JOSE LUIS BORGES DE MESQUITA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
3 resultados
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bookPart Emergências Relacionadas aos Testículos, Escroto, Epidídimo e Apêndices(2013) MAZZUCCHI, Eduardo; MESQUITA, José Luiz Borges de; SROUGI, Miguel- Septic Shock Following Surgical Decompression of Obstructing Ureteral Stones: A Prospective Analysis(2018) SROUGI, Victor; MOSCARDI, Paulo R.; MARCHINI, Giovanni S.; BERJEAUT, Ricardo Haidar; TORRICELLI, Fabio C.; MESQUITA, Jose L. B.; SROUGI, Miguel; MAZZUCCHI, EduardoPurpose: To investigate risk factors for septic shock and death in patients with obstructive pyelonephritis due to ureteral stone, who underwent urinary tract decompression. Patients and Methods: We prospectively enrolled patients who presented at the emergency department of our institution with clinical signs of pyelonephritis, Systemic Inflammatory Response Syndrome (SIRS), and obstructive ureteral stone confirmed by computed tomography scan. Forty patients that underwent urinary tract decompression were included. Demographical, medical, and laboratorial characteristics were recorded; antibiotic regimen and time from presentation to decompression were compared between patients with septic complications. Results: Septic shock and death occurred in 6 (15%) and 2 (5%) patients, respectively. Gender, age, and comorbidities were not associated with septic complications. Urinary culture was negative in 40% of the cohort and the most prevalent pathogen was Escherichia coli. Administration of antibiotics other than third-generation cephalosporin was associated with septic shock (p=0.02). There was no difference between groups regarding the time of antibiotics use (p=0.63) and time from presentation to urinary tract decompression (p=0.07). Patients with leukocyte count above 15.6x10(3)/mu L had 2.2-fold greater risk of having septic shock (p=0.027). Conclusions: We failed to find an association between time of antibiotic use or delayed urinary tract decompression and occurrence of septic complications; antibiotic choice was determinant of prognosis. Elevated serum leukocytes could be used as a trigger to indicate prompt surgical intervention.
- Renal artery pseudoaneurysm after blunt renal trauma: report on three cases and review of the literature(2013) YAMACAKE, Kleiton Gabriel Ribeiro; LUCON, Marcos; LUCON, Antonio Marmo; MESQUITA, Jose Luiz Borges; SROUGI, MiguelCONTEXT: Renal artery pseudoaneurysm is a rare complication after renal injury but should be suspected whenever there is recurrent hematuria after renal trauma. CASE REPORTS: We present three cases of pseudoaneurysm after blunt renal trauma and a review of the literature. All patients underwent renal angiography. Two cases were diagnosed during the initial hospital stay due to hematuria, or in the follow-up period during recovery. One patient was hemodynamically unstable. Two patients successfully underwent coil embolization in a single session. In the other case, selective embolization was attempted, but was unsuccessful because artery catheterization was impossible. Procedural and medical success and complications were retrospectively assessed from the patients' records. The clinical presentation, treatment options and clinical decisions are discussed. CONCLUSIONS: Renal artery pseudoaneurysm may develop acutely or even years after the initial injury. Signs and symptoms may have a wide spectrum of presentation. Selective angiographic embolization is an effective treatment that reduces the extent of parenchymal infarction.