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Hakan Poyrazoglu - One of the best experts on this subject based on the ideXlab platform.

Eduardo A Oliveira - One of the best experts on this subject based on the ideXlab platform.

  • Outcome of isolated antenatal hydronephrosis: a prospective cohort study
    Pediatric Nephrology, 2007
    Co-Authors: Graziela M. Coelho, Maria Candida F. Bouzada, Alamanda K. Pereira, Bruno F. Figueiredo, Maria Rafaela S. Leite, Danielly S. Oliveira, Eduardo A Oliveira
    Abstract:

    The purpose of this study was to report the outcome of infants with antenatal hydronephrosis. Between May 1999 and June 2006, all patients diagnosed with isolated fetal renal pelvic dilatation (RPD) were prospectively followed. The events of interest were: presence of Uropathy, need for surgical intervention, RPD resolution, urinary tract infection (UTI), and hypertension. RPD was classified as mild (5–9.9 mm), moderate (10–14.9 mm) or severe (≥15 mm). A total of 192 patients was included in the analysis; 114 were assigned to the group of non-significant findings (59.4%) and 78 to the group of significant Uropathy (40.6%). Of 89 patients with mild dilatation, 16 (18%) presented Uropathy. Median follow-up time was 24 months. Twenty-seven patients (15%) required surgical intervention. During follow-up, UTI occurred in 27 (14%) children. Of 89 patients with mild dilatation, seven (7.8%) presented UTI during follow-up. Renal function, blood pressure, and somatic growth were within normal range at last visit. The majority of patients with mild fetal RPD have no significant findings during infancy. Nevertheless, our prospective study has shown that 18% of these patients presented Uropathy and 7.8% had UTI during a medium-term follow-up time. Our findings suggested that, in contrast to patients with moderate/severe RPD, infants with mild RPD do not require invasive diagnostic procedures but need strict clinical surveillance for UTI and progression of RPD.

  • diagnostic accuracy of fetal renal pelvis anteroposterior diameter as a predictor of Uropathy a prospective study
    Ultrasound in Obstetrics & Gynecology, 2004
    Co-Authors: Maria Cândida Ferrarez Bouzada, Eduardo A Oliveira, Alamanda Kfoury Pereira, Henrique Vitor Leite, Andreia Moura Rodrigues, Livia A Fagundes, Ricardo Goncalves, R L Parreiras
    Abstract:

    Objective The purpose of this study was to assess the accuracy of prenatal ultrasound measurement of anteroposterior renal pelvis diameter (APD) to discriminate between significant Uropathy and idiopathic renal pelvis dilatation. Methods One-hundred-and-three neonates who were found to have fetal renal pelvis dilatation, defined as presence of an APD ≥ 5 mm, underwent systematic investigation for uropathies and were prospectively followed. An ultrasound scan was performed after the first week of postnatal life and all infants underwent a voiding cystourethrogram. Neonates with an APD larger than 10 mm underwent renal scintigraphy. Ultrasound scans, clinical examination and laboratory reviews were scheduled at 6-month intervals. Receiver–operating characteristics (ROC) curves were constructed to determine the best cut-offs for APD to identify renal units with significant Uropathy as well as those requiring surgical intervention. Significant Uropathy was defined as the presence of well-established urinary tract abnormalities or when there was abnormal renal scintigraphy. Results The estimated area under the curve for APD was 0.900 (95% CI, 0.841–0.942) indicating excellent power to discriminate between idiopathic pelvis dilatation and significant Uropathy. The sensitivity and specificity for the 7.5 mm cut-off point were 97.9% and 40.6%, respectively. To identify infants who required surgical intervention, the calculated area under the curve was 0.953 (95% CI, 0.908–0.980). Conclusion Our results suggest that measurement of APD is an excellent test to identify fetuses with significant Uropathy, as well as those requiring postnatal intervention. Copyright © 2004 ISUOG. Published by John Wiley & Sons, Ltd.

Richard G Robinson - One of the best experts on this subject based on the ideXlab platform.

  • obstructive Uropathy as the etiology of renal failure in ovarian hyperstimulation syndrome
    Fertility and Sterility, 2008
    Co-Authors: David Alastair Merrilees, Andrew Kennedysmith, Richard G Robinson
    Abstract:

    Objective To make people aware that there is potential for obstructive Uropathy to complicate ovarian hyperstimulation syndrome (OHSS) and cause renal impairment. Design Case report. Setting Hospital. Patient(s) A 28-year-old Caucasian female presenting with acute severe OHSS. Intervention(s) Bilateral JJ stenting. Main Outcome Measure(s) Resolution of renal impairment. Result(s) Successful treatment of renal failure. Conclusion(s) Patients with severe OHSS and renal impairment should be evaluated with renal ultrasound to rule out hydronephrosis and therefore an obstructive Uropathy. Patients potentially at risk for such a complication from OHSS may include those with prior abdominal or pelvic surgery.

Jinrui Yang - One of the best experts on this subject based on the ideXlab platform.

  • ketamine induced ulcerative cystitis is perhaps better labelled ketamine induced Uropathy
    Addiction, 2013
    Co-Authors: Yongbao Wei, Jinrui Yang
    Abstract:

    Morgan & Curran’s paper [1] on ketamine use concludedthat the major physical harm was ketamine-inducedurinary system damage, which they referred to asketamine-induced ulcerative cystitis. We would like todiscuss the symptoms of this condition, and whether itwould be more appropriate and concise to describe it asketamine-induced Uropathy.The key symptoms of ketamine-induced Uropathyare severe dysuria, painful haematuria, frequency andurgency of urination, urge incontinence and nocturia.Auxiliary examination often offered some importantfindings, including sterile pyuria, contracted bladderinvolving chronic inflammation with ulceration, ery-thematous swelling, necrotic mucosa, thin epitheliumwith neutrophilic and lymphoplasma cell infiltrationin bladder mucosa, collagen and adipose tissue andbladder wall fibrosis with or without vesico–uretericreflux and involvement of the upper urinary tract. Basedon the urinary symptoms, cystoscopy findings andpathology, earlier reports have described ketamine-induced Uropathy as an interstitial cystitis-like condi-tion [2,3]. However, the cause of interstitial cystitisis unknown, while ketamine-induced Uropathy ischaracterized as a series of common peculiarities withketamine abuse as the evident cause, and with symp-toms improving after cessation of ketamine use. Wesuspect that Morgan

Mark P Johnson - One of the best experts on this subject based on the ideXlab platform.

  • fetal therapy for obstructive Uropathy past present future
    Pediatric Nephrology, 2000
    Co-Authors: Andrew L Freedman, Mark P Johnson, Ricardo González
    Abstract:

    Antenatal treatment of obstructive Uropathy, although widely performed, remains controversial. An overview of prenatal therapy for obstructive Uropathy, the limitations of the early published experience, advances of recent years, and future directions for treatment are reviewed. The clinical approach and outcomes of the Fetal Treatment Program of Hutzel Hospital and Wayne State University are presented. Patient selection for antenatal treatment is based on the existence of a significant threat of neonatal death due to pulmonary hypoplasia, pending exclusion criteria such as anatomical structural anomalies and chromosomal defects. Ultrasonography, karyotyping, and sequential urinary electrolyte analysis are essential. Current treatment involves the placement under ultrasonic guidance of a Rodeck vesicoamniotic shunt. Recent technical advances include the use of amnioinfusion for fetal visualization, temporary fetal paralysis, routine antibiotics, and more-precise catheter placement. The establishment of standardized short- and long-term outcome measures and the documentation of fetal and maternal complications are in progress. Procedural refinement, development of fetoscopic techniques and equipment, identification of urinary markers to aid patient selection, and the collection of multicenter outcome data will assist the future management of prenatally detected obstructive Uropathy.

  • prenatal diagnosis of cloacal dysgenesis sequence differential diagnosis from other forms of fetal obstructive Uropathy
    Fetal Diagnosis and Therapy, 1998
    Co-Authors: Faisal Qureshi, Mark I. Evans, Suzanne M Jacques, Yuval Yaron, Ralph L Kramer, Mark P Johnson
    Abstract:

    Cloacal dysgenesis sequence (CDS) is a rare cause of fetal obstructive Uropathy (FOU). The prenatal differentiation of CDS from other FOU is important because CDS is not amenable to in utero surgical

  • sequential urinalysis improves evaluation of fetal renal function in obstructive Uropathy
    American Journal of Obstetrics and Gynecology, 1995
    Co-Authors: Mark P Johnson, Paul Corsi, William Bradfield, Roderick F. Hume, Craig Allen Smith, Alan W. Flake, Faisal Qureshi, Mark I. Evans
    Abstract:

    Abstract OBJECTIVES: The purpose of our study was to determine whether sequential vesicocenteses improve the evaluation of renal damage, compared with single urine sampling in obstructive Uropathy. STUDY DESIGN: A total of 29 fetuses with complete obstructive Uropathy underwent a minimum of three sequential complete vesicocenteses at 48- to 72-hour intervals. First and last urine values were analyzed for multiple parameters. The ability of first versus last urine values to detect the presence of renal damage was compared according to postnatal or fetal autopsy information. RESULTS: Fetuses with minimal renal damage had patterns of decreasing hypertonicity and last urine values below cutoff thresholds indicative of favorable prognosis. Fetuses with significant renal damage had higher initial values and patterns of increasing hypertonicity. For five of six parameters, last urine samples were more predictive of renal damage than first urine samples. CONCLUSION: Last urine values together with pattern-of-change trend analysis after serial vesicocenteses improve diagnostic precision in fetuses with complete obstructive Uropathy.