Endoscopic treatment of vesicoureteral reflux with polyacrylate polyalcohol copolymer and dextranomer/hyaluronic acid in adults

Purpose Aim of this study is to examine the effectiveness of dextranomer/hyaluronic acid copolymer and polyacrylate polyalcohol copolymer in endoscopic treatment of vesicoureteral reflux disease in adult patients with and without chronic renal failure. Materials and Methods Thirty two patients (12 female, 20 male) with a total of 50 renal units were treated for vesicoureteral reflux. There were 26 (81%) chronic renal failure patients. The success of treatment was evaluated by voiding cystouretrography at 3rd and 12th months after subureteric injection. The persistence of reflux was considered as failure. Patients were divided into two groups according to injected material. Age, sex, grade of reflux and treatment results were recorded and evaluated. Results Reflux was scored as grade 1 in seven (14%), grade 2 in 16 (32%), grade 3 in 21 (42%) and grade 4 in six (12%) renal units. There was not patient with grade 5 reflux. Fourteen renal units (28%) were treated with dextranomer/hyaluronic acid copolymer (group 1) and 36 renal units (72%) were treated with polyacrylate polyalcohol copolymer (group 2). The overall treatment success was achieved at 40 renal units (80%). The treatment was successful at 11 renal units (79%) in group 1 and 29 renal units (81%) in group 2 (p = 0.71). There was not statistically significant difference between two groups with patients with chronic renal failure in terms of treatment success (p = 1.00). Conclusions The effectiveness of two bulking agents was similar in treatment of vesicoureteral reflux disease in adult patients and patients with chronic renal failure

Predicción de la proporción de aspartato aminotransferasa a alanina aminotransferasa (De Ritis) para detectar necrosis intestinal en pacientes con hernia inguinal incarcerada

Antecedentes: El diagnóstico temprano del segmento intestinal necrótico resultante de una hernia inguinal incarcerada es crucial para reducir la morbilidad y la mortalidad. Objetivo: Investigar la eficacia del índice de De Ritis (IDR), también conocido como cociente de aspartato aminotransferasa a alanina aminotransferasa, como biomarcador de necrosis intestinal. Método: Estudio retrospectivo que incluyó a 132 pacientes que fueron intervenidos de urgencia por hernia inguinal incarcerada. Los pacientes se dividieron en dos grupos: los que se sometieron a resección intestinal por necrosis (grupo 1) y los que no (grupo 2). Se registraron los datos demográficos y clínicos de los pacientes. Usando los resultados de las pruebas de laboratorio, se calcularon el IDR, el índice neutrófilos-linfocitos (INL), el índice plaquetas-linfocitos (IPL), el índice linfocitos-monocitos (ILM) y el índice linfocitos-proteína C reactiva (ILPCR). Resultados: Las tasas de morbilidad, mortalidad y duración de la estancia para el grupo 1 fueron estadísticamente significativas (p < 0.0001). Los valores de IDR, INL, IPL, ILM, ILPCR del mismo grupo también fueron significativamente diferentes (p < 0.05). Conclusiones: El IDR puede utilizarse como biomarcador para el diagnóstico precoz de necrosis intestinal en pacientes con hernia inguinal incarcerada