Occurrence Of Hematuria Research Articles

#2983 Correlation of microRNA expression with IgA nephropathy progression: preliminary results

Abstract Background and Aims IgA nephropathy (IgAN) is the most common cause of glomerulonephritis worldwide. IgAN is diagnosed based on the result of histopathological examination. The risk factors for disease progression primarily include the level of impairment of renal function at the time of diagnosis (GFR < 60 ml/min/1.73 m2), the presence of hypertension, daily administration of more than 1.0 g, and the occurrence of hematuria. MicroRNAs (miRNAs) are important regulators of gene expression. Their role has a significant impact on the proper functioning of the body, and disorders related to their expression can lead to the development of many pathological processes in the body. The study aimed to assess the dependence of microRNA expression on the stage of the disease in patients with IgA nephropathy. Method A study was conducted involving patients newly diagnosed with IgA nephropathy based on histopathological examination results. The expression of microRNA molecules (miR-146a, miR-155, miR-200b, miR-429) was determined in urine sediment and blood. The analysis focused on examining the relationship between microRNA expression and the stage of disease progression (proteinuria, renal parameters). Blood and urine tests were performed before the start of immunosuppressive treatment with glucocorticosteroids according to the Pozzi regimen. Results Twenty-seven patients were included in the study group- 14 women (51.9%) and 13 men (48.1%). Nephrotic-range proteinuria (>3000 mg/24 h) was observed in 5 patients (18.5%), while subnephrotic proteinuria was present in 22 patients (77.8%). Reserved kidney function (eGFR > 90) was found in 17 patients (63%). The exact distribution of results according to the stage of renal failure is given in the Table 1. Statistically significant positive correlation was found between serum creatinine concentration and miR-200b expression in urine (R = 0,398, p = 0,049). Initially, no statistically significant correlation was found between the expression of selected miRNA molecules and the degree of 24-hour proteinuria. Conclusion MiRNA molecules may be promising, non-invasive biomarkers widely used in clinical practice. Determining the viability of clinical use of microRNA molecules will require a panel of miRNAs or miRNAs used in combination with other biomarkers and clinical outcomes to improve diagnostic utility.

MP56-20 ETIOLOGY, EVALUATION, AND MANAGEMENT OF HEMATURIA FOLLOWING RADICAL CYSTECTOMY AND ORTHOTOPIC URINARY DIVERSION

You have accessJournal of UrologyCME1 Apr 2023MP56-20 ETIOLOGY, EVALUATION, AND MANAGEMENT OF HEMATURIA FOLLOWING RADICAL CYSTECTOMY AND ORTHOTOPIC URINARY DIVERSION Daniel I. Sanford, Muhannad Alsyouf, Sanam Ladi-Seyedian, Kevin Wayne, Alireza Ghoreifi, Anne Schuckman, Hooman Djaladat, and Siamak Daneshmand Daniel I. SanfordDaniel I. Sanford More articles by this author , Muhannad AlsyoufMuhannad Alsyouf More articles by this author , Sanam Ladi-SeyedianSanam Ladi-Seyedian More articles by this author , Kevin WayneKevin Wayne More articles by this author , Alireza GhoreifiAlireza Ghoreifi More articles by this author , Anne SchuckmanAnne Schuckman More articles by this author , Hooman DjaladatHooman Djaladat More articles by this author , and Siamak DaneshmandSiamak Daneshmand More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003309.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Up to 20% of patients presenting with gross hematuria have underlying urologic malignancy. In patients with orthotopic neobladder (ONB) following cystectomy, the occurrence of hematuria at follow-up has not been evaluated. Here, we assessed the etiology, evaluation, and subsequent management of patients who developed hematuria following ONB diversion. METHODS: All patients who underwent radical cystectomy and ONB between 2017-2022 and who subsequently underwent cystoscopy for hematuria were identified. Patient demographics, cystoscopy reports, cytology findings, and relevant imaging were reviewed to determine the etiology of hematuria and subsequent management. Causes of hematuria were categorized as recurrence, anticoagulation-related, inflammation/infection, or undetermined. A univariate analysis was performed to identify factors predictive of oncologic recurrence presenting with hematuria. RESULTS: Of 55 patients with ONB who underwent subsequent cystoscopy on follow-up, hematuria was the indication in 24 (44%) patients (Table 1a). Median patient age was 71 (IQR 66-74) years. Seven patients (29%) had hematuria secondary to cancer recurrence, including four with urethral recurrence, one with ureteral recurrence, and two with positive urine cytology. Other etiologies of hematuria included anticoagulation (13%), pouchitis (13%), mesh erosion into neobladder (4%), and bladder inflammation (4%). Nine patients (37%) had an undetermined cause of hematuria. In patients with recurrence, median time from cystectomy to development of hematuria was 20.1 (15.6–32.8) months. Positive surgical margins were associated with cancer recurrence in our cohort (p<0.05) (Table 1b). CONCLUSIONS: The majority of patients presenting with gross hematuria following radical cystectomy and ONB have benign etiology, yet up to one-third of patients will have underlying malignancy. A thorough evaluation is required for all patients, especially those with positive surgical margins. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e783 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel I. Sanford More articles by this author Muhannad Alsyouf More articles by this author Sanam Ladi-Seyedian More articles by this author Kevin Wayne More articles by this author Alireza Ghoreifi More articles by this author Anne Schuckman More articles by this author Hooman Djaladat More articles by this author Siamak Daneshmand More articles by this author Expand All Advertisement PDF downloadLoading ...

Risk Factors and Prediction Methods for Endometriosis Combined with Ureteral Stricture Based on Logistic-Regression Analysis.

This study aimed to explore the risk factors of patients with endometriosis (EMS) and ureteral stricture and to establish a prediction model based on logistic-regression analysis. The clinical data of 228 EMS patients in Jiaozhou Central Hospital of Qingdao from May 2019 to May 2022 were selected for a retrospective study. According to the results of ureteroscopic biopsy, they were divided into concurrent (n = 32) and nonconcurrent (n = 196) groups. Univariate analysis was performed on the general data and situations of clinical treatment in both groups. Single factor with statistically significant differences was included in unconditional logistic-regression analysis with multiple factors to explore the risk factors of such patients and establish a prediction model. Overt differences were found in previous history of ureter operation (odds ratio (OR) = 3.711, p = 0.006), course of EMS (OR = 3.987, p = 0.007), presence or absence of haematuria (OR = 3.586, p = 0.009) and lateral abdominal pain (OR = 4.451, p = 0.002), and invasion depth of lesion (OR = 7.271, p < 0.001) between the two groups (p < 0.05), without distinct difference in age, menstrual duration, BMI values, history of dysmenorrhea, previous history of drug therapy, smoking history, and drinking history (p > 0.05). Logistic-regression analysis showed that previous history of ureter operation (a1), course of EMS (b2), occurrence of haematuria (c3) and lateral abdominal pain (d4), and invasion depth of lesion ≥5 mm (e5) were risk factors for EMS combined with ureteral stricture (p < 0.05), taking logit (p) = -4.990 + 1.311a1 + 1.383b2 + 1.277c3 + 1.493d4 + 1.984e5 as regression model. The receiver operating characteristic (ROC) curve analysis based on this model showed that the area under the curve (AUC), standard error, and 95% confidence interval (CI) were 0.813, 0.062, and 0.692-0.934, respectively. One hundred EMS patients were re-included, whose values for predictive sensitivity, specificity, and kappa coefficient were 71.40%, 91.10% and 0.615. Previous history of ureter operation, course of EMS, occurrence of haematuria and lateral abdominal pain, and invasion depth of lesion ≥5 mm were risk factors for EMS combined with ureteral stricture. Therefore, the use of this model has a certain clinical value.

Profil mikroskopis sedimen urin pada kondisi glukosuria di Laboratorium Klinik Prodia, Banda Aceh

Background: Laboratory examination of urine (urinalysis) is crucial in establishing various diagnoses. Urine examination can be done through macroscopic examination, including color, clarity, and microscopic examination of urine sediment (U-sed) and urine chemical examination such as glucose. Urine sediment is insoluble elements such as erythrocytes, leukocytes, epithelial cells, thorax, bacteria, crystals, fungi, and parasites originating from the blood, kidneys, and urinary tract. Glucosuria is a condition where glucose is found in the urine, and when excessive &gt;180 mg/dL can experience hyperglycemia, the impact is to damage the capillary blood vessels in the kidneys. U-sed is used to identify sediment elements that can be used to detect kidney and urinary tract abnormalities.Objectives: This study aims to determine the U-sed profile in glucosuria at Prodia Clinical Laboratory, Banda Aceh.Methods: Descriptive research using an experimental design and analyzing secondary data from patients with glucosuria and referred for U-sed examination at Prodia Clinical Laboratory, Banda Aceh Branch. The study was conducted in Mai 2022, with a total sample size of 24 respondents. Microscopic examination U-sed data was processed in stages starting from editing, coding, entry, and cleaning data. Data were only analyzed descriptively using frequency distribution.Results: The results of the study of the U-sed profile in patients with glucosuria conditions were abnormal flat epithelial cells (50,0%), the occurrence of leukocyturia (67,7%), the occurrence of hematuria (70,8%), and other sediments that were above normal only 25,0% of patients. Thus, the U-sed profile in patients with glucosuria conditions may be pathological such as infection, inflammation, and stones in the urinary tract.Conclusion: Some of the MSU profile data in patients who performed laboratory examinations at Prodia Banda Aceh showed above-normal threshold values, such as the data of flat epithelial cells, leukocytes, erythrocytes, and some other sentiments that were above normal had a low frequency. Patients who perform urine tests are at risk of infection and inflammation of the urinary tract and even the risk of kidney stones.

Anthocran® Phytosome®: Prevention of Recurring Urinary Infections and Symptoms after Catheterization

In this preliminary pilot registry study, we investigated the effects of the oral supplementation of a standardized cranberry extract (Anthocran® Phytosome®, Indena) delivered by a lecithin-based system, for the prophylactic management of recurrent-urinary tract infections (R-UTIs). We included 64 otherwise healthy subjects who underwent a surgical procedure and required post-surgical urinary catheterization for high-risk UTIs or a previous history of R-UTIs. Patients were given supplementation with the standardized cranberry extract at the dose of either 120 mg/day (n = 12) or 240 mg/day (n = 12) or assigned to a control group consisting of standard management (SM; n = 18) or nitrofurantoin administration (n = 22) for 4 weeks. After 4 weeks, patients receiving the standardized cranberry supplementation reported to have a more effective reduction in UTI symptoms, as assessed on the visual analogue scale, compared with patients in the SM or nitrofurantoin groups. The occurrence of hematuria and urine bacterial contamination were decreased among patients treated with the supplement compared with controls (p < 0.05). The cranberry extract was also superior to the control management in terms of recurrence of signs/symptoms, with none of the patients in this group suffering from a R-UTI in the 3 months following the study end (p < 0.05). The supplementation showed an optimal safety profile, with no significant adverse events and no drop-outs in the supplement group. This registry shows that this cranberry extract is effective as a supplementary, preventive management in preventing post-operative, post-catheter UTIs; the product has a good tolerability profile.

Incidence and consequences of resuming oral anticoagulant therapy following hematuria and risks of ischemic stroke and major bleeding in patients with atrial fibrillation.

Following hematuria, it is uncertain to what extent a vitamin K antagonist (VKA) or non-VKA oral anticoagulant (NOAC) is resumed, and the risks of ischemic stroke/systemic embolism and major bleeding associated with NOAC and VKA resumption are unknown. A cohort study was conducted using electronic medical records collected from 2009 to 2017 at a multicenter healthcare provider in Taiwan. The cohort included 4155 atrial fibrillation patients receiving anticoagulant therapy with hematuria (age: 71.4 ± 11.2years; 48.8% female). Within 90days following hematuria, 3287 patients (79.1%) resumed oral anticoagulants including VKA (n = 1554, 37.4%) and NOACs (n = 1733, 41.7%), whereas 868 patients did not resume anticoagulant. Follow-up was initiated 90days after the occurrence of hematuria, and time-varying multiple Cox regression analyses were used for comparisons between the resumption of NOAC and VKA. The event rates per 100 person-years in the VKA resumption and NOAC resumption groups were 3.04 and 3.28 for ischemic stroke/systemic embolism, and 2.63 and 2.92 for major bleeding, respectively. Patients resuming NOAC had similar risks of ischemic stroke/systemic embolism (hazard ratio 1.14, 95% CI 0.75-1.74) and major bleeding (hazard ratio 1.12, 95% CI 0.72-1.74) compared with those resuming VKA. Since 2011, the proportion of NOAC resumption has increased, whereas the proportions of VKA resumption and non-resumption have decreased. In conclusion, more and more patients who suffer a hematuria while on oral anticoagulant therapy resume NOAC. Patients resuming NOAC have similar risks of ischemic stroke/systemic embolism and major bleeding compared with those resuming VKA.

Increased risk of acute kidney injury with percutaneous mechanical thrombectomy using AngioJet compared with catheter-directed thrombolysis

ObjectiveThe objective of this study was to investigate the risk of postoperative acute kidney injury (AKI) in patients with acute iliofemoral deep venous thrombosis (IFDVT) who underwent percutaneous pharmacomechanical thrombectomy (PMT) using AngioJet (Boston Scientific, Marlborough, Mass) or catheter-directed thrombolysis. MethodsElectronic medical records of patients with acute IFDVT from January 2014 to September 2017 were reviewed. Those who received PMT with AngioJet (AJ-PMT group) or catheter-directed thrombolysis (CDT group) were included in this study. Baseline characteristics were recorded and compared. Postoperative serum creatinine concentration was compared with baseline serum creatinine concentration to determine the occurrence of postoperative AKI. Hemolysis was diagnosed on the basis of the decrease of hematocrit (HCT) and the occurrence of hematuria. The incidence of postoperative AKI in the two groups was analyzed. Univariable analysis and logistic regression analysis were used to determine risk factors that contribute to postoperative AKI. ResultsA total 198 patients with acute IFDVT were included (79 in the AJ-PMT group, 119 in the CDT group). Baseline data of the two groups were of no statistical difference. The AJ-PMT group suffered more from acute hemolysis (P = .018). Compared with baseline HCT, the absolute HCT reduction of each group was of statistical significance (P < .01). The percentage change of absolute HCT of the two groups was of statistical significance (P < .01). Univariate analysis and multivariate analysis demonstrated that percutaneous AJ-PMT (odds ratio [OR], 2.82; 95% confidence interval [CI], 1.16-6.82; P = .02), history of major surgery within 3 months of endovascular intervention (OR, 8.51; 95% CI, 2.90-24.94; P < .01), and HCT drop >14% (OR, 2.73; 95% CI, 1.08-6.87; P = .03) are independent risk factors that raise the odds of postoperative AKI. ConclusionsIn patients with acute IFDVT, AJ-PMT will raise the risk of postoperative AKI compared with CDT, especially in patients with a history of major surgery within 3 months of endovascular intervention. AJ-PMT causes more hemolysis and hematuria. An HCT drop >14% may indicate upcoming AKI.

Application of modified indwelling catheterization method for the prevention of urethral injury

Objective To study the effect of modified indwelling catheterization method for the prevention of urethral injury. Methods A total of 136 cases of urethral catheterization were randomly divided into two groups. The observation group had 68 cases using the conventional catheterization method, and the control group had 68 cases using the modified indwelling catheterization method, respectively. The time of inserting catheter, indwelling catheter time, removal time of the catheter, and the incidence of blood urine were compared between two groups. Results The time of inserting catheter, indwelling catheter time, removal time of the catheter, and the incidence of blood urine were significantly of the observation group were significantly lower than those of the control group (χ2=6.81, 3.89, 8.38, 28.57, respectively; P 0.05). Conclusions The modified indwelling catheterization method can reduce the occurrence of hematuria traumatic urethral and it is worthy of application in clinical environment. Key words: Modified indwelling catheter; Urethral injury; Blood urine; Prevention

Urogenital schistosomiasis and urological assessment of hematuria in preschool-aged children in rural communities of Nigeria

ObjectiveThe study evaluates the prevalence of urogenital schistosomiasis and diagnostic performance of chemical reagent strips used for disease diagnosis in preschool-aged children (≤5 years) in Nigeria rural communities. Patients and methodsUrine samples from 419 children were observed microscopically for Schistosoma haematobium and screened for hematuria using standard urine chemical reagent strips. ResultsPrevalence and intensity of infection were 9.8% and 14.4 eggs/10 ml of urine, respectively. Prevalence of infection was similar in girls (10%) and boys (9.6%) (p > 0.05). The intensity of infection was higher in boys (17.1 eggs/10 ml of urine) than in girls (12.8 eggs/10 ml of urine); however, this was not gender dependent (p > 0.05). The occurrence of hematuria was not associated with gender (p > 0.05), but was associated with prevalence of infection (p < 0.05). ConclusionInfection with S. haematobium occurs early in life in the communities and although intensity of infection is low, it could have serious implications in disease transmission. Hematuria, although moderately sensitive to infection, is an important morbidity indicator of urogenital schistosomiasis in the study population.

A 68-year-old Caucasian man presenting with urinary bladder lymphoepithelioma: a case report

IntroductionLymphoepithelioma is a very rare form of malignant tumor originating from epithelial line cells. Its occurrence has potential clinical, therapeutic and prognostic implications. In the present report we describe an unusual case of bladder cancer with two different histological varieties: transition cell carcinoma and lymphoepithelioma-like carcinoma. Lymphoepithelioma-like carcinoma of the bladder has only been rarely reported in the literature to date.Case presentationWe present the case of a 68-year-old Caucasian man who, after occurrence of hematuria, underwent transurethral resection of a bladder tumor. The results of a histological examination confirmed a high-grade non-muscle-invasive pT1 lymphoepithelioma-like carcinoma of the urinary bladder, associated with a concurrent high-grade transition cell carcinoma. After analyzing the histological features, our patient was subjected to treatment with intra-vesical instillations of bacillus Calmette-Guérin. Our work stresses that diagnosis and therapeutic approaches can be difficult and controversial, especially in the early stages of this rare carcinoma.ConclusionsThis report emphasizes the importance of extending our knowledge and experiences regarding this uncommon carcinoma. Further studies are needed to better understand this rare disease and define more accurate diagnostic and therapeutic strategies.

Development of myeloperoxidase-antineutrophil cytoplasmic antibody-associated renal vasculitis in a patient receiving treatment with anti-tumor necrosis factor-α

We report on a 33-year-old woman who presented with positive myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) during rheumatoid arthritis treatment with infliximab. She had a history of worsening arthralgia, and urinalysis showed the new occurrence of hematuria and proteinuria. Renal biopsy showed necrotizing crescentic glomerulonephritis. Immunosuppressive therapy and discontinuation of the infliximab therapy alleviated her arthralgia and improved the urinalysis results. We report this rare case in which an anti-tumor necrosis factor-α (TNF-α) agent for ANCA-associated systemic vasculitis was studied.

Alarm symptoms in early diagnosis of cancer in primary care: cohort study using General Practice Research Database

Objective To evaluate the association between alarm symptoms and the subsequent diagnosis of cancer in a large population based study in primary care.Design Cohort study.Setting UK General Practice Research Database.Patients...

Do contusions in judo induce haematuria?

Sports haematuria is a well recognized phenomenon whose mechanisms have also been well established. In this study, judo practitioners carried out a quite strenuous throwing exercise, each judoka executed 80–100 falls. There was no haematuria in any of the 39 judokas, whether the 4.5-cm-thick judo mats were placed on a wooden floor or on a concrete one. The occurrence of haematuria must always be taken seriously and as an abnormal phenomenon on an individual level.

Intermittent Catheterisation with Hydrophilic-Coated Catheters (SpeediCath) Reduces the Risk of Clinical Urinary Tract Infection in Spinal Cord Injured Patients: A Prospective Randomised Parallel Comparative Trial

ObjectivesTo compare the performance of SpeediCath hydrophilic-coated catheters versus uncoated polyvinyl chloride (PVC) catheters, in traumatic spinal cord injured patients presenting with functional neurogenic bladder-sphincter disorders. MethodsA 1-year, prospective, open, parallel, comparative, randomised, multi centre study included 123 male patients, ≥16 y and injured within the last 6 months. Primary endpoints were occurrence of symptomatic urinary tract infection (UTI) and hematuria. Secondary endpoints were development of urethral strictures and convenience of use. The main hypothesis was that coated catheters cause fewer complications in terms of symptomatic UTIs and hematuria. Results57 out of 123 patients completed the 12-month study. Fewer patients using the SpeediCath hydrophilic-coated catheter (64%) experienced 1 or more UTIs compared to the uncoated PVC catheter group (82%) (p=0.02). Thus, twice as many patients in the SpeediCath group were free of UTI. There was no significant difference in the number of patients experiencing bleeding episodes (38/55 SpeediCath; 32/59 PVC) and no overall difference in the occurrence of hematuria, leukocyturia and bacteriuria. ConclusionsThe results indicate that there is a beneficial effect regarding UTI when using hydrophilic-coated catheters.

Collection of urine from each kidney in the rabbit without ureteral cannulation.

Collection of urine in rabbits by conventional methods such as catheterization of ureters or bladder with polyethylene tubing or Foley cannulas is hampered by the occurrence of hematuria or obstruction of urine flow, or both. These problems were solved by placing in the bladder a stainless steel device with a horizontal round disk attached to an eliptic vertical septum. The vertical septum divides the bladder into two compartments in such a way as to allow the collection of urine from each kidney. Studies show that this intrabladder devide can be satisfactorily used in acute experiments in anesthetized or conscious rabbits for periods up to 5-6 h.

HEMATURIA FOLLOWING THE USE OF HEPARIN

Since the recent report of Crafoord and Jorpes¹of Stockholm, Sweden, the use of heparin prophylactically to prevent the formation of thrombosis has been stimulated and accelerated. They reported the use of more than 30,000 doses of heparin given intravenously in from 50 to 100 mg. doses without fatality and without any apparent drawbacks. They conclude that "evidently the treatment is quite harmless." The harmlessness of artificially producing a hemorrhagic diathesis by prolonging the coagulation time is not borne out in the case reported here. Massive hematuria with the use of heparin had not been reported previously. Ershler and Blaisdell²reported the first occurrence of hematuria in a patient with cavernous sinus thrombosis treated with sulfathiazole and heparin in whom the renal damage was not due to sulfathiazole crystals. <h3>REPORT OF CASE</h3> A girl aged 13 years was admitted to St. Vincent Hospital with a provisional diagnosis of