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Id: biblio-985180
Autor: García Hevia, Alejandro; Pierini, Ángel L; Rabellino, Alejandro.
Título: Coledocolitiasis insospechada en pacientes con litiasis vesicular / Unsuspected choledocholithiasis in patients with gallbladder stones
Fonte: Rev. argent. cir;110(3):152-155, set. 2018. ilus, graf, tab.
Idioma: es.
Resumo: Antecedentes: actualmente un punto discutido de la colecistectomía laparoscópica (CL) es la realización sistemática de la colangiografía intraoperatoria (CIO); sin embargo, esta permite el diagnóstico de litiasis coledociana insospechada (LCI). Objetivo: establecer el porcentaje de CIO realizadas, el número de LCI diagnosticadas, describir qué terapéutica se utilizó para resolverlas y establecer si existe relación entre el tamaño de las litiasis diagnosticadas y su tratamiento transcístico. Resultados: de las 1077 CL electivas, la CIO pudo realizarse en el 89,14% de los pacientes. En 2014, el porcentaje de CIO fue el más alto de la serie (95,38%). Se encontraron 38 LCI. El tratamiento realizado incluyó el abordaje transcístico y la colangiopancreatografía retrógrada endoscópica (CPRE) intraoperatoria. La morbilidad global fue del 7,9 % sin mortalidad. Discusión: nuestro porcentaje de CIO se encuentra por debajo del enunciado en otras publicaciones, pero el porcentaje aumentó con los años. La incidencia de LCI en nuestro caso fue del 3,96%. En nuestro servicio primeramente se intenta la resolución transcística (tasa de éxito del 77,42% sin complicaciones). Otra opción es la CPRE intraoperatoria, que se utilizó en 4 casos con una eficacia del 100% sin complicaciones. Conclusión: el tratamiento de la LCI continúa siendo un reto para los cirujanos, debido sobre todo a la imprevisibilidad del cuadro; resulta un factor muy importante para la resolución transcística el tamaño de la litiasis encontrada (más o menos de 6 mm). Consideramos la CPRE intraoperatoria como una herramienta importante en la resolución de esta patología.

Background: currently a discussed point of laparoscopic cholecystectomy (LC) is the systematic implementation of intraoperative cholangiography (IOC); however, it allows the diagnosis of unsuspected common bile duct stones (UBDS). Objective: to establish the percentage of IOC performed, the number of UBDS diagnosed, to describe what therapeutic was used to solve them and to establish if there is a relationship between the size of the diagnostic lithiasis and the transcystic treatment of the same. Results: of the 1077 elective LC, IOC could be performed in 89.14% of patients. In 2014 the percentage of IOC was the highest in the series (95.38%). 38 UBDS were found. The treatment included the transcritical approach and intraoperative ERCP. Overall morbidity was 7.9% without mortality. Discussion: our IOC percentage is below the utterance in other publications, but the percentage has increased over the years. The incidence of UBDS in our case was 3.96%. In our service we first try the transcritical resolution (success rate of 77.42% without complications). Another option is intraoperative ERCP that was used in 4 cases with 100% efficacy without complications. Conclusion: the treatment of the UBDS continues being a challenge for the surgeons, mainly due to the unpredictability of the picture; a very important factor for transcystic resolution is the size of the stone found (more or less than 6 mm). We consider intraoperative ERCP as an important tool in the resolution of this pathology.
Descritores: Cálculos da Bexiga Urinária
Colangiopancreatografia Retrógrada Endoscópica
Colecistectomia Laparoscópica
Coledocolitíase
-Patologia
Terapêutica
Colangiografia
Eficácia
Incidência
Morbidade
Mortalidade
Ducto Colédoco
Litíase
Diagnóstico
Vesícula Biliar
Limites: Humanos
Masculino
Feminino
Tipo de Publ: Relatos de Casos
Relatório Técnico
Responsável: AR144.1 - CIBCHACO - Centro de Información Biomedica del Chaco


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Torres, Orlando Jorge Martins
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Id: biblio-1054595
Autor: Torres, Orlando Jorge Martins; Linhares, Marcelo Moura; Ramos, Eduardo José B; Amaral, Paulo Cezar G; Belotto, Marcos; Lucchese, Angelica Maria; Neiva, Romerito Fonseca; Freitas, Theago Medeiros; Santana, Rodolfo; Vieira, Josiel Paiva; Freire, Jaldo Santos; Torres, Camila Cristina S; Kalil, Antonio Nocchi.
Título: Liver resection for non-oriental hepatolithiasis / Ressecção hepática no tratamento da hepatolitíase não oriental
Fonte: ABCD arq. bras. cir. dig;32(4):e1463, 2019. tab, graf.
Idioma: en.
Resumo: ABSTRACT Background: Primary intrahepatic lithiasis is defined when the stones are formed in the liver and associated with local dilatation and biliary stricture. Liver resection is the ideal procedure. Aim: To evaluate the results of liver resection in the treatment of non-oriental intrahepatic lithiasis. Methods: Fifty-one patients with symptomatic benign non-oriental hepatolithiasis underwent surgical resection in six institutions in Brazil. Demography data, clinical symptoms, classification, diagnosis, management and postoperative course were analyzed. Results: Of the 51 patients, 28 were male (54.9%), with a mean age of 49.3 years. History of cholangitis was observed in 15 (29.4%). The types of intrahepatic lithiasis were type I in 39 (76.5%) and type IIb in 12 (23.5%), with additional type Ea in six (11.8%). Liver function test were normal in 42 patients (82.4%). Segmental atrophy was observed in 12 (23.5%). Treatments included left lateral sectionectomy in 24 (47.1%), left hepatectomy in 14 (27.5%) and right hepatectomy in eight (15.7%), with associated hepaticojejunostomy in four (7.8%). Laparoscopic liver resection was performed in eight (15.7%). Postoperative complications were observed in 20 (39.2%) with no mortality. Conclusion: Liver resection in patients with hepatolithiasis is the ideal procedure as it removes stones, stricture, atrophic parenchyma, and minimizes the risk of cholangiocarcinoma.

RESUMO Racional: Litíase intra-hepática primária é definida quando os cálculos são formados dentro do fígado, podendo estar associada à dilatação local e estenosa da via biliar. A ressecção hepática é considerada o procedimento ideal. Objetivo: Avaliar os resultados da ressecção hepática no tratamento da litíase intra-hepática não oriental. Métodos: Cinquenta e um pacientes com hepatolitíase benigna não oriental sintomática foram submetidos à ressecção hepática em seis instituições no Brazil. Os dados demográficos, sintomas clínicos, classificação, diagnóstico, tratamento e evolução pós-operatória foram analisados. Resultados: Dos 51 pacientes havia 28 homens (54,9%), e a idade média era de 49,3 anos. História de colangite foi observada em 15 pacientes (29,4%). Os tipos de litíase observados foram tipo I em 39 (76,5%) e tipo IIb em 12 (23,5%), com o tipo adicional Ea em seis pacientes (11,8%). Os testes de função hepática estavam normais em 42 (82,4%) e atrofia segmentar foi observada em 12 (23,5%). O tratamento incluiu setorectomia lateral esquerda em 24 (47,1%), hepatectomia esquerda em 14 (27,5%) e hepatectomia direita em oito pacientes (15,7%). A hepaticojejunostomia esteve associada ao procedimento inicial em quatro (7,8%). Hepatectomia por videolaparoscopia foi realizada em oito (15,7%). Complicações pós-operatórias foram observadas em 20 pacientes (39,2%) e não houve mortalidade. Conclusão: Ressecção hepática na hepatolitíase é o procedimento ideal, pois remove os cálculos, a estenose, o parênquima atrofiado e minimiza os riscos para colangiocarcinoma.
Descritores: Litíase/cirurgia
Hepatectomia/métodos
Hepatopatias/cirurgia
-Resultado do Tratamento
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Responsável: BR1.1 - BIREME


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Id: biblio-1126285
Autor: Ojeda-Crespo, Alexander Oswaldo; Ojeda-Cedillo, Alexander Xavier; Ojeda-Cedillo, Andrés Eduardo; Ojeda-Cedillo, Peter Oswaldo; Mengual, Edgardo.
Título: Litiasis renal en paciente con enfermedad de crohn: reporte de caso / Renal lithiasis in patient with crohn's disease: case report
Fonte: Rev. cientif. cienc. med;23(1):97-101, 2020. ilus.
Idioma: es.
Resumo: Caso de litiasis renal por oxalato de calcio asociado a enfermedad de Crohn de reciente debut en paciente masculino 43 años proveniente del Canton las Piñas, Provincia El Oro en Ecuador, sin antecedentes patológicos en relación a su enfermedad. En enero 2020 acude a consulta particular con dolor en fosa iliaca derecha, fiebre, fatiga, hiporexia, pérdida de peso, tenesmo y diarrea. Gastroenterólogo observó colon derecho con úlceras, áreas de mucosa infiltrada, y el estudio anatomopatológico identifica ulceraciones en subserosa, abscesos, infiltrado inflamatorio mixto, granulomas epitelioides con células gigantes multinucleadas. Previo consentimiento se realiza ecosonografía, detectándose un cálculo renal derecho de 5 mm de tamaño y otro de 4 mm en el izquierdo. El análisis de orina reporta aciduria, cristales oxalato de calcio y la radiografía simple demostró sombra de los cálculos. El estudio metabólico la 1,25 dihidroxivitamina D y la hormona paratiroidea resultó negativo. La evolución fue favorable y continua en control periódico que de ameritar se ordenaría tomografía helicoidal sin contraste o urograma excretorio.

We present a case of kidney stones due to calcium oxalate stones associated with Crohn's disease of recent debut in a 43-year-old male patient from the Piñas canton-El Oro Province-Ecuador with no personal and family pathological history in relation to his disease and that in January 2020 he went to a private medical consultation for presenting colic-type abdominal pain located in the right iliac fossa, fever, fatigue, hyporexia, weight loss, tenesmus and sometimes diarrhea. The gastroenterologist observed: right colon with ulcers and infiltrated mucosa areas; samples are taken for histopathological study. Anatomopathology It was identified ulcerations in subserosa, abscesses, mixed inflammatory infiltrate, epithelioid granulomas with multinucleated giant cells diagnosed with Crohn's disease. With the patient's consent, an echo-sonographic study was made, detecting a right kidney stone 5 mm in size and 4 mm in the left. Urinalysis showed aciduria, calcium oxalate crystals, and plain abdominal radiography showed shadow of the stones. In the metabolic study the 1,25 dihydroxyvitamin D and parathyroid hormone was negative. The evolution was favorable and he continuous in periodic control that, if it's required, would be ordered a helical computed tomography without contrast or excretory urogram.
Descritores: Úlcera
Cálculos
Cálculos Renais
Litíase
-Células Gigantes
Colo
Responsável: BO138.1 - Biblioteca Central


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Id: biblio-1138787
Autor: Toro-Calle, Jerónimo; Guzmán-Arango, Carolina; Ramírez-Ceballos, Mariana; Guzmán-Arango, Natalia.
Título: ¿Son los criterios de la ASGE suficientes para la estratificación del riesgo de coledocolitiasis? / ¿Are the ASGE criteria sufficient to stratify the risk of choledocholithiasis?
Fonte: Rev. colomb. gastroenterol;35(3):304-310, jul.-set. 2020. tab, graf.
Idioma: es.
Resumo: Resumen Introducción: la patología biliar litiásica es una de las entidades más frecuentes en el área de cirugía general y en gastroenterología. El tratamiento varía según el lugar donde se alojen los cálculos. Para esto, se han definido diversas escalas de estratificación del riesgo de presentar coledocolitiasis, pero son los criterios planteados por la Sociedad Americana de Endoscopia Gastrointestinal (American Society for Gastrointestinal Endoscopy, ASGE) los más usados a nivel mundial, ya que tienen una precisión diagnóstica definida del 70 %. Los procedimientos o ayudas diagnósticas establecidas por estos criterios, en ocasiones, prolongan el tiempo de hospitalización, aumentan los costos y pueden tener complicaciones. Metodología: se realizó un estudio observacional analítico, de tipo transversal retrospectivo, con datos obtenidos a partir de las historias clínicas de pacientes sometidos a colecistectomía laparoscópica, en la Clínica CES de Medellín, entre julio y diciembre de 2017. Resultados y conclusiones: se analizaron 424 historias clínicas de pacientes sometidos a colecistectomia laparoscópica. De ellos, 254 (56,76 %) se categorizaron como de riesgo bajo, mientras que 94 (22,11 %) fueron de riesgo intermedio y 76 (17,88 %) de riesgo alto. Se encontró una frecuencia de coledocolitiasis del 90,8 % en aquellos categorizados como de riesgo alto y del 26,6 % en los pacientes de riesgo intermedio. En la categoría de riesgo intermedio se hallaron diferencias estadísticamente significativas entre ambos grupos para los valores de bilirrubina total, bilirrubina directa y aspartato aminotransferasa (AST) (p = 0,001; p = 0,014; p = 0,007, respectivamente). La baja frecuencia de coledocolitiasis en la categoría de riesgo intermedio puede ser explicada por cálculos menores a 5 mm no visibles en la colangiorresonancia. A partir de este estudio, se propone ajustar los rangos de valores de los criterios de la ASGE para la categoría de riesgo intermedio, permitiendo tener una mayor precisión a la hora de clasificar los pacientes con patología litiásica y disminuir costos y estancia hospitalaria.

Abstract Introduction: Biliary lithiasis is one of the most frequent diseases in the area of general surgery and gastroenterology. Treatment varies depending on the location of the gallstones. Several stratification scales of the risk of choledocholithiasis have been defined, being the criteria proposed by the American Society of Gastrointestinal Endoscopy (ASGE) the most used worldwide, with a diagnostic accuracy of 70%. However, the procedures or diagnostic aids defined by these criteria, sometimes, increase hospital stay, costs, and may lead to the development of complications. Methodology: An observational, analytical, retrospective, cross-sectional study was conducted with data obtained from the clinical records of patients undergoing laparoscopic cholecystectomy at the CES Clinic in Medellín, Colombia, between July and December of 2017. Results and conclusions: 424 medical records were analyzed, of which 254 (56.76%) were classified as low-risk, 94 (22.11%) as intermediate-risk and 76 (17.88%) as high-risk. The frequency of choledocholithiasis was 90.8% in high-risk patients and 26.6% in intermediate-risk patients. For the intermediate-risk category, statistically significant differences were found between the two groups for the total bilirubin, direct bilirubin, and AST values (p: 0.001, p: 0.014, p:0.007, respectively). The low frequency of choledocholithiasis in the intermediate-risk category can be explained by less than 5mm gallstones not identified by the cholangioresonance. Based on this study, we propose to adjust the ranges of the ASGE criteria variables for the intermediate-risk category for better accuracy when classifying patients with biliary lithiasis and, thus, reduce costs and hospital stay.
Descritores: Doença
Colecistectomia Laparoscópica
Coledocolitíase
-Pacientes
Aspartato Aminotransferases
Bilirrubina
Risco
Estudos Transversais
Litíase
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Tipo de Publ: Estudo Observacional
Responsável: CO354 - Sociedad Colombiana de Gastroenterología


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Id: biblio-1134287
Autor: Socarrás, Moisés E. Rodríguez; Esperto, Francesco; Bapstistussi, Marcelo Denilson; Barufaldi, Felipe; Vital, Matheus Soares; Papalia, Rocco; Salerno, Annamaria; Cataldo, Rita; Autrán-Gómez, Ana María; Scarpa, Roberto Mario.
Título: Endourology (Lithiasis). management, surgical considerations and follow-up of patients in the COVID-19 era
Fonte: Int. braz. j. urol;46(supl.1):39-49, July 2020. tab.
Idioma: en.
Resumo: ABSTRACT Purpose: To provide recommendations on the endourological management of lithiasis in the scenario of the COVID-19 pandemic. Materials and Methods: A non-systematic review in PubMed and the grey literature, as well as recommendations by a panel of stakeholders was made, regarding management, surgical considerations and follow-up of patients affected by lithiasis in the COVID-19 era. Results: Under the current outbreak and COVID-19 pandemic scenario, patients affected by lithiasis should be prioritized into low, intermediate and high risk categories, to decide their delay and save resources, healthcare personnel, beds and ventilators. However, patients with potentially serious septic complications need emergency interventions. The possibility of performing or restarting elective activity depends on local conditions, the availability of beds and ventilators, and the implementation of screening protocols in the context of the COVID-19 pandemic. Delaying lithiasis surgery and increasing waiting lists will have consequences and will require considerable additional effort. Teleconsultation may be useful in guiding these patients, reducing visits and unnecessary exposure. Conclusions: categorization and prioritization of patients affected by lithiasis is crucial for management, surgical selection and follow-up. Protocols, measures and additional efforts should be carried out in the current situation of the COVID-19 pandemic.
Descritores: Pneumonia Viral/epidemiologia
Urologia/métodos
Infecções por Coronavirus/epidemiologia
Litíase/terapia
-Seguimentos
Pandemias
Betacoronavirus
SARS-CoV-2
COVID-19
Limites: Humanos
Tipo de Publ: Revisão
Responsável: BR1.1 - BIREME


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Id: biblio-1251329
Autor: Brízido, Margarida Costa e Silva Sena; Lopes, Beatriz de Oliveira; Almeida, Ana Catarina Rodrigues; Miranda, Margarida Maria Domingas Isidoro; Soares, Ícaro Perez.
Título: Amniotic membrane graft after excision of widespread conjunctival concretions / Enxerto de membrana amniótica após remoção de concreções conjuntivais
Fonte: Rev. bras. oftalmol;80(3):e0002, 2021. graf.
Idioma: en.
Resumo: ABSTRACT Conjunctival concretions are single or clustered lesions frequently found on the palpebral conjunctiva. They are commonly present in older individuals, despite being rarely symptomatic. This case report describes an 83-year-old man with multiple conjunctival concretions, which were surgically treated. The patient was symptomatic on presentation and did not respond to conservative treatment. For this reason, a surgical approach was considered. After wide excision of the conjunctival lesions, a piece of amniotic membrane was fitted using fibrin glue. During follow-up, a markedly improvement in patient's symptoms was observed, along with nearly complete absence of conjunctival concretions. This is the first case report addressing extensive conjunctival concretions with a surgical approach using amniotic membrane. The authors conceived the technique described after noticing the limited clinical options in the literature. This technique was easily performed and achieved satisfactory results.

RESUMO As concreções conjuntivais representam lesões amareladas, simples ou múltiplas, frequentemente encontradas na conjuntiva palpebral. São mais prevalentes em idades avançadas e raramente sintomáticas. Este relato de caso descreve o quadro clínico de um paciente de 83 anos com múltiplas concreções conjuntivais, cirurgicamente tratadas. Por se tratar de um paciente sintomático com resposta insuficiente ao tratamento conservador, foi considerada a abordagem cirúrgica. Após remoção das lesões, foi aplicado um enxerto de membrana amniótica, adaptado com cola de fibrina. No acompanhamento pós-operatório, verificou-se melhoria significativa dos sintomas, com desaparecimento quase total das concreções conjuntivais. Este é o primeiro caso que descreve uma abordagem cirúrgica com utilização de membrana amniótica na resolução desse tipo de lesões. A técnica, de fácil execução e com resultados muito favoráveis, foi desenvolvida pelos autores após constatarem a escassez de alternativas na literatura.
Descritores: Adesivo Tecidual de Fibrina/uso terapêutico
Doenças da Túnica Conjuntiva/cirurgia
Litíase/cirurgia
Âmnio/transplante
Limites: Humanos
Masculino
Idoso de 80 Anos ou mais
Tipo de Publ: Relatos de Casos
Responsável: BR1.2 - Biblioteca Central


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Id: lil-397499
Autor: Abbate, Alejandro.
Título: Litiasis urinaria / Urinary lithiasis
Fonte: Evid. actual. práct. ambul;7(1):14-17, ene.-feb. 2004. tab.
Idioma: es.
Descritores: Litíase
Cálculos Urinários/diagnóstico
Cálculos Urinários/epidemiologia
Cálculos Urinários/fisiopatologia
Cálculos Urinários/genética
Cálculos Urinários/terapia
Cólica/diagnóstico
Cólica/terapia
-Litotripsia
Fatores de Risco
Limites: Humanos
Masculino
Feminino
Tipo de Publ: Revisão
Responsável: AR2.1 - Biblioteca Central


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Id: biblio-905956
Autor: Astroza, Gastón; Catalán, Manuel; Rubilar, Francisco.
Título: Enfrentamiento terapéutico en litiasis urinarias: adherencia de urólogos chilenos a las guías clínicas / Therapeutic confrontation in urinary lithiasis: adherence of chilian urologists to clinicals guidelines
Fonte: Rev. chil. urol;82(2):26-33, 2017. tab.
Idioma: es.
Resumo: Introducción. La urolitiasis es una patología prevalente en el mundo occidental. Hoy en día, existen distintas opciones terapéuticas para el manejo de esta patología en sus diferentes formas de presentación. En la mayoría de estas situaciones, se dispone de guías clínicas que orientan el manejo. Nuestro objetivo fue determinar la adherencia a guías clínicas de manejo de urolitiasis frente a situaciones hipotéticas, por parte de urólogos pertenecientes a la Sociedad Chilena de Urología. Materiales y Métodos. Se diseñó una encuesta en línea, a través de la plataforma Formularios de Google, consistente de preguntas generales para caracterizar a los encuestados y 11 preguntas de selección múltiple de casos clínicos hipotéticos. Los escenarios clínicos variaban en: localización, tamaño, densidad del cálculo y tiempo de evolución. La encuesta fue difundida a través de correo electrónico de urólogos pertenecientes a la Sociedad Chilena de Urología. Se excluyó del análisis a urólogos infantiles. Las variables tiempo de ejercicio profesional y número de pacientes manejados fueron dicotomizadas según media. Se realizó análisis estadístico con test exacto de Fisher. Resultados. 67 urólogos contestaron la encuesta. El 98,5 por ciento era de adultos; 73,1 por ciento realizó residencia de 3 años de duración. Un 38,8 por ciento manejó más de 80 pacientes con litiasis en el último año. La media de años de ejercicio como especialista fue 13,8 años. Un 56,1 por ciento tenían menos de 14 años de ejercicio y 43,9 por ciento 14 o más. No se observó diferencia significativa en cuanto a adherencia a guías clínicas en los distintos escenarios de litiasis ureteral, entre los grupos dicotomizados por años de ejercicio (p=0,47) ni al dicotomizarlos por número de pacientes manejados (P=0,63). Un 48 por ciento adhiere a terapia médica expulsiva y un 68 por ciento a terapia quirúrgica (p=0,000009). Conclusiones. Una mayoría de los urólogos encuestados refiere utilizar opciones terapéuticas similares a las recomendadas por las guías clínicas. No se observó diferencia en las conductas propuestas entre los grupos de mayor o menor experiencia profesional ni entre los grupos con mayor o menor número de pacientes manejados por urolitiasis. (AU)

SUMMARY Introduction. Urolithiasis is a prevalent pathology in the western world. There are different therapeutic options for the management of this pathology in its different forms of presentation. In most of these situations, clinical guidelines are available. Our objective was to determine the adherence in certain hypothetical situations to clinical guidelines of urolithiasis management, by urologists belonging to Sociedad Chilena de Urología. Materials y Methods. An online survey was developed using Google Forms platform, consisting of general questions to characterize the respondents and 11 multiple-choice questions of hypothetical clinical cases. The clinical scenarios varied in: location, size, density of the calculi and time. The survey was sent via email to urologists belonging to Sociedad Chilena de Urología. Pediatric urologists were excluded from analysis. Two variables: years of practice as a specialist and number of patients treated, were dichotomized according to mean. Statistical analysis was performed with Fisher's exact test. Results. 67 urologists answered the survey. 98.5 pertcent were non-pediatric urologists; 73.1 pertcent completed residence for 3 years. 38.8 pertcent treated more than 80 patients with lithiasis in the last year. Average number of years of practice as a specialist was 13.8 years. 56.1 pertcent had less than 14 years of exercise and 43.9 pertcent had 14 or more. There was no significant difference in adherence to clinical guidelines in the different scenarios of ureteral lithiasis between groups dichotomized by years of exercise (p = 0.47) or dichotomized by number of patients treated (p = 0.63). 48 pertcent adhered to medical expulsive therapy and 68 percent to surgical therapy (p = 0.000009). Conclusions. Most urologists surveyed use similar therapeutic options to those recommended by clinical guidelines. No difference was observed between groups of greater or lesser professional experience nor among groups with greater or lesser number of patients managed by urolithiasis. (AU)
Descritores: Urolitíase
-Terapêutica
Ureter
Litíase
Limites: Humanos
Tipo de Publ: Revisão
Responsável: CL10.1 - Biblioteca Biomédica


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Id: lil-388377
Autor: Martínez Ramos, Gilberto; Torres Fragela, Salvador; González Delis, Remberto; Garrido Lena, Lilia Isabel.
Título: Comportamiento de la cirugía mayor ambulatoria: estudio de 5 años / Behavior of ambulatory major surgery: a 5-year study
Fonte: Rev. cuba. cir;42(4), oct.-dic. 2003. tab, graf.
Idioma: es.
Resumo: Se realizó un estudio descriptivo, longitudinal y retrospectivo de 2 208 pacientes operados por el método de cirugía mayor ambulatoria en el servicio de cirugía del Hospital Militar Clinicoquirúrgico Docente "Comandante Manuel Fajardo Rivero" de Santa Clara, durante el período comprendido desde enero de 1997 hasta diciembre del 2001, con el propósito de demostrar las ventajas de este método para el paciente y para la institución. Los pacientes operados de hernias inguinales, epigástricas y umbilicales fueron los que predominaron. También fueron tratados por este método pacientes con litiasis vesicular, fibromiomas uterinos, nódulos de mamas, ginecomastias y hemorroides. Del total de los pacientes la mayor cantidad pertenecía al sexo femenino y en cuanto a la edad los grupos comprendidos entre 20 y 49 años fueron los que más se beneficiaron con este método. Los tipos de anestesia con preferencia a ser utilizados en estos pacientes fueron la anestesia regional y la analgesia quirúrgica acupuntural(AU)

A descriptive, cross-sectional and prospective study was conducted among 2 208 patients operated on by ambulatory major surgery at the surgery service of "Comandante Manuel Fajardo Rivero" Military Clinical and Surgical Hospital, in Santa Clara, from January, 1997, to December, 2001, aimed at showing the advantages of this method for the patient and the health institution. The patients operated on of inguinal, epigastric and umbilical hernias predominated. This method was also used with vesicular lithiasis, uterine fibromyomas, breast nodules, gynecomasties and hemorrhoids. Most of the patients were females and the groups aged 20-49 were the most benefitted with this method. The types of anesthesia preferably used were regional anesthesia and acupunctural surgical analgesia(AU)
Descritores: Analgesia por Acupuntura/métodos
Litíase/etiologia
Procedimentos Cirúrgicos Ambulatórios/métodos
Anestesia por Condução/métodos
Leiomioma/etiologia
-Estudos Prospectivos
Estudos Retrospectivos
Estudos Longitudinais
Limites: Humanos
Feminino
Adulto
Pessoa de Meia-Idade
Responsável: CU1.1 - Biblioteca Médica Nacional


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Id: lil-414174
Autor: Pérez González, Domingo; Scorza Sánchez, Carlos; León Rubio, Nancy de; Hernández Mulet, Hermidio; Pérez Palenzuela, Javier.
Título: Criterios de selección para fragmentación de cálculos vesiculares por ondas de choque extracorpóreas / Selection criteria for fragmenting gallstones by extracorporeal shock waves
Fonte: Rev. cuba. cir;43(2), 2004. tab.
Idioma: es.
Resumo: La fragmentación de cálculos vesiculares por ondas de choque extracorpóreas es otra de las variantes terapéuticas no quirúrgicas a tener en cuenta en esta entidad. Se estudiaron 1 957 pacientes remitidos de todo el país con el diagnóstico de litiasis vesicular en una consulta especializada creada el efecto en el Hospital Clínico Quirúrgico Hermanos Ameijeiras. Se seleccionaron 626 (32 por ciento) y se siguieron inicialmente los criterios del Grupo de Munich; 479 (76,6 por ciento) del sexo femenino y 147 (23,4 por ciento) del masculino. En 125 pacientes (20,0 por ciento) la edad sobrepasó los 60 años. No se incluyeron 672 por componente litiásico grande (50,4 por ciento); 276 por vesícula excluida en la colecistografía oral (20,8(por ciento) y 212 por vaciamiento vesicular insuficiente (16,0 por ciento). La hipertensión arterial (67,0), la diabetes melitus (45,0 por ciento) y la cardiopatía isquémica (28,0 por ciento) fueron las enfermedades asociadas más frecuentes en los seleccionados; en ellos predominaron los cálculos únicos (71,7 por ciento), de hasta 20 mm de diámetro (65,7 por ciento), radiotransparentes (83 por ciento) y con densidades inferiores a las 50 unidades Houndsfield (60,5 por ciento)(AU)

The fragmentation of gallstones by extracorporeal shock waves is other of the nonsurgical threapeutic variants to be taken into account in this entity. 1 957 patients referred from all over the country with the diagnosis of biliary lithiasis were studied in a specialized office established to this end at Hermanos Ameijeiras Clinical and Surgical Hospital. 626 (32 percent) were selected, 479 (76.6 percent) females and 147 (23.4 percent) males, and the criteria of the Group of Munich were initially followed. 125 patients (20.0 percent) were over 60. 672 were not included due to large lithiasic component (50.4 percent); 276 due to gallblader excluded in oral cholecistography (20,8 percent); and 212 to insufficient gallblader dumping (16,0 percent). Arterial hypertension (67,0 percent), diabetes melitus (45,0 percent) and ischemic heart disease (28.0 percent) were the most frequent associated diseases among the selected individuals. The single calculi (71.7 percent) of up to 20 mm of diameter (65.7 percent), radiotransparent (83 percent) and with densities under 50 Houndsfield units (60.5 percent) predominated(AU)
Descritores: Cálculos da Bexiga Urinária/diagnóstico
Colelitíase/terapia
Esvaziamento da Vesícula Biliar
Litíase/terapia
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Responsável: CU1.1 - Biblioteca Médica Nacional



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