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Biomedical subjects

A Fernández Rodríguez

Publications and source records attributed to A Fernández Rodríguez.

At least 19 recordsLinked to original sources
PubMed2001

[Effect of thiazide therapy in the prophylaxis of calcium lithiasis].

OBJECTIVE: To analyze the role of thiazide therapy in the prevention of recurrent calcium nephrolithiasis, considering the hypocalciuric action of this drug. METHODS: A prospective study before and after treatment, with a 3-year follow-up, was carried out on 150 patients with recurrent calcium renal stone. The patients were divided into three groups: (A) no treatment, (B) treatment with thiazide 50 mg/day and (C) treatment with thiazide and potassium citrate. The treated groups were randomly assigned to the treatment arms. Control analytical tests and radiological assessments were performed regularly. RESULTS: Excellent results were achieved with thiazide therapy in regard to stone recurrence and changes in residual stone in comparison to the group of untreated patients (group A). The most common metabolic disorder was absorptive hypercalciuria type I. Most of the patients showed a single metabolic disorder. The side effects were generally not relevant. CONCLUSIONS: Thiazides should be considered as the first line of treatment in absorptive and excretory hypercalciuria. We believe that in unselected patients with calcium stone, thiazide therapy can be effective in its prevention. It is important to take into account the possible side effects of the drug and supplementation with potassium citrate for thiazide-induced hypocitraturia.

Benzothiadiazines↗
PubMed2000

[Renoureteral malformation and lithiasis. Therapeutic approach].

OBJECTIVE: To analyze our results in the treatment of calculi in renoureteral malformations with extracorporeal shock wave lithotripsy (ESWL) alone and the efficacy of ESWL and adjuvant methods in the resolution of calculi in different types of renoureteral malformations. METHODS: The study comprised 141 cases of renoureteral malformations with urinary calculi; 68 were renal, 69 ureteral and 4 in the Bricker urinary diversion. All patients had been diagnosed by IVP and treated by ESWL. These patients were compared with a control group of 125 patients with calculi and a normal renoureteral system that were treated similarly. RESULTS: The malformations accounted for 2.61% of the 5,400 patients that had been treated in our unit from 1990-1998. The mean number of sessions for the patients with malformations was 1.5 versus 1.2 for the control group. The results of treatment were significantly lower for the group of patients with renal malformations than for the control group (54% vs. 87.2%, respectively). Similar results were obtained for the group of patients with ureteral malformations and the control group (87% vs. 75%). CONCLUSIONS: ESWL can be the first treatment option for calculi in patients with renal malformations, although they should be individually evaluated for status of the excretory system, urinary flow dynamics and size of the calculus in order to select the best treatment option. In patients with ureteral malformations, the same criteria utilized for those with a normal excretory system should be applied.

Adult↗
PubMed1998

[Efficacy of radiotherapy for upper urinary tract tumor following radical surgery].

OBJECTIVE: To determine the efficacy of postoperative irradiation for locoregional tumor recurrence and in the prevention of distant metastasis in patients with upper urinary tract tumor treated by radical surgery. METHODS: 51 urothelial tumors of the upper urinary tract, most of which had been treated by radical surgery (nephroureterectomy with resection of bladder cuff were analyzed. Since 1989 an adjuvant postoperative radiotherapy protocol (55 Gy) has been included for high grade and stage tumors. Tumor staging was done according to the Jewett-Marshall classification and the Mostoffi cytological grading. RESULTS: Of the total number of cases analyzed, 16 received postoperative irradiation; of these, 5 (31%) showed recurrence. The recurrence rate was 47% for those treated by radical surgery alone. In patients with stage C tumors, 5 out of 12 cases (41.6%) showed recurrence. The recurrence rate was higher (83%) for patients with stage C tumors treated by radical surgery alone. CONCLUSIONS: Adjuvant postoperative radiotherapy is advocated for high grade and stage upper urinary tract tumors. This therapeutic approach has been found to reduce the number of recurrences and, consequently, morbidity. Although the overall survival rate did not increase, a larger series may show more consistent results in this regard.

Adolescent↗
PubMed1997

[Xanthogranulomatous pyelonephritis: experience at the General Hospital of Albacete. Report of 16 cases].

A retrospective study of 16 Xanthogranulomatous Pyelonephritis (XGP) cases seen during a 12-years period (1983-1994) at the Hospital General de Albacete was performed. An analysis is made of the clinical features, laboratory data and imaging diagnostic techniques, comparing our findings with those of several series published in the literature. The outcome of this study is that clinical and biological picture of XGP is characteristic: Middle-aged woman admitted to a Internal Medicine Service because a constitutional syndrome, with important weight loss, general poor health, acceleration of erythrocyte sedimentation rate (ESR), anemia, hepatic disfunction and renal destruction imagings, frequently with renal stone and urinary tract infection history. This characteristics can be useful to suspect a XGP.

Aged↗
PubMed1997

[Incidental prostatic adenocarcinoma in the ere of the PSA].

Prostate adenocarcinoma is occasionally and incidentally found in the prostate gland after enucleation through adenomectomy or transurethral resection (incidentaloma). We contribute 17 cases (3.38%) of incidentaloma found among 503 patients who underwent adenomectomy vs. TUR due to prostate obstructive-irritative symptomatology of likely benign etiology. The diagnostic methods, pathological findings, treatment and evolution in our series versus other recent ones are explained.

Adenocarcinoma↗
PubMed1997

[Determining factors in the success of the treatment of ureteral lithiasis by ESWL].

Shock-wave extracorporeal lithotripsy (SWEL) is admittedly the choice method for most ureteral calculi (UC). Treatment of 1.674 UC was carried out with a Lithostar (Siemens). Endourologic support manoeuvres (ESM) were used in 11.7% patients. To determine their statistical influence on treatment's result variables such as site, size, calculus density, obstruction and functionality of the renal unit, as well as presence of ureteral malformation, were analyzed. With an average of 1.3 sessions (9100 waves) success rate was 91.8% cases. Only the variables of size, obstruction and function showed statistical significance, thus identifying through a multistep logistic regression test the subgroup of calculi less likely to succeed (calculi > 1 cm2, with severe uropathy and functional annulment or delay). Complication were rare (7.5%) and minimally relevant. We conclude than SWEL is the first choice treatment for UC regardless the location. Ureteroscopy (UR) should be considered as the first option particularly in distal (iliopelvic ureter), obstructive calculi and those of difficult radiological study.

Adolescent↗
PubMed1997

[Sertoli cell tumor of the testis: clinical pathologic varieties. Report of a case].

Tumours derived from sex cords and primitive gonadal stroma account for 4% of total testicular tumours. The low frequency of Sertoli's cells tumour (SCT) and the uneven study and follow-up of patients makes analysis of this tumoral entity difficult. This paper contributes one case report of a Sertoli's giant cell tumour calcified in a 13-year old patient, and reviews the clinical aspects, clinico-pathological varieties believed to require assessment in patients with this type of disease. This type of tumour is considered benign in its biological behaviour, although some malignant forms have also been described. SCT is actually an heterogeneous tumoral pathogenic entity with regard to pathogenic and prognostic aspects. Our final conclusions show that the clinico-pathological variety, age, size and associated clinical manifestations appear to be related to the prognosis.

Adolescent↗
PubMed1996

[Clinical assessment and treatment of spontaneous perirenal hemorrhage].

OBJECTIVES: Four cases of spontaneous perirenal hemorrhage are reviewed, with special reference to the clinical features, diagnosis and treatment. METHODS/RESULTS: Two were due to tumor (sarcomatoid carcinoma and angiomyolipoma) and the rest were secondary to renal lesions. All patients underwent nephrectomy due to hemodynamic instability. CONCLUSIONS: Nephrectomy appears to be the best treatment since this condition may arise from a malignant tumor which, to date, cannot be determined by any diagnostic method.

Adult↗
PubMed1996

[Post-TUR radiotherapy in the treatment of locally advanced bladder tumor].

Treatment of infiltrant vesical cancer has traditionally been the grounds for intense controversy. Transurethral resection (TUR) followed by high voltage radiotherapy (RT) in selected cases of locally advanced vesical urothelial tumours can be a valid alternative for the treatment of this condition. This paper discloses the experience of our center in the treatment of this type of tumours over the last few years (1979-1993) on 85 selected patient, with a considerable percentage of living patients and with no evidence of disease after the follow-up period; taking into account the influence on these results of the cytologic grade, tumoral size, gross appearance of the tumour, and tumoral stage. Additionally, these results are compared with those from other authors using similar therapeutic method as well as with the results from different therapeutical approaches, illustrating one more the intense controversy that exists relative to the management of these patients.

Combined Modality Therapy↗
PubMed1996

[Premalignant and benign lesions in nodules of adenomatous hyperplasia].

OBJECTIVES: Currently, two premalignant lesions have been recognized: prostatic intraepithelial neoplasia (PIN) and atypical adenomatous hyperplasia (AAH). Due to the possible clinical implications of these lesions, we attempted to determine their incidence in specimens of benign prostatic hyperplasia (BPH), the most frequent pathology of the prostate. METHODS: A pathological and immunohistochemical study using several markers was performed to detect premalignant lesions in 156 specimens obtained by adenomectomy and TUR from 1990 to 1992. RESULTS: 20 PIN and 8 AAH (20.6%) were found. There were other equivocal prostatic lesions, not only with respect to premalignant lesions but prostatic carcinoma as well. CONCLUSIONS: Premalignant lesions within BPH nodules are frequent (20.6%). Furthermore, other lesions were also found that caused difficulty in making the differential diagnosis.

Humans↗
PubMed1995

[Testicular cavernous angioma: a difficult clinical diagnosis].

OBJECTIVE: The present report highlights the difficulty encountered in the diagnosis of cavernous testicular angioma in spite of the ultrasound study. METHODS/RESULTS: The clinical and ultrasound data of a patient with cavernous angioma of the testis were analyzed. To our knowledge, only 10 such cases have been reported in the literature. This condition could not be diagnosed on the basis of the clinical or ultrasound findings. CONCLUSIONS: Only pathological analysis and, therefore, surgical exploration can accurately diagnose cavernous angioma of the testis.

Adolescent↗
PubMed1995

[Laparoscopic treatment of the symptomatic renal cyst: the indications and a bibliographic review].

OBJECTIVES: The indications and usefulness of laparoscopic renal cystectomy are analyzed. METHODS: Five patients with symptomatic or recurrent simple renal cyst were submitted to laparoscopic cystectomy; section of the posterior peritoneum, dissection of the cyst, puncture-aspiration and resection of the cyst wall. RESULTS: Complete removal of the cyst wall was achieved with minimum morbidity, the cyst and symptoms disappeared and the hospital stay was short. There was one case of hematoma in the lumbar fossa that resolved with conservative management. CONCLUSIONS: Laparoscopic resection of the cyst wall appears to be a useful therapeutic approach for symptomatic or recurrent simple renal cysts.

Adult↗