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[PMID]:28562534
[Au] Autor:Ren J; Huo Z; Wang X; Liu Y; Yang G
[Ad] Endereço:aSchool of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan bDepartment of Radiology, Jining No.1 People's Hospital, Jining Shandong cDepartment of Nuclear Medicine, Shandong Cancer Hospital affiliated to Shandong University dShandong Academy of Medical Sciences, Jinan, People's Republic of China.
[Ti] Título:Serial renography for evaluation of the impact of capecitabine therapy on renal function: A case report.
[So] Source:Medicine (Baltimore);96(22):e6861, 2017 Jun.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Cancer can cause renal dysfunction and disease either directly or indirectly, through adverse effects of therapies, including chemotherapy and radiation. The assessment of renal function in cancer patients is necessary in clinical practice. PATIENT CONCERNS: A 31-year-old woman had proctoscopy performed in our hospital for a principal complaint of bloody stool for 6 months and worsening 1 month prior to presentation. DIAGNOSES: Following proctoscopy, she was diagnosed with a signet-ring cell carcinoma of the rectum. Hartman surgery was performed. Metastasis of the carcinoma to regional lymph nodes around the rectum was verified by postoperative pathology. INTERVENTIONS: The patient was treated with capecitabine, and renal function was monitored over the course of treatment by renography before, during, and after chemotherapy. OUTCOMES: We found that capecitabine caused a reversible decline of renal function. However, the value of blood urea nitrogen (BUN) and serum creatinine (Cr) remained within the normal range during chemotherapy. The patient's chemotherapy regimen was altered after her oncologists concluded that she was developing nephrotoxicity from capecitabine. She was treated with tegafur, gimeracil and oteracil potassium capsules. This patient was followed over the next 6 months, and no abnormal renal function re-occurred. LESSONS: Our experience with capecitabine shows that dosing adjustments can be warranted for chemotherapy in cancer patients, requiring monitoring of renal function. Renography may provide an early warning to protect the renal function of tumor patients when they receive chemotherapy.
[Mh] Termos MeSH primário: Antimetabólitos Antineoplásicos/efeitos adversos
Capecitabina/efeitos adversos
Monitoramento de Medicamentos
Rim/efeitos dos fármacos
Rim/diagnóstico por imagem
Renografia por Radioisótopo
[Mh] Termos MeSH secundário: Adulto
Assistência ao Convalescente
Antimetabólitos Antineoplásicos/uso terapêutico
Capecitabina/uso terapêutico
Carcinoma de Células em Anel de Sinete/diagnóstico por imagem
Carcinoma de Células em Anel de Sinete/tratamento farmacológico
Carcinoma de Células em Anel de Sinete/cirurgia
Feminino
Seres Humanos
Metástase Linfática/diagnóstico por imagem
Neoplasias Retais/diagnóstico por imagem
Neoplasias Retais/tratamento farmacológico
Neoplasias Retais/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antimetabolites, Antineoplastic); 6804DJ8Z9U (Capecitabine)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170626
[Lr] Data última revisão:
170626
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170601
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006861


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[PMID]:28404588
[Au] Autor:Choi SY; Yoo S; You D; Jeong IG; Song C; Hong B; Hong JH; Ahn H; Kim CS
[Ad] Endereço:Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
[Ti] Título:Adaptive functional change of the contralateral kidney after partial nephrectomy.
[So] Source:Am J Physiol Renal Physiol;313(2):F192-F198, 2017 Aug 01.
[Is] ISSN:1522-1466
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Partial nephrectomy aims to maintain renal function by nephron sparing; however, functional changes in the contralateral kidney remain unknown. We evaluate the functional change in the contralateral kidney using a diethylene triamine penta-acetic acid (DTPA) renal scan and determine factors predicting contralateral kidney function after partial nephrectomy. A total of 699 patients underwent partial nephrectomy, with a DTPA scan before and after surgery to assess the separate function of each kidney. Patients were divided into three groups according to initial contralateral glomerular filtration rate (GFR; : <30 ml·min ·1.73 m , : 30-45 ml·min ·1.73 m , and : ≥45 ml·min ·1.73 m ). Multiple-regression analysis was used to identify the factors associated with increased GFR of the contralateral kidney over a 4-yr postoperative period. Patients in had a higher mean age and hypertension history, worse American Society of Anesthesiologists score, and larger tumor size than in the other two groups. The ipsilateral GFR changes at 4 yr after partial nephrectomy were -18.9, -3.6, and 3.9% in , , and , respectively, whereas the contralateral GFR changes were 10.8, 25.7, and 38.8%. Age [ß: -0.105, 95% confidence interval (CI): -0.213; -0.011, < 0.05] and preoperative contralateral GFR (ß: -0.256, 95% CI: -0.332; -0.050, < 0.01) were significant predictive factors for increased GFR of the contralateral kidney after 4 yr. The contralateral kidney compensated for the functional loss of the ipsilateral kidney. The increase of GFR in contralateral kidney is more prominent in younger patients with decreased contralateral renal function.
[Mh] Termos MeSH primário: Taxa de Filtração Glomerular
Neoplasias Renais/cirurgia
Rim/fisiopatologia
Nefrectomia/efeitos adversos
[Mh] Termos MeSH secundário: Adaptação Fisiológica
Fatores Etários
Meios de Contraste/administração & dosagem
Feminino
Seres Humanos
Rim/diagnóstico por imagem
Neoplasias Renais/patologia
Neoplasias Renais/fisiopatologia
Modelos Lineares
Masculino
Meia-Idade
Análise Multivariada
Nefrectomia/métodos
Valor Preditivo dos Testes
Renografia por Radioisótopo/métodos
Estudos Retrospectivos
Fatores de Risco
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contrast Media)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170414
[St] Status:MEDLINE
[do] DOI:10.1152/ajprenal.00058.2017


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[PMID]:28212051
[Au] Autor:Taylor AT; Folks RD; Rahman AKMF; Polsani A; Dubovsky EV; Halkar R; Manatunga A
[Ad] Endereço:From the Department of Radiology and Imaging Sciences (A.T.T., R.D.F., A.P., R.H.) and Department of Biostatistics and Bioinformatics (A.K.M.F.R., A.M.), Emory University School of Medicine, 1364 Clifton Rd, Atlanta, GA 30322; Veterans Administration Medical Center, Decatur, Ga (A.T.T.); and Departm
[Ti] Título:Tc-MAG : Image Wisely.
[So] Source:Radiology;284(1):200-209, 2017 Jul.
[Is] ISSN:1527-1315
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose To determine if commonly administered doses of technetium 99m ( Tc) mertiatide (MAG ) in the range of 300-370 MBq (approximately 8-10 mCi) contribute to image interpretation and justify the resulting radiation exposure. Materials and Methods The respective institutional review boards approved this HIPAA-compliant study and waived informed consent. Baseline and furosemide Tc-MAG imaging examinations in 50 patients suspected of having renal obstruction and 48 patients suspected of having renovascular hypertension (RVH) were randomly selected from archived databases and were independently scored by three experienced readers without access to 2-second flow images. Readers were blinded to their original scores, and then they rescored each examination with access to high-activity 2-second flow images. Relative renal function was determined after a low activity (62.9 MBq ± 40.7) baseline acquisition for RVH and a high activity (303.4 MBq ± 48.1) acquisition after administration of enalaprilat. Data were analyzed by using random effects analysis of variance and mean and standard error of the mean for the difference between sets of scores and the difference between relative function measurements. Results There was no significant difference in the scores without flow images compared with blinded scores with high-activity flow images for patients suspected of having obstruction (P = .80) or RVH (P = .24). Moreover, there was no significant difference in the relative uptake measurements after administration of low and high activities (P > .99). Conclusion Administered doses of Tc-MAG in the range of 300-370 MBq (approximately 8-10 mCi) do not affect the relative function measurements or contribute to interpretation of images in patients suspected of having RVH or obstruction compared with administration of lower doses; unnecessary radiation exposure can be avoided by administering doses in the range of 37-185 MBq as recommended incurrent guidelines. RSNA, 2017.
[Mh] Termos MeSH primário: Renografia por Radioisótopo/métodos
Compostos Radiofarmacêuticos/administração & dosagem
Obstrução da Artéria Renal/diagnóstico por imagem
Tecnécio Tc 99m Mertiatida/administração & dosagem
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Meia-Idade
Reprodutibilidade dos Testes
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Radiopharmaceuticals); 36ITO9SKQJ (Technetium Tc 99m Mertiatide)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170218
[St] Status:MEDLINE
[do] DOI:10.1148/radiol.2017152311


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[PMID]:28108166
[Au] Autor:Degen DA; Janardan J; Barraclough KA; Schneider HG; Barber T; Barton H; Snell G; Levvey B; Walker RG
[Ad] Endereço:Department of Nephrology, Alfred Health, Melbourne, Australia. Electronic address: dovdegen@optusnet.com.au.
[Ti] Título:Predictive performance of different kidney function estimation equations in lung transplant patients.
[So] Source:Clin Biochem;50(7-8):385-393, 2017 May.
[Is] ISSN:1873-2933
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: There has been limited examination of the performance of glomerular filtration rate estimation (eGFR) equations in lung transplant populations. This study aimed to compare the performance of serum creatinine and cystatin C based eGFR equations with Tc-99m diethylenetriaminepentaacetic acid (DTPA) GFR measurements in individuals with end-stage lung disease, either prior to, or following, lung transplantation. METHODS: In this prospective observational study, participants underwent GFR measurements with Tc-99m Pentetate. Measured results were compared with GFR estimates derived from estimation equations [4-variable Modification of Diet in Renal Disease, Cockcroft-Gault, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine, cystatin C and creatinine-cystatin C combined equations]. RESULTS: Ninety-seven individuals were studied (77 post- and 20 wait-listed for transplantation). Median (range) radionucleotide GFR was 56.7ml/min/1.73m (22.8-109.2ml/min/1.73m ). In the study cohort as a whole, the CKD-EPI creatinine-cystatin C combined equation showed the highest performance, but was only slightly superior to the CKD-EPI creatinine equation. However, in individuals with cystic fibrosis, low arm muscle mass and/or low body mass index, all of the creatinine-based equations showed unacceptable performance. In these subgroups, improved GFR estimation was seen with the CKD-EPI cystatin C equation, and predictions were better still using the CKD-EPI creatinine-cystatin C combined equation. CONCLUSIONS: This study shows adequate predictive ability of CKD-EPI creatinine in the cohort as a whole, but unacceptable performance in patients with cystic fibrosis, low arm muscle mass and/or low body mass index. Our findings demonstrate that cystatin C may be a preferable filtration marker in these subgroups.
[Mh] Termos MeSH primário: Creatinina/sangue
Cistatina C/sangue
Taxa de Filtração Glomerular
Transplante de Pulmão
Renografia por Radioisótopo
Compostos Radiofarmacêuticos/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Biomarcadores/sangue
Feminino
Seres Humanos
Masculino
Meia-Idade
Ácido Pentético/administração & dosagem
Valor Preditivo dos Testes
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Biomarkers); 0 (Cystatin C); 0 (Radiopharmaceuticals); 7A314HQM0I (Pentetic Acid); AYI8EX34EU (Creatinine)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170621
[Lr] Data última revisão:
170621
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170122
[St] Status:MEDLINE


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[PMID]:27851658
[Au] Autor:Santos AI; Violante L; Carmona S; Prata A; Rodrigues Victor M; Santos JG; Araújo Sequeira J; Alves M; Papoila AL; Piepsz A
[Ad] Endereço:aNuclear Medicine Service, Garcia de Orta Hospital, E.P.E., Almada bNuclear Medicine Service, Francisco Gentil Portuguese Institute of Oncology from Porto, E.P.E. cEpidemiology and Statistics Research Unit, Central Lisbon Hospital Center, E.P.E. dNOVA Medical School FCM, Universidade Nova de Lisboa, Lisbon, Portugal eRadioisotopes Department, St Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
[Ti] Título:Interobserver agreement on cortical tracer transit in 99mTc-MAG3 renography applied to congenital hydronephrosis.
[So] Source:Nucl Med Commun;38(2):124-128, 2017 Feb.
[Is] ISSN:1473-5628
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: This study aims to evaluate interobserver agreement on visual analysis of technetium-99m mercaptoacetyltriglycine (Tc-MAG3) renal tissue transit used for the evaluation of antenatal hydronephrosis. MATERIALS AND METHODS: Thirty-eight Tc-MAG3 diuretic renograms were retrospectively collected between 1 and 31 December 2015. The 1-min reframed images were presented to four nuclear medicine consultants and to two nuclear medicine residents, one in the first year of the training program and the others in their fourth and final year. These observers were asked to classify the radiotracer cortical transit (normal/delayed) based solely on visual assessment of the images. For the interobserver agreement, modified Fleiss' kappa (κ) analysis for multiple raters was carried out. For both groups, percentages of agreement were also calculated. RESULTS: A total of 69 kidneys were evaluated. All four nuclear medicine consultants agreed on the classification of 88.4% of the kidneys. When the agreement of at least three of the four observers was considered, the percentage of agreement reached 98.6%. The two nuclear medicine residents agreed on the classification of 69.6% of the kidneys. The modified Fleiss' κ-value was 0.88 (95% confidence interval: 0.79-0.95) for the group of nuclear medicine consultants, indicating almost perfect agreement. For the residents, it was 0.39 (95% confidence interval: 0.16-0.59), suggesting fair agreement. CONCLUSION: Our results seem to indicate that there is an almost perfect agreement in the qualitative identification of delayed cortical transit among physicians with experience at observing renographic images.
[Mh] Termos MeSH primário: Hidronefrose/congênito
Hidronefrose/diagnóstico por imagem
Renografia por Radioisótopo/métodos
Tecnécio Tc 99m Mertiatida
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Seres Humanos
Hidronefrose/metabolismo
Lactente
Recém-Nascido
Rim/anormalidades
Rim/diagnóstico por imagem
Rim/metabolismo
Córtex Renal/diagnóstico por imagem
Córtex Renal/metabolismo
Variações Dependentes do Observador
Compostos Radiofarmacêuticos/farmacocinética
Estudos Retrospectivos
Tecnécio Tc 99m Mertiatida/farmacocinética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Radiopharmaceuticals); 36ITO9SKQJ (Technetium Tc 99m Mertiatide)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161117
[St] Status:MEDLINE
[do] DOI:10.1097/MNM.0000000000000620


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[PMID]:27683747
[Au] Autor:Genseke P; Rogasch JM; Steffen IG; Neumann G; Apostolova I; Ruf J; Rißmann A; Wiemann D; Liehr UB; Schostak M; Amthauer H; Furth C
[Ti] Título:Detection of obstructive uropathy and assessment of differential renal function using two functional magnetic resonance urography tools. A comparison with diuretic renal scintigraphy in infants and children.
[So] Source:Nuklearmedizin;56(1):39-46, 2017 Feb 14.
[Is] ISSN:0029-5566
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:AIM: After detection of obstructive uropathy (OU), the indication for or against surgery is primarily based on the differential renal function (DRF). This is to compare functional magnetic resonance urography (fMRU) with dynamic renal scintigraphy (DRS) to assess OU and DRF in infants and children. PATIENTS, METHODS: Retrospective analysis in 30 patients (female: 16; male: 14; median age: 5.5 years [0.2-16.5]), divided into subgroup A (age: 0-2 years; n = 16) and B (> 2-17 years; n = 14). fMRU was assessed by measuring renal transit time (RTT) and volumetric DRF with CHOP fMRU tool (CT) and ImageJ MRU plug-in (IJ). OU detection by fMRU was compared with DRS (standard of reference) using areas under the curves (AUC) in ROC analyses. Concordant DRF was assumed if absolute deviation between fMRU and DRS was ≤ 5 %. RESULTS: DRS confirmed fixed OU in 4/31 kidneys (12.9 %) in subgroup A. AUC of CT was 0.94 compared with 0.93 by IJ. Subgroup B showed fixed OU in 1/21 kidneys (4.8 %) with AUCs of 0.98 each. RTT measured neither by CT nor by IJ in confirmed fixed OU was < 1200 s - resulting in negative predictive values of 1.0 each. In subgroup A, DRF was concordant in 81.3 % of the kidneys for CT and DRS compared with 75.0 % for IJ and DRS. In subgroup B, CT and DRS were concordant in 91.7 %, and IJ and DRS in 45.8 % of the kidneys. CONCLUSION: fMRU accurately excluded fixed OU in infants and children, independent from the software used for quantification. However, assessment of DRF with fMRU deviated from DRS especially in infants who may profit most from early intervention. Thus, fMRU cannot fully replace DRS as primary functional examination. If, for clinical reasons, fMRU is performed in first place and it cannot exclude fixed OU, it should be followed by DRS for validation and DRF quantification.
[Mh] Termos MeSH primário: Testes de Função Renal/métodos
Imagem por Ressonância Magnética/métodos
Renografia por Radioisótopo/métodos
Cintilografia/métodos
Software
Obstrução Uretral/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Diuréticos
Feminino
Seres Humanos
Interpretação de Imagem Assistida por Computador/métodos
Lactente
Recém-Nascido
Masculino
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
Urografia/métodos
[Pt] Tipo de publicação:COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Diuretics)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170313
[Lr] Data última revisão:
170313
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160930
[St] Status:MEDLINE
[do] DOI:10.3413/Nukmed-0833-16-06


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[PMID]:27556274
[Au] Autor:Yuan X; Zhang J; Tang K; Quan C; Tian Y; Li H; Ao G; Qiu L
[Ad] Endereço:From the Departments of Radiology (X.Y., J.Z., C.Q., Y.T., H.L., G.A.) and Neurosurgery (K.T.), the 309th Hospital of Chinese People's Liberation Army, 17 Heishanhu Rd, Haidian District, Beijing 100091, People's Republic of China; and Department of Nuclear Medicine, Peking University People's Hospit
[Ti] Título:Determination of Glomerular Filtration Rate with CT Measurement of Renal Clearance of Iodinated Contrast Material versus Tc-DTPA Dynamic Imaging "Gates" Method: A Validation Study in Asymmetrical Renal Disease.
[So] Source:Radiology;282(2):552-560, 2017 Feb.
[Is] ISSN:1527-1315
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose To validate a computed tomographic (CT) glomerular filtration rate (GFR) measurement and compare it with renal dynamic imaging GFR obtained by using the "Gates" method, with dual plasma sampling technetium 99m ( Tc) diethylenetriaminepenta-acetic acid (DTPA) clearance ("true GFR") as the reference standard. Materials and Methods This prospective study was approved by the institutional review board, and written informed consent was obtained from all patients. Forty-two patients with unilateral renal disease were included. Single-kidney CT GFR was calculated as excretory phase whole-kidney CT number enhancement divided by the area under the time-attenuation curve for the aorta, multiplied by (1 - hematocrit level). The CT GFR was then obtained by summing the result of the two sides. The true GFR and the Gates GFR were measured by using a single injection of Tc-DTPA. The CT GFR and Gates GFR were respectively compared with the true GFR by using a paired t test and linear regression analysis. Results The difference between CT GFR (mean ± standard deviation, 96.02 mL/min ± 23.11) and true GFR (90.50 mL/min ± 21.46) was 5.51 mL/min ± 6.96 (P < .001), demonstrating 6.09% systemic overestimation. The difference between Gates GFR (93.93 mL/min ± 26.97) and true GFR was 3.42 mL/min ± 16.10 (P = .176). Linear regression findings confirmed the association between CT GFR (y-axis) and true GFR (x-axis) and between Gates GFR (y-axis) and true GFR (x-axis) (P < .001 for both). Both regression lines paralleled the diagonal (intercept = 0 and slope = 1) (P = .599 and P = .945, respectively). The 95% confidence interval of the former was above the diagonal, confirming the systemic overestimation. The standard deviations of residuals of both linear regressions were 7.02 mL/min and 16.30 mL/min, respectively, demonstrating smaller deviation of the CT GFR (P < .001). Conclusion The proposed CT GFR measurement was validated in this study and was proved to be more accurate than the Gates method despite slight (6.09%) systemic overestimation. RSNA, 2016 Online supplemental material is available for this article.
[Mh] Termos MeSH primário: Meios de Contraste/farmacocinética
Taxa de Filtração Glomerular
Nefropatias/diagnóstico por imagem
Renografia por Radioisótopo/métodos
Compostos Radiofarmacêuticos/farmacocinética
Pentetato de Tecnécio Tc 99m/farmacocinética
Tomografia Computadorizada por Raios X
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Testes de Função Renal
Masculino
Meia-Idade
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contrast Media); 0 (Radiopharmaceuticals); VW78417PU1 (Technetium Tc 99m Pentetate)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170522
[Lr] Data última revisão:
170522
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160825
[St] Status:MEDLINE
[do] DOI:10.1148/radiol.2016160425


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[PMID]:27355216
[Au] Autor:Roupakias S; Sinopidis X; Tsikopoulos G; Spyridakis I; Karatza A; Varvarigou A
[Ad] Endereço:Department of Pediatric Surgery, University of Patras Medical School, Patras, Greece - stylroup@yahoo.gr.
[Ti] Título:Dimercaptosuccinic acid scan challenges in childhood urinary tract infection, vesicoureteral reflux and renal scarring investigation and management.
[So] Source:Minerva Urol Nefrol;69(2):144-152, 2017 Apr.
[Is] ISSN:1827-1758
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:Vesicoureteral reflux (VUR) is a precipitating factor in acute pyelonephritis (APN), and a risk factor for renal scar formation, even if VUR and APN occur independently. There is no scientific evidence on a specific diagnostic evaluation of children after a febrile urinary tract infection (UTI). Based on recent literature and our clinical experience, we reviewed the role of 99mTc dimercaptosuccinic acid (DMSA) renal scan in UTI/VUR imaging. We also reviewed the DMSA challenges and controversies in UTI/VUR management. A DMSA renal scan is the most reliable tool for the establishment of the diagnosis of APN during febrile UTIs acute phase. The "top-down" approach focuses on kidney involvement during UTI rather than on VUR existence, with a goal of diagnosing APN and/or renal dysplasia. Therefore, DMSA is performed before void cysteourethrography (VCUG). Late DMSA scanning should be performed to evaluate the presence of permanent renal scars. DMSA may be considered valuable in the follow-up of children with VUR, in order to detect new renal scarring after breakthrough or recurrent UTIs. An abnormal DMSA scan comprises a risk factor for VUR identification after UTI, for recurrent UTIs, renal damage/scarring, renal function deterioration, and a negative predictive risk factor for VUR improvement and/or spontaneous resolution. An individualized DMSA risk-based dynamic approach may assist physicians on VUR management decisions. DMSA could play an important role in selecting children with UTI/VUR who would benefit from close monitoring and/or early intervention. However, more data are needed for evidence-based guidelines.
[Mh] Termos MeSH primário: Rim/diagnóstico por imagem
Rim/patologia
Renografia por Radioisótopo/métodos
Compostos Radiofarmacêuticos
Ácido Dimercaptossuccínico Tecnécio Tc 99m
Infecções Urinárias/diagnóstico por imagem
Refluxo Vesicoureteral/diagnóstico por imagem
[Mh] Termos MeSH secundário: Criança
Seres Humanos
Rim/microbiologia
Pielonefrite/diagnóstico por imagem
Pielonefrite/microbiologia
Pielonefrite/patologia
Infecções Urinárias/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Radiopharmaceuticals); 494JNQ8L28 (Technetium Tc 99m Dimercaptosuccinic Acid)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160630
[St] Status:MEDLINE
[do] DOI:10.23736/S0393-2249.16.02509-1


  9 / 4267 MEDLINE  
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[PMID]:27717293
[Au] Autor:Roosen A; Dogan C; Nguyen HH; Heiland M; Longwitz D; Ubrig B
[Ad] Endereço:1 Department of Urology, Augusta-Kranken-Anstalt gGmbH , Bochum, Germany .
[Ti] Título:Is One Early Renographic Follow-Up Adequate to Measure the Success of Robotic Pyeloplasty?
[So] Source:J Endourol;30(12):1301-1305, 2016 Dec.
[Is] ISSN:1557-900X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Diuretic renography (DRG) is commonly used to diagnose ureteropelvic junction obstruction (UPJO) and to evaluate the success of surgical repair (pyeloplasty). Duration, frequency, and interpretation of renographic follow-ups are still under dispute. METHODS: We retrospectively reviewed 94 consecutive patients diagnosed with UPJO who underwent a minimally invasive, robotically assisted laparoscopic pyeloplasty at our institution between January 2009 and September 2015. DRG was carried out preoperatively and again routinely 4 to 6 weeks postoperatively the day after stent removal (early DRG). Patients were scheduled for repeat (late) DRG and follow-up examinations, including clinical status and ultrasonography. RESULTS: Nineteen patients with missing preoperative DRG were excluded from the study; the remaining 75 patients were eligible for statistical evaluation. At follow-up, 98.7% reported no or only very mild and rare symptoms. On early DRG, 52.5% had T ≤ 10 min (unobstructed), 39.3% had T between 10 and 20 minutes (equivocal), and 8.2% had T ≤ 20 minutes (obstructed). At late follow-up, the DRG results had improved to 80.8% unobstructed with 19.2% remaining equivocal, and no patients were obstructed; thus, the overall success rate was 80.8%. There was only one patient who worsened from unobstructed to equivocal from early to late DRG assessment. CONCLUSION: In case of complete symptom resolution, a nonobstructive diuretic half-time of ≤10 minutes on early DRG following stent removal suggests that further routine renographic follow-up is unnecessary. Patients with an equivocal early DRG (T between 10 and 20 minutes) require further scintigraphic follow-up, as they have a 42.1% chance of staying equivocal.
[Mh] Termos MeSH primário: Pelve Renal/cirurgia
Renografia por Radioisótopo
Procedimentos Cirúrgicos Robóticos
Ureter/cirurgia
Obstrução Ureteral/cirurgia
[Mh] Termos MeSH secundário: Adulto
Remoção de Dispositivo
Diuréticos
Endoscopia
Feminino
Seguimentos
Seres Humanos
Rim/cirurgia
Masculino
Meia-Idade
Procedimentos Cirúrgicos Minimamente Invasivos
Período Pós-Operatório
Procedimentos Cirúrgicos Reconstrutivos
Estudos Retrospectivos
Stents
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Diuretics)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161009
[St] Status:MEDLINE


  10 / 4267 MEDLINE  
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[PMID]:27492776
[Au] Autor:Rubenwolf P; Herrmann-Nuber J; Schreckenberger M; Stein R; Beetz R
[Ad] Endereço:Department of Urology, Division of Pediatric Urology, Mainz University Medical Center, Mainz, Germany. peterrubenwolf@gmx.de.
[Ti] Título:Primary non-refluxive megaureter in children: single-center experience and follow-up of 212 patients.
[So] Source:Int Urol Nephrol;48(11):1743-1749, 2016 Nov.
[Is] ISSN:1573-2584
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Primary non-refluxing megaureter (pMU) is a multifaceted and challenging congenital pathology of the urinary tract. We report our 23-year experience with this anomaly in terms of presentation, diagnostic work-up and management. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 212 children diagnosed with pMU between 1986 and 2009 at our institution. Mean follow-up was 45.17 (0-192) months. RESULTS: Of the total, 168 (79 %) children presented with upper urinary tract dilation on perinatal ultrasound screening. In 44 (21 %) patients, the diagnosis was made following diagnostic work-up of a urinary tract infection (UTI, 18 %) or flank pain (3 %). In total, 203 of 254 pMUs (79.9 %) were successfully treated conservatively during the 23-year observation period. Forty-eight children (23 %) underwent ureteric reimplantation. UTIs occurred in 91 of 212 children (43 %). Of these, 41 (45 %) occurred despite antibacterial infection prophylaxis. Within the past three decades, there has been a marked shift from surgical toward conservative therapy at our institution. CONCLUSION: Neonatal renal ultrasound is the method of choice to timely identify children with pMU and, alongside dynamic renography, to monitor the clinical course. Nowadays, only a minor subset of children with asymptomatic course requires surgical correction. Antibacterial prophylaxis has the potential to reduce the risk of febrile UTIs. Prospective randomized studies are warranted to provide evidence of the beneficial effect of antibacterial prophylaxis.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Antibioticoprofilaxia
Tratamento Conservador
Ureter/anormalidades
Ureter/diagnóstico por imagem
Obstrução Ureteral/terapia
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Dilatação Patológica/complicações
Dilatação Patológica/diagnóstico por imagem
Dilatação Patológica/terapia
Feminino
Dor no Flanco/etiologia
Seguimentos
Seres Humanos
Lactente
Recém-Nascido
Masculino
Renografia por Radioisótopo
Reimplante
Estudos Retrospectivos
Ultrassonografia Pré-Natal
Ureter/cirurgia
Obstrução Ureteral/diagnóstico por imagem
Obstrução Ureteral/etiologia
Infecções Urinárias/etiologia
Infecções Urinárias/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160806
[St] Status:MEDLINE



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