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Biomedical subjects

A Rodríguez Alonso

Publications and source records attributed to A Rodríguez Alonso.

At least 19 recordsLinked to original sources
PubMed2006

[The utility of artificial neural networks in the prediction of prostate cancer on transrectal biopsy].

OBJECTIVE: To determine whether the development of an artificial neural network (ANN) made up of clinical variables allows for the prediction of prostate biopsy (PB) outcome. MATERIALS AND METHODS: Patients (n=953) underwent PB at the Arquitecto Marcide Hospital in Ferrol (Spain), between january 2000 and june 2005. The variables studied were age, PSA, digital rectal examination (DRE) and prostate volume, data for all of which were available in 843 cases. In order to determine factors related to prostate cancer (PC) diagnosis, a logistic regression analysis and a feed-forward neural network were developed, including three hidden layer nodes and an output node, representing the probability of PC. Both models were constructed from a random sample of n=643 patients (derivation set). The predictive capacity was assessed with the remaining 200 patients (validation set), by means of ROC curves and the area under the curve (AUC). RESULTS: PC was detected in 500 (59.3%) cases. Adjusting for age, PSA, digital rectal examination and prostate volume, in a multivariate logistic regression model it was observed that all the variables were independent predictors of PC. The AUC were 0.693 for PSA, 0.707 for prostate volume, 0.815 for logistic regression and 0.819 for ANN. The predictive capacity of the ANN was significantly higher than that of the PSA (p=0.002) and prostate volume (p<0,001) and similar to that of logistic regression (p=0.760). CONCLUSIONS: The ANN shows a PC prediction capacity that is significantly higher than unimodal diagnosis methods, and similar to that of logistic regression.

Aged↗
PubMed2005

[Partial substitution of the ureter using a short segment of the ileum following the Monti procedure].

The partial substitution of the ureter using a pediculated segment of the ileum is a technique used to re-establish ureteral transit and preserve the renal unit, following the resection of extensive ureteral lesions. Standard surgical procedure for an ileoureteroplasty consists of isolating an ileal duct of equal or greater length than the ureteral defect and interposing it in the urinary tract in an isoperistaltic direction. Monti described a surgical technique that allows for the creation of catheterizable stomas in continent urinary diversions, using the Mitrofanoff principle. These passageways were created from one or several 2.5 cm long ileal sections by means of their detubulization and transverse retubulization. The clinical case study presented here corresponds to a 57 year-old male with a history of ureteral lithiasis, with a 9 cm stenosis of the sacroiliac ureter. He was treated surgically by means of a resection of the stenotic ureter and the interposition of a duct made up of 2.5 ileal sections, treated in accordance with the Monti procedure. Since this operation, the patient's metabolic state has been completely normal. Morphological and functional results have also proved totally satisfactory, as the use of image techniques have shown.

Humans↗
PubMed2004

[Giant retroperitoneal cystic mass: appendiceal mucocele].

Appendiceal mucocele is a term used to describe the dilatation of the vermiform appendix produced by an intraluminal accumulation of mucus. Four pathological processes have been described that may lead to an appendiceal mucocele: obturation of cecoappendiceal communication, mucosal hyperplasia, mucinous cystadenoma and mucinous cystoadenocarcinoma. The most frequent is mucinous cystadenoma, seen in 50% of appendiceal mucoceles. 6% of patients with appendiceal mucocele develop peritoneal pseudomixoma, possibly through dissemination of the epithelial cells into the abdominal cavity. Preoperative diagnosis of the lesion is particularly important in order to deal with it carefully during surgery. CT scan is the most precise radiological exploration, although there are no pathognomonic signs of mucocele. Typical CT finding of a mucocele is a well-defined cystic mass that compresses the cecum without any peripheral inflammatory reaction, and with low levels of attenuation that vary between water and soft tissue density. We present a case of an appendiceal mucocele caused by a mucinous cystadenoma clinically presented as a giant retroperitoneal mass. Diagnosis was postoperatively made, after pathological study of the surgical sample.

Aged↗
PubMed2003

[Multivariate analysis of recurrence and progression in stage T1 transitional-cell carcinoma of the bladder. Prognostic value of p53 and Ki67].

OBJECTIVE: To establish prognostic factors of recurrence and progression in stage T1 transitional cell bladder carcinoma, paying special attention to prognostic value of p53 and ki67. MATERIALS AND METHODS: 175 patients with incident bladder tumour at T1 category. The immunohistochemical study was performed using the monoclonal antibodies DO-7, for p53 and MIB-1, for ki67. Kaplan-Meier methodology was used, and a multivariate analysis using Cox's proportional hazards model was carried out in order to determine the variables associated with recurrence and progression. ROC curves were also drawn up. RESULTS: The average follow up period was 8.55 years. 5 and 12-year recurrence-free survival rates were 57.98% and 48.47%. The independent variables for recurrence were histological grade, tumour multifocality, tumour size > 3 cm, presence of carcinoma in situ and ki67 expression. 5 and 12-year progression-free survival rates were 83.12% and 75.63%. The independent variables for progression were age, tumour multifocality, solid microscopic morphology, p53 expression and ki67 expression. CONCLUSIONS: Solid microscopic pattern and p53 expression are the variables which best predict progression. A positive relationship was observed between p53 and progression: the greater the expression of p53, the greater the progression. Tumour multifocality and ki67 expression > 27% are the main prognostic factors for recurrence.

Aged↗
PubMed2002

[Duplication of the male urethra].

Duplication of the male urethra is an uncommon congenital malformation. The majority of cases are diagnosed during infancy, and are detected by observing two urethral meatus, or by the appearance of some form of complication, normally of an obstructive nature. Micturitional cystourethrography is an essential test, both in confirming diagnosis of this pathology, and in determining the type of urethral duplication. Excretory urography is also recommended due to its association with other possible urological and extra-urological congenital disorders. Treatment is based on the patient's clinical symptoms, with a waiting period considered advisable for asymptomatic cases. Here we present a case of incomplete urethral duplication, diagnosed from a bladder outlet obstruction, secondary to stenosis of the urethra, which was treated with an endoscopic urethrotomy and distal septotomy, obtaining excellent clinical results.

Humans↗
PubMed2002

[Subepithelial hematoma of kidney pelvis and ureter: Antopol-Goldman lesion].

The subepithelial hematoma of the renal pelvis and ureter was described by Antopol and Goldman in 1948. Hematuria and filling defect in the renal pelvis are the most consistently recurring clinical and radiological findings. Only 21 cases were found in the literature on the subject and all of them were treated surgically, usually with partial or total nephrectomy. Here we present a case of Antopol-Goldman lesion which was treated conservatively.

Adult↗
PubMed2002

[Primary bladder osteosarcoma treated with hemicystectomy].

Primary osteosarcoma of the bladder is an extremely rare type of tumour, and less than 30 adequately documented cases have been registered. From a clinical and radiological point of view, it is impossible to distinguish from other types of bladder tumours, since despite the fact that calcification of the bladder wall is common in osteosarcoma, other bladder diseases exist which may also present calcification. Prior to primary bladder osteosarcoma diagnosis, it is vital to first rule out the existence of an skeletal origin. Differential diagnosis must be carried out essentially with other bone-forming tumours, such as carcinosarcoma and transitional cell carcinoma with bone metaplasia. Prognosis for bladder osteosarcoma is extremely pessimistic, as the majority of patients do not survive beyond 6 months, regardless of the treatment carried out. We present a case of bladder osteosarcoma treated by right hemi-cystectomy, which remains disease free after a follow-up period of one year.

Aged↗
PubMed2002

[Obstructive anuria secondary to uterine prolapse].

The prevalence of obstructive uropathy linked to uterine prolapse ranges between 4% and 80%, depending on the series, probably due to the varying degree of severity of the prolapses under consideration. Renal failure or anuria is an unusual complication. Several etiopathogenic theories regarding obstructive uropathy secondary to prolapse have been put forward: ureteral compression by the uterine vessels, severe urethral angulation, ureteral compression against levator ani muscles and the elongation and narrowing of the distal ureter. The major radiological exploration used in studying the urinary tract of these patients is intravenous urography in bipedestation. Emergency treatment for obstructive anuria resulting from a uterine prolapse consists of manually replacement of the prolapse. Surgery is considered to be the definitive ideal treatment, although in the case of surgical or anaesthetic high risk patients, inserting a permanent pessary may constitute a satisfactory solution. We present a case of obstructive anuria resulting from uterine prolapse, which was successfully treated with the insertion of a ring pessary.

Aged↗
PubMed2000

[Metachronous tumors of the upper urinary tract following primary superficial tumors of the bladder].

OBJECTIVE: To evaluate the long term incidence of upper urinary tract tumours in patients with surface tumours of the bladder. MATERIAL AND METHODS: Analysis of 78 patients with primary tumour of the bladder pTa-pTl diagnosed between 1978 and 1988. These patients were followed for up to 10 to 21 years (mean follow-up 13.4 years) and were treated with transurethral resection and a variety of endovesical cytostatic agents. RESULTS: Of all 78 patients, 9 (11%) developed an upper urinary tract tumour over an average of 9 years (range 4-18); 2 in the first 5 years, 4 between 5 to 10 years, and 3 between 10 and 18 years. The likelihood of finding a tumour in the upper tract if all 20-year old patients were to be followed would be 25.6% (Kaplan-Meier's method). A high percentage of all upper urinary tract tumours are infiltrant, but the cause of death in 44% of these patients is progression of the tumour of the bladder. CONCLUSIONS: The percentage of tumours of the upper urinary tract that become metachronic following a tumour of the bladder, increases with the duration of the follow-up. A high percentage of these cases are already in high stages when diagnosed. It would be convenient to monitor the upper urinary tract with the same periodicity than the bladder in order to establish early diagnoses. These patients show a high mortality rate, in most cases secondary to progression of the tumour of the bladder.

Adult↗
PubMed2000

[Bilateral testicular luxation].

Contribution of a case report of long-standing bilateral testicular luxation, the result of scrotal trauma caused by a soccer ball. Good aesthetic, endocrine and exocrine results were obtained with surgical treatment. Androgenic hormonal profile and spermiogram performed at six months showed values within the normal range.

Adult↗
PubMed2000

[Abdominal-pelvic actinomycosis with urinary tract involvement, secondary to gynecologic infection caused by intrauterine device].

Abdomino-pelvic actinomycosis is a condition caused by Actinomyces israelii, a Gram-positive opportunistic bacteria that triggers and develops the infection only in previously injured tissues, and then slowly progresses and spreads until it extrinsically affects the urinary tract. Use of an intrauterine device is a known risk factor to suffer from this disease. Relative risk in IUD users is two- to four-fold higher compared to IUD non-users. Risk increased with prolonged IUD use. Treatment is by removal of the causative agent, surgical resection of necrotic tissues and administration of intravenous Penicillin G, 4 million units every 4 hours for 30 days, followed by Amoxicillin 500 mg every 8 hours for 12 months. This paper contributes two cases of abdomino-pelvic actinomycosis with urinary tract involvement in IUD users. Standard treatment was employed with good evolution.

Actinomycosis↗
PubMed2000

[Fournier's gangrene: anatomo-clinical features in adults and children. Therapy update].

Fournier's gangrene is a skin infectious-necrotising process in the peri-neogenital area affecting males, usually in their sixties or seventies. Isolated flora from cultures of the necrotic lesion is commonly multi-microbial. In a majority of cases both aerobic and anaerobic micro-organisms are found in the cultures, Escherichia coli being the most commonly identified germ. Although considered in the past an idiopathic condition, in most patients today a genitourinary, anorectal or dermal triggering factor can be identified. There are a series of systemic host debilitating disorders such as diabetes mellitus, chronic alcohol abuse, and malignant neoplasia that are associated to this condition and may be considered risk factor to suffer this disease. Fournier's gangrene in children show specific bacteriological, pathogenic, clinical, therapeutic and prognostic features that distinguish it from that in adults. The most extensively accepted management for this condition includes therapy with broad-spectrum parenteral antibiotics and early and aggressive surgical debridement of the necrotic areas. Mortality continues to be high, ranging between 10-80% in the various series. Finally, a group of 7 patients with Fournier's gangrene is analyzed (1991-1998) aiming to establish a comparison between our results and those seen in recent series.

Adult↗
PubMed2000

[Leiomyoma of the female urethra].

Leiomyoma of the female urethra is a benign mesenchymal tumour highly infrequent in the clinical practice. There is controversy as to its degree of oestrogen hormone dependency and its diagnosis is reached only after pathohistological study of the resection specimen. This type of tumour has excellent prognosis, with few tumoral relapses and no case of malignant transformation having been reported for the time being. Contribution of one case report of leiomyoma of the female urethra with typical clinical-epidemiological features but very uncommon from a topographic insight, as it was located in the anterior side of the distal urethra.

Female↗
PubMed1999

[Indications for BCG in surface tumors of the bladder].

Overall view of Bacille de Calmette-Guerin (BCG) immunotherapy in the prophylaxis and treatment of surface cancer of the bladder. A series of issues, on some of which a consensus has been reached while controversy is still frequent in others are discussed. Intravesical instillation of BCG as the single route has been considered to best mode of administration. With regard to the BCG strain to be used, there is still no consensus after the analysis of the data provided by the studies conducted. Relative to the treatment schedule, it appears clear that maintenance therapy is superior to an exclusively induction regime. No consensus has been reached about optimal dosage or the possibility to reduce toxicity. Although some studies support the belief that intravesical immunotherapy with BCG is superior to chemotherapy, further data is required to confirm such assumption. In conclusion, although treatment with BCG has proven to be effective in patients with surface tumours of the bladder, it should not be considered a panacea to be indiscriminately used in any patient with this malignancy.

BCG Vaccine↗
PubMed1999

[Metastatic prostate adenocarcinoma in hernial sac. Contribution of one case].

Presentation of a case of stage D2 prostatic adenocarcinoma, diagnosed through a chance finding of micrometastasis in the pathohistological study of the hernial sac of a patient undergoing inguinal herniorrhaphy. Most usual sites for prostate cancer metastasis are lymph nodes, bones, lungs, liver, and brain. During our revision of unusual anatomical sites for prostatic carcinoma metastasis, we found references of metastasis on the uvea, larynx, orbit and maxillary sinus. The peritoneal cavity was not found to be a common site for metastatic implants. It was also found that such peritoneal spread was usually diagnosed after a postmortem examination.

Adenocarcinoma↗
PubMed1999

[Value of non-contrast helical computerized tomography in nephrotic colic assessment].

OBJECTIVE: To compare non-contrast helicoid CAT to urological ultrasound in order to determine the sensitivity of both in the etiological diagnosis of nephritic colic. MATERIAL AND METHODS: Retrospective study conducted on a total of 86 patients seen in our ER service over a 12-month period with a diagnosis of nephritic colic. All patients with suspicious diagnosis of nephritic colic underwent X-ray examination, with either non-contrast helicoid CAR or urological ultrasound, or with a combination of both imaging techniques. Radiologic diagnosis of nephritic colic was made by direct visualization of the obstructive cause or by the presence of indirect radiological signs of upper urinary tract obstruction. RESULTS: Of 86 patients studied, in 84 (97.67%) a urinary stone was the cause for obstruction. Overall sensitivity of helicoid CAT to diagnose colic etiology was 94.73%, whereas ultrasound sensitivity was only 53.42%, displaying a particularly low sensitivity when the obstruction was located at the mid third level of the ureter. CONCLUSIONS: Non-contrast helicoid CAT shows superior sensitivity as a radiologic technique than ultrasound to identify the cause of a nephritic colic in any segment of the upper urinary tract.

Adult↗
PubMed1999

[A massive hernia of the bladder into the scrotum. A report of a case].

The hernia of the bladder in the scrotum is a highly uncommon observation. From the clinical standpoint the usual manifestation is a two-stroke voiding. The recommended urological examinations to reach a diagnosis are ultrasound, endovenous urography, retrograde urethrocystography and cystoscopy. Management includes the de-obstruction of the lower urinary tract, if present, resection of associated peritoneum, resection or reduction of the vesical hernia and repairment of inguinal path. The case contributed corresponds to a vesical hernia in a 72-year-old patient, with no obstructive cause, that was treated surgically by resection of the herniated bladder, with good morphological and functional results.

Aged↗