PubMed Health⌕ Search

Biomedical subjects

A Gelabert Mas

Publications and source records attributed to A Gelabert Mas.

At least 19 recordsLinked to original sources
PubMed2006

[Development of tissue microarray technology (TMA) for immunohistochemical study of molecular expression profiling in prostate cancer (part 1)].

Tissue microarray technology (TMA) is nowadays considered as a powerful tool for the high-throughput analysis of molecular expression pattern of cancer. In this manuscript we show the experience of both groups in the design and building of a TMA for the study of protein expression pattern of prostatecancer as well as a summary of the technical points to analyze the results obtained with this technology. Today, different data generated by the immunostained tissues are studied to achieve a molecular profile in different clinical scenarios.

Equipment Design↗
PubMed2004

[Doxazosin in the gastrointestinal therapeutic system (GITS) formulation and trial without catheter after acute urinary retention due to BPH. Dose increase action on recovery effect].

OBJECTIVE: Prospective and randomised study to assess the effectiveness of doxazosin in sustained release formulation in Acute Urinary Retention (AUR) treatment due to benign prostatic hyperplasia (BPH). MATERIAL AND METHODS: The trial was carried out with a cohort of 40 males who had all suffered their first attack of AUR caused by BPH. Twenty were randomly selected and treated for 7 days with 4 mg of sustained release doxazosin before removing the catheter. The patients not treated that could not spontaneously urinate were also administered 4 mg of doxazosin. Finally, all the patients that still had a catheter due to unsuccessful removal were treated with 8 mg of doxazosin and the percentage of patients responding to treatment was assessed. The predictive value of the response to treatment for age, IPSS, QoL, retained urine volume, prostate volume and the evolution time of the prostratism was determined by means of logistic regression analysis. RESULTS: 82.5% of the patients (33/40) could urinate after removal of the catheter. 84.8% (28/33) were treated with doxazosin (21 with 4 mg and 7 with 8 mg). In the first attempt at removal, 60% of the patients (12/20) treated with 4 mg of doxazosin could spontaneously urinate, while only 25% (5/20) of those not treated, p=0.02. Similarly, 60% of the patients (9/15) treated with 4 mg of doxazosin in the second attempt could spontaneously urinate. Fifty per cent (7/14) of the patients still with a catheter, after the treatment with 4 mg of doxazosin, could urinate with 8 mg. In the logistic regression analysis, none of the variables analyzed allowed us to predict the response to the treatment. CONCLUSION: The treatment for 7 days with 4 mg of sustained release doxazosin shows greater success when removing the catheter after suffering AUR due to BPH. With this treatment, 60% of the patients could spontaneously urinate again. By increasing the dose to 8 mg, the catheter can be removed in half the patients that did not initially respond. Before removing the catheter it is not possible to predict which patients would be able to spontaneously urinate.

Acute Disease↗
PubMed2004

[Histopathologic validation of the tissue-microarray technology of urothelial cancer. Our experience].

INTRODUCTION: The array technology offers: a big advance to clinic and basic investigator, it provides a variety of technics (immunohistochemistry, FISH, proteomics) to understand the molecular mechanisms of cancer. It offers scale economy in reagents versus the conventional methods. Array most be ratified because the sample is so reduced. MATERIAL AND METHODS: 52 consecutive cases have been chosen from paraffin blocks of bladder and ureteral cancer which are 5-7 years old, a tissue array has been made; disks have been arranged in lines and columns, in an aleatory way, in order to guide it's reading. It has been evaluated by a pathologist with any relation to specimen selection. RESULTS: 87 sheets ha been obtained. Number 1 has been dyed with HE. Has been discrepancy in 27% of sample's stage. Has not been a discrepancy in histopathologic diagnostic. There is no sample's representation in 11 points (17%). DISCUSSION: Our results offer good results in sample's validation. The sample's antigenicity of tissue is conserved. Array sample's represent a 97%, similarly to all unit of conventional sections of the specimen.

Humans↗
PubMed2003

[Cystoscopic impression versus histologic diagnosis in bladder tumors. Do they coincide?].

OBJECTIVE: How quality control in a university hospital and immediatly after to resents publications; we planed to evaluation of the correlation of cystoscopy impression with the histologic diagnosis after of transurethral resection (TUR). MATERIAL AND METHODS: To give more truthfulness to the study, we requested to all department member's, that to base in your experience to describe the endoscopic characteristic of the next bladder tumors groups: superficial and low-grade GI-II Ta, superficial and high-grade GIII Ta and high grade and/or T1-< T2. In a total of 172 patients, we evaluated the initial cystoscopy impression and we to compared it with histologic diagnosis after to TUR. RESULTS: In 172 tumors the cystoscopy classifed in 69 cases how superficial and low grade GI-II Ta-T1, 40 how superficial and high grade and 55 how high grade and/or invasive tumors GIII T1-< T2. When, we compared it with the histologic diagnosis, the cystoscopy to coincided in 46 de 69 cases (66.6%) (PNS) with the group of low-grade GI-II Ta-T1 in 13 of 40 (32.5%) (P < 0.005) with the group of superficial high grade GIII Ta and 45 of 51 (88.2%) (PNS) with the group of GIII T1 and/or invasive tumors. In 15 of 172 the endoscopic description its not conclusive. And finally in 12 cases the histologic diagnosis were normal. CONCLUSIONS: In order of this results, we to consider that in a university hospital is essential the histologic diagnosis before any therapeutic decision, because the initial cystoscopy impression have a low correlation with the histologic diagnosis. We are disagreement with recent publication that propose the outpatient cystoscopy with fulguration to base only to the cystoscopy impression.

Cystoscopy↗
PubMed2003

[Diagnostic and therapeutic approach to bilateral germinal tumor. Presentation of a case and review of the literature].

The germinal bilateral tumor represents from 1 to 4% of the testicle tumors, and it usually turns to be one of the most difficult ones when talking about diagnosis and treatment. We are attaching a 30 years old patient case, with a diagnosis consisting in a seminoma with yolk sac tumor area from the left testicle, that was treated with orquiectomy. Eleven months later, the patient presented a second neoplasm in the contralateral testicle, whose histology was a classical seminoma with carcinoma "in situ" peritumoral, being also treated with orquiectomy. Medical literature is revised with emphasis in the involved risk factors and the techniques used to treat these testis tumor groups: carcinoma "in situ" detection appears to be the strongest predicting factor. Testicular contralateral biopsy is proposed in some select cases. Even though radical orquiectomy is still the treatment to choose, local radiotherapy and conservative surgery are also an option in patients with bilateral tumor.

Adult↗
PubMed2001

[Anemia and neoadjuvant hormone therapy in radical surgery of localized cancer of the prostate].

RATIONALE: Erythropoiesis is stimulated by androgens either through a direct action on bone marrow cells or through increased erythropoietin production. Androgen deprivation is a known cause for anaemia. The aim of this study was to evaluate the effect of neoadjuvant hormone therapy prior to radical surgery on haemoglobin (Hb) and haematocrit (Ht) levels in localised prostate cancer. MATERIAL AND METHOD: 47 patients with clinical localised prostate cancer were given LH-RH analogs plus flutamide for complete androgenic blockade (CAB) for at least 3 months prior to radical prostatectomy. A blood profile was obtained prior to start CAB and 3 months after therapy, and peri-operative transfusional requirements were evaluated. To assess any significant changes. Student's t test was used in the statistical analysis of paired data. RESULTS: In our study all patients (100%) showed decreased Hb and Ht levels after 3 months on CAB. Mean decline for Hb was 1.9 g/dL (range 1.6-2.2) p:0.0001, and for Ht 5.8% (range 4.8-6.8) p:0.0001. Hb was lower than 12 g/dL in 10.6% patients after hormone therapy and anaemia results were normocytic-normochromic. 60% patients needed peri-operative blood transfusion, 2 units of packed cells on average. CONCLUSIONS: Neoadjuvant CAB prior to radical prostatectomy results in a significant decline of Hb and Ht levels after 3 months treatment. Such decline may contribute to increase peri-operative transfusional requirements in a group of patients undergoing aggressive surgery which in itself involves a significant blood loss.

Androgen Antagonists↗
PubMed2001

[Clinical prognostic factors in superficial cancer of the urinary bladder].

OBJECTIVE: To determine the relation of the classical prognostic factors (tumor stage, grade, size and location) to the recurrence rate, disease free interval and overall survival in patients with superficial bladder cancer. METHODS: The study was carried out on 144 patients with superficial transitional cell carcinoma of the bladder (pTa, pT1) over a period of three years. Age, sex, history of exposure to aniline, smoking, histological type, tumor grade, size, stage, localization (single vs multiple) and type of complementary treatment were analyzed. Tumors were staged according to the TNM classification (1997 version) and cell grade was determined according to the Broders classification. RESULTS: Mean age was 70 years +/- 12.55 (range 22-100); 124 (86%) were males and 20 (14%) were females. All tumors were superficial transitional cell carcinoma; 93% were papillary and the remaining 7% were solid tumors. There were 52 recurrences (36%); of these, only 13 (25%) showed tumor progression: 4 became infiltrating (31%), one (8%) advanced in superficial tumor stage and 8 (61%) advanced in grade. Mean follow-up was 31 months (range 3-61). Overall and disease free survival at 5 years were 88.42% and 45%, respectively. No differences were found for disease free survival according to the different prognostic factors analyzed. Tumor grade correlated with stage and size. Thus, grade III tumors are likely to be stage pT1 and greater than 3 cm. in size. CONCLUSIONS: The histological grade is the most important prognostic factor in bladder cancer progression. However, while grade I and III tumors show a rather similar behavior, the moderately differentiated tumors comprise a heterogeneous group with a very disparate behavior. Tumor grade was found to correlate with stage and size.

Adult↗
PubMed2001

[Vesico-sphincter dysfunction in 108 cases of multiple sclerosis].

OBJECTIVE: To study vesicosphincteric dysfunction in 108 patients with multiple sclerosis. METHODS: We reviewed the clinical records of 108 patients with multiple sclerosis and analyzed those with voiding symptoms ascribable to multiple sclerosis. These patients underwent complete urodynamic assessment and complementary tests according to their symptoms. The Blaivas classification was used for the clinical classification of multiple sclerosis. RESULTS: 64 of the 108 patients presented voiding symptoms ascribable to multiple sclerosis (59.2%). The clinical features presented as episodes in 75% and were progressive in 25% of the cases. In 6% of the patients, the voiding symptoms were the first symptoms of multiple sclerosis. Urodynamic assessment showed detrusor hyperreflexia in 73% of the patients, hyporeflexia in 14%, and 13% showed normal urodynamics. All complications were infective; no patient showed upper urinary tract complications. CONCLUSIONS: Vesicosphincteric dysfunction in multiple sclerosis is frequent. Most of the patients present bladder hyperreflexia. The urological complications are usually infective. Involvement of the upper urinary tract is rare.

Adult↗
PubMed1999

[Hydraulic prosthesis for regulating the sling tension in the treatment of urinary incontinence in women].

OBJECTIVE: To improve the results of corrective surgery for severe urinary incontinence in the female (sphincteric lesion) utilizing a new prosthesis that allows adjusting the degree of tension of the band or urethrocervical sling. METHODS: We have added the use of a subcutaneous hydraulic device to the classical pubovaginal sling procedure. The device can be gradually filled by percutaneous punction to adjust the urethral closure pressure. RESULTS: All patients had previously undergone different procedures and had grade III stress urinary incontinence. With the hydraulic device, the success rate (complete continence) was 95.5% (21/22 patients) and the complication rate was 9% (2 cases; one developed infection and the other chronic urinary retention). CONCLUSIONS: The hydraulic device described herein is easy to place, low-cost and carries a minimum morbidity. Its use is indicated in patients who have previously undergone surgery, with a sphincteric lesion and who require precise adjustment of the urethrocervical sling. The degree of tautness can be adjusted repeatedly according to the clinical course of a patient without requiring reoperation.

Adult↗
PubMed1998

[Management of hyposalivation caused by oxybutynin chloride in the treatment of the unstable bladder].

OBJECTIVE: To know the incidence of adverse reactions from Oxybutynin Chloride, with special reference to salivary hyposecretion and to evaluate the effectiveness of the different alternatives employed to solve it. MATERIAL AND METHOD: 144 adult patients with signs and symptoms of voiding urgency and detrusor-hyperactivity incontinence, who were treated with Oxybutynin 5 to 15 mg/day. Hyposecretion of several exocrine glands was evaluated using a questionnaire that included subjective and objective parameters. For managing purposes, patients were divided into 3 groups: 1) General measures; 2) Therapy with sialagogues; and 3) Replacement therapy with artificial saliva. RESULTS: 42% patients treated with Oxybutynin developed mild-to-moderate hyposialism. 26% had severe hyposialism, always related to high dose Oxybutynin. 6% skin dryness, 3% eye dryness and 2% dryness in all the above glands (dry syndrome). Regarding treatment, most patients with mild-to-moderate hyposialism were managed with simple general measures. In severe hyposialism, both sialagogues (Eledoisine) and artificial saliva (Bucalsone) were resolutive in over 90% cases. CONCLUSIONS: Oxybutynin is an effective drug to stop detrusor hyperactivity, but it has a high rate of anticholinergic adverse reactions. There is a number of effective therapeutic options available to alleviate these effects, which allow the patient to continue with the treatment.

Adult↗
PubMed1997

Experimental assessment of ureteral free autograft.

OBJECTIVE: To establish the sequence of ureteral events under ischemic and desvascularized conditions but without immunologic interference. MATERIALS AND METHODS: Sixty-two rats were divided into four groups. NU group (n 20) control group, normal ureter; SC group (n 15) only surgical control ureterolysis; NIAFG group (n 13) ureter used as non integrated autologous free graft; IAFG group (n 14): ureter used as integrated autologous free graft. Urographic, histologic and histomorphometric studies were performed. RESULTS: We established ureteral changes in the NIAFG and IAFG groups, compared to the control groups (NU, SC). Surgical findings and urographic assessment revealed normal peristalsis with no ectasia in some cases, and no ureteral fistulas or extravasations were found in the IAFG group. Histologic findings showed preservation of the architecture of the three normal layers. Histomorphometric studies showed that ureterolysis caused edema in the lamina propria, while changes in ureter free graft depended on whether the ureter was integrated or not. In the NIAFG group only the urothelial layers showed differences and in the IAFG group the ureteral wall appeared thicker. Histomorphometric studies showed preservation of the normal histologic structures in all cases. CONCLUSIONS: The rat ureter can be used as a free autologous graft and represents an experimental model for immunologic events. We may assume that the necrosis and fibrosis observed in transplanted ureters are secondary to rejection in some cases.

Animals↗
PubMed1997

[Surgical solutions to iatrogenic ureteral lesions in 31 cases].

OBJECTIVE: To conduct a critical review of the etiological, clinical and diagnostic aspects of iatrogenic ureteral lesions caused by various surgical disciplines, primarily focused on the different therapeutical options used. PATIENTS AND METHOD: Between January 1985 and December 1995, 31 iatrogenic lesions of the ureter, 19 female and 10 male, mean age 52 years, were examined. The right ureter was involved in 19 cases and the left one in 12 (2 bilateral). The ureteral lesion resulted from gynaecological surgery in 19 cases (61%), general surgery in 6 (19%), vascular surgery in 3 (10%) and urology in 3 (10%). In 9 cases (29%) it was diagnosed during surgery: in 14 cases (45%) as a result of clinical signs and symptoms and in 8 cases (25%) casually. Surgery was the option chosen in 22 cases, while in 9 conservative treatment was followed. RESULTS: Surgery solved 91% of damaged ureters, and the best results were seen in patients where lesion was repaired immediately. Conservative treatment was resolutive in all cases. CONCLUSIONS: Gynaecological surgery continues to be the most frequent cause of iatrogenic lesions of the ureter. Ureteral damage in males is now increasing due to the demands from general oncologic surgery, which is usually appreciated by the surgeon which allows immediate repair. Lesions caused by gynaecologic and vascular surgery are commonly overlooked and are diagnosed post-surgically either because of their clinical manifestations or accidentally. The different surgical techniques currently available allow a successful repair of this kind of lesions. Conservative therapy is appropriate in cases that fulfil a series of basic requirements.

Adult↗
PubMed1997

[Early diagnosis by opportunistic screening in cancer of the prostate. Results of a 1-year protocol. Comparison with historical data].

RATIONALE: The high prevalence of Prostate Cancer (PC) and long survival of patients with advanced disease, added to the high cost of palliative treatment (hormone therapy), versus the existence of curative therapies at earlier stages, fully justify the campaigns for early diagnosis. The objective of the study was to increase the number of cases diagnosed at local stages, using an opportunistic screening methodology. METHODS: All male patients between 50-70 years of age, seen over one year in Urology and primary care in CAP-Barceloneta because of urinary symptomatology, were included in a screening program. This cohort were performed total PSA determination and digital rectal examination. When digital rectal examination was suspicious and/or PSA values higher than 4 ng/ml, they underwent echo-guided prostate biopsy. RESULTS: A total of 595 male were seen; 43.9% met the inclusion criteria; 39.4% were rated as suspicious, neoplasia being confirmed in 51% of these. Prevalence of PC in this cohort was 20.1%, half of them in local stage. CONCLUSIONS: Populational screening in PC has proven to be ineffective from a health care standpoint, as opposed to opportunistic screening. Overdiagnosis was not significant, although there were more cases diagnosed in organ-confined stages, this is, eligible for curative therapy; thus, hormone therapy and the resulting morbidity were significantly decreased; quality of life of patients under curative treatment was improved; there was a large reduction of health care costs and, although it will have to be further confirmed in large multicentre series, we believe survival was improved.

Aged↗