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Ultrasound spectrum of tubular ectasia of rete testis and epididymis: Emphasis on early detection 睾丸网和附睾管状扩张的超声频谱:强调早期发现
Pub Date : 2017-01-01 DOI: 10.4103/2394-2916.201280
A. Kulkarni, M. Tinmaswala, S. Shetkar
Background and Objectives: Tubular ectasia is a rare, pathologically benign condition which initially may present as tiny cyst. Knowledge of typical ultrasound features of this condition helps to differentiate it from other malignant lesions of testis. This study was conducted to find out ultrasound spectrum of tubular ectasia of rete testis and epididymis. Methods: Patients undergoing scrotal ultrasound and doppler for various indications including scrotal pain, infertility, postvasectomy and prior to recanalisation of vas were studied. The history, clinical examination, semen analysis and ultrasound features were analyzed. Our emphasis was on early detection of this rare but benign entity involving testis and epididymis. Results: Scrotal ultrasound with colour doppler in these patients revealed the abnormalities ranging from early changes like specked appearance and tiny cysts to more severe forms involving rete testis and epididymis. Associated abnormalities like epididymal cyst, hydrocele and spermatocele were also found in addition to tubular ectasia in some cases. Conclusion: Tubular ectasia is a pathologically benign condition which can be reliably diagnosed on ultrasound and colour doppler. Familiarity with the ultrasound and doppler features of tubular ectasia will definitely help in early diagnosis which in turn will help in reducing patients' anxiety and prevent unnecessary interventions.
背景和目的:小管扩张是一种罕见的病理良性疾病,最初可能表现为微小的囊肿。了解这种疾病的典型超声特征有助于将其与其他睾丸恶性病变区分开来。本研究旨在探讨睾丸网及附睾管状扩张的超声频谱。方法:对因阴囊疼痛、不孕症、输精管结扎后及输精管再通术前行阴囊超声及多普勒检查的患者进行研究。分析病史、临床检查、精液分析及超声特征。我们的重点是早期发现这种罕见但良性实体累及睾丸和附睾。结果:这些患者的阴囊超声彩色多普勒显示异常,从早期的斑点状外观和微小的囊肿到更严重的累及睾丸网和附睾的形式。附睾囊肿、精囊积液、精索膨出等相关异常也可在部分病例中发现。结论:肾小管扩张是一种病理良性疾病,超声和彩色多普勒诊断可靠。熟悉管状扩张的超声和多普勒特征将有助于早期诊断,从而有助于减少患者的焦虑,防止不必要的干预。
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引用次数: 0
Nondiabetic renal disease in type 2 diabetes mellitus 2型糖尿病患者的非糖尿病性肾病
Pub Date : 2017-01-01 DOI: 10.4103/JINA.JINA_33_16
Lakshminarayana R Gopaliah, Sheetal G Lakshminarayana, S. V. Nalumakkal
Background and Objectives: The prevalence of nondiabetic renal disease (NDRD) in those with type 2 diabetes mellitus (T2DM) is common worldwide; however, data from India are limited. Materials and Methods: This study included participants with T2DM who underwent renal biopsy with suspicion of NDRD from September 2009 to August 2016. Results: Seventy-one participants (males: 47 [66.2%] and females: 24 [33.8%]) of T2DM with mean age and standard deviation of 52.93 ± 12.56 years were included in the study. The indications for renal biopsy included acute on chronic renal failure in 35.2% (25), nephrotic syndrome in 31% (22), acute renal failure in 14.1% (10), nephritic syndrome in 14.1% (10), and others in 5.6% (4) of participants. The prevalence rates of NDRD, diabetic nephropathy (DN), and DN with NDRD were 50.71% (36), 28.16% (20), and 21.13% (15), respectively. Among the participants with NDRD, 69.44% (25) had primary glomerular diseases (PGDs), 16.67% (6) had tubulointerstitial diseases (TIDs), and 13.89% (5) had secondary glomerular diseases (SGDs). IgA nephropathy was the most common of PGDs affecting 28% (7), followed by postinfective glomerulonephritis (PIGN) in 20% (5), membranous nephropathy in 16% (4), focal segmental glomerulosclerosis in 12% (3), and miscellaneous lesions in 24% (10). Acute interstitial nephritis and primary amyloidosis were the most common of TIDs and SGDs, respectively. Among the patients with combination of DN with NDRD, 53.33% (8) were TIDs and 46.67% (7) had glomerular diseases. Acute tubular injury/necrosis and PIGN were the most common of TIDs and glomerular disease, respectively. The figures in brackets representing number of patients. Conclusions: The majority of the participants with T2DM had NDRD either alone or in combination with DN in the study, underlining the utility of renal biopsy for their diagnoses in those with appropriate indication. Wide spectrum of PGDs, TIDs, and SGDs was found in the study.
背景和目的:2型糖尿病(T2DM)患者中非糖尿病性肾病(NDRD)的患病率在世界范围内很普遍;然而,来自印度的数据有限。材料和方法:本研究纳入了2009年9月至2016年8月期间怀疑有NDRD的T2DM患者。结果:纳入T2DM患者71例(男性47例[66.2%],女性24例[33.8%]),平均年龄和标准差为52.93±12.56岁。肾活检的适应症包括急性或慢性肾功能衰竭(35.2%,25例)、肾病综合征(31%,22例)、急性肾功能衰竭(14.1%,10例)、肾病综合征(14.1%,10例)和其他5.6%(4例)。NDRD患病率为50.71%(36例),糖尿病肾病(DN)患病率为28.16%(20例),糖尿病肾病合并NDRD患病率为21.13%(15例)。在NDRD患者中,69.44%(25人)患有原发性肾小球疾病(PGDs), 16.67%(6人)患有小管间质疾病(TIDs), 13.89%(5人)患有继发性肾小球疾病(SGDs)。IgA肾病是最常见的PGDs,占28%(7),其次是感染后肾小球肾炎(PIGN)(20%)(5),膜性肾病(16%)(4),局灶节段性肾小球硬化(12%)(3)和其他病变(24%)(10)。急性间质性肾炎和原发性淀粉样变性分别是最常见的TIDs和SGDs。DN合并NDRD患者中,tid占53.33%(8例),肾小球疾病占46.67%(7例)。急性小管损伤/坏死和PIGN分别是最常见的TIDs和肾小球疾病。括号内的数字代表病人人数。结论:在研究中,大多数T2DM患者都有NDRD,无论是单独的还是合并DN的,这强调了肾活检在有适当适应症的患者诊断中的作用。在研究中发现了广谱的PGDs、TIDs和SGDs。
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引用次数: 3
Anaphylactic reaction during hemodialysis on polysulfone membrane in a patient receiving angiotensin II receptor antagonist 接受血管紧张素II受体拮抗剂的患者血液透析期间聚砜膜的过敏反应
Pub Date : 2017-01-01 DOI: 10.4103/2394-2916.201278
Ji-lian Fang, Lin Feng, Hao Wang
Allergic reactions happened during hemodialysis (HD) on polysulfone membrane in a 59-year-old female patient who was being treated with an angiotensin II receptor antagonist, olmesartan, for aggravated hypertension. Anaphylactic reactions including itching, hypoxemia, and facial swelling appeared 1 h after starting the 6th session of HD and lasted for 30 min. When we changed dialyzer and stopped olmesartan for 4 days, the reactions disappeared.
1例59岁女性患者因高血压加重接受血管紧张素II受体拮抗剂奥美沙坦治疗,在血液透析(HD)期间对聚砜膜发生过敏反应。第6次HD开始1 h后出现瘙痒、低氧血症、面部肿胀等过敏反应,持续30 min。更换透析器并停用奥美沙坦4 d后,反应消失。
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引用次数: 0
Association of lipid abnormalities and oxidative stress with diabetic nephropathy 脂质异常和氧化应激与糖尿病肾病的关系
Pub Date : 2017-01-01 DOI: 10.4103/JINA.JINA_1_17
Kamal Kachhawa, D. Agrawal, B. Rath, Sanjay Kumar
Chronic kidney disease (CKD) is characterized by progressive loss of renal function. Although the burden of CKD in India cannot be assessed accurately, its approximate prevalence is believed to be 800 per million populations (pmp), and the incidence of end-stage renal disease (ESRD) is 150–200 pmp. Diabetic nephropathy is a leading cause of ESRD worldwide. Another cause of ESRD is dyslipidemia, which is one of the most common quantitative lipid abnormalities in patients with CKD. In diabetes, the total cholesterol and triglyceride levels rise as the albumin excretion rate increases, leading to renal injury. Oxidative stress generated by hyperglycemia increases reactive oxygen species production, which causes cellular dysfunction and damage, and ultimately results in diabetic micro- and macro-vascular complications. Therefore, lipids may represent a useful clinical tool for not only identifying patients at a high risk of developing CVD but also assessing the development and progression of renal disease. In this review, we summarize the effects of lipid abnormalities and oxidative stress in patients with diabetes and nephropathy.
慢性肾脏疾病(CKD)以肾功能进行性丧失为特征。虽然无法准确评估印度CKD的负担,但据信其患病率约为百万分之800 (pmp),终末期肾脏疾病(ESRD)的发病率为150-200 pmp。糖尿病肾病是世界范围内ESRD的主要原因。ESRD的另一个原因是血脂异常,这是CKD患者中最常见的定量脂质异常之一。在糖尿病中,总胆固醇和甘油三酯水平随着白蛋白排泄速率的增加而升高,导致肾损伤。高血糖引起的氧化应激增加活性氧的产生,导致细胞功能障碍和损伤,最终导致糖尿病的微血管和大血管并发症。因此,血脂可能是一种有用的临床工具,不仅可以识别发生心血管疾病的高风险患者,还可以评估肾脏疾病的发生和进展。在这篇综述中,我们总结了脂质异常和氧化应激对糖尿病和肾病患者的影响。
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引用次数: 8
Pruritus in Patients on Maintenance Hemodialysis in Benin City, Edo State, Nigeria 尼日利亚埃多州贝宁市维持性血液透析患者的瘙痒
Pub Date : 2016-10-01 DOI: 10.4103/2394-2916.193498
B. A. Odonmeta, E. Unuigbe, C. Otene
Background and Objectives: Pruritus is an unpleasant cutaneous sensation prompting a desire to scratch. It can be very disturbing and is common in patients on maintenance hemodialysis (HD). Its pathogenesis is not very clear but has been attributed to diverse factors including uremia and iron deficiency anemia. The aims and objectives of this study are to determine the frequency of pruritus in HD patients in Benin City, to evaluate the relationship of pruritus in these patients with age, sex, body mass index (BMI), skin changes, peripheral neuropathy, duration of dialysis, and laboratory findings including packed cell volume (PCV), creatinine, urea, calcium, and phosphate, and to get the percentage of patients with increasing pruritus during and after dialysis. Methods: Consenting patients on maintenance HD were consecutively recruited into the study. Some relevant clinical and laboratory parameters (age, sex, BMI, skin changes, neuropathy, presence of pruritus, severity and intensity of pruritus, serum urea, creatinine, calcium, and phosphate) were evaluated using the SPSS version 17 package. Results: A total of fifty patients participated in the study. Twenty-four (48%) of these patients had pruritus. Of the 24 patients with pruritus, 14 (58.3%) were males while 10 (41.7%) were females. The mean age, BMI, and duration of HD of the patients with pruritus were 51.0 ± 13.61 years, 23.3 ± 1.77 kg/m 2 , and 7.4 ± 9.31 months, respectively. In addition, the mean serum urea, calcium, and PCV of the patients were 252.1 ± 65.10 mg/dL, 7.0 ± 1.04 mg/dL, and 25.5% ±4.38%, respectively. Eight (33.3%) had an increasing intensity of pruritus during and after HD. Twelve (50%) of the patients had mild pruritus while another 12 (50%) had moderate pruritus. There was no case of severe pruritus. Anemia, serum urea, duration of HD and increasing the age of patients were found to be significantly related to pruritus. Conclusion: Pruritus is relatively prevalent among our patients on maintenance HD and factors significantly associated with this condition include anemia, serum urea, and increasing the age of the patient as well as duration on HD.
背景和目的:瘙痒症是一种令人不愉快的皮肤感觉,引起搔抓的欲望。它可能非常令人不安,在维持性血液透析(HD)患者中很常见。其发病机制尚不清楚,但已归因于多种因素,包括尿毒症和缺铁性贫血。本研究的目的和目的是确定贝宁市HD患者瘙痒的频率,评估这些患者瘙痒与年龄、性别、体重指数(BMI)、皮肤变化、周围神经病变、透析持续时间和实验室检查结果(包括堆积细胞体积(PCV)、肌酐、尿素、钙和磷酸盐)的关系,并获得患者在透析期间和透析后瘙痒加重的百分比。方法:连续招募同意维持HD的患者加入研究。一些相关的临床和实验室参数(年龄、性别、BMI、皮肤变化、神经病变、瘙痒症的存在、瘙痒症的严重程度和强度、血清尿素、肌酐、钙和磷酸盐)使用SPSS version 17软件包进行评估。结果:共50例患者参与研究。24例(48%)患者有瘙痒。24例瘙痒患者中,男性14例(58.3%),女性10例(41.7%)。瘙痒患者的平均年龄为51.0±13.61年,BMI为23.3±1.77 kg/ m2, HD病程为7.4±9.31个月。血清尿素、钙、PCV平均值分别为252.1±65.10 mg/dL、7.0±1.04 mg/dL、25.5%±4.38%。8例(33.3%)患者在HD期间和之后瘙痒强度增加。轻度瘙痒12例(50%),中度瘙痒12例(50%)。无严重瘙痒病例。贫血、血清尿素、HD病程、患者年龄增加与瘙痒有显著关系。结论:瘙痒在我们的维持性HD患者中相对普遍,与此相关的因素包括贫血、血清尿素、患者年龄的增加以及HD持续时间的延长。
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引用次数: 3
The Role of Varicocelectomy on Patients with Premature Ejaculation and Varicoceles 精索静脉曲张切除术在早泄和精索静脉曲张患者中的作用
Pub Date : 2016-10-01 DOI: 10.4103/2394-2916.193515
M. El-Hamd, Hosam Abdel Hameed
Objectives: This study aimed to assess the role of varicocelectomy in the improvement of premature ejaculation (PE) in patients with clinical varicoceles and PE. Materials and Methods: In a prospective clinical study, it conducted on 85 male patients with clinical varicoceles and PE. Those patients were selected from whom attending the Outpatient Clinics of Andrology and General Surgery at Sohag University Hospital, Upper Egypt, between February 2015 and May 2016. All patients were subjected to preliminary assessment included a detailed medical and sexual history and general and genital examination. Patients were treated with open bilateral subinguinal varicocelectomy under spinal anesthesia. All patients were evaluated before and 6 months after the varicocelectomy by PE diagnostic tool (PEDT). The intravaginal ejaculatory latency times (IELTs) per minute and overall sexual satisfaction scores were evaluated before and 6 months after varicocelectomy. All patients were asked to indicate their sexual satisfaction on a scale of 0-5, with 0 being extremely dissatisfied and 5 being extremely satisfied. Results: The mean scores of the five questions of the PEDT measuring ejaculation control, frequency of inability of ejaculation control, ejaculation with minimal stimulation, feel of distress, and interpersonal difficulty owing to PE had statistically significant improvements at 6 months after varicocelectomy. The mean IELTs per minute and overall sexual satisfaction scores were significantly improved at 6 months after varicocelectomy. Conclusions: The study concluded that varicocelectomy improve PE in patients with bilateral clinical varicoceles and PE. Further prospective, controlled studies are needed to provide further characterization of this potential relationship.
目的:本研究旨在评估精索静脉曲张切除术在改善临床精索静脉曲张和PE患者早泄(PE)中的作用。材料与方法:对85例临床精索静脉曲张合并PE的男性患者进行前瞻性临床研究。这些患者是从2015年2月至2016年5月在上埃及Sohag大学医院男科和普通外科门诊就诊的患者中挑选出来的。所有患者都接受了初步评估,包括详细的病史和性史以及一般和生殖器检查。在脊髓麻醉下行双侧腹股沟下精索静脉曲张切除术。所有患者在精索静脉曲张切除术前和术后6个月通过PE诊断工具(PEDT)进行评估。在精索静脉曲张切除术前和术后6个月评估每分钟阴道内射精潜伏期(IELTs)和总体性满意度评分。所有患者都被要求在0-5的范围内表示他们的性满意度,0表示非常不满意,5表示非常满意。结果:精索静脉曲张切除术后6个月,PEDT测量射精控制、射精无法控制频率、射精轻微刺激、痛苦感和PE导致的人际关系困难5个问题的平均得分均有统计学意义的改善。在精索静脉曲张切除术后6个月,每分钟平均雅思分数和总体性满意度得分显著提高。结论:本研究认为精索静脉曲张切除术可改善双侧临床精索静脉曲张合并PE患者的PE。需要进一步的前瞻性对照研究来进一步描述这种潜在关系。
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引用次数: 1
Purple Urine Bag Syndrome: Are We Aware? 紫色尿袋综合征:我们知道吗?
Pub Date : 2016-10-01 DOI: 10.4103/2394-2916.193518
S. Yadav, G. Rawal, Amrita Singh
Purple urine bag syndrome is a rare, striking medical phenomenon observed in patients having indwelling urinary catheters having urinary tract infection. It is commonly observed in elderly patients having constipation and long-standing indwelling urinary catheters and indicates bacterial urinary tract infection. The purple discoloration of the urinary bag is reported to be due to the presence of indigo and indirubin pigment produced by tryptophan metabolism by Gram-negative Bacteria. The authors present a case of 67-year-old female with purple discoloration of her urine bag due to urinary tract infection caused by Klebsiella pneumoniae.
紫尿袋综合征是尿路感染留置导尿管患者出现的一种罕见而显著的医学现象。常见于便秘和长期留置导尿管的老年患者,提示细菌性尿路感染。据报道,尿袋的紫色变色是由于革兰氏阴性菌的色氨酸代谢产生的靛蓝和靛玉红色素的存在。作者报告一例67岁女性,因肺炎克雷伯菌引起的尿路感染,尿袋呈紫色变色。
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引用次数: 3
Renal Lymphangioma 肾淋巴管瘤
Pub Date : 2016-10-01 DOI: 10.4103/2394-2916.193517
H. Lal, V. Agarwal, S. Naik
Renal lymphangiomas are rare benign mass-like renal conditions that refer to the presence of multiple cysts in both the renal sinus and the renal parenchyma. It has been found in both adults and children. The etiology is unknown, but it has been thought to be the result of lymphatic obstruction. Renin-dependent hypertension may be the presenting clinical complaint. The purpose of this study is to describe the radiological appearances of a rare case of renal lymphangioma that we encountered in our hospital.
肾淋巴管瘤是一种罕见的良性肿块样肾脏疾病,指的是在肾窦和肾实质同时存在多个囊肿。在成人和儿童中都有发现。病因不明,但被认为是淋巴阻塞的结果。肾素依赖性高血压可能是临床主诉。本研究的目的是描述我们在医院遇到的一个罕见的肾淋巴管瘤病例的影像学表现。
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引用次数: 0
Reflections on the Medical History of the Kidney: From Alcmaeon of Croton to Richard Bright - Standing on the Shoulders of Giants 肾的医学史反思:从克罗顿的阿尔克迈翁到理查德·布莱特——站在巨人的肩膀上
Pub Date : 2016-10-01 DOI: 10.4103/2394-2916.193496
D. Greydanus, M. Kadochi
Although renal disease has been present for over 200 millennia of Homo sapiens′ existence, knowledge of the causes and management of these disorders has only emerged during the last 4000 years. Brilliant insights into human disease probably emerged from time to time over the long period of human existence, but observations could only be advanced after writing began in 3200 BC. Humans could then make observations, record these thoughts, and have others in their present and future critique them leading to improvement in this information. This discussion selectively considers some of the medical giants who led the way to clinical nephrology of the 21st century. It reflects on who taught us basic principles of renal disease that led to our current knowledge. Attention is given to the ancient Egyptians, Ancient Greeks, Galen of Pergamon, the Byzantine Greeks of the 5th-9th centuries, the Arab/Persian Physicians of the 9th-12th centuries, Moses Maimonides of the 12th century, selective Renaissance Physicians, and the father of modern nephrology - Richard Bright MD. This reflection celebrates au courant renal sagacity by celebrating the past clinicians who led the way from their eras to ours.
尽管肾脏疾病在智人存在的20万年中就已经存在,但关于这些疾病的原因和治疗的知识只是在最近4000年才出现。在人类长期存在的过程中,对人类疾病的杰出见解可能不时出现,但只有在公元前3200年文字开始出现之后,观察才得以推进。然后,人类可以进行观察,记录这些想法,并让其他人在现在和将来对这些想法进行批评,从而改进这些信息。本讨论选择性地考虑了一些引领21世纪临床肾脏病学的医学巨头。它反映了谁教给我们肾脏疾病的基本原理,导致我们目前的知识。关注古埃及人,古希腊人,佩加蒙的盖伦,5 -9世纪的拜占庭希腊人,9 -12世纪的阿拉伯/波斯医生,12世纪的摩西·迈蒙尼德,选择性文艺复兴时期的医生,以及现代肾脏病学之父——理查德·布莱特医学博士。这一反思通过庆祝从他们的时代到我们的时代引领道路的过去的临床医生,来庆祝勇敢的肾脏智慧。
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引用次数: 4
Various Presentations of Postpartum Acute Kidney Injury 产后急性肾损伤的各种表现
Pub Date : 2016-10-01 DOI: 10.4103/2394-2916.193516
V. K. Binwal, Dilip Ahir, Thabish Syed, M. Rana, Zara Wani
We report a series of cases with multiple presentations of postpartum acute kidney injury presented to the NIMS Kidney Institute, Jaipur, India.
我们报告了一系列的病例与产后急性肾损伤提出了NIMS肾脏研究所,斋浦尔,印度。
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引用次数: 0
期刊
Journal of Integrative Nephrology and Andrology
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