Abstract:
INTRODUCTION:Urosepsis is an underdiagnosed entity with high morbidity and mortality and significant associated costs. The delay in diagnosis leads to an increased risk of multiorgan failure and death. Although its prognosis is better than that of other sepsis, the mortality rate is 20 - 40%. OBJECTIVE:Describe the obstructive uropathy cases (OU) that are complicated by severe sepsis (SS) and identify early biomarkers of SS. MATERIAL AND METHODS:Observational and prospective study of 65 patients with urgent high OU. All patients were evaluated at three different times (0, 24 and 48 hours). An SS predictor model has been constructed and a multivariate risk analysis has been carried out. RESULTS:64.61% (n=42) developed SS (NSS: n=13). The only statistically significant variables in the 3 moments evaluated and that obtained a good area under the curve [AUROC (>0.70)] were the elevation of neutrophils, procalcitonin, and decrease of bicarbonate. At the time of patient admission, the variable that best predicted SS was the elevation of procalcitonin (AUROC:0.919). SS risk factors (p<0.005) were the history of cancer immunosuppression, and/or urinary tract surgeries, complete UO and high blood values of lactate, potassium and decrease of bicarbonate. The potassium-lactate combination on admission predicted SS with a probability function of 0.805. CONCLUSIONS:There is an analytical profile maintained over the time characteristic of SS that allows anearly identification of patients with OU subsidiary of been complicated with SS. :INTRODUCCIÓN: La Sepsis urinaria obstructiva (SUO) es una entidad infradiagnosticada con una elevada morbimortalidad e importantes costes asociados. El retraso en su diagnóstico condiciona un mayor riesgo de fracaso multiorgánico y fallecimiento. Aunque su pronóstico es mejor que el de otros focos de sepsis, su mortalidad es del 20 - 40%. OBJETIVO:Describir los cuadros de uropatía obstructiva (UO) que se complican con sepsis grave (SG) e identificarlos biomarcadores diagnósticos de SG en la UOde forma precoz.MATERIAL Y MÉTODOS: Estudio observacional y prospectivo de 72 pacientes con UO alta ingresados de manera urgente en el Servicio de Urología del Hospital Clínico Universitario de Valladolid. Todos los pacientes del estudio fueron evaluados en tres momentos diferentes (0, 24 y 48 horas). Se ha creado un modelo predictor de SG y se ha realizado un análisis multivariante de riesgo. RESULTADOS:El 64,61% de los pacientes (n=42) desarrolló SG (NSG: n=13). Las únicas variables estadísticamente significativas en los tres momentos evaluados y que obtenían una buena área bajo la curva [AUROC (>0,70)] fueron la elevación de neutrófilos y procalcitonina y la disminución de bicarbonato. En el momento del ingreso la variable que mejor predecía SG fue la elevación de procalcitonina (AUROC: 0,919). Los factores de riesgo de SG (p<0,05) fueron los antecedentes de cáncer, la inmunosupresión y/o cirugías de vías urinarias, la UO completa y los valores elevados en sangre de lactato y potasio y la disminución del bicarbonato en la gasometría venosa. La combinación potasio-lactato al ingreso predecía SG con una función de probabilidad de 0,805. CONCLUSIONES:Existe un perfil analítico, mantenido en el tiempo, característico de SG que permite la identificación precoz de los pacientes con UO subsidiarios de complicarse con SG.
journal_name
Arch Esp Uroljournal_title
Archivos espanoles de urologiaauthors
Bedate-Núñez M,Moreno-Racionero F,de Andrés-Asenjo B,Díaz-Romero JM,Soto-Rodríguez JL,Torrecilla-García-Ripoll JR,Martín-Martín S,Rivero-Martínez MD,Calleja-Escudero J,De Castro-Olmedo C,Pascual-Samaniego M,Calvo-González R,Valsesubject
Has Abstractpub_date
2020-05-01 00:00:00pages
257-267issue
4eissn
0004-0614issn
1576-8260pii
2020-73-4-71c199a97852b944a3f05636da820db3c4d08c9ajournal_volume
73pub_type
杂志文章abstract::We report a case of spontaneous retroperitoneal hematoma from rupture of the right adrenal in a patient with asymptomatic left renal adenocarcinoma that had been incidentally detected during evaluation to determine the cause of the retroperitoneal hematoma. ...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1992-09-01 00:00:00
abstract:OBJECTIVE:Although urine cytology plays an important role in the diagnosis of lower urinary tract neoplasias, it should be complemented with other diagnostic tests for the diagnosis of upper urinary tract tumors. METHODS:We present one case of synchronic transitional cell carcinoma of the ureter and bladder papilary n...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:10.4321/s0004-06142007001000011
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVES:The present study describes two patients with retroperitoneal fibrosis following prolonged use of bromocriptine and pergolide for Parkinson's disease. Both patients also presented severe atheromatosis. METHODS:Similar cases reported in the literature are reviewed and the possible relationship between the us...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:
更新日期:1995-12-01 00:00:00
abstract:OBJECTIVES:To study the clinical, diagnostic, and therapeutic features of upper urinary tract tumors. METHODS:We perform a retrospective study of upper urinary tract tumors treated in our Department at Clinica La Luz Madrid between 1995 and 2008. RESULTS:We treated 42 tumors in 40 patients. Mean age was 64 years; the...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:10.4321/s0004-06142009000500004
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVES:To study patient satisfaction and complications appeared in a series of patients with erectile dysfunction undergoing implant of penile prosthesis. METHODS:Retrospective study of all patients undergoing surgical treatment for erectile dysfunction by penile prosthesis implant between 1993 and 2003. Collected...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:10.4321/s0004-06142005000900009
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVES:The aim of this review is to evaluate the place of transurethral resection of the prostate (TURP) in patients with elevated and/or rising prostate specific antigen (PSA). The role of TURP in these patients is assessed in symptomatic as well as in asymptomatic patients. METHODS:Current literature (1987-2009)...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVES:We report the case of a patient who had underwent surgery for a clear cell renal carcinoma 2 years before presenting with metastasic extension to bladder on follow-up. METHODS:Radiological finding of a bladder mass during follow-up after nephrectomy. RESULTS:TURBT was carried out with the pathologic report...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVES:44/2003 Law involved the creation of the National Council of Specialties in Health Sciences and the National Commissions of the Specialties in Health Sciences. METHODS:Analysis of the main laws implicated in Specialized Training and the role of the National Specialty Commission. DISCUSSION:44/2003 Law regu...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2018-01-01 00:00:00
abstract::Renal lithiasis is known for its high incidence and prevalence, but mainly for its morbidity and recurrence. Despite a good indication and appropriate surgical treatment, the essential problem, the origin of the formation of the stones, generally persists and it is not uncommon that patients suffer multiple treatments...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVES:We report one case of seminal vesicle cyst with ectopic drainage of the left ureter. We performed a bibliographic review of this pathology. METHODS:23-year-old patient who presented several episodes of acute epididymitis. Complementary study showed a retroprostatic cystic structure on transrectal ultrasound...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:
更新日期:2004-03-01 00:00:00
abstract::We report 16 cases of priapism in 13 of 404 patients who received intracavernous injection of vasoactive drugs to induce erection. In 10 patients the complication presented following injection of papaverine and phentolamine in combination. Despite reducing the dose of both agents, one patient had another episode of pr...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1992-10-01 00:00:00
abstract:OBJECTIVE:Cystic tumors of the adrenal gland are uncommon, but are being increasingly more frequently diagnosed during routine radiological evaluation as "incidentalomas". We discuss the differential diagnosis, therapeutic approach and the existing controversies concerning the management of this tumor type. METHODS:Tw...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVES:To determine and compare the antioxidant power, cellular damage by lipidic peroxidation, and membrane damage in normal patients and patients with prostate cancer, so determining the antitumoral capacity. METHODS:The study population included 19 patients with elevated total PSA, greater than 4 ng/ml, with a ...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:10.4321/s0004-06142008000500001
更新日期:2008-06-01 00:00:00
abstract::Clinical stage I testicular nonseminomatous germ cell tumours (NSGCT) are highly curable. Following orchidectomy a risk-adapted approach using active surveillance (AS), nerve sparing retroperitoneal lymph node dissection (nsRPLND) and primary chemotherapy is recommended by the current guidelines. CS I is defined neg...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:
更新日期:2012-03-01 00:00:00
abstract::Management of complex female urethral injuries is challenging. We present our experience of 9 cases over the last 3 years with a mean follow-up of 14 months. The spectrum of clinical problems and results of various forms of innovative management are highlighted. Injuries which could not be managed by primary repair or...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVES:To compare methodology and recommendations for the diagnosis of prostate cancer between the different clinical Guidelines currently existent. METHODS:We searched for clinical practice Guidelines published in the period 2007-2009 in the web pages of the urological scientific associations, National Guideli...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:
更新日期:2011-10-01 00:00:00
abstract::Oligometastatic prostate cancer (PCA) has increasingly been detected in the era of modern imaging studies such as choline-specific and prostate-specific membrane antigen (PSMA)-positron emission tomography and X-ray computed tomography (PET/CT). Recent evidence suggests that durable control is attainable with local tr...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVES:To move towards a more standardized approach in clinical practice to manage patients with castration-resistant prostate cancer (CRPC) in Spain. METHODS:A panel of 18 Spanish experts in Urology with expertise managing CRPC followed a modified Delphi process with two rounds and a final face-to-face consensus ...
journal_title:Archivos espanoles de urologia
pub_type: 共识发展会议,杂志文章
doi:
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:Indinavir is a protease inhibitor used in the treatment of HIV with a lithogenic capacity as a urological side effect. The pathogenesis, diagnosis and treatment of indinavir urolithiasis are briefly reviewed. METHODS:A 37-year-old male, seropositive for HIV on treatment with indinavir, lamiduvine and zidovud...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVES:Urodigestive fistulas are secondary complications of inflammatory, traumatic or neoplastic disease and can occasionally be difficult to diagnose, although the typical symptoms of pneumaturia and fecaluria should make the urologist and surgeon suspect the presence of a fistula, determine its etiology and loca...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract:OBJECTIVE:To report one case of transitional cell carcinoma with areas of small cell carcinoma presenting in its evolution an adrenal metastasis with the neuroendocrine component only. We perform a bibliography review for the cases of small cell carcinoma of the bladder, its epidemiology, prognosis and treatment. METH...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:10.4321/s0004-06142007000300016
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVES:Testicular (TT) and paratesticular (PT) tumors account for 1-2%of all infant solid tumors. Due to the increased frequency of benign tumors, conservative management is recommended. Our experience and the therapeutic approach adopted considering testis-sparing surgery, was reviewed. METHODS:A retrospective ob...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2016-12-01 00:00:00
abstract::Tuberculosis stricture of the ureter is a process that may lead to loss of renal function if undiagnosed and untreated at the right time. Currently, tuberculostatic agents combined with steroids, and the possibility of recurring to endourological treatment, achieve a high success rate. Our experience with 4 cases is d...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVE:To describe our experience with bladder endometriosis at the Department of Urology of Complejo Hospitalario Universitario de Santiago de Compostela. METHODS:We performed a retrospective analysis of the cases of bladder endometriosis diagnosed during the last 11 years in our hospital, from January 2000 to Dec...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVES:To investigate the postoperative surgical complications and patient satisfaction with the outside-in transobturator tape (TOT) procedure performed by an experienced surgeon compared to those performed by residents in training. METHODS:Patients who received TOT surgery performed by a resident under supervisi...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVES:To compare the success of the 'tubularized incised plate urethroplasty' (TIPU) and 'Onlay island flap urethroplasty' (OIFU) techniques for the repair of primary proximal hypospadias. MATERIAL AND METHODS:A retrospective evaluation was made of the medical records of 68 patients with primary, non-complicated ...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVES:Extracorporeal shock wave lithotripsy is a minimally invasive therapeutic option for the treatment of renal-ureteral lithiasis. The aim of this study was to analyze the results and complications of shock wave extracorporeal lithotripsy treatment with the Dornier Gemini® Generator EMSE 220f-XXP device in pati...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:2019-05-01 00:00:00
abstract::Papillary transitional cell carcinoma of the bladder (PTCCB) is characterized by a high recurrence rate with infiltration of bladder wall and surrounding tissues. The outcome is poor in 10-20% of the cases and these cannot be detected by conventional methods. Different methods have been utilized to identify this high ...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:To review the diagnostic and therapeutic aspects of carcinoma in situ of the testis, the preinvasive stage of testicular germ cell tumors. METHODS:The indications for performing testicular biopsy in patients with a higher incidence of testicular carcinoma in situ (patients with infertility, cryptorchidism an...
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章,评审
doi:
更新日期:2000-07-01 00:00:00
abstract::We report a case of squamous cell carcinoma of the ureter with periureteral infiltration. Three years following radical surgery, no evidence of tumor progression has been observed. Only 1% to 1.6% of urothelial tumors of the upper urinary tract are purely squamous cell tumors. This tumor type carries a poor prognosis....
journal_title:Archivos espanoles de urologia
pub_type: 杂志文章
doi:
更新日期:1992-06-01 00:00:00