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[PMID]:28753632
[Au] Autor:Long X; Qi L; Ou Z; Zu X; Cao Z; Zeng X; Li Y; Chen M; Wang Z; Wang L
[Ad] Endereço:Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
[Ti] Título:Evolving use of social media among Chinese urologists: Opportunity or challenge?
[So] Source:PLoS One;12(7):e0181895, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Social media has revolutionized the way people communicate, and it has been widely incorporated into medical practice. However, limited data are available regarding the use of social media by Chinese urologists in their practice. METHODS: From 2014 to 2016, during the China Urological Association's (CUA) Annual National Minimally Invasive Urology Academic Conference, an anonymous survey on social media usage was distributed to participant urologists. RESULTS: The results of the survey, which was completed by 665 participants, indicate a conspicuous increase in social media use during the last three years. Regression analysis showed that year (2014 compared to 2016 and 2015), institute location (in the eastern region of China) and age (<35 y) were independent predictors of social media use. Rather than for personal use, an increasing number of respondents said they used social media for professional purposes, and for most respondents, social media has had a positive impact on their practice. However, when posting information on social media, few respondents were aware of the issue of protecting patients' privacy. CONCLUSIONS: Our study demonstrates a dramatic increase in social media use among Chinese urologists, which provides great opportunities for online academic communication and medical education. However, unprofessional use of social media in the medical practice may bring about potential risks and challenges for the further development of social media in medical practice.
[Mh] Termos MeSH primário: Grupo com Ancestrais do Continente Asiático
Mídias Sociais
Urologistas
[Mh] Termos MeSH secundário: Adolescente
Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Padrões de Prática Médica
Análise de Regressão
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170729
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0181895


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[PMID]:28581066
[Au] Autor:Hall SJ; Williams ST
[Ad] Endereço:Urology Department, Royal Derby Hospital, Derby, UK.
[Ti] Título:The pregnant urologist.
[So] Source:BJU Int;120(5):731-734, 2017 Nov.
[Is] ISSN:1464-410X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Female urologists represent an ever-increasing percentage of the work force; more and more of our colleagues will be working through pregnancy. There is a lack of clear and concise advice for pregnant urologists about occupational risks during pregnancy. Urology exposes expectant mothers to potential risks from radiation, teratogenic and cytotoxic drugs, iodine hand scrub, infections, and long working hours. We aim to provide a review of the current evidence and guidance to aid expectant mothers in their decision making. Relevant research articles and up-to-date guidance were reviewed. The millisevert (the average accumulated background radiation dose to an individual for 1 year, exclusive of radon) was used as the main unit of radiation dose. There is no published evidence to date in pregnant clinicians that shows a received radiation dose of more than the recommended dose for a pregnant lady, and no data showing an increased risk of foetal abnormalities in clinicians who continue to screen during pregnancy; however, the data are from small studies. There is strong advice suggesting avoidance of contact with crushed or broken 5α-reductase inhibitor tablets (finasteride and dutasteride), mitomycin and other cytotoxic drugs during pregnancy. Pregnant surgeons should avoid frequent use of iodine hand wash. Good hygiene precautions will protect from many infections along with up-to-date immunisations and use of personal protective equipment for certain cases.
[Mh] Termos MeSH primário: Exposição Ocupacional
Licença Parental
Gravidez
Exposição à Radiação
Urologistas
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Povidona-Iodo
Dose de Radiação
Fatores de Risco
Teratogênios
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Teratogens); 85H0HZU99M (Povidone-Iodine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170606
[St] Status:MEDLINE
[do] DOI:10.1111/bju.13927


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[PMID]:28326796
[Au] Autor:Best SL; Blute M; Lane B; Abel EJ
[Ad] Endereço:1 Department of Urology, William S. Memorial Veterans Hospital , Madison, Wisconsin.
[Ti] Título:Surgical Treatment of 4-10 cm Renal-Cell Carcinoma: A Survey of the Lions and Gazelles.
[So] Source:J Endourol;31(S1):S43-S47, 2017 Apr.
[Is] ISSN:1557-900X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The decision between partial nephrectomy (PN) and radical nephrectomy (RN) may be influenced by training, practice type, or location. We sought to evaluate current opinions about the optimal management of 4-10 cm renal-cell carcinoma (RCC). MATERIALS AND METHODS: A survey was emailed to ∼2500 Endourologic Society and Society of Urologic Oncology members regarding training, practice setting, and interest in clinical trials in addition to questions about four patient scenarios. We evaluated the associations of demographic variables with specific answers. RESULTS: 399 physicians completed the survey with 37% and 34% completing urologic oncology and endourology fellowships, respectively. More respondents reported receiving adequate training in complex open PN compared with complex minimally invasive surgery (MIS) PN, 81% vs 37%. Eighty-three percent of respondents would offer a healthy patient a PN for a 7 cm exophytic mass. Receiving adequate training in complex PN is predictive of offering PN for a central RCC (p = 0.001). Academic practitioners were more likely to offer PN in these patients (p = 0.03). Those completing training after 2000 were more likely to offer MIS (p = 0.02), and respondents who completed an oncology fellowship were more likely to offer PN to unhealthy patients (p = 0.03). CONCLUSIONS: Opinions about the best treatment for 4-10 cm RCC differ significantly, with 70% of respondents willing to enroll patients in a randomized clinical trial. Effective efforts in teaching PN and minimally-invasive surgery result in practices that favor these approaches.
[Mh] Termos MeSH primário: Carcinoma de Células Renais/cirurgia
Neoplasias Renais/cirurgia
Nefrectomia/métodos
Padrões de Prática Médica/estatística & dados numéricos
Urologistas
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos
Carcinoma de Células Renais/patologia
Bolsas de Estudo
Seres Humanos
Neoplasias Renais/patologia
Procedimentos Cirúrgicos Minimamente Invasivos/métodos
Nefrectomia/educação
Oncologia Cirúrgica/educação
Inquéritos e Questionários
Carga Tumoral
Urologia/educação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170606
[Lr] Data última revisão:
170606
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170323
[St] Status:MEDLINE
[do] DOI:10.1089/end.2016.0559


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[PMID]:28315424
[Au] Autor:Williamson SR; Gadde R; Trpkov K; Hirsch MS; Srigley JR; Reuter VE; Cheng L; Kunju LP; Barod R; Rogers CG; Delahunt B; Hes O; Eble JN; Zhou M; McKenney JK; Martignoni G; Fleming S; Grignon DJ; Moch H; Gupta NS
[Ad] Endereço:Department of Pathology and Laboratory Medicine, Detroit, MI, 48202, United States; Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, 48202, United States; Department of Pathology, Wayne State University School of Medicine, Detroit, MI, 48202, United States. Electronic address: sea
[Ti] Título:Diagnostic criteria for oncocytic renal neoplasms: a survey of urologic pathologists.
[So] Source:Hum Pathol;63:149-156, 2017 May.
[Is] ISSN:1532-8392
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Renal oncocytoma and chromophobe renal cell carcinoma have been long recognized as distinct tumors; however, it remains unknown if uniform diagnostic criteria are used to distinguish these tumor types in practice. A survey was distributed to urologic pathologists regarding oncocytic tumors. Responses were received from 17 of 26 invitees. Histologically, more than 1 mitotic figure was regarded as most worrisome (n=10) or incompatible (n=6) with oncocytoma diagnosis. Interpretation of focal nuclear wrinkling, focal perinuclear clearing, and multinucleation depended on extent and did not necessarily exclude oncocytoma if minor. Staining techniques most commonly used included the following: cytokeratin 7 (94%), KIT (71%), vimentin (65%), colloidal iron (59%), CD10 (53%), and AMACR (41%). Rare cytokeratin 7-positive cells (≤5%) were regarded as most supportive of oncocytoma, although an extent excluding oncocytoma was not universal. Multiple chromosomal losses were most strongly supportive for chromophobe renal cell carcinoma diagnosis (65%). Less certainty was reported for chromosomal gain or a single loss. For tumors with mixed or inconclusive features, many participants use an intermediate diagnostic category (82%) that does not label the tumor as unequivocally benign or malignant, typically "oncocytic neoplasm" or "tumor" with comment. The term "hybrid tumor" was used variably in several scenarios. A slight majority (65%) report outright diagnosis of oncocytoma in needle biopsies. The morphologic, immunohistochemical, and genetic characteristics that define oncocytic renal tumors remain incompletely understood. Further studies correlating genetics, behavior, and histology are needed to define which tumors truly warrant classification as carcinomas for patient counseling and follow-up strategies.
[Mh] Termos MeSH primário: Adenoma Oxífilo/patologia
Carcinoma de Células Renais/patologia
Neoplasias Renais/patologia
Patologistas
Urologistas
[Mh] Termos MeSH secundário: Adenoma Oxífilo/química
Adenoma Oxífilo/genética
Biomarcadores Tumorais/análise
Biomarcadores Tumorais/genética
Biópsia
Carcinoma de Células Renais/química
Carcinoma de Células Renais/genética
Proliferação Celular
Diagnóstico Diferencial
Pesquisas sobre Serviços de Saúde
Seres Humanos
Imuno-Histoquímica
Queratina-7/análise
Neoplasias Renais/química
Neoplasias Renais/genética
Índice Mitótico
Técnicas de Diagnóstico Molecular
Valor Preditivo dos Testes
Prognóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers, Tumor); 0 (KRT7 protein, human); 0 (Keratin-7)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170319
[St] Status:MEDLINE


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[PMID]:28299765
[Au] Autor:Kim SO; Kang TW; Kwon D
[Ad] Endereço:Department of Urology, Chonnam National University Medical School, Gwangju, Korea. seinsena@hanmail.net.
[Ti] Título:Gender Preferences for Urologists: Women Prefer Female Urologists.
[So] Source:Urol J;14(2):3018-3022, 2017 Mar 16.
[Is] ISSN:1735-546X
[Cp] País de publicação:Iran
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To investigate patients' preferences for the gender of their urologist. MATERIALS AND METHODS: Patients who visited a urologic center were asked to complete a self-administered questionnaire on the preferences for the gender of their urologist as well as on their age, education level and employment status. RESULTS: Of 270 respondents, 144 subjects (53%) had a preference for the gender of their urologist, whereas 126 subjects (47%) had no preference. Among 154 female respondents, 56 (36.4%) patients had no preference;96 (62.3%) patients had preferences for female urologists; and only 2 (1.3%) patient preferred male urologists. Among 116 male respondents, 70 (60.3%) patients had no preference; 30 (25.9%) patients had preferences for male urologists; and 16 (13.8%) preferred female urologists. Of patients that did express a preference, 87.5% (126/144) preferred the same gender urologist, with 65.2% (30/46) of male patients preferring male urologists and 97.9% (96/98) of female patients preferring female urologists (p < .001). However, age and education level werenot correlated with gender preference. CONCLUSION: More than half the female participants had a preference for the same gender of urologist, whereas the majority of male participants expressed no preference for the gender of their urologist. Furthermore, gender preference was not correlated with age and education level.
[Mh] Termos MeSH primário: Preferência do Paciente/estatística & dados numéricos
Médicas
Urologistas
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Idoso
Escolaridade
Feminino
Seres Humanos
Masculino
Meia-Idade
Ocupações
República da Coreia
Fatores Sexuais
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170317
[St] Status:MEDLINE


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[PMID]:28263389
[Au] Autor:Radhakrishnan A; Grande D; Mitra N; Bekelman J; Stillson C; Pollack CE
[Ad] Endereço:Division of General Internal Medicine, Johns Hopkins University, Baltimore, Maryland.
[Ti] Título:Second opinions from urologists for prostate cancer: Who gets them, why, and their link to treatment.
[So] Source:Cancer;123(6):1027-1034, 2017 May 15.
[Is] ISSN:1097-0142
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cancer patients are encouraged to obtain second opinions before starting treatment. Little is known about men with localized prostate cancer who seek second opinions, the reasons why, and the association with treatment and quality of care. METHODS: We surveyed men who were diagnosed with localized prostate cancer in the greater Philadelphia area from 2012 to 2014. Men were asked if they obtained a second opinion from a urologist, and the reasons why. We used multivariable logistic regression models to evaluate the relationship between second opinions and definitive prostate cancer treatment and perceived quality of care. RESULTS: A total of 2386 men responded to the survey (adjusted response rate, 51.1%). After applying exclusion criteria, the final analytic cohort included 2365 respondents. Of these, 40% obtained second opinions, most commonly because they wanted more information about their cancer (50.8%) and wanted to be seen by the best doctor (46.3%). Overall, obtaining second opinions was not associated with definitive treatment or perceived quality of cancer care. Men who sought second opinions because they were dissatisfied with their initial urologist were less likely to receive definitive treatment (odds ratio, 0.49; 95% confidence interval, 0.32-0.73), and men who wanted more information about treatment were less likely to report excellent quality of cancer care (odds ratio, 0.70; 95% confidence interval, 0.49-0.99) compared with men who did not receive a second opinion. CONCLUSIONS: Although a large proportion of men with localized prostate cancer obtained a second opinion, the reasons for doing so were not associated with treatment choice or perceived quality of cancer care. Future study is needed to determine when second opinions contribute to increasing the value of cancer care. Cancer 2017;123:1027-34. © 2016 American Cancer Society.
[Mh] Termos MeSH primário: Neoplasias da Próstata/epidemiologia
Encaminhamento e Consulta
Urologistas
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Tomada de Decisão Clínica
Gerenciamento Clínico
Seres Humanos
Masculino
Meia-Idade
Gradação de Tumores
Estadiamento de Neoplasias
Razão de Chances
Satisfação do Paciente
Pennsylvania/epidemiologia
Pennsylvania/etnologia
Padrões de Prática Médica
Neoplasias da Próstata/diagnóstico
Neoplasias da Próstata/mortalidade
Neoplasias da Próstata/terapia
Qualidade da Assistência à Saúde
Fatores de Risco
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170307
[St] Status:MEDLINE
[do] DOI:10.1002/cncr.30412


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[PMID]:28160087
[Au] Autor:Schneidewind L; Neumann T; Kranz J; Knoll F; Pelzer AE; Schmidt C; Krüger W
[Ad] Endereço:Institute of Virology, University Medical Center of the Saarland, Saarland University, Kirrberger Strasse 100, 66424, Homburg, Saar, Germany. laila.schneidewind@uks.eu.
[Ti] Título:Nationwide survey of BK polyomavirus associated hemorrhagic cystitis in adult allogeneic stem cell transplantation among haematologists and urologists.
[So] Source:Ann Hematol;96(5):797-803, 2017 May.
[Is] ISSN:1432-0584
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:There are no epidemiological data on BK virus associated hemorrhagic cystitis (BKHC) in adult allogeneic stem cell transplantation in Germany available and associations with clinical conditions like GvHD are controversially discussed. Therefore, we conducted a nationwide survey among haematologists and urologists about this disease. We developed two questionnaires, one for haematologists (26 items) and one for urologists (20 items) concerning BKHC in adult allogeneic stem cell transplantation with epidemiological data and clinical implications. The survey was sent out at least three times to EBMT registered centres performing at least five transplantations a year, leading to 39 centres. The recruiting time was between January and June 2016. Total response rates were 76.9% among haematologists and 74.4% among urologists. BKHC seems to appear less frequent in this survey than it is described in the literature. Six deaths in the last 5 years due to this disease have been reported. Interestingly, haematologists as well as urologists mostly think that local therapy is most effective while 50.0% stated that there is no real effective oral or intravenous medication. Associations with other clinical conditions mentioned were heterogeneous, e.g. transplantation type, CMV reactivation, acute GvHD, nephropathy and worse clinical outcome. There was a significant discrepancy between haematologists and urologist concerning the association with acute GvHD (p = 0.004). We need prospective, multicentric clinical studies to evaluate local therapy and for developing a risk stratification model since this disease can be severe with morbidity and rarely mortality. In our opinion, this should be an interdisciplinary approach.
[Mh] Termos MeSH primário: Vírus BK
Cistite/epidemiologia
Cistite/etiologia
Transplante de Células-Tronco Hematopoéticas
Hemorragia/epidemiologia
Hemorragia/etiologia
Médicos
Infecções por Polyomavirus/complicações
[Mh] Termos MeSH secundário: Adulto
Idoso
Comorbidade
Cistite/terapia
Feminino
Alemanha/epidemiologia
Doença Enxerto-Hospedeiro/etiologia
Transplante de Células-Tronco Hematopoéticas/efeitos adversos
Hemorragia/terapia
Seres Humanos
Incidência
Masculino
Meia-Idade
Sistema de Registros
Inquéritos e Questionários
Transplante Homólogo
Infecções Tumorais por Vírus/complicações
Urologistas
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170418
[Lr] Data última revisão:
170418
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170205
[St] Status:MEDLINE
[do] DOI:10.1007/s00277-017-2935-8


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[PMID]:28117608
[Au] Autor:Wallis CJ; Garbens A; Chopra S; Gill IS; Satkunasivam R
[Ad] Endereço:1 Division of Urology, Department of Surgery, Sunnybrook Health Sciences Centre and University of Toronto , Toronto, Canada .
[Ti] Título:Robotic Partial Nephrectomy: Expanding Utilization, Advancing Innovation.
[So] Source:J Endourol;31(4):348-354, 2017 Apr.
[Is] ISSN:1557-900X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Robotic partial nephrectomy (RPN) is gaining increasing prominence for nephron-sparing surgery in the treatment of patients with localized kidney tumors. RPN offers the benefits of minimally invasive surgery with a shorter learning curve compared with its laparoscopic counterpart. While long-term data are awaited, RPN does provide short-term oncologic and functional outcomes comparable to open and laparoscopic partial nephrectomy. Furthermore, robotic surgery has facilitated technical innovation, including the elimination of warm ischemia, provided minimally invasive alternatives to patients with complex tumors, and importantly, has fuelled increased dissemination of partial nephrectomy surgery among community urologists.
[Mh] Termos MeSH primário: Neoplasias Renais/cirurgia
Nefrectomia/métodos
Procedimentos Cirúrgicos Robóticos/métodos
[Mh] Termos MeSH secundário: Seres Humanos
Laparoscopia/métodos
Procedimentos Cirúrgicos Minimamente Invasivos
Néfrons
Tratamentos com Preservação do Órgão
Resultado do Tratamento
Urologistas
Isquemia Quente
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170602
[Lr] Data última revisão:
170602
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170125
[St] Status:MEDLINE
[do] DOI:10.1089/end.2016.0639


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[PMID]:28116915
[Au] Autor:Sountoulides P; Mykoniatis I; Metaxa L
[Ad] Endereço:a Department of Urology , The Pennine Acute Hospitals NHS Trust , Manchester , UK.
[Ti] Título:Non-visible asymptomatic haematuria: a review of the guidelines from the urologist's perspective.
[So] Source:Expert Rev Anticancer Ther;17(3):203-216, 2017 Mar.
[Is] ISSN:1744-8328
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Non-visible hematuria, also referred to as 'microscopic hematuria' or 'dipstick positive hematuria' is a common reason for urology referrals with prevalence rates that range from 13% to 20%. The main concern for investigating non-visible hematuria, especially in the absence of lower urinary tract symptoms, is its potential relation to urinary tract malignancy, which however does not exceed 5%. The pathway of investigation of non-visible hematuria is impeded by the lack of clarity over definitions, diagnosis and specialist referral criteria. Towards that goal guidelines have been introduced by different societies. In this review we aim to discuss differences in current guideline regarding the investigation, management and follow up of non-visible hematuria. Areas covered: Guidelines, recommendations, algorithms and original articles on hematuria published in the English literature were retrieved using the following PubMed search terms 'microscopic hematuria', 'dipstick hematuria', 'non-visible hematuria' and 'guidelines'. Expert commentary: Available guidelines for investigation of microscopic hematuria actually differ both in the extent and the intensity of the proposed imaging and invasive tests. There is evidence that guidelines are not adhered to and this reflects the necessity for introducing selection criteria and maybe variable levels of investigation for microscopic hematuria depending on the individual patient.
[Mh] Termos MeSH primário: Hematúria/diagnóstico
Guias de Prática Clínica como Assunto
Neoplasias Urológicas/diagnóstico
[Mh] Termos MeSH secundário: Algoritmos
Hematúria/epidemiologia
Hematúria/etiologia
Seres Humanos
Prevalência
Encaminhamento e Consulta
Neoplasias Urológicas/epidemiologia
Neoplasias Urológicas/patologia
Urologistas
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170605
[Lr] Data última revisão:
170605
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170125
[St] Status:MEDLINE
[do] DOI:10.1080/14737140.2017.1284589


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[PMID]:28114785
[Au] Autor:Luk AC; Cleaveland P; Olson L; Neilson D; Srirangam SJ
[Ad] Endereço:Department of Urology, Royal Blackburn Hospital , Blackburn, United Kingdom .
[Ti] Título:Pelvic Phlebolith: A Trivial Pursuit for the Urologist?
[So] Source:J Endourol;31(4):342-347, 2017 Apr.
[Is] ISSN:1557-900X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Pelvic phleboliths are commonly encountered on plain and CT imaging and remain a source of frustration when attempting to differentiate them from ureteral calculi. Given their frequency, surprising little is known about their significance. We review the literature on pelvic phleboliths, specifically in relation to their history, demography, clinical significance, and methods to distinguish them from ureteral calculi. METHODS: A comprehensive literature search was performed for all articles concerning pelvic phleboliths. RESULTS: Pelvic phleboliths were first described in 19th century when the presence of calcified intravenous nodules was observed in human dissection. With the discovery of X-ray imaging in 1895, they have caused much diagnostic controversies since. Histologically they are composed of calcified laminated fibrous tissue, with a surface layer continuous with vein endothelium. Prevalence of pelvic phleboliths in adults is reported to be 38.9%-48%. They are more common in adults aged over 40, and appear to equally affect both genders. They may be associated with diverticulitis, vascular abnormalities, and are more commonly seen in individuals from economically developed countries. The soft-tissue "rim"sign (50%-77% sensitivity and 92%-100% specificity) and a geometric shape (100% positive predictive value [PPV]) are radiological signs predictive of ureteral calculi on unenhanced CT scanning. Radiological signs suggestive of phleboliths include the presence of central lucency (8%-60% sensitivity and 100% specificity), rounded shape (91% PPV), and the comet-tail sign (21%-65% sensitivity and 100% specificity). Phleboliths appear to have a significantly lower Hounsfield unit enhancement than ureteral calculi (160-350 HU). CONCLUSIONS: Pelvic phleboliths are a common radiological finding, especially in the older population, which continue to present diagnostic challenges in those with suspected ureteral calculi. With greater awareness, the uncertainty can be overcome by identifying defining characteristics when interpreting radiological investigations.
[Mh] Termos MeSH primário: Cálculos Ureterais/diagnóstico por imagem
Calcificação Vascular/diagnóstico por imagem
Veias/diagnóstico por imagem
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Seres Humanos
Pelve
Radiografia
Sensibilidade e Especificidade
Tomografia Computadorizada por Raios X/métodos
Urologistas
Calcificação Vascular/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170602
[Lr] Data última revisão:
170602
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170125
[St] Status:MEDLINE
[do] DOI:10.1089/end.2016.0861



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