Biomedical subjects

Daniel Santos Arrontes

Publications and source records attributed to Daniel Santos Arrontes.

12 recordsLinked to original sources

PubMed2006

[Tobacco consumption and bladder cancer mortality in Spain].

OBJECTIVES: To establish the trend of the bladder cancer adjusted mortality and its correlation with tobacco consumption in different Spanish Autonomic Communities over a 15 year period. METHODS: We evaluate the trends of mortality rates associated with bladder cancer between January 1st 1989 and December 31st 2002 in the geographic area of Spain, as well as the tendency of tobacco consumption. Demographic and mortality data were obtained from the National Institute of Statistics, and consumption data were obtained from the Commissioner for the Tobacco Market in the Spanish Economics and Finances Ministry. We calculate the average number of cigarettes (1 package = 20 cigarettes) consumed per person; we also calculate bladder cancer adjusted mortality rates, presented as number of deaths for that cause per 100.000 persons year, and the ratio between number of packages of cigarettes consumed and adjusted mortality rate. We determine the yearly percentage increase over the whole period of study for both the mortality rate and tobacco consumption, and evaluate their correlation by the Spearman's coefficient. RESULTS: Mean adjusted bladder cancer mortality rate over the period of study was 9.4 deaths per 100.000 habitants year, and mean tobacco consumption was 109.7 packages per person year. There has been a 2.05% yearly increase of bladder cancer associated mortality, mean cigarette consumption has diminished 1.3% per year. The Spearman's test did not show any correlation between both factors (p = 0.722). CONCLUSIONS: Despite preventive measures for tobacco addiction in our country, there is an important continuous consumption. The increase in the incidence of bladder cancer does not seem to be related with higher tobacco consumption currently, therefore it may be related with other genetic or environmental factors.

Humans↗

PubMed2006

[Renal cell renal carcinoma. Analysis of incidence and survival in a 90.000 citizens healthcare area].

OBJECTIVES: To evaluate the most relevant epidemiological and survival data of the renal cell carcinoma (RCC) in a 90.000 citizens geographic area, as well as its association with risk factors such as tobacco or diuretic drugs use. METHODS: All patients with the pathologic diagnosis of renal cell carcinoma between January 1st 1987 and January 31st 2004 were included in the study. Adjusted incidence rates (standardized) per 100.000 inhabitants year, annual percentage increase, and epidemic index in the health-care area VIII in Ciudad Real (90.000 inhabitants) were calculated. For the population adjustment we used the data Published by the National Institute of Statistics. We evaluated the differences in mortality between males/females, as well as in relation to tobacco consumption, using the chi-square test or the Fisher exact test, and the overall survival by a Cox regression model. RESULTS: Thirty-eight RCC were diagnosed, with a maximum incidence of 7.21 cases per 100.000 inhabitants year. There was an annual percentage increase of 2.06% over the whole period. There were no statistically significant differences in gender-associated mortality (p = 0.1), tumor stage (p = 0.063), tobacco consumption (p = 0.13), diuretic drugs consumption (p = 0.69), or both (p = 0.5). Mortality was significantly higher during the first 5 years after surgery. CONCLUSIONS: The incidence of RCC is progressively increasing, and it is predictable that this trend will be maintained in the next years. Overall mortality (any cause) associated with RCC is higher in the first five years after diagnosis.

Aged↗

PubMed2005

[Subcapsular orchiectomy in the treatment of prostate cancer: results].

OBJECTIVES: To analyze the role of orchiectomy in the management of metastasic prostate cancer in our environment. METHODS: We studied 76 patients with the diagnosis of prostate cancer who underwent subcapsular orchiectomy. RESULTS: Mean age was 72 years, median Gleason score was 7, and only 17% had organ confined tumors. Mean follow-up was 2.3 yr. and hospital stay median three days. Ten of the 76 patients in the study died from cancer, being overall five-year survival 75%. Regarding cost analysis, surgical castration was cheaper in the long-term but has the disadvantage of its greater psychological impact. CONCLUSIONS: Orchiectomy is a valid hormonal blockade option when estimated patient survival is longer than one year.

Aged↗

PubMed2005

[Transrectal prostatic biopsy management policy for patients older than 50 years in relation to PSA values elaborated by a mathematical decision tree].

OBJECTIVES: To decide the action politics (to perform or not transrectal prostatic biopsy) for a PSA cut point of 4 and 10 ng/ml through the construction of a mathematical decision tree. METHODS: We calculate the usefulness of the biopsy through a subjective score, from 0 to 10, established after a survey of the 20 staff members of the health-care area, applying an global analysis with creation of total profile cards through an orthogonal design. RESULTS: The main usefulness of prostate cancer screening would be not to perform transrectal prostatic biopsies when PSA is lower than 4 ng/ml.

Adenocarcinoma↗

PubMed2005

[Synchronous renal clear-cell carcinoma and ipsilateral transitional-cell carcinoma: case report and bibliographic review].

OBJECTIVES: We report a new case of simultaneous renal cell adenocarcinoma and ipsilateral multifocal transitional cell carcinoma. METHODS: 73-year-old man with initial diagnosis of transitional cell carcinoma of the urinary tract whose pathological report showed a asynchronous renal cell carcinoma. RESULTS: We present microphotographs of both tumors after radical surgery. CONCLUSIONS: The presentation of both tumors in the same kidney is unusual, although there are around 47 cases in the bibliography worldwide, 8 of them in Spanish. Presentation of both tumors altogether does not worsen prognosis.

Adenocarcinoma, Clear Cell↗

PubMed2005

[Circumcision in religious art].

OBJECTIVES: The objective of this study is to perform a historical journey through the topic of circumcision from the Italian Renaissance to the Spanish Baroque. METHODS: We evaluated the paintings about circumcision between both periods, including their most representative works. RESULTS AND CONCLUSIONS: Circumcision is a frequent topic in the religious painting in both periods.

Circumcision, Male↗

PubMed2005

[Epidemiological analysis of the squamous cell carcinoma of the penis in a 90,000 inhabitant health area].

OBJECTIVES: To establish the most relevant epidemiological features of the squamous cell carcinoma of the penis (absolute, adjusted and accumulated incidence, incidence density, and epidemic index), as well as its related survival. METHODS: We included all patients with the diagnosis of squamous cell carcinoma of the penis in the health area No. VIII of Ciudad Real (90,000 inhabitant) between January 1981 and December 2003. Data from the national Institute of Statistics were used for population adjustments. A Cox regression model was applied for survival analysis. RESULTS: The incidence of squamous cell carcinoma of the penis has increased over the last years (yearly increase 5.86%) with a high mortality rate within the first year (median survival 407 days) CONCLUSIONS: It would be recommendable to intensify preventive measures to try a stop the increase in incidence, as well as successful adjuvant treatments to increase cancer specific survival.

Aged↗

PubMed2004

[Preliminary results in a series of patients with prostate cancer who underwent radical prostatectomy].

OBJECTIVES: To analyze the preliminary results in our series of radical retropubic prostatectomies (RRP) in terms of complications; and to evaluate also its efficacy in disease control (cancer progression and survival). METHODS: We reviewed the charts of 139 patients who underwent radical prostatectomy. Preoperative data such as age at the time of diagnosis, serum PSA, presence of suspicious digital rectal examination (DRE), clinical stage, and Gleason's score on biopsy. Complications noted after RRP were studied. Survival analysis (Kaplan-Meier) was performed to study clinical and biochemical progression in relation to factors such as baseline PSA, pathologic Gleason's score, pathologic stage, affected surgical margins and capsular penetration. Univariate comparison of factors was performed using the log-rank test. Multivariate analysis (Cox model) was also carried out to identify predictive variables (or risk factors) for progression. RESULTS: 127 patients were available for progression assessment (91.4%). Overall, 19 complications were registered in the immediate postoperative period. 89 patients (91.8%) stated being continent in their last follow-up visit. Complete erectile dysfunction (ED) was noted in 74 patients (76.3%), partial ED in fifteen (15.5%), and 8 (8.2%) reported not they have not problems with their erectile function after surgery. Thirty-four patients (26.8%) presented biochemical progression, being the mean time to progression for the whole series 5.8 years (standard error 0.38). 2 and 5-year probability to remain free of biochemical progression were 71.2% and 58.8%, respectively. Only preoperative PSA (p = 0.023) and Gleason's score in the surgical specimen (p = 0.001) were identified as predictive variables for biochemical progression on the univariate analysis (log-rank). CONCLUSIONS: Radical prostatectomy offers acceptable results in terms of tolerability and short and mid-term survival. Preoperative PSA or Gleason's score in the surgical specimen may help to predict subsequent outcome of the disease.

Adult↗

PubMed2004

[Descriptive epidemiology of bladder exstrophy in an area of Madrid].

OBJECTIVE: To describe the procedures and complications of bladder exstrophy closure, epispadias repair and bladder neck surgery to achieve urinary control. METHODS: Retrospective chart review of 11 patients with the exstrophy-epispadias complex. RESULTS: Early bladder closure is performed after birth with or without concomitant pelvic osteotomy. The preferred procedures are: the Cantwell-Ransley technique for epispadias repair, the Young-Dees-Leadbetter procedure for bladder neck reconstruction and ileocystoplasty with Mitrofanoff for bladder augmentation. CONCLUSIONS: Augmentation and continent diversion procedures can increase the functional capacity of the exstrophic bladder, and allow the vast majority of patients to achieve continence and preserve renal function. Bladder lithiasis is the most significant complication in these patients.

Bladder Exstrophy↗

PubMed2003

[Comparative analysis of complications between different surgical techniques in the treatment of urinary stress incontinence at our centre].

OBJECTIVES: Surgical repair is the most effective treatment for stress urinary incontinence (SUI) currently. Nevertheless, this method is not without complications. The objective of this work is to compare the incidence of complications between different groups of surgical techniques employed for the treatment of SUI in our patients. METHODS: We performed a retrospective analysis of patients diagnosed of SUI who underwent surgery at our department between January 1991 and December 1999, grouping patients in three categories depending on the procedure: abdominal technique, abdomino-vaginal techniques, and sling procedures. Complications were grouped into two categories: major and minor complications. Chi-square and Fisher's test were used for the association analysis of complications' frequencies. All confidence intervals and level of statistical significance were calculated for a p value < 0.05. RESULTS: 5.16% of the patients undergoing surgery for SUI suffered major complications. Globally, the most frequent complications were suprapubic pain (33%), wound seroma and/or infection (20%), postoperative acute urinary retention (AUR) (26%), and presence of significant post void residual (24%), being the sling procedure with a greater number of postoperative complications, as much in postoperative pain, as in AUR, as in presence of post void residual (p < 0.05). CONCLUSIONS: Sling procedures present a significantly higher percentage of complications when compared with abdominal and combined techniques.

Female↗

PubMedDate not supplied

["Mini-percutaneous" percutaneous nephrolithotomy: technique and indications].

OBJECTIVES: Since Helal and Jackman developed the mini-percutaneous ("mini-perc") percutaneous nephrolithotomy (PCNL) for the treatment of pediatric renal lithiasis various authors have used is technique in adults with the aim to preserve renal parenchyma and diminish morbidity associated with the standard PCNL. METHODS: We describe the surgical technique of "mini-perc" PCNL in the treatment of renal lithiasis. RESULTS: We review various case series from the literature of "mini perc" PCNL for the treatment of adult renal lithiasis, its current indications, percentages of stone free patients, and associated problems, mainly the required instruments. CONCLUSIONS: Morbidity associated with "miniperc" PCNL seems to be lower than with the standard PCNL, but the use a smaller calibre tract with the only aim to preserve renal parenchyma does not offer advantages. It is a complementary technique to the standard PCNL; however, the diameter of the percutaneous access is not well defined yet and depends on the calibre of the instruments used.

Humans↗

PubMedDate not supplied

[Descriptive analysis of adverse events associated with transrectal prostatic biopsy after 603 procedures].

OBJECTIVES: To establish the incidence of complications secondary to performance of transrectal prostatic biopsy, and to establish the hypothetical relationship between the rate of fever and the type of antibiotic prophylaxis employed. METHODS: All patients undergoing transrectal prostatic biopsy between January 1992 and December 2003 were included in this prospective nonrandomized study. Patients were given a self-administered questionnaire to obtain data about complications related to biopsy that included the following variables: fever, hematuria, rectal bleeding, hemospermia, voiding difficulties, acute urinary retention, need to visit primary care physician or an emergency department, hospital admissions and need of medication. The incidence of observed complications was calculated and the relationship between post-biopsy fever and type of antibiotic prophylaxis employed (oral ciprofloxacin vs. intramuscular tobramycin) was studied by means of the chi-square test, using the SPSS 11.5 for Windows; a p < 0.05 was considered significant. RESULTS: Overall, 705 questionnaires were received; 603 (85.5%) were considered valid for processing. Almost three quarters (73.9%) of the patients undergoing biopsy presented some complications, being hematuria the most frequent (53% of the cases). 40 patients presented fever (6.64%). Among 360 patients treated with oral ciprofloxacin for three days 16 developed fever (4.4%), in comparison to 24 patients out of 243 treated with intramuscular tobramycin (9.87%) (p = 0.009). CONCLUSIONS: Ultrasound guided transrectal prostatic biopsy is associated with frequent complications, although most of them are mild. The most frequent complication is hematuria; fever is the most severe. To prevent post-biopsy fever, antibiotic prophylaxis with ciprofloxacin for three days is more effective than single dose intramuscular tobramycin. However, prospective randomize studies are required to confirm it.

Antibiotic Prophylaxis↗