Objectives: To determine the prevalence of prostate cancer and to assess potential associations between race and prostate adenocarcinoma according to age in patients followed in an outpatient service of general urology in an university hospital.Materials and Methods: Retrospective study of men aged from 40 to 79 years, followed during the period from 1999 to 2001. Patients were classified according to race in White, Mulatto and Black. Those with abnormal digital rectal examination and/or serum level of prostate specific antigen (PSA) > 4.0 ng/ml, underwent a transrectal prostate biopsy.Results: 580 patients with mean age of 60.7 ± 10.0 years were studied, with 116 Whites (20.0%), 276 Mulattos (47.6%) and 188 Blacks (32.4%). There was no significant difference regarding the mean age (p = 0.62), serum level of PSA (p = 0.65) and prevalence of prostate adenocarcinoma between Whites, Mulattos and Blacks (p = 0.36). While studying the association between race classified in 2 groups (Whites versus Mulattos and Blacks) and prostate adenocarcinoma according to age, no association was found when the total group was assessed, neither among those with age above 60 years old. In the group between 40 and 60 years, even though without statistical significance, the estimate of prevalence ratio was 2.2 (CI 95%: 0.52 to 9.0; p = 0.38).Conclusion: Prostate adenocarcinoma was found in 16.6% of the patients aged between 40 and 79 years. We did not find a racial influence in our population.
150Acute renal failure is a severe condition that occurs in 2.0% to 7.0% of patients during hospital stay [1][2][3] . In 18.0% to 47.0% of cases, it is related to a surgical event, and acute tubular necrosis is the main type of lesion 1,2,4 . The great variation in the incidence of acute renal failure among the studies presents a multifactor profile, including different diagnostic criteria, such as the study design, inclusion and exclusion criteria, profile of the patients and of the centers involved in the sample, hindering study comparisons 5 .In cardiac surgery, its incidence ranges from 3.5% to 31.0% [5][6][7][8][9][10][11][12] , and the need for dialysis occurs in 0.3% to 15.0% of cases [5][6][7][8][9][10][11][12][13][14][15][16][17][18] . The presence of acute renal failure in these patients increases the mortality rate from 0.4% to 4.4% to 1.3% to 22.3%, and when dialysis is required, these rates reach 25.0% to 88.9% [5][6][7][8][9][10][11][12][13][14][15][16][17][18] , making it an independent risk factor for mortality, according to Chertow et al 16 , and increasing 8-fold the death odds ratio among these patients.The presence of conditions that determine hypoperfusion and renal ischemia are directly related to the development of ARF. Patients who present with reduced renal functional reserve, in whom a reduction occurs in the glomerular filtration rate without serum creatinine elevation above normal values, are more likely to have ARF even with minor renal lesions 16 . Preoperative and intraoperative factors, such as age, previous level of creatinine, diabetes mellitus, cardiac output, the duration of extracorporeal circulation, and the use of the intraaortic balloon, are influencial in the development of ARF [5][6][7][8][10][11][12]19 . The severity of ARF may increase with the occurrence of complications in the postoperative period, such as infections, hemorrhage, and the use of nephrotoxic substances 20 .In Brazil, few studies have reported the incidence of ARF after cardiac surgery, its risk factors, and its outcomes. The great impact of ARF in the outcomes of cardiac surgery demand its study in our population, encouraging to the elaboration of this study, which aims at identifying the incidence, risk factors, duration of ICU stay, and mortality due to ARF after myocardial coronary artery bypass surgery in a university hospital in Brazil. MethodsFrom 10/1/2001 to 9/30/2002, 223 of 247 patients undergoing myocardial coronary artery bypass surgery were prospectively studied. Exclusion criteria were: surgery without extracorporeal circulation (12 patients), death within the first 24h after surgery ConclusionAcute renal failure after myocardial coronary artery bypass surgery is a frequent complication associated with a high mortality rate. The independent risk factors are age, previous renal failure, and the need for inotropic drugs.
Introduction. The postoperative acute renal failure (ARF) incidence in different kinds of surgery has rarely been studied. Age, cardiac dysfunction, previous renal dysfunction, intraoperative hypoperfusion, and use of nephrotoxic medications are mentioned as risk factors for ARF at the postoperative period. The postoperative ARF definition was based on the creatinine increase by the RIFLE classification (R = risk, I = injury, F = failure, L = loss, E = end stage), which corresponds to a 1.5 creatinine increase, two to three times, respectively, above the basal value. This study aimed to evaluate the postoperative ARF incidence in elderly patients who underwent femur fracture surgery under subarachnoid anesthesia and stratify it by the RIFLE criteria. Methods. Ninety patients older than 65 years under spinal anesthesia with fixed dosage of 15 mg of 0.5% isobaric bupivacaine associated with morphine 50 μg were studied. Immediate postoperative creatinine was considered basal and compared with maximal creatinine evaluated at 24, 48, and 72 postoperative hours. Results. The mean age of the patients was 80.27 years. ARF incidence was 24.44% and stratified this way: R = 21.11% and I = 3.33%. Conclusions. In conclusion, the postoperative ARF incidence after femur fracture surgery in patients over 65 years was 24.44%. By analyzing the stratification based on the RIFLE classification, the incidence was categorized as Risk (R) = 21.11% and Injury (I) = 3.33%.
INTRODUÇÃOGlomerulonefrite continua sendo uma importante causa de doença renal terminal (DRT) 1 . Nos Estados Unidos, a incidência de DRT atribuída às glomerulonefrites primárias é aproximadamente duas vezes maior nos negros do que nos brancos 21 . As razões para estas diferenças raciais, entretanto, não são claras. Apesar da evidência de que o negro hipertenso apresenta uma , não tem sido avaliado se a associação raça versus DRT em pacientes com glomerulonefrites difere entre grupos de pessoas com e sem hipertensão arterial (HA). É também interessante explorar uma possível influência da distribuição dos tipos histológicos de glomerulonefrites nesta associação (i.e., entre raça e vs DRT), considerando as diferenças regionais [4][5][6] e raciais 7,8 na distribuição das glomerulonefrites. O presente trabalho estuda uma amostra de pacientes portadores de glomerulonefrites residentes no estado da
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