Browsing by Author "Pereira, P."
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- Comparative study of the degree of patient satisfaction in intermittent catheterization with Lofric and polyvinyl chloride cathetersPublication . Pereira, P.; Urrutia, M.; Lobato, L.; Rivas, S.; Monereo, E.Actas Urol Esp. 2001 Nov-Dec;25(10):725-30. [Comparative study of the degree of patient satisfaction in intermittent catheterization with Lofric and polyvinyl chloride catheters]. [Article in Spanish] López Pereira P, Martínez Urrutia MJ, Lobato L, Rivas S, Jaureguizar Monereo E. SourceUnidad de Urología Infantil, Hospital Universitario La Paz, Madrid. Abstract PURPOSE: To assess the grade of satisfaction in children on intermittent catheterization with the use of LoFric and PVC conventional catheters. MATERIAL AND METHODS: A total of 40 p with experience in CIC were included in this study. An anonymous questionnaire was sent to all patients after 2-months using the LoFric catheter. Patients were divided in 3 groups (bladder augmentation, artificial sphincter, Mitrofanoff) because of major differences in CIC discomfort between these groups. RESULTS: The questionnaire was completed by 87.5% of the patients (35 p). In 86% (30 p) LoFric catheter training was easy or very easy but in 14% (5 p) it was difficult. Four patients had some difficulty during conventional catheter insertion, in 3 (75%) the difficulty disappeared with the use of LoFric catheter. Of the 51% (18 p) who reported some discomfort during the insertion of conventional catheter, 72% said it was eliminated when the LoFric catheter was used. Of 6 p with some discomfort when removing the conventional catheter, 5 (83%) said it disappeared with the new catheter. Th LoFric catheter was favored by 70% of patients because it reduced the discomfort caused by conventional catheters, bladder insertion was easier and smoother, and gel lubrication was not needed. The 17% of patients reported some difficulty dealing with this slippery catheter. CONCLUSIONS: The use of the LoFric catheter could be justified in patients who report with conventional catheters have some discomfort. It can also be recommended in patients with artificial sphincter, bladder augmentation and Mitrofanoff procedure, in whom any complication related to CIC would have serious consequences.
- Infeção do trato urinário - agentes etiológicos e padrão de resistência localPublication . Brito, H.; Gonzaga, D.; Pereira, P.; Rocha, L.; Matos, P.RESUMO Introdução: A infeção urinária é uma patologia comum em idade pediátrica. A antibioterapia deve ser iniciada empiricamente antes do isolamento do agente causal e os fármacos utilizados devem ter em conta os microrganismos e o padrão de resistência local. Objetivos: Identificação dos agentes etiológicos de infeção urinária e os seus padrões de resistência antibiótica no nosso hospital. Material e Métodos: Análise retrospetiva dos resultados das uroculturas realizadas em crianças num hospital terciário entre Janeiro de 2009 e Junho de 2010. Resultados: 257 uroculturas correspondentes a 176 doentes (68% ♀) foram analisadas. A idade mediana foi quatro anos. Os agentes mais frequentes foram E. coli (55%), P. mirabilis (16%) e Klebsiella (14%). A resistência aos antibióticos foi de: 59% ampicilina, 18% amoxicilina / ácido clavulânico, 22% cefuroxime e cefaclor, 37% cotrimoxazol, 26% nitrofurantoina e inferior a 10% para ceftriaxone, ceftazidime e gentamicina. Conclusões: A resistência antibiótica tem aumentado e constitui um aspeto a refletir. De entre os fármacos geralmente usados para tratamento acima dos três meses de idade, a amoxicilina/ácido clavulânico e o cefuroxime apresentam valores semelhantes, pelo que o uso da associação amoxicilina/ácido clavulânico como fármaco de primeira linha se mantém uma boa opção terapêutica. ABSTRACT Introduction: Urinary tract infection is a common condition in children. The antibiotic therapy should be initiated empirically before the isolation of the causative agent. The drugs used should take account of the microorganisms and the pattern of local resistance. Objectives: Identification of the etiologic agents of urinary tract infection and their antibiotic resistance patterns in our hospital. Methods: Retrospective analysis of the results of urine cultures performed on children in a tertiary hospital between January 2009 and June 2010. Results: 257 urine cultures corresponding to 176 patients (68% ♀) were analyzed. The median age was 4 years. The agents most common were E. coli (55%), P. mirabilis (16%) and Klebsiella (14%). Antibiotic resistance was: 59% ampicillin, 18% amoxicillin / clavulanate, 22% cefuroxime and cefaclor, 37% cotrimoxazol, 26% nitrofurantoin and less than 10% for ceftriaxone, ceftazidime, and gentamicin. Conclusions: Antibiotic resistance has increased and it’s a worrying aspect. Among the drugs commonly used to treatment beyond three months, amoxicillin / clavulanate and cefuroxime, resistance pattern is similar, so the use of amoxicillin clavulanate as the first option remains a good therapeutic option.
- Renal amyloidosis: classification of 102 consecutive casesPublication . Tavares, I.; Vaz, R.; Moreira, L.; Pereira, P.; Sampaio, S.; Vizcaíno, J.; Costa, P.P.; Lobato, L.Amyloidoses are a group of heterogeneous diseases classified according to the nature of their causative amyloid proteins. Commonly, paraffin-embedded tissue is used for the typing of amyloid by immunohistochemistry. DNA analysis should always be considered if hereditary amyloidosis is suspected. Since the kidneys are one of the organs that are most commonly involved in amyloid deposition in systemic amyloidoses, we screened 102 consecutive cases with biopsy-proven amyloid disease by immunohistochemistry. DNA analysis was performed to confirm a diagnosis of hereditary amyloidosis. Demographic characteristics, underlying disease and clinical data at the time of renal biopsy were obtained by retrospective review of medical records. The amyloidosis type according to immunohistochemical amyloid protein identification was AA in 60 (58.8%) patients, AL in 21 (20.6%), AFib in four (3.9%), ATTR in two (2.0%), AApoAI in one (1.0%), ALys in one (1.0%) and combined AL and AA in one (1.0%). The type of protein could not be classified in 12 (11.7%) patients: eight (7.8%) because of negative immunohistochemistry and four (3.9%) due to the lack of adequate tissue. DNA analysis confirmed AFib and ATTR cases by the identification of the point mutations FGA p.Glu545Val and TTR p.Met51Val, respectively. Mean age at diagnosis was 53.3 years (49.4 for AA, 63.0 for AL and 53.9 for AFib). Chronic infections were the most frequent disorder associated with AA amyloidosis, mainly tuberculosis, and only one patient had familial AA associated with Muckle-Wells syndrome. Nephrotic syndrome was the most frequent clinical manifestation, independently of the amyloid type. In our series, AA amyloidosis is still the most frequent type of systemic amyloidoses. Six patients had unequivocal hereditary amyloidosis. Immunohistochemistry did not establish the precursor protein in almost 8% of patients; however, an improvement could be obtained using a wider panel of amyloid antibodies.