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Hematuria --- Nephrotic Syndrome --- genetics
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Hematuria in children --- Proteinuria in children --- Child --- Hematuria --- Infant --- Proteinuria
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Une caractéristique habituelle de la tigette urinaire -le fait qu'elle est « multizone », peut mener le médecin généraliste à la découverte « fortuite » ou inattendue de la présence de sang dans l'urine. Il ne peut alors ignorer cette constatation faite par exemple, lors d'une tigette réalisée pour exclure une infection urinaire en cas de fièvre dont l'étiologie est peu évidente. Deux cas cliniques illustrent les différentes questions suscitées par ce genre de découverte. Ce travail a pour but de tenter de répondre à ces questions. Un algorithme diagnostique est élaboré à l'intention du médecin généraliste, face à une tigette urinaire positive pour le sang, et face à une hématurie microscopique asymptomatique si elle est confirmée. La méthode utilisée comprend une revue de la littérature, dont les niveaux de preuve sont modestes, ainsi que la rencontre de plusieurs experts. Une tigette urinaire nettement positive pour le sang (> 1 +) requiert tout d'abord que l'urine soit examinée au microscope. La définition de l'hématurie repose en effet exclusivement sur un examen microscopique. Une fois l'hématurie confirmée, il importe de commencer par exclure les causes bénignes d'hématurie. Il convient ensuite d'en déterminer l'origine (glomérulaire ou non), en particulier par un examen microscopique ciblé (globules rouges dysmorphiques, cylindres hématiques).Une hématurie glomérulaire nécessite presque toujours un bilan néphrologique (excepté lorsqu'elle est isolée). La présence de facteurs de risque de cancer implique un bilan urologique concomitant. Une hématurie non glomérulaire nécessite toujours une mise au point urologique, partielle ou complète. Le type d'évaluation dépend de la présence de facteurs de risque de cancer des voies urinaires et d'un âge-seuil (variable dans la littérature). Lorsqu'un bilan urologique est recommandé, une cystoscopie est réalisée ainsi qu'une imagerie (dont le type varie d'une recommandation à l'autre).Il est important de ne pas banaliser une hématurie microscopique, même en l'absence de symptômes. La cause de cette hématurie doit être recherchée, en n'oubliant pas de prendre en compte le contexte et les éventuels facteurs de risque de cancer, afin de ne pas réaliser inutilement un bilan non dénué de risque, coûteux et anxiogène pour le patient. Davantage d’études sont cependant nécessaires afin de déterminer la démarche diagnostique optimale lors de la découverte d’une hématurie microscopique asymptomatique.
Urinary Tract Infections --- Urine Specimen Collection --- Urinalysis --- Hematuria
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Antigen-Antibody Complex --- Hematuria --- Immunoglobulin A --- Spondylitis, Ankylosing --- Colitis, Ulcerative --- Glomerulonephritis, IGA --- analysis --- complications --- analysis --- immunology --- immunology --- immunology
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There have been recent significant improvements in the short-term survival of solid organ transplantation patients due to advances in immunosuppression and transplant techniques. However, long-term graft survival has still lagged behind other outcomes and has now become one of the main problems in solid organ transplantation.For this Special Issue, we invited researchers and clinicians to submit studies on solid organ transplantation. These have provided us with additional knowledge and skills that will ultimately help us to improve outcomes after solid organ transplantation.
Medicine --- Pharmacology --- living donation --- nephrectomy --- hand-assisted laparoscopic nephrectomy --- body composition --- complications --- simultaneous pancreas-kidney transplantation --- immunosuppression --- graft order --- sequence --- outcome --- survival --- kidney transplantation --- hydrogen --- diarrhea --- small intestinal bacterial overgrowth --- sickle cell disease --- sickle cell --- transplantation --- outcomes --- big data --- tacrolimus --- metabolism --- C/D ratio --- cholesterol --- dyslipidemia --- LDL-C --- liver transplantation --- hematuria --- chronic kidney disease --- tocilizumab --- clazakizumab --- desensitization --- anti-HLA alloantibody --- post traumatic growth --- psychiatric morbidity --- network analysis --- ESAS --- MINI --- CPC --- DCPR --- distress --- demoralization --- alexithymia --- anxiety --- antibody-mediated rejection --- recurrent primary disease --- renal transplantation --- pancreas transplantation --- cold ischemia time --- delayed graft function --- Eurotransplant Senior Program --- end-stage renal disease --- intensive care unit --- bioimpedance analysis --- drug dosing --- lean body mass index --- pharmacokinetics --- tacrolimus C/D ratio --- mineral bone disorder --- parathyroidectomy --- parathyroid hormone --- osteoporosis --- bone fractures --- Contrast-enhanced ultrasound --- kidney perfusion --- kidney function --- kidney donation --- n/a
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There have been recent significant improvements in the short-term survival of solid organ transplantation patients due to advances in immunosuppression and transplant techniques. However, long-term graft survival has still lagged behind other outcomes and has now become one of the main problems in solid organ transplantation.For this Special Issue, we invited researchers and clinicians to submit studies on solid organ transplantation. These have provided us with additional knowledge and skills that will ultimately help us to improve outcomes after solid organ transplantation.
Medicine --- Pharmacology --- living donation --- nephrectomy --- hand-assisted laparoscopic nephrectomy --- body composition --- complications --- simultaneous pancreas-kidney transplantation --- immunosuppression --- graft order --- sequence --- outcome --- survival --- kidney transplantation --- hydrogen --- diarrhea --- small intestinal bacterial overgrowth --- sickle cell disease --- sickle cell --- transplantation --- outcomes --- big data --- tacrolimus --- metabolism --- C/D ratio --- cholesterol --- dyslipidemia --- LDL-C --- liver transplantation --- hematuria --- chronic kidney disease --- tocilizumab --- clazakizumab --- desensitization --- anti-HLA alloantibody --- post traumatic growth --- psychiatric morbidity --- network analysis --- ESAS --- MINI --- CPC --- DCPR --- distress --- demoralization --- alexithymia --- anxiety --- antibody-mediated rejection --- recurrent primary disease --- renal transplantation --- pancreas transplantation --- cold ischemia time --- delayed graft function --- Eurotransplant Senior Program --- end-stage renal disease --- intensive care unit --- bioimpedance analysis --- drug dosing --- lean body mass index --- pharmacokinetics --- tacrolimus C/D ratio --- mineral bone disorder --- parathyroidectomy --- parathyroid hormone --- osteoporosis --- bone fractures --- Contrast-enhanced ultrasound --- kidney perfusion --- kidney function --- kidney donation --- n/a
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There have been recent significant improvements in the short-term survival of solid organ transplantation patients due to advances in immunosuppression and transplant techniques. However, long-term graft survival has still lagged behind other outcomes and has now become one of the main problems in solid organ transplantation.For this Special Issue, we invited researchers and clinicians to submit studies on solid organ transplantation. These have provided us with additional knowledge and skills that will ultimately help us to improve outcomes after solid organ transplantation.
living donation --- nephrectomy --- hand-assisted laparoscopic nephrectomy --- body composition --- complications --- simultaneous pancreas-kidney transplantation --- immunosuppression --- graft order --- sequence --- outcome --- survival --- kidney transplantation --- hydrogen --- diarrhea --- small intestinal bacterial overgrowth --- sickle cell disease --- sickle cell --- transplantation --- outcomes --- big data --- tacrolimus --- metabolism --- C/D ratio --- cholesterol --- dyslipidemia --- LDL-C --- liver transplantation --- hematuria --- chronic kidney disease --- tocilizumab --- clazakizumab --- desensitization --- anti-HLA alloantibody --- post traumatic growth --- psychiatric morbidity --- network analysis --- ESAS --- MINI --- CPC --- DCPR --- distress --- demoralization --- alexithymia --- anxiety --- antibody-mediated rejection --- recurrent primary disease --- renal transplantation --- pancreas transplantation --- cold ischemia time --- delayed graft function --- Eurotransplant Senior Program --- end-stage renal disease --- intensive care unit --- bioimpedance analysis --- drug dosing --- lean body mass index --- pharmacokinetics --- tacrolimus C/D ratio --- mineral bone disorder --- parathyroidectomy --- parathyroid hormone --- osteoporosis --- bone fractures --- Contrast-enhanced ultrasound --- kidney perfusion --- kidney function --- kidney donation --- n/a
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