OBJECTIVE: Urinary lithiasis is a common disease. The aim of the present study is to assess the knowledge regarding the diagnosis, treatment and recommendations given to patients with ureteral colic by professionals of an academic hospital. MATERIALS AND METHODS: Sixty-five physicians were interviewed about previous experience with guidelines regarding ureteral colic and how they manage patients with ureteral colic in regards to diagnosis, treatment and the information provided to the patients. RESULTS: Thirty-six percent of the interviewed physicians were surgeons, and 64% were clinicians. Forty-one percent of the physicians reported experience with ureterolithiasis guidelines. Seventy-two percent indicated that they use noncontrast CT scans for the diagnosis of lithiasis. All of the respondents prescribe hydration, primarily for the improvement of stone elimination (39.3%). The average number of drugs used was 3.5. The combination of nonsteroidal anti-inflammatory drugs and opioids was reported by 54% of the physicians (i.e., 59% of surgeons and 25.6% of clinicians used this combination of drugs) (p = 0.014). Only 21.3% prescribe alpha blockers. CONCLUSION: Reported experience with guidelines had little impact on several habitual practices. For example, only 21.3% of the respondents indicated that they prescribed alpha blockers; however, alpha blockers may increase stone elimination by up to 54%. Furthermore, although a meta-analysis demonstrated that hydration had no effect on the transit time of the stone or on the pain, the majority of the physicians reported that they prescribed more than 500 ml of fluid. Dipyrone, hyoscine, nonsteroidal anti-inflammatory drugs, and opioids were identified as the most frequently prescribed drug combination. The information regarding the time for the passage of urinary stones was inconsistent. The development of continuing education programs regarding ureteral colic in the emergency room is necessary.

A vasculite é uma síndrome pleomórfica composta por um grupo heterogêneo de processos inflamatórios que acometem principalmente a parede dos vasos sangüíneos. A infecção pelo vírus C da hepatite (VCH) pode associar-se a manifestações extra-hepáticas, incluindo doenças auto-imunes. Duas formas de vasculite podem associar-se ao VCH: a crioglobulinemia mista e a semelhante à poliarterite nodosa. O diagnóstico e o manuseio terapêutico nessas condições são desafios. Existem poucos dados a respeito da eficácia da terapia antiviral em pacientes com VCH crônica e doenças auto-imunes. Apresentamos um relato de caso de vasculite de pequenos vasos de apresentação incomum associado ao VCH.

Vasculitis is a pleomorfic inflammatory syndrome that involves mainly the wall of blood vessels. The hepatitis C virus infection may be associated to extra-hepatic manifestations, including autoimmune diseases. Two forms of vasculitis have been associated to hepatitis C virus, namely: mixed cryoglobulinemia and polyarteritis nodosa. The diagnosis and the therapeutic management of these conditions are clinical challenges. There are few data available in the literature about the antiviral treatment efficacy in patients with hepatitis C virus and autoimmune diseases. We describe an unusual patient displaying vasculitis of small vessels and with hepatitis C virus infection.