جستجوی مقالات مرتبط با کلیدواژه « هماچوری » در نشریات گروه « پزشکی »

Abdominal trauma is one of the most common causes of death in trauma patients, occurring in 20% of cases. Kidney damage is the most common complication of non-penetrating abdominal trauma. In patients with abdominal trauma, it is important to diagnose and treat possible abdominal injuries. The presence of hematuria and clinical examinations often have little sensitivity and specificity to diagnose the intra-abdominal injury. Although Computed Tomography (CT) scan is the standard diagnostic method for abdominal trauma, it has its own drawbacks, including radiation. On the contrary, ultrasound is a cheaper, more repetitive, and non-invasive procedure. The present study aimed to determine the diagnostic value of Focused Assessment with Sonography for Trauma (FAST) scan and ultrasound by a radiologist in comparison with abdomen and pelvis CT scan with intravenous (IV) contrast in determining the severity of kidney damage in patients with microscopic hematuria due to non-penetrating abdominal and pelvic trauma.

This forward-looking study was conducted on patients with blunt abdominal trauma with hematuria in Hamadan Besat Educational and Medical Center in 2018 and 2019. The sampling was performed by census method based on inclusion and exclusion criteria. Patient demographic information, as well as accident information that led to abdominal trauma, were recorded in a checklist. All participants were trained by a third-year emergency medicine assistant and then by a third- or fourth-year radiology assistant via FAST ultrasound to diagnose free abdominal fluid. In the next step, all participants were examined after IV contrast injection using a CT scan device. Finally, the data were analyzed in SPSS software (version 22) using appropriate statistical methods.

In this study, 60 eligible patients, including 47 males (78.4%) and 13 females (21.6%), with a mean age of 36.75±17.81 years, were examined. The percentage of agreement between the FAST ultrasound findings performed in the emergency and radiology departments was 93.3%. The agreement between the two methods was significant, with a coefficient of 0.837 (P<0.001). Sensitivity (75 and 80), specificity (100 and 92.5), positive (100 and 84.2) and negative (88.8 and 90.2) predictive values, as well as the accuracy (91.6 and 88.3) of FAST ultrasound, in both emergency and radiology groups were acceptable in comparison with CT scan.

As evidenced by the obtained results, it can be concluded that ultrasound is a reliable tool for examining patients with abdominal trauma with suspected kidney damage.

Obesity effects on kidney function. Urinary disorders after exercise are also common, and probably due to transient hemodynamic problems in the glomerular and tubular renal function. The purpose of this research is to investigate the relationship of BMI with proteinuria and hematuria after one session of intense continuous and interval exercise in girls.

In this quasi-experimental research, 45 hostelry high school girl students with a mean age of 15.18 ± 0.39 years were randomly selected and in three groups of 15, they ran 1600 meters in a continuous and interval manner. Urine test collected before, one and 24 hours after activity. The results were analyzed by SPSS version 16 software and one way ANOVA and Pearson correlation coefficient.

Increased proteinuria was significant one hour (P = 0.002) and 24 hours after activity (P = 0.001) in the continuous group. In the continuous group, the relationship between fat percentage (P=0.017) and body mass index (P=0.001) with protein excretion 24 hours after activity was positive and significant. One hour after activity, protein excretion with fat percentage and Body mass index (BMI) had no significant relationship. Hematuria was also not significant after activity. 

Body mass index (BMI) and fat percentage were effective on protein excretion after one session of intense physical activity and had no significant effect on hematuria. Therefore, overweight people were advised to participate in interval exercise to lose weight.

Pelvic fracture is the second most common cause of death in patients with multiple trauma, after head trauma. The present study was performed with the aim of determining the frequency of genitourinary tract injuries in patients with pelvic fractures referring to Poursina Hospital, Rasht, Iran, so that the initial steps required for treating patients (with pelvic fractures) in the emergency department can be specified.

In this retrospective study, the records of 170 patients with pelvic fractures, who referred to Poursina Hospital in Rasht from the beginning of January 2018 until the beginning of January 2019 were reviewed. Using the prepared checklist and based on the patient's clinical examination by the resident, information including age, sex, level of education, presence or absence of hematuria, type of trauma, and type of pelvic fracture were collected. Data were analyzed using STATA - Se v 13.1 software.

Out of the 170 patients referring to the hospital due to pelvic fracture, 70% were male. The patients’ mean age was 45.02 ± 20.10 years and their mean length of hospital stay was 8.11 ± 7.13 days. Motor vehicle accidents were the most important cause of pelvic fractures and urethral injury. Fifty-five patients (33.4%) with pelvic fractures had a genitourinary tract injury. Hematuria was present in 48 of them, and blood at the tip of the meatus and perineal hematoma were symptoms that were significantly associated with genitourinary tract injury following pelvic fracture.

Considering the relatively high prevalence of genitourinary tract injury in pelvic trauma, it is best to perform a complete examination in all patients who present with high-energy trauma, especially in people with pelvic fractures; and if any of the above-mentioned symptoms are observed, genitourinary tract injuries should be suspected and the location of the injury should be further investigated and treated.

Abnormal placental implantation with bladder invasion is a rare obstetric complication, which can be accompanied with severe maternal and fetal morbidity. Gross hematuria is a rare manifestation of these syndromes, placenta percreta. Awareness of rare and unusual manifestations of placenta accrete syndromes is crucial for effective and timely management of this condition. In this report, a case of placenta percreta with manifestation of gross hematuria is introduced.

The patient was a 32-year-old pregnant woman at 17 weeks of gestation and a history of two previous cesarean sections who was evaluated with MRI following gross hematuria and suspicion of abnormal placental adhesion. Hysterectomy was performed with the diagnosis of placenta percreta and due to severity of placental invasion.

In the evaluation of a pregnant woman with gross hematuria, even as very early, especially with history of previous cesarean sections, awareness of probable diagnosis of placenta percreta with urinary tract involvement is needed for timely diagnosis and proper management.

Various maternal obstetrical complications may occur following each type of delivery. One of these rare but important and problematic complications is orogenital fistula. The incidence of different types of orogenital fistula following delivery is more common in cesarean section and only few cases have been reported following normal vaginal delivery. In this article, a case of vesicouterine fistula after normal vagina delivery is reported.

The patient was a 31-year-old woman with third pregnancy and history of two previous normal vaginal deliveries without complication who had referred to the emergency ward of Mashhad Imam Reza hospital because of labor pain at gestational age of 38 weeks. Delivery progressed from the initial dilation 5 cm and effacement 60% within 2 hours of admission by spontaneous contractions. After delivery of head and shoulders, dystocia occurred during expulsion of abdomen due to large palpable abdominal mass in the fetus; and delivery was done with difficultly. Approximately 10 days after delivery, the patient referred with complaint of malodor watery discharge from vagina. After performing the methylene blue test, diagnosis of the vesicouterine fistula was confirmed by cystography. Urinary foley catheterization was inserted for the patient for 3 months and after re-performing cystography, vesicouterine fistula was completely repaired without need to surgery.

Vesicouterine fistula is of the rarest types of urogenital fistula which is often occurred following cesarean section and sometimes after normal vaginal delivery. One of the risk factors of vesicouterine fistula following vaginal delivery is “labor dystocia”. Many cases of vesicouterine fistula are treated by conservative management and surgery is not needed.

Concerning the importance and the high frequency of renal involvement in patients with systemic lupus erythematosus (SLE), and the ability to measure the value of hematuria on predicting the incidence of lupus nephritis, this study aimed to determine the frequency of lupus nephritis in SLE patients with hematuria. This cross-sectional study investigated 500 patients with SLE in Isfahan City, Iran, between the years 2001 and 2015. Medical history, as well as demographic and clinical data of patients including the levels of C3, C4, and anti-dsDNA antibody, presence of lupus nephritis, proteinuria, cellular cast, pyuria, urinary tract infection, urinary tract stones, congenital renal defects, and history of any kidney disease were obtained from the patients' files at the end of the study period, and analyzed using SPSS software. The frequency of hematuria in patients with lupus nephritis was 36.1%, and there was no significant relationship between the presence of hematuria and the existence of lupus nephritis in patients with SLE [odds ratio (OR) = 0.727, confidence interval of 95% = 0.376-1.648, P = 0.520]. The individuals with lupus nephritis had a lower age distribution compared to the cases without it (P = 0.005). Most of the cases in the lupus nephritis group had low C3 and C4, but most patients in non-lupus nephritis group had normal levels of C3 and C4 (P < 0.05).  The relative frequency of lupus nephritis in SLE patients with hematuria was approximately 36%. Therefore, the presence of hematuria in patients with SLE may account for incidence of lupus nephritis one-third of the cases.

We report a case of endometriosis of the bladder diverticulum that was created after cesarean section.

Case Report:

A 45-year-old woman was diagnosed with abdominal pain during menstruation and hematuria after cesarean section.
Pelvic tests and pelvic ultrasonography are normal in non-menstrual days. However, the last pelvic ultrasound showed a solid 9 × 6 mm anterior mass that adheres to the posterior wall of the bladder during menstruation.
During a menstrual period, a cystoscope showed a 1-centimeter bulging nodular mass in a posterior wall diverticulum. Histologic diagnosis of endometriosis was in the bladder diverticulum wall.

The post-operative period was not a problem and the clinical symptoms were completely resolved after removing the endometriosis of the bladder diverticulum

Hematuria is blood in the urine and one of the most common disorders of the urinary tract, which is characterized by its simplicity. Hematuria in adults should be considered as a sign of urologic malignancy until proven otherwise.In this study, 28 articles in English and 7 articles in Persian were reviewed. Persian articles with Key words including hematuria, infection and trauma were surveyed in Iranmedex and Magiran(1991- 2012) and English articles with key words including kidney injuries, hematuria and bladder cancer were surveyed in PubMed, Scopus and Sciencedirect(1990-2012).Also the books: Nelson, Campbell, Surgery(Oxford), Urologic Trauma were used.Hematuria is indicative bleeding in urinary tract. Bleeding may be occurred suddenly or frequently. Incidence of urological cancer in patients with Frank hematuria reported between 18.9% - 24.2% that usually are seen in bladder and kidney tumors. In 85-90% patients with bladder cancer, first sign is hematuria with no sign or pain. Urinary tract infection (UTI) is the most common bacterial infection. Urinary tract infections are common in older men and women who are associated in some cases with hematuria. According to statistics, injuries in genitourinary system are seen almost in 10% of patients who referred to emergency centers because of trauma.The causes of hematuria from benign causes such as infections to serious causes such as kidney disease or cancer are different.

Introduction & Abdominal trauma is one of the major causes of mortality in human populations. The aim of this prospective study was to evaluate the predictive value of sonography versus CT scan in the detection of renal injuries in patients، with high energy blunt abdominal trauma and microscopic hematuria، who referred to emergency department of Shohadaye Tajrish hospital. This study included all 400 patients (279 males and 121 females)، with 15-65 old ages، who referred to the emergency department of Shohadaye Tajrish Hospital for high energy blunt abdominal trauma، between 2010 and 2012. Patients with gross hematuria، hemodynamic instability، past medical history of renal failure، contrast agent allergy، renal failure، pregnancy and other contraindication of contrast injection were excluded. Personal characteristics of the patients such as age، sex، cause and mechanism of trauma، severity of trauma and physical examinations were recorded. Then all patients were evaluated underwent، separately abdominal and pelvic spiral CT scanning with intravenous contrast and abdominal sonography by an experienced radiologist. The positive and negative results of sonography were compared to the findings of abdominal and pelvic CT scan، as a gold standard procedure. Of the 400 patients (with the mean age 25. 9±14. 1 years) who were admitted to the emergency department due to high energy trauma، renal damage was detected in 68 cases by CT scan (17%). In 8 patients (11. 8%)، bilateral renal injury and in 60 patients (88. 2%) unilateral renal injury was identified. According to the grading classification proposed by the American Association for the Surgery of Trauma (AAST)، the severity of injury (in 76 kidney) were diagnosed، by CT scan as grade І، ІІ، ІІІ، in 49 (64. 5%)، 20 (26. 3%) and 7 (9. 2%) respectively. According to ultrasonography results، renal damage was found in 61 cases (15. 2%). Signs of sub-capsular hematoma، laceration، perinephric hematoma and parenchymal hematoma were detected by ultrasound in 37)55. 2% (، 25) 37. 4% (، 3(4. 4%) and 2 (3%) respectively. Overall sensitivity and specificity of sonography versus CT scan in the detection of renal injury were calculated to be 52. 76 (68. 4%) and 309. 324 (95. 37%)، respectively، with a 52. 67 (77. 6%) positive predictive value and a 309. 333 (92. 7%) negative predictive value. Generally، according to the results of this study، the role of sonography as one of the primary diagnostic technique for the detection of renal injury، in the patients who are affected by high energy trauma and microscopic hematuria and with stable vital signs، is confirmed.

Hematuria is one of the common causes of pediatric nephrology and urology diseases and is reported in 0.5-2% of children. This study was performed to determine the causes of hematuria in infants and children. This descriptive study was done on 200 infants, children and adolescents in one month to 18 year old ages with chief complaint of hematuria in Hamadan, Iran. Patients were evaluated by urinalysis, urine culture, measurement of calcium, creatinine and uric acid in random urine sample and abdominal sonography. Microscopic and gross hematuria was detected in 79.5% and 20.5% of patients, respectively. Hematuria was idiopathic in 74 (37%) of patients. Urinary tract stones (18%), urinary tract infections (15.5%), hypercalciuria (13%), hyperuricosuria (10%), urinary tract anomalies (5.5%) and glomerulonephritis (1%) were diagnosed as causes of hematuria. In 56% of patients, hematuria was caused by three common etiologies of stone, urinary tract infections and crystalluria.

Bladder cancer is the ninth most common cancer worldwide and the fourth most common cancer in males in Iran and the second most common cancer of the genitourinary system after prostate cancer. The aim of this study was to assess demographic characteristics, clinical presentation, treatments and clinical course in patients with bladder cancer in Babol city in order to provide a way for future studies and enhancing treatment quality. This cross- sectional study was performed on 175 cases of bladder cancer within the period between 2001 and 2011 and treated at hospitals affiliated to Babol Medical University. All patients’ demographic data, tumor location, clinical presentation, smoking history, primary treatment strategy and histopathologic data were collected and finally 175 patients that their information was complete enrolled in the study. Then, the survival status of each patient was followed by their medical records and phone contacting. Out of 153 men and 22 women with the mean age of 62.76±16.25 years, 19 (10.9%) patients were under 40 years of age. About 55.3% of men and 7.7% of women were smoker. Hematuria was the most common symptom at first presentation (63.4%). With respect to pathological report, 96% of the patients had transitional cell carcinoma that of all 168 TCC patients, 36 had muscle invasion. There was no significant difference between the patients over 40 years old and invasion to the muscles but there was a significant difference between hematuria and invasion to the muscles in patients with bladder cancer (p=0.017). The results of this study show that hematuria is the most common clinical symptom in patients with bladder cancer. Since there is no specific tumor marker for screening, it seems that hematuria in the men over 40 years should be followed by more serious diagnostic actions.

In fertility clinics and diagnostic laboratories, a great number of male subjects undergo urinary sampling for urine analysis (U/A) after semen sampling.Despite taking thorough medical histories in these centers, questions on intercourses or ejaculations prior to the sampling are occasionally neglected. Due to the noticeable increases in urinary protein upon S/A and the possibilities for U/A parameters distortion, this study was undertaken to compare urinary indices before and after semen sampling. Urine samples were obtained from 220 men attending Avicenna Infertility Clinic in Tehran, Iran, before and after semen sampling and two urinalyses were done for each patient. Eventually, the findings were statistically compared and analyzed. Biochemical and physical characteristics of urine samples, including color, blood, ascorbic acid, urobilinogen, bilirubin, nitrite, ketone, glucose and specific gravity did not undergo significant changes after semen sampling, while turbidity and protein were increased (p<0.001) and urine pH was decreased but with no statistical significance (p=0.46). It is recommended to ask about ejaculation or prior intercourses before urine sampling for urinalysis, especially at times when urinary protein is of importance. This will avoid unnecessary, additional diagnostic testing, which in turn will prevent psychological distress and save money and time.

Proteinuria and hematuria are two important modifiable risk factors for the progression of chronic renal failure. The purpose of the present study was to identify the prevalence of these abnormalities among school aged children undergoing urinary screening. A cross-sectional study was conducted among school children aged 7-15 years in Zahedan (South East of Iran) in 2003. A total of 1169 children (51% girls & 48.6% boys) were selected at random using multistage cluster sampling method. The first morning urine was examined twice by a simple dipstick read based on changes in colour and positivity of proteinuria and hematuria. Those who had abnormal results in the first screening test with dipstick were tested again microscopy. The overall prevalence of urinary abnormalities was 2.2 % among school children. Proteinuria was three times more frequent in girls compared with boys (1.05% vs. 0.33%). The proportion of hematuria was also two times higher in girls than boys (2.1% compared with 1%). There is a considerable burden of urinary abnormalities among school children in Iran. Therefore, a simple dipstick method for the early detection of proteinuria and hematuria has significant value in identifying asymptomatic school children with possible renal disorders.

Asymptomatic hematuria is seen in 0.5-2% of school age children. Screening for proteinuria and hematuria is important in the prevention of chronic renal disease. In order to reveal the prevalence of asymptomatic hematuria, 2047 primary school children of Bushehr port and Kharg Island were chosen by multiple cluster sampling method. The screened children with positive protein or blood by dipstick were re-examined 2 weeks later. In the second phase 10 cc of urine of each student who had >= 1+ blood and/or >=2 + protein was centrifuged and examined by microscope. The prevalence of isolated microscopic hematuria in the first phase was 5.91% and it was decreased to 2.1% in the second phase. The prevalence of isolated microscopic hematuria was 1.5% (1.74 for males & 1.27 for females) and 3.4% (1.45 for males & 5.65 for females) in Bushehr port and Kharg Island, respectively. In conclusion, the prevalence of isolated microscopic hematuria in Bushehr port was the same as the other parts of the world, however the prevalence of isolated hematuria was high in Kharg Island which needs further investigations.