SNU - Artigos publicados em revistas indexadas na Medline
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- Neoplasia renal con extensión a la vena cavaPublication . Barradas, D.; Araújo, D.; Pimenta, A.La neoplasia renal con extensión a la vena cava es relativamente rara (4-10%). Cualquiera que sea la terapia coadjuvante (radioterapia, hormonal, quimioterapia e inmunoterapia), la exéresis completa del trombo tumoral de la vena cava continúa siendo la mejor forma de tratamiento. El valor pronóstico de la extensión cefálica de un trombo tumoral en la vena cava inferior en enfermos con carcinoma de células renales es controvertido. Es posible conseguir una larga supervivencia después del tratamiento quirúrgico en enfermos con carcinoma de células renales localizado (supervivencia de 50% en 5 años). Los autores describen un caso de carcinoma de células renales con extensión a la vena cava en un enfermo del sexo masculino, de 70 años de edad. El enfermo presentaba una historia de lumbalgia derecha y edema del miembro inferior homolateral. La resonancia magnética demostró la presencia y el nivel del trombo tumoral. El enfermo fue sometido a nefrectomía radical derecha y exéresis completa del trombo tumoral de la vena cava. Renal cancer with vena cava tumour thrombus is relatively rare (4 to 10%). Because of the poor results obtained with any kind of alternative therapy (e.g. radiation, hormonal, chemotherapy and immunotherapy) operation with complete removal of the vena cava tumour thrombus continues to be the better method of treatment. The prognostic significance of the cephalic extent of an inferior vena caval tumor thrombus associated with renal cell carcinoma is controversial. Long-term survival after surgical treatment is possible in patients with localized renal cell carcinoma (survival 50% at five years). The authors report a case of vena caval extension of renal cell carcinoma in a 70-years-old man. The patient presented with a history of right lombar pain and pedal edema. Magnetic Ressonance demonstrated the presence and the level of tumoral thrombus. The patient was submitted to a radical nefrectomy and complete removal of tumor thrombus from vena caval.
- ALTERAÇÕES VÉSICO-ESFINCTERIANAS NO PARKINSONISMOPublication . Andrade, M.; Trêpa, ADepois de uma breve revisão da euroanatomia e da neurofisiologia vésico-esfincteriana é feita uma análise das alterações vésico-esfincterianas no Parkinsonismo e a sua correlação com a doença, com os fármacos utilizados no tratamento desta doença e com eventuais problemas prostáticos. Conclui-se que cada caso terá obrigatoriamente que ser estudado individualmente.Further to a brief review of the vesical-sphincterian neuroanatomy and neurophisology, we analyse the vesical-sphincterian dysfunction in the Parkinson disease and its relation with this illness, with the drugs used in its treatment and with eventual prostatic problems. We therefore conclude that each case should be studied individually.
- Evaluation of effluent markers cancer antigen 125, vascular endothelial growth factor, and interleukin‐6: relationship with peritoneal transportPublication . Rodrigues, Anabela; Martins, M.; Santos, M.; Fonseca, Isabel; Carlos Oliveira, José; Cabrita, A.; Castro e Melo, J.; Krediet, R.Peritoneal hyperpermeability has been associated with increased levels of effluent vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6). Mesothelial cells can produce various vasoactive substances besides VEGF. A large mesothelial mass may possibly lead to high dialysate VEGF concentrations and may partly explain some cases of peritoneal hyperpermeability during a patient’s early months on peritoneal dialysis (PD). Early peritoneal fast transport may therefore not necessarily be associated with systemic inflammation. To investigate the relationship of effluent markers and peritoneal transport, we measured the appearance rates of cancer antigen 125 (CA125), VEGF, and IL-6 in 4-hour effluents from 69 peritoneal equilibration tests (PETs) using 3.86% glucose solution. At the same time, we measured serum VEGF and IL-6. Our analyses included an early group (EG), whose members had been on PD for 4.6 ± 3.3 months, and a later group (LG), whose members had been on PD for 30 ± 17 months. In EG, dialysate-to-plasma creatinine at 4 hours (D/PCr240) correlated significantly with effluent CA125/min (r = 0.51, p = 0.006) and VEGF/min (r = 0.57, p = 0.001), but not with serum VEGF or IL-6. The values of CA125/min and VEGF/min also correlated (r = 0.40, p = 0.034). Fast transporters in EG had higher effluent CA125 (p = 0.057) and VEGF (p = 0.0001), but not serum or effluent IL-6. In LG, D/PCr240 again correlated significantly with dialysate VEGF(r = 0.51, p = 0.009), but not with CA125. Fast transporters in LG tended to have higher levels of serum and effluent IL-6 and effluent VEGF. We conclude that fast solute transport rates at the beginning of PD are associated with signs of a large mesothelial cell mass and not consistently associated with higher systemic IL-6. The VEGF produced by mesothelial cells can mediate early peritoneal hyperpermeability in some populations. Later, mesothelial mass is lost and is no longer related to increased intraperitoneal VEGF or IL-6.
- Longitudinal membrane function in functionally anuric patients treated with APD: Data from EAPOS on the effects of glucose and icodextrin prescriptionPublication . Davies, S.; Brown, E.; Frandsen, N.; Rodrigues, A.; Rodriguez-Carmona, A.; Vychtyl, A.; MacNamara, E.; Ekstrand, A.; Tranaeus, A.; Filho, J.Longitudinal membrane function in functionally anuric patients treated with APD: Data from EAPOS on the effects of glucose and icodextrin prescription. Background: Peritoneal dialysis is associated with changes in membrane function that can lead eventually to ultrafiltration (UF) failure. Factors driving these changes are thought to include hypertonic glucose exposure, but previously reported associations are confounded by the presence of residual renal function. Methods: Longitudinal membrane function (solute transport and UF capacity) were measured annually in a prospective cohort of 177 functionally anuric patients as part of the European Automated Peritoneal Dialysis Outcomes Study (EAPOS). Subgroup analysis was performed according to glucose exposure and icodextrin use at baseline. Results: The whole cohort experienced an increase in solute transport and reduction in UF capacity at 12 and 24 months that could not be explained by informative censoring. These changes were accelerated and more severe in patients using either 2.27% or 3.86% glucose, or those not using icodextrin at baseline. These differences could not be explained by age, comorbidity score, previous time spent on renal replacement, differential dropout from the study, peritonitis rates, or, by definition, residual renal function. Patients using icodextrin at baseline had worse membrane function and were more likely to be diabetic. There was an association between membrane function changes and achieved 24-hour ultrafiltration over the 2-year study period. Conclusion: Anuric automated peritoneal dialysis (APD) patients experience significant detrimental changes in membrane function over a relatively short time period. Glucose appears to enhance these changes independent of residual renal function. Icodextrin use in these circumstances is associated with less deterioration in membrane function
- European best practice guidelines for peritoneal dialysis. 1 General guidelines.Publication . Dombros, N.; Dratwa, M.; Feriani, M.; Gokal, R.; Heimbürger, O.; Krediet, R.; Plum, J.; Rodrigues, A.; Selgas, R.; Struijk, D.; Verger, C.
- European best practice guidelines for peritoneal dialysis. 7 Adequacy of peritoneal dialysis.Publication . Dombros, N.; Dratwa, M.; Feriani, M.; Gokal, R.; Heimbürger, O.; Krediet, R.; Plum, J.; Rodrigues, A.; Selgas, R.; Struijk, D.; Verger, C.
- European best practice guidelines for peritoneal dialysis. 9 PD and transplantation.Publication . Dombros, N.; Dratwa, M.; Feriani, M.; Gokal, R.; Heimbürger, O.; Krediet, R.; Plum, J.; Rodrigues, A.; Selgas, R.; Struijk, D.; Verger, C.
- European best practice guidelines for peritoneal dialysis. 2 The initiation of dialysis.Publication . Dombros, N.; Dratwa, M.; Gokal, R.; Heimbürger, O.; Krediet, R.; Plum, J.; Rodrigues, A.; Selgas, R.; Struijk, D.; Verger, C.
- European best practice guidelines for peritoneal dialysis. 8 Nutrition in peritoneal dialysisPublication . Dombros, N.; Dratwa, M.; Feriani, M.; Gokal, R.; Heimbürger, O.; Krediet, R.; Plum, J.; Rodrigues, A.; Selgas, R.; Struijk, D.; Verger, C.
- European best practice guidelines for peritoneal dialysis. 5 Peritoneal dialysis solutionsPublication . Dombros, N.; Dratwa, D.; Feriani, M.; Gokal, R.; Heimbürger, O.; Krediet, R.; Plum, J.; Rodrigues, A.; Selgas, R.; Struijk, D.; Verger, C.