTIs, increase of serum creatinine, BUN and CRP, presence of DM and HT are associated with perirenal urinoma.


Assuntos
Tomografia Computadorizada por Raios X/métodos , Cálculos Ureterais/diagnóstico por imagem , Urinoma/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Diabetes Mellitus/epidemiologia , Feminino , Hematúria/epidemiologia , Humanos , Hidronefrose/epidemiologia , Hipertensão/epidemiologia , Leucocitose/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Infecções Urinárias/epidemiologia , Urinoma/etiologia , Adulto Jovem
8.
Acta Trop ; 194: 195-203, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30871989

RESUMO

OBJECTIVES: The study assessed associations between Schistosoma haematobium infection (presence of parasite eggs in urine or hematuria) and self-reported metrics (macrohematuria, fetching surface water, or swimming) to evaluate their performance as proxies of infection in presence of regular preventive chemotherapy. It also examined community water characteristics (safe water access, surface water access, and groundwater quality) to provide context for schistosomiasis transmission in different types of communities and propose interventions. METHODS: Logistic regression was used to assess the associations between the various measured and self-reported metrics in a sample of 897 primary school children in 30 rural Ghanaian communities. Logistic regression was also used to assess associations between community water characteristics, self-reported water-related behaviors and S. haematobium infection. Communities were subsequently categorized as candidates for three types of interventions: provision of additional safe water sources, provision of groundwater treatment, and health education about water-related disease risk, depending on their water profile. RESULTS: Microhematuria presence measured with a reagent strip was a good proxy of eggs in urine at individual (Kendall's τb = 0.88, p < 0.001) and at school-aggregated (Spearman's rs = 0.96, p < 0.001) levels. Self-reported macrohematuria and swimming were significantly associated (p < 0.05) with egg presence, but self-reported fetching was not. Of the community water characteristics, greater surface water access and presence of groundwater quality problems were significantly associated with increased likelihood of fetching, swimming, and S. haematobium infection. Access to improved water sources did not exhibit an association with any of these outcomes. CONCLUSIONS: The study illustrates that in presence of regular school-based treatment with praziquantel, microhematuria assessed via reagent strips remains an adequate proxy for S. haematobium infection in primary schoolchildren. Community water profiles, in combination with self-reported water-related behaviors, can help elucidate reasons for some endemic communities continuing to experience ongoing transmission and tailor interventions to these local contexts to achieve sustainable control.


Assuntos
Schistosoma haematobium , Esquistossomose Urinária/diagnóstico , Esquistossomose Urinária/epidemiologia , Esquistossomose Urinária/transmissão , Animais , Criança , Feminino , Gana/epidemiologia , Hematúria/epidemiologia , Humanos , Modelos Logísticos , Masculino , Fitas Reagentes , Fatores de Risco , População Rural , Esquistossomose Urinária/urina , Instituições Acadêmicas , Natação , Água/parasitologia
9.
Urology ; 127: 86-90, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30817961

RESUMO

OBJECTIVE: To study the feasibility of transvesical prostate resection and its effect on urethral stricture. MATERIALS AND METHODS: We included 99 patients with symptomatic bladder outlet obstruction who underwent transvesical resection of prostate (TVRP; n = 48) and transurethral (TURP; n = 51) prostatectomy. We examined all the patients by means of digital rectal examination, transrectal ultrasound, and evaluated them by international prostate symptom score, quality of life score, uroflowmetric assessment and PSA level, and established definitive diagnosis. We followed up the patients in first month, third month, and the first year of the operation and monitored once a year in the following years. RESULTS: In this study, totally 99 symptomatic bladder outlet obstruction patients were included (TVRP = 48 and TURP = 51). Mean age of the patients were 66.5 ± 8.2vs 68 ± 9.8years for our patients with TVRP and TURP, respectively. Two groups displayed similar values in terms of improvements in the Qmax and PVR, and there were no statistically significant differences in between. We obtained similar values for resection time and weight of resected prostate tissue in both groups. Urethral stricture was not observed in TVRP group. In TURP group however, stricture was observed in 4 (7.8%) patients in bulbar urethra in sixth month at average. And there was also a concomitant urethral meatal stricture in one of these patients. When the 2 groups were compared, the rate of urethral stricture was statistically significantly higher in the TURP group (P = .001). CONCLUSION: Resection of prostate without using urethra significantly reduces the incidence of urethral stricture due to mucosal damage.


Assuntos
Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/cirurgia , Ressecção Transuretral da Próstata/métodos , Obstrução do Colo da Bexiga Urinária/diagnóstico , Obstrução do Colo da Bexiga Urinária/cirurgia , Idoso , Estudos de Casos e Controles , Estudos de Coortes , Estudos de Viabilidade , Seguimentos , Hematúria/diagnóstico , Hematúria/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/fisiopatologia , Prostatectomia/efeitos adversos , Prostatectomia/métodos , Medição de Risco , Índice de Gravidade de Doença , Ressecção Transuretral da Próstata/efeitos adversos , Resultado do Tratamento , Ultrassom Focalizado Transretal de Alta Intensidade/métodos , Estreitamento Uretral/diagnóstico por imagem , Estreitamento Uretral/cirurgia , Retenção Urinária/diagnóstico , Retenção Urinária/epidemiologia , Infecções Urinárias/diagnóstico , Infecções Urinárias/epidemiologia
10.
Neuro Endocrinol Lett ; 39(7): 489-495, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30860680

RESUMO

INTRODUCTION: The clinical characteristics of subacute thyroiditis (SAT) has been changing in recent years. There are more and more patients with painless SAT, and more cases of SAT with elevated levels of anti-thyroid antibodies were reported. The aim of the study was to evaluate the clinical characteristics of SAT patients with special regard to the differences between the previously described and currently observed features of the disease. MATERIAL AND METHODS: Clinical and laboratory data were retrospectively reviewed for 64 patients with confirmed SAT. RESULTS: Mean age of the patients was 42.67 years. The male to female ratio was 1:7. Neck or ear pain was reported by 93.75% of patients, while fever occurred in 65.63% of patients. The aTPO and aTg levels were increased in 15.5% and 33.3% of patients, respectively. TRAb level was increased in 6% of patients. Transient microhaematuria was present in 63% of analyzed cases. No statistically significant differences in clinical characteristics or laboratory results were found between the groups with- and without neck/ear pain, with- and without elevated TRAb, and with- and without elevated aTPO and/or aTg. CONCLUSION: In our study, several new features of current SAT course, different from what we used to know about the disease, were reported. Higher frequency of painless SAT than it was ever described, was observed. Moreover, in as much as one third of the patients aTPO and/or aTg were present, and in 6% of SAT cases the coexistence of TRAb was demonstrated. Transient microhaematuria was typical for the acute SAT phase.


Assuntos
Febre/epidemiologia , Hematúria/epidemiologia , Dor/epidemiologia , Tireoidite Subaguda/epidemiologia , Adulto , Idoso , Anticorpos/imunologia , Comorbidade/tendências , Feminino , Humanos , Iodeto Peroxidase/imunologia , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Receptores da Tireotropina/imunologia , Estudos Retrospectivos , Tireoglobulina/imunologia , Adulto Jovem
11.
Exp Clin Transplant ; 17(Suppl 1): 148-152, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30777542

RESUMO

OBJECTIVES: Ureteral complications remain a major source of morbidity and occasional mortality in renal transplant. Among all ureteral complications, leaks are the most frequently encountered in the early posttransplant period. The routine use of a double-J ureteric stent remains controversial, with reported increased incidence of urinary tract infection. Here, we retrospectively compared the efficacy of a double J stent in kidney transplant patients to investigate ureteral complication incidence in our center. MATERIALS AND METHODS: Our study included 382 kidney transplant patients. At 5 weeks after transplant, the double J stent was removed under sedation. Patients were divided into 2 groups: 125 patients with double J stent placement (group 1) and 257 patients without double J stent placement (group 2). RESULTS: We observed no significant demographic differences between the 2 groups with regard to patient age (median patient age of 30 y [range, 2-73 y] for group 1; median patient age of 33 y [range, 4-69 y] for group 2), patient sex (30.2% females in group 1, 32.4% females in group 2), and body mass index (median of 25.1 vs 24.9 kg/m2 in groups 1 and 2, respectively). Cold and warm ischemia time for donor organ, delayed graft function, and episodes of acute rejection did not differ significantly between the groups. Urinary tract infection was observed in 25/125 (20.4%) and 50/257 patients (19.2%) in groups 1 and 2, respectively. Urinary leak was present in 8/125 group 1 (6.4%) and 6/257 group 2 patients (2.3%). CONCLUSIONS: A double J stent in ureteral anastomosis was not likely to decrease the frequency of leakage but is likely to reduce the gravity of the complication and the need for reoperation. In addition, the use of a double J stent was not associated with increased urinary tract infections in renal transplant recipients.


Assuntos
Hematúria/epidemiologia , Transplante de Rim/instrumentação , Stents , Obstrução Uretral/epidemiologia , Incontinência Urinária/epidemiologia , Infecções Urinárias/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Hematúria/diagnóstico , Humanos , Incidência , Transplante de Rim/efeitos adversos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Turquia/epidemiologia , Obstrução Uretral/diagnóstico , Incontinência Urinária/diagnóstico , Infecções Urinárias/diagnóstico , Infecções Urinárias/microbiologia , Adulto Jovem
12.
Scand J Urol ; 52(5-6): 407-410, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30451058

RESUMO

BACKGROUND: Due to the high incidence of benign lesions in renal masses, numerous studies have been performed to clarify the value of core needle biopsies. The aim of the present study was to describe the complication rate after renal tumor biopsies (RTB), in order to make recommendations on observation after the procedure. MATERIALS AND METHODS: Data from all patients who underwent percutaneous ultrasound-guided RTB between February 2013 and October 2016 due to CT verified solid renal masses were prospectively collected and kept in a well-maintained database. Complications were collected retrospectively and classified according to the Clavien-Dindo (CD) classification system. RESULTS: Data from 224 consecutive patients were retrieved. Thirteen patients underwent unilateral repeat biopsies and three patients underwent bilateral biopsies; thus, a total of 240 procedures were analyzed. A total of 124 patients (51.7%) were discharged within 4 hours after the RTB procedures and 110 patients (45.8%) were discharged within 24 hours. The remaining six patients (2.5%) were hospitalized for more than 1 day, all due to co-morbidities which were unrelated to the procedure. In total, five patients (2.1%) experienced post-biopsy complications: one case of iatrogenic pneumothorax, one case of spontaneously resolving hematuria and three cases of fever. All complications were CD ≤2 and all patients with complications were discharged within 24 hours, except for one patient who was hospitalized for 3 days due to management of bone pain. No correlation was found between the number of biopsies and complication rate. CONCLUSION: The overall complication rate following ultrasound-guided biopsies of renal tumors was low and all complications were mild. Given the current evidence, it is believed that ultrasound-guided RTB can be done as an outpatient procedure without the need for hospitalization.


Assuntos
Biópsia com Agulha de Grande Calibre/métodos , Febre/epidemiologia , Hematúria/epidemiologia , Neoplasias Renais/patologia , Pneumotórax/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Idoso , Biópsia com Agulha de Grande Calibre/efeitos adversos , Feminino , Humanos , Biópsia Guiada por Imagem/métodos , Neoplasias Renais/terapia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Pneumotórax/etiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Carga Tumoral , Ultrassonografia
13.
Clin J Oncol Nurs ; 22(6): E146-E151, 2018 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-30451996

RESUMO

BACKGROUND: Hyperbaric oxygen therapy is a rare treatment modality for hemorrhagic cystitis (HC) following BK virus reactivation in the immunosuppressed population. Clinicians need to be aware of the etiology, preventive measures, complications, and various management techniques in HC while treating patients undergoing bone marrow transplantation. OBJECTIVES: This study details the pathologic progression of HC in a patient with acute lymphoblastic leukemia harboring BK virus after cytotoxic induction chemotherapy and haploidentical marrow transplantation. METHODS: A search of PubMed for literature published from 1973-2018 was conducted using keywords. FINDINGS: Hyperbaric oxygen therapy in chemotherapy-induced and BK virus-associated HC is a viable management option in parallel with tapering of immunosuppressives, bladder irrigation, and IV resuscitation within the post-transplantation acute lymphoblastic leukemia population.


Assuntos
Cistite/epidemiologia , Cistite/terapia , Hematúria/terapia , Oxigenação Hiperbárica/métodos , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Transplante de Medula Óssea/métodos , Comorbidade , Cistite/diagnóstico , Intervalo Livre de Doença , Feminino , Hematúria/diagnóstico , Hematúria/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Prognóstico , Medição de Risco , Índice de Gravidade de Doença , Taxa de Sobrevida , Resultado do Tratamento
14.
Scand J Urol ; 52(4): 237-243, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30411661

RESUMO

OBJECTIVE: This study assessed a national healthcare intervention launched in Sweden in 2015 to reduce the time between macroscopic haematuria, diagnosis and treatment of urinary tract cancer. METHODS: The outcome of the first 11 months was evaluated in 1697 individuals referred to a standardized care pathway for urinary tract cancer compared with 174 patients with conventionally diagnosed urothelial carcinoma. RESULTS: Among the referred individuals, 317 (19%) were diagnosed with cancer, 1034 (61%) had a benign diagnosis and 345 (20%) had a negative evaluation. Bladder cancer was the most common malignant diagnosis [262/317 (83%)]. Cancers were diagnosed in 23% of males and 13% of females, and showed a strong correlation with age: cancer diagnosis in 2% aged <50 years and in 44% aged ≥90 years. Results were affected by bacteriuria but not by anticoagulant medication, with 12%/22% and 19%/19% cancer detection, respectively. The standardized care pathway shortened the diagnostic delay to a median of 25 days compared to 35 days for regular referral (p = .01). However, median time to treatment was unchanged: 39 days from referral to transurethral resection, 42 days from primary resection to re-resection for stage TaG3/T1 disease and 100 days from referral to curative treatment for muscle-invasive disease. CONCLUSIONS: Macroscopic haematuria had a cancer capture rate of 19%, with higher predictive values in men and at older age, whereas anticoagulant therapy did not influence the diagnostic yield. The demonstrated lack of effect on time to treatment underscores the need to consider the entire patient process when initiating healthcare reforms to improve outcome.


Assuntos
Carcinoma de Células de Transição/diagnóstico , Diagnóstico Tardio , Hematúria/etiologia , Encaminhamento e Consulta , Tempo para o Tratamento , Neoplasias Urológicas/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/uso terapêutico , Bacteriúria/epidemiologia , Carcinoma de Células de Transição/complicações , Carcinoma de Células de Transição/terapia , Procedimentos Clínicos , Cistoscopia , Feminino , Hematúria/epidemiologia , Humanos , Neoplasias Renais/complicações , Neoplasias Renais/diagnóstico , Neoplasias Renais/terapia , Masculino , Pessoa de Meia-Idade , Suécia/epidemiologia , Neoplasias Ureterais/complicações , Neoplasias Ureterais/diagnóstico , Neoplasias Ureterais/terapia , Neoplasias da Bexiga Urinária/complicações , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/terapia , Neoplasias Urológicas/complicações , Neoplasias Urológicas/terapia , Procedimentos Cirúrgicos Urológicos
15.
Am J Trop Med Hyg ; 99(6): 1567-1572, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30277203

RESUMO

The sensitivity of a point-of-care circulating cathodic antigen (POC-CCA) urine cassette test for diagnosis of Schistosoma mansoni in low-endemicity settings is poorly understood. We conducted a cross-sectional survey in 14 villages in western Côte d'Ivoire and diagnosed children aged 9-12 years for schistosomiasis. Two stool samples were subjected to triplicate Kato-Katz thick smears each for diagnosis of S. mansoni, whereas a single urine sample was examined by POC-CCA for S. mansoni, filtration for Schistosoma haematobium, and reagent strip for microhematuria. According to the Kato-Katz technique, we found 45 out of 681 children positive for S. mansoni (6.6%) with a mean intensity among infected children of 72.2 eggs per gram of stool. Point-of-care circulating cathodic antigen revealed a prevalence of S. mansoni of 33.0% when trace results were considered positive and 12.5% when trace results were considered negative. Eggs of S. haematobium were found in eight participants (1.2%), whereas the prevalence of microhematuria was 13.5%. A single POC-CCA urine cassette test revealed a several-fold higher prevalence of S. mansoni than multiple Kato-Katz thick smears in this low-endemicity area. Our findings have important ramifications for choosing an appropriate diagnostic tool in low-endemic areas that might be targeted for elimination.


Assuntos
Antígenos de Helmintos/urina , Hematúria/diagnóstico , Hematúria/epidemiologia , Testes Imediatos/normas , Schistosoma mansoni/isolamento & purificação , Esquistossomose mansoni/diagnóstico , Esquistossomose mansoni/epidemiologia , Adolescente , Animais , Anti-Helmínticos/uso terapêutico , Criança , Costa do Marfim/epidemiologia , Estudos Transversais , Fezes/parasitologia , Feminino , Hematúria/tratamento farmacológico , Hematúria/parasitologia , Humanos , Masculino , Contagem de Ovos de Parasitas/estatística & dados numéricos , Praziquantel/uso terapêutico , Prevalência , Fitas Reagentes , População Rural , Schistosoma haematobium/imunologia , Schistosoma haematobium/isolamento & purificação , Schistosoma mansoni/imunologia , Esquistossomose mansoni/tratamento farmacológico , Esquistossomose mansoni/parasitologia
16.
Niger Postgrad Med J ; 25(3): 172-176, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30264769

RESUMO

Background: Transrectal ultrasound (TRUS)-guided biopsy of the prostate is considered as a standard of care for diagnosis of prostate cancer. The objective of this study was to document our experience in the use of TRUS in the management of urologic diseases in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Materials and Methods: This was a retrospective study of patients who had TRUS at UDUTH from December 2009 to November 2017. Relevant data were extracted from the procedure register, and case folders of the patients. Data analysis was performed using IPSS 20.0 version. Results: A total of 844 patients had the procedure within the period of the study. The mean age of the patients was 65.6 ± 10.6 years with a range of 7-98 years. The main clinical diagnoses of the patients were benign prostatic hyperplasia in 528 patients (62.6%), prostate cancer in 285 patients (33.8%) and primary infertility + azoospermia in 17 patients (2.1%). Transrectal ultrasound-guided prostate biopsy was done for 807 patients (96%). TRUS only was done for assessment of seminal vesicle and ejaculatory duct in 17 patients (2.1%), prostate volume assessment in 10 patients (1.1%) and deflation of retained urethral catheter balloon in 9 patients (1%). There was self-limiting rectal bleeding in 600 patients (74.4%) and 3 patients (0.4%) each developed haematuria and postbiopsy infections. Conclusion: Prostate biopsy is the most common indication for TRUS in our practice. Other indications were estimation of prostatic volume, evaluation of azoospermia and deflation of retained urethral catheter balloon.


Assuntos
Azoospermia/diagnóstico por imagem , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Hematúria/etiologia , Próstata/patologia , Hiperplasia Prostática/diagnóstico por imagem , Neoplasias da Próstata/patologia , Reto/diagnóstico por imagem , Ultrassonografia/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Azoospermia/epidemiologia , Criança , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/efeitos adversos , Hematúria/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Hiperplasia Prostática/epidemiologia , Neoplasias da Próstata/epidemiologia , Estudos Retrospectivos , Centros de Atenção Terciária , Adulto Jovem
17.
Mayo Clin Proc ; 93(8): 991-1008, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30077216

RESUMO

OBJECTIVE: To describe the clinicopathological features, complement abnormalities, triggers, treatment, and outcomes of C3 glomerulopathy. PATIENTS AND METHODS: A total of 114 patients with C3 glomerulopathy seen at Mayo Clinic from January 1, 2007, through December 31, 2016, were evaluated in this study. RESULTS: The mean age at diagnosis for the entire cohort was 40.4±22.3 years, with a median serum creatinine level and proteinuria value of 1.6 mg/dL (range: 0.3-14.7) (to convert to mmol/L, multiply by 0.0259) and 2605 mg/24 h (range: 233-24,165), respectively. Hematuria was present in 100 patients (87.7%). The C3 and C4 levels were low in 50 of 112 (44.6%) and 13 of 110 (11.8%) patients, respectively. A history of infection, positive autoimmune findings, and monoclonal gammopathy (MIg) were present in 33 of 114 (28.9%), 28 of 114 (24.6%), and 36 of 95 (37.9%) patients, respectively. However, 28 of 43 patients 50 years or older (65.1%) had MIg. A genetic variant in complement genes, C3 nephritic factor (C3Nef), and other autoantibodies was present in 26 of 70 (37.1%), 30 of 69 (43.5%), and 9 of 67 (13.4%) patients, respectively. Membranoproliferative and mesangial proliferative glomerulonephritis were the common patterns of injury. Patients without MIg were younger (mean age, 32.3±20.6 years), with a median serum creatinine level and proteinuria value of 1.4 mg/dL (range: 0.3-7.9) and 2450 mg/24 h (range: 250-24, 165) and with low C3 and C4 levels in 38 of 77 (49.4%) and 9 of 75 (12.0%) patients, respectively. Most patients received corticosteroids and other immunosuppressive drugs. In patients without MIg, at a median follow-up of 22.3 months (range: 0.1-201.1), the median serum creatinine level and proteinuria value were 1.4 mg/dL (range: 0.3-3.7) and 825.5 mg/24 h (range: 76-22, 603), and 7 patients (9.2%) had progression to end-stage renal disease. CONCLUSION: C3 glomerulopathy is a heterogeneous disease entity with complex triggering events and abnormalities of the alternative pathway of complement. The disease tends to be progressive and exhibits a variable response to immunosuppressive therapy.


Assuntos
Glomerulonefrite , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Autoanticorpos/sangue , Doenças Autoimunes/epidemiologia , Criança , Pré-Escolar , Complemento C3/genética , Fator Nefrítico do Complemento 3/análise , Fator H do Complemento/genética , Proteínas do Sistema Complemento , Creatinina/sangue , Progressão da Doença , Feminino , Variação Genética , Glomerulonefrite/sangue , Glomerulonefrite/tratamento farmacológico , Glomerulonefrite/genética , Glucocorticoides/uso terapêutico , Hematúria/epidemiologia , Humanos , Imunoglobulinas/sangue , Imunossupressores/uso terapêutico , Falência Renal Crônica/epidemiologia , Masculino , Pessoa de Meia-Idade , Minnesota/epidemiologia , Síndrome Nefrótica/epidemiologia , Paraproteinemias/epidemiologia , Proteinúria/epidemiologia , Adulto Jovem
18.
Crit Pathw Cardiol ; 17(3): 139-146, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30044254

RESUMO

BACKGROUND: Clinical variables including hypertension could be linked with major bleeding events and death beyond vitamin K antagonist (warfarin) or direct oral anti-coagulants (DOACs) treatment strategy. METHODS: Subgroup analysis of major bleeding (primary endpoint) associated with clinical variables, site of bleeding, ongoing antithrombotics, reversal treatment or blood transfusion, outcomes (secondary endpoints) was performed in patients with bleeding events submitted to hard 5:1 propensity-score matching for hypertension. RESULTS: Enrolled patients were 2,792 (mean age, 65.6 ± 19.9 years) during 2-year survey including 166,000 visits, of 200,000 inhabitants catchment area; 8,239 patients received warfarin and 3,797 DOACs. Hypertension account for 1,077 (39%) patients; major bleeding for 474 (17%); death for 29 (1%), and 72 (3%) on 1-month and 1-year, respectively. Hypertension, age, glucose, cancer, ischemic vascular disease, and CHA2D2VASc score were more likely to link with major bleeding. On multivariate analysis, only age (odds ratio [OR], 1.02; P < 0.001), CHA2DS2VASc score ≥ 2 (OR, 2.14; P = 0.001), and glucose (OR, 1.01; P = 0.005) were predictors of major bleeding. Kaplan-Meier analysis demonstrated patients with hypertension as compared with patients without showed 60% versus 20% death on 1-month (P < 0.001). Warfarin compared with DOACs was more likely to present with major bleeding (0.7% versus 0.2%; OR, 2.8; P = 0.005). Receiver operator characteristics analysis showed high value (0.61) of age and glucose over creatinine and systolic arterial pressure (P = NS). CONCLUSIONS: Four in 10 patients with major bleeding showed hypertension; of these 8 in 10 will die within 1 month. Warfarin compared with DOACs was more likely to present with major bleeding.


Assuntos
Glicemia/metabolismo , Creatinina/metabolismo , Hemorragia/epidemiologia , Hipertensão/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/efeitos adversos , Transfusão de Sangue , Doenças Cardiovasculares/epidemiologia , Dabigatrana/efeitos adversos , Serviço Hospitalar de Emergência , Epistaxe/induzido quimicamente , Epistaxe/epidemiologia , Feminino , Hemorragia Gastrointestinal/induzido quimicamente , Hemorragia Gastrointestinal/epidemiologia , Hematúria/induzido quimicamente , Hematúria/epidemiologia , Hemoptise/induzido quimicamente , Hemoptise/epidemiologia , Hemorragia/induzido quimicamente , Humanos , Hemorragias Intracranianas/induzido quimicamente , Hemorragias Intracranianas/epidemiologia , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Prognóstico , Pontuação de Propensão , Pirazóis/efeitos adversos , Piridinas/efeitos adversos , Piridonas/efeitos adversos , Rivaroxabana/efeitos adversos , Índice de Gravidade de Doença , Fatores Sexuais , Tiazóis/efeitos adversos , Varfarina/efeitos adversos
19.
Sci Rep ; 8(1): 10822, 2018 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-30018344

RESUMO

There are limited data on the disease of bladder cancer in Libya. The objective of this study was to assess the pattern of incidence and clinical presentation of bladder cancer in Benghazi, Libya. This study was a retrospective cohort analysis conducted among consecutive individuals who were diagnosed and/or were treated for bladder cancer from January 1st 1983 to December 31st 2009. A total of 835 cases of bladder tumour were recorded. The world age-standardized incidence rate was 13.1 and 1.9 per 100,000 for males and females, respectively. The mean (standard deviation) age of all patients was 63.7 (14.7). The majority of patients (n = 750, 89.8%) were male, two-thirds of which (n = 594, 79.2%) were smokers while all female patients were non-smokers. Hematuria was the most frequent presenting symptom. Most tumours were well differentiated, and transitional cell carcinoma was the most frequent histological type. The incidence of bladder cancer in Libya is lower than most developed countries, increases by aging, and is more prevalent among males. The incidence of this disease is expected to grow in developing countries such as Libya because of increase in smoking popularity, the shift to sedentary life, diabetes mellitus, and obesity.


Assuntos
Carcinoma de Células de Transição/epidemiologia , Neoplasias da Bexiga Urinária/epidemiologia , Adolescente , Adulto , Idoso , Carcinoma de Células de Transição/diagnóstico , Feminino , Hematúria/complicações , Hematúria/diagnóstico , Hematúria/epidemiologia , Humanos , Incidência , Líbia/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias da Bexiga Urinária/diagnóstico , Adulto Jovem
20.
J Urol ; 200(5): 1062-1067, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29906435

RESUMO

PURPOSE: Prostate biopsy complications have important consequences that may affect patient compliance with rebiopsy schemes. However, to our knowledge this has not been studied in earnest. Thus, we evaluated whether previous prostate biopsy related complications and the type of complication were associated with repeat prostate biopsy compliance in a clinical trial with study mandated systematic biopsies. MATERIALS AND METHODS: We retrospectively analyzed the records of 4,939 men 50 to 75 years old who underwent 2-year prostate biopsy and were recommended to undergo 4-year prostate rebiopsy in the REDUCE (Reduction by Dutasteride of Prostate Cancer Events) study. The analyzed biopsy complications were hematuria, urinary tract infection, acute urinary retention and hemospermia. RESULTS: A total of 260 men (5.3%) had a 2-year prostate biopsy related complication, including hematuria in 180 (3.6%), urinary tract infection in 36 (0.7%), acute urinary retention in 26 (0.5%) and hemospermia in 102 (2.1%). A total of 474 men (9.6%) were noncompliant with 4-year rebiopsy. On univariable analysis any previous complication (OR 1.56, 95% CI 1.08-2.24, p = 0.018), urinary tract infection (OR 2.72, 95% CI 1.23-6.00, p = 0.013), acute urinary retention (OR 4.24, 95% CI 1.83-9.81, p = 0.016) and hemospermia (OR 1.78, 95% CI 1.03-3.06, p = 0.037) were associated with rebiopsy noncompliance. Hematuria was not associated with rebiopsy noncompliance (OR 1.19, 95% CI 0.74-1.91, p = 0.483). Results were unchanged on multivariable analysis, including for any complication (OR 1.65, 95% CI 1.08-2.26, p = 0.018), for urinary tract infection (OR 2.62, 95% CI 1.07-3.21, p = 0.029), for acute urinary retention (OR 4.51, 95% CI 1.93-10.54, p = 0.001), for hemospermia (OR 1.85, 95% CI 1.07-3.21, p = 0.029) and for hematuria (OR 1.19, 95% CI 0.74-1.93, p = 0.472). CONCLUSIONS: In men who undergo repeat prostate biopsy a previous biopsy related complication and the type of complication were associated with lower compliance with rebiopsy schemes. Patients who experience biopsy related complications are ideal candidates to receive intervention regarding the importance of prostate rebiopsy to prevent noncompliance.


Assuntos
Dutasterida/uso terapêutico , Cooperação do Paciente/estatística & dados numéricos , Complicações Pós-Operatórias/psicologia , Neoplasias da Próstata/tratamento farmacológico , Reoperação/estatística & dados numéricos , Idoso , Biópsia com Agulha de Grande Calibre/efeitos adversos , Biópsia com Agulha de Grande Calibre/psicologia , Biópsia com Agulha de Grande Calibre/estatística & dados numéricos , Ensaios Clínicos como Assunto , Hematúria/epidemiologia , Hematúria/etiologia , Hematúria/psicologia , Hemospermia/epidemiologia , Hemospermia/etiologia , Hemospermia/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente/psicologia , Educação de Pacientes como Assunto , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Próstata/patologia , Neoplasias da Próstata/patologia , Reoperação/psicologia , Estudos Retrospectivos , Resultado do Tratamento , Retenção Urinária/epidemiologia , Retenção Urinária/etiologia , Retenção Urinária/psicologia , Infecções Urinárias/epidemiologia , Infecções Urinárias/etiologia , Infecções Urinárias/psicologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA