Objective To explore the clinical value of computer-assisted pathologic imaging analysis in evaluating urinary red blood cell morphology. Method 24 nephropathy patients were treated as study group, and 28 patients who...Objective To explore the clinical value of computer-assisted pathologic imaging analysis in evaluating urinary red blood cell morphology. Method 24 nephropathy patients were treated as study group, and 28 patients whose haematuria due to shockwave lithotomy were treated as control. Urine sediment of each patient was stained,and red blood morphology analysis with computer-assisted imaging system was made. Result The sensitivity and specificity were 83.3% and 90.9% respectively in diagnosis of glomerular haematuria; for non-glomerular haematuria,the sensitivity and specificity all were 100%. Conclusion There are high sensitivity and specificity in diagnosis of glomerular haematuria using computer-assisted imaging analysis.It is reliable and has significant clinical value.展开更多
Haematuria was known as a benign hallmark of some glomerular diseases, but over the last decade, new evidences pointed its negative implications on kidneydisease progression. Cytotoxic effects of oxidative stress indu...Haematuria was known as a benign hallmark of some glomerular diseases, but over the last decade, new evidences pointed its negative implications on kidneydisease progression. Cytotoxic effects of oxidative stress induced by hemoglobin, heme, or iron released from red blood cells may account for the tubular injury observed in human biopsy specimens. However, the precise mechanisms responsible for haematuria remain unclear. The presence of red blood cells （RBCs） with irregular contours and shape in the urine indicates RBCs egression from the glomerular capillary into the urinary space. Therefore glomerular haematuria may be a marker of glomerular filtration barrier dysfunction or damage. In this review we describe some key issues regarding epidemiology and pathogenesis of haematuric diseases as well as their renal morphological fndings.展开更多
目的通过分析6例左肾静脉压迫综合征合并IgA肾病患者的临床资料，提高临床医师对于左肾静脉压迫综合征合并IgA肾病的认识和诊治水平。方法回顾性分析2012年1月至2014年1月我院的6例左肾静脉压迫综合征合并IgA肾病患者的临床资料。6例左...目的通过分析6例左肾静脉压迫综合征合并IgA肾病患者的临床资料，提高临床医师对于左肾静脉压迫综合征合并IgA肾病的认识和诊治水平。方法回顾性分析2012年1月至2014年1月我院的6例左肾静脉压迫综合征合并IgA肾病患者的临床资料。6例左肾静脉压迫综合征患者均由左肾静脉彩色多普勒诊断，其中1例患者同时行CT血管三维成像（computed tomography angiography，CTA）诊断；记录患者的性别、年龄、身高、体质量、尿常规、24h尿蛋白定量、血常规、血肌酐、血白蛋白、血尿酸、补体C3、肾活检病理类型及影像学资料等。结果6例患者均为男性，平均年龄（16．5±4．3）岁，平均体质量指数（body mass index，BMI）为17．8±1．3，以血尿、蛋白尿、腰痛为主要临床表现。病理级别为LeeI级LeeⅢ级；6例患者中1例患者为LeeI级，4例患者为LeeⅡ级，1例患者为LeeⅢ级；1例患者有细胞性新月体形成（占。肾小球总数比例的5．9％），1例患者有。肾小球球性硬化（占肾小球总数比例的14．3）％。6例患者均有不同程度系膜增生（轻度～中度）及轻度肾小管萎缩、肾小管纤维化，所有患者均无间质血管炎；2例患者有间质灶性炎细胞浸润；免疫荧光检测，6例患者均有不同程度系膜区IgA沉积（＋＋～＋＋＋）、IgG沉积（＋＋）及补体c3沉积（＋～＋＋），6例患者均无系膜区IgM沉积。结论对于BMI偏低的儿童和青少年出现血尿和（或）蛋白尿，行左肾静脉彩色多普勒检查和仰卧位／站立位尿液检查不仅有助于明确诊断，还有助于指导治疗，避免过度医疗。展开更多
Purpose: We describe the commonest pathology responsible for lower urinary tract obstruction (LUTO) and associated symptoms such as UTI, etc. among males at the Komfo Anokye Teaching Hospital (KATH) in Kumasi. Materia...Purpose: We describe the commonest pathology responsible for lower urinary tract obstruction (LUTO) and associated symptoms such as UTI, etc. among males at the Komfo Anokye Teaching Hospital (KATH) in Kumasi. Materials and Methods: Between January and December 2009, prospective cross sectional hospital based study was conducted involving 103 subjects. Patients with symptoms of LUTO and who were on short admission (up to 48 hours) at the accident and emergency unit of KATH were identified as potential study subjects. All the patients presented with acute retention of urine at the emergency unit of KATH and urethral catheterization was attempted to relieve them of the retention under sterile conditions. Those patients whose initial catheterization failed went through suprapubic cystostomy (suprapubic catheterization). Urine specimens for culture and sensitivity tests were then collected into sterile urine containers immediately after the catheterization (irrespective of type). Ultrasound Scan was requested for all the patients to assist in diagnosing enlargement of the prostate and other associated urological pathologies. Retrograde urethrogram was however, requested for those patients with suprapubic catheterization and which helped in the diagnosis of the urethral stricture. For a particular child, urethral catheter was passed under sterile condition and Micturicting Cysto-Urethrogram (MCUG) was done to assist in diagnosing posterior urethral valve and other conditions. Those subjects whose urinalysis revealed pyuria and positive urine culture and who had voluntarily agreed to enter the study were enrolled. Subjects whose urine culture had multiple bacteria growth that was deemed to be contaminants were excluded from the study. Results: The mean age for males with LUTO was 62 years. The youngest male with LUTO was aged 2 years whilst the maximum age was 93 years. LUTO due to prostatic hyperplasia was found in 79 (76.7%) men;23 (22.3%) had LUTO due to urethral stricture and 1 (1.0%) (youngest male). The mean age 展开更多
Background: Dutasteride has been found to reduce chronic prostatic bleeding and when taken 2 - 6 weeks preoperatively reduces bleeding during transurethral prostate resection. The aim of this study is to determine if ...Background: Dutasteride has been found to reduce chronic prostatic bleeding and when taken 2 - 6 weeks preoperatively reduces bleeding during transurethral prostate resection. The aim of this study is to determine if the drug will be effective in the control of acute gross prostatic haematuria. Patients and Method: 87 Consecutive patients with gross haematuria were enrolled. Clotting Profile, Cystoscopy and Intravenous Urography were done to exclude haematuria from medical, renal and bladder causes. Patients suspected to have prostatic haematuria were further evaluated using serum Prostate specific antigen (PSA) and Prostate scan. Those with elevated PSA ≥ 10 ng/ml and abnormal digital rectal examination (DRE) finding had prostate biopsy. The patients were randomly divided into 2 treatment groups. The control group had Normal saline irrigation and broad spectrum antibiotics while the second group received 0.5 mg oral dutasteride in addition. The time taken and volume of irrigation fluid used before haematuria stopped were noted. Statistical analysis was done using SPSS version 20.0. Result: 75 patients had haematuria of prostatic origin. 49 (65.3%) of these had benign prostatic hyperplasia (BPH) and 26 (34.7%) had cancer of prostate. 25(51%) of the 49 patients with BPH had Normal saline irrigation and antibiotics while 24 (49%) had oral dutasteride in addition. 14 (53.8%) of the prostate cancer patients had Normal saline irrigation and antibiotics while 12 (46.2%) had dutasteride in addition. Haematuria resolved in significantly shorter length of time using lesser volume of irrigation fluid in those treated with dutasteride than in those on control arm. Conclusion: Addition of 0.5 mg oral dutasteride daily leads to early resolution of acute prostatic haematuria.展开更多
Due to limited resources and experience, rapid diagnostic techniques are advocated in nations with a resource shortage when diagnosing schistosomiasis. We used rapid diagnostic tests to access the prevalence and inten...Due to limited resources and experience, rapid diagnostic techniques are advocated in nations with a resource shortage when diagnosing schistosomiasis. We used rapid diagnostic tests to access the prevalence and intensity of schistosome infection in North Central, Nigeria. A total of 1951 participants were recruited for this study. The participants were screened for S. haematobium infection;haematuria and proteinuria were monitored in the recruited patients with a commercial reagent strip. Of the 1951 participants recruited for the study, 587 were found to be infected. Children aged 0 to 10 years showed the highest levels of haematuria with (100%) specificity. Meanwhile, other age groups (11 - 20, 21 - 30, 31 - 40 and above 40 years) had rates higher than 90%. The degree of haematuria increased with egg intensity. The same was seen in proteinuria, with a percentage of 41.9%. A significant difference (p S. haematobium in rural endemic areas.展开更多
Haematuria is the presence of red blood cells in urine. It is most often caused by urinary tract infections of which Escherichia coli is frequently implicated. Impairment of kidney functions could occur as a result of...Haematuria is the presence of red blood cells in urine. It is most often caused by urinary tract infections of which Escherichia coli is frequently implicated. Impairment of kidney functions could occur as a result of infection or other complications of the kidney. The aim of the study was to determine the prevalence of uropathogenic Escherichia coli among adult male patients with haematuria and impaired kidneys attending a general hospital in Benue state. Three hundred and sixty-eight (368) samples of urine were collected from 368 male patients (≥ 40 years) attending the 23 general hospitals in Benue state. Each of the urine samples was divided into two parts for haematuria and isolation and identification of Escherichia coli. Blood samples (368) were also collected from the patients and used for quantitative determination of creatinine and estimation of glomerular filtration rate. The presence of haematuria was 45.1% and ranges from 12.5% to 100%. Prevalence of haematuria with respect to age shows that patients within the age group of 90 - 99 years had the highest rate (100%) and the least were those within the ages of 40 - 49 years (20.0%). Isolation rate of uropathogenic Escherichia coli was 16.3% and ranged from 6.3 to 37.5%. Patients within the age group of 90 - 99 years had the highest elevated impaired renal function of 4 (80%), followed by patients within the ages of 80 - 89 years [17 (77.3%)] and the lowest were those within the ages of 40 - 49 [6 (10.0%)]. The overall presence of haematuria in the patients was high (45.1%) with similar high Escherichia coli isolation rate and impaired renal function which could mean that acute or chronic kidney disease may set in.展开更多
Renal biopsy was performed for the first time more than one century ago, but its clinical use was routinely introduced in the 1950s. It is still an essential tool for diagnosis and choice of treatment of several prima...Renal biopsy was performed for the first time more than one century ago, but its clinical use was routinely introduced in the 1950s. It is still an essential tool for diagnosis and choice of treatment of several primary or secondary kidney diseases. Moreover, it may help to know the expected time of end stage renal disease. The indications are represented by nephritic and/or nephrotic syndrome and rapidly progressive acute renal failure of unknown origin. Nowadays, it is performed mainly by nephrologists and radiologists using a 14-18 gauges needle with automated spring-loaded biopsy device, under real-time ultrasound guidance. Bleeding is the major primary complication that in rare cases may lead to retroperitoneal haemorrhage and need for surgical intervention and/or death. For this reason, careful evaluation of risks and benefts must be taken into account, and all procedures to minimize the risk of complications must be observed. After biopsy, an observation time of 12-24 h is necessary, whilst a prolonged observation may be needed rarely. In some cases it could be safer to use different techniques to reduce the risk of complications, such as laparoscopic or transjugular renal biopsy in patients with coagulopathy or alternative approaches in obese patients. Despite progress in medicine over the years with the introduction of more advanced molecular biology techniques, renal biopsy is still an irreplaceable tool for nephrologists.展开更多
文摘Objective To explore the clinical value of computer-assisted pathologic imaging analysis in evaluating urinary red blood cell morphology. Method 24 nephropathy patients were treated as study group, and 28 patients whose haematuria due to shockwave lithotomy were treated as control. Urine sediment of each patient was stained,and red blood morphology analysis with computer-assisted imaging system was made. Result The sensitivity and specificity were 83.3% and 90.9% respectively in diagnosis of glomerular haematuria; for non-glomerular haematuria,the sensitivity and specificity all were 100%. Conclusion There are high sensitivity and specificity in diagnosis of glomerular haematuria using computer-assisted imaging analysis.It is reliable and has significant clinical value.
基金Supported by Grants from FIS (Programa Miguel Servet:CP10/00479,PI13/00802 and PI14/00883)Spanish Society of Nephrology to Moreno JAInstitute of Research Queen Sophia,FRIAT and ISCIII fund PI10/00072 to Egido J.
文摘Haematuria was known as a benign hallmark of some glomerular diseases, but over the last decade, new evidences pointed its negative implications on kidneydisease progression. Cytotoxic effects of oxidative stress induced by hemoglobin, heme, or iron released from red blood cells may account for the tubular injury observed in human biopsy specimens. However, the precise mechanisms responsible for haematuria remain unclear. The presence of red blood cells （RBCs） with irregular contours and shape in the urine indicates RBCs egression from the glomerular capillary into the urinary space. Therefore glomerular haematuria may be a marker of glomerular filtration barrier dysfunction or damage. In this review we describe some key issues regarding epidemiology and pathogenesis of haematuric diseases as well as their renal morphological fndings.
文摘目的通过分析6例左肾静脉压迫综合征合并IgA肾病患者的临床资料，提高临床医师对于左肾静脉压迫综合征合并IgA肾病的认识和诊治水平。方法回顾性分析2012年1月至2014年1月我院的6例左肾静脉压迫综合征合并IgA肾病患者的临床资料。6例左肾静脉压迫综合征患者均由左肾静脉彩色多普勒诊断，其中1例患者同时行CT血管三维成像（computed tomography angiography，CTA）诊断；记录患者的性别、年龄、身高、体质量、尿常规、24h尿蛋白定量、血常规、血肌酐、血白蛋白、血尿酸、补体C3、肾活检病理类型及影像学资料等。结果6例患者均为男性，平均年龄（16．5±4．3）岁，平均体质量指数（body mass index，BMI）为17．8±1．3，以血尿、蛋白尿、腰痛为主要临床表现。病理级别为LeeI级LeeⅢ级；6例患者中1例患者为LeeI级，4例患者为LeeⅡ级，1例患者为LeeⅢ级；1例患者有细胞性新月体形成（占。肾小球总数比例的5．9％），1例患者有。肾小球球性硬化（占肾小球总数比例的14．3）％。6例患者均有不同程度系膜增生（轻度～中度）及轻度肾小管萎缩、肾小管纤维化，所有患者均无间质血管炎；2例患者有间质灶性炎细胞浸润；免疫荧光检测，6例患者均有不同程度系膜区IgA沉积（＋＋～＋＋＋）、IgG沉积（＋＋）及补体c3沉积（＋～＋＋），6例患者均无系膜区IgM沉积。结论对于BMI偏低的儿童和青少年出现血尿和（或）蛋白尿，行左肾静脉彩色多普勒检查和仰卧位／站立位尿液检查不仅有助于明确诊断，还有助于指导治疗，避免过度医疗。
文摘Purpose: We describe the commonest pathology responsible for lower urinary tract obstruction (LUTO) and associated symptoms such as UTI, etc. among males at the Komfo Anokye Teaching Hospital (KATH) in Kumasi. Materials and Methods: Between January and December 2009, prospective cross sectional hospital based study was conducted involving 103 subjects. Patients with symptoms of LUTO and who were on short admission (up to 48 hours) at the accident and emergency unit of KATH were identified as potential study subjects. All the patients presented with acute retention of urine at the emergency unit of KATH and urethral catheterization was attempted to relieve them of the retention under sterile conditions. Those patients whose initial catheterization failed went through suprapubic cystostomy (suprapubic catheterization). Urine specimens for culture and sensitivity tests were then collected into sterile urine containers immediately after the catheterization (irrespective of type). Ultrasound Scan was requested for all the patients to assist in diagnosing enlargement of the prostate and other associated urological pathologies. Retrograde urethrogram was however, requested for those patients with suprapubic catheterization and which helped in the diagnosis of the urethral stricture. For a particular child, urethral catheter was passed under sterile condition and Micturicting Cysto-Urethrogram (MCUG) was done to assist in diagnosing posterior urethral valve and other conditions. Those subjects whose urinalysis revealed pyuria and positive urine culture and who had voluntarily agreed to enter the study were enrolled. Subjects whose urine culture had multiple bacteria growth that was deemed to be contaminants were excluded from the study. Results: The mean age for males with LUTO was 62 years. The youngest male with LUTO was aged 2 years whilst the maximum age was 93 years. LUTO due to prostatic hyperplasia was found in 79 (76.7%) men;23 (22.3%) had LUTO due to urethral stricture and 1 (1.0%) (youngest male). The mean age
文摘Background: Dutasteride has been found to reduce chronic prostatic bleeding and when taken 2 - 6 weeks preoperatively reduces bleeding during transurethral prostate resection. The aim of this study is to determine if the drug will be effective in the control of acute gross prostatic haematuria. Patients and Method: 87 Consecutive patients with gross haematuria were enrolled. Clotting Profile, Cystoscopy and Intravenous Urography were done to exclude haematuria from medical, renal and bladder causes. Patients suspected to have prostatic haematuria were further evaluated using serum Prostate specific antigen (PSA) and Prostate scan. Those with elevated PSA ≥ 10 ng/ml and abnormal digital rectal examination (DRE) finding had prostate biopsy. The patients were randomly divided into 2 treatment groups. The control group had Normal saline irrigation and broad spectrum antibiotics while the second group received 0.5 mg oral dutasteride in addition. The time taken and volume of irrigation fluid used before haematuria stopped were noted. Statistical analysis was done using SPSS version 20.0. Result: 75 patients had haematuria of prostatic origin. 49 (65.3%) of these had benign prostatic hyperplasia (BPH) and 26 (34.7%) had cancer of prostate. 25(51%) of the 49 patients with BPH had Normal saline irrigation and antibiotics while 24 (49%) had oral dutasteride in addition. 14 (53.8%) of the prostate cancer patients had Normal saline irrigation and antibiotics while 12 (46.2%) had dutasteride in addition. Haematuria resolved in significantly shorter length of time using lesser volume of irrigation fluid in those treated with dutasteride than in those on control arm. Conclusion: Addition of 0.5 mg oral dutasteride daily leads to early resolution of acute prostatic haematuria.
文摘Due to limited resources and experience, rapid diagnostic techniques are advocated in nations with a resource shortage when diagnosing schistosomiasis. We used rapid diagnostic tests to access the prevalence and intensity of schistosome infection in North Central, Nigeria. A total of 1951 participants were recruited for this study. The participants were screened for S. haematobium infection;haematuria and proteinuria were monitored in the recruited patients with a commercial reagent strip. Of the 1951 participants recruited for the study, 587 were found to be infected. Children aged 0 to 10 years showed the highest levels of haematuria with (100%) specificity. Meanwhile, other age groups (11 - 20, 21 - 30, 31 - 40 and above 40 years) had rates higher than 90%. The degree of haematuria increased with egg intensity. The same was seen in proteinuria, with a percentage of 41.9%. A significant difference (p S. haematobium in rural endemic areas.
文摘Haematuria is the presence of red blood cells in urine. It is most often caused by urinary tract infections of which Escherichia coli is frequently implicated. Impairment of kidney functions could occur as a result of infection or other complications of the kidney. The aim of the study was to determine the prevalence of uropathogenic Escherichia coli among adult male patients with haematuria and impaired kidneys attending a general hospital in Benue state. Three hundred and sixty-eight (368) samples of urine were collected from 368 male patients (≥ 40 years) attending the 23 general hospitals in Benue state. Each of the urine samples was divided into two parts for haematuria and isolation and identification of Escherichia coli. Blood samples (368) were also collected from the patients and used for quantitative determination of creatinine and estimation of glomerular filtration rate. The presence of haematuria was 45.1% and ranges from 12.5% to 100%. Prevalence of haematuria with respect to age shows that patients within the age group of 90 - 99 years had the highest rate (100%) and the least were those within the ages of 40 - 49 years (20.0%). Isolation rate of uropathogenic Escherichia coli was 16.3% and ranged from 6.3 to 37.5%. Patients within the age group of 90 - 99 years had the highest elevated impaired renal function of 4 (80%), followed by patients within the ages of 80 - 89 years [17 (77.3%)] and the lowest were those within the ages of 40 - 49 [6 (10.0%)]. The overall presence of haematuria in the patients was high (45.1%) with similar high Escherichia coli isolation rate and impaired renal function which could mean that acute or chronic kidney disease may set in.
文摘Renal biopsy was performed for the first time more than one century ago, but its clinical use was routinely introduced in the 1950s. It is still an essential tool for diagnosis and choice of treatment of several primary or secondary kidney diseases. Moreover, it may help to know the expected time of end stage renal disease. The indications are represented by nephritic and/or nephrotic syndrome and rapidly progressive acute renal failure of unknown origin. Nowadays, it is performed mainly by nephrologists and radiologists using a 14-18 gauges needle with automated spring-loaded biopsy device, under real-time ultrasound guidance. Bleeding is the major primary complication that in rare cases may lead to retroperitoneal haemorrhage and need for surgical intervention and/or death. For this reason, careful evaluation of risks and benefts must be taken into account, and all procedures to minimize the risk of complications must be observed. After biopsy, an observation time of 12-24 h is necessary, whilst a prolonged observation may be needed rarely. In some cases it could be safer to use different techniques to reduce the risk of complications, such as laparoscopic or transjugular renal biopsy in patients with coagulopathy or alternative approaches in obese patients. Despite progress in medicine over the years with the introduction of more advanced molecular biology techniques, renal biopsy is still an irreplaceable tool for nephrologists.
