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Biomedical subjects

E Broseta

Publications and source records attributed to E Broseta.

At least 19 recordsLinked to original sources
PubMed2003

Mycobacterial infection in a series of 1261 renal transplant recipients.

OBJECTIVE: To describe the incidence and clinical characteristics of mycobacterial infection in renal transplant recipients. METHODS: We retrospectively analyzed the cases of mycobacterial infection in a series of 1261 renal transplants carried out in our Unit of Renal Transplantation from 1980 to 2000. Demographic parameters and clinical antecedents such as age, cause of end-stage renal disease, time of follow-up of the graft, previous renal function and type of immunosuppression were considered. Moreover, the clinical onset, diagnostic tools, treatment policy and evolution were studied. The pathogenesis of the different types of mycobacteria isolated was also analyzed. Diagnosis was made with the Ziehl-Neelsen staining method. Culture was performed by the conventional Löwenstein-Jensen method and the Bactec-460 radiometric method. RESULTS: We found mycobacterial infection in 27 patients (2.1%), due to Mycobacterium tuberculosis in 20 cases, M. kansasii in five patients, and M. fortuitum in two patients. The mean elapsed time from the renal transplant was 20.5 months; the infection appeared in 18 patients during the first eight months after transplantation. The clinical onset was pulmonary infection in 17 cases (12 M. tuberculosis and five M. kansasii); five had urinary symptoms (three M. tuberculosis and two M. fortuitum); three cases of M. tuberculosis infection had abdominal symptoms; another one began with a perineal tuberculous abscess; the rest of the patients were asymptomatic. The types of specimen on which microbiological identification was carried out were, in decreasing order: sputum and/or bronchial washing/pleural aspiration, urine, feces, gastric and peritoneal fluids, bone marrow and blood. The first-line drug isoniazid had the highest resistance index in the susceptibility test. Clinical dissemination was observed in eight patients, four of whom died. Another three patients had a significant impairment in renal function, and in one of these patients an allograft nephrectomy was necessary due to a severe septic syndrome. CONCLUSIONS: Mycobacterial infection, mainly by M. tuberculosis, has an important impact on kidney transplant recipients, particularly during the first year after surgery. Diagnosis often presents some difficulties, and a delay in treatment represents a determinant factor for the evolution, with a risk of death or permanent damage in renal function. Therefore, early diagnosis is mandatory. When the Mantoux reaction is positive, antituberculous prophylaxis seems advisable.

Adult↗
PubMed2002

[Urinary infection].

The term urinary infection defines those processes located in the urinary tract due to the presence of microorganisms in the urine, particularly bacteria. Regardless the sex or age of the patient, they represent the second most frequent type of infection, after respiratory tract infections, not only in outpatients but also in hospitalized patients. There is an ongoing interest about the etiology and pathogenesis of urinary infections in order to identify the virulence-factor profiles of bacterial isolates and the characteristics of the infection-prone individuals. Urinary infections are caused by a wide range of pathogens, specially gramnegative rods (E. coli, P. mirabilis, Klebsiella). However, there is an increasing evidence of the role as pathogens of some microorganisms that have long been regarded as apathogenic like E. faecalis and the Staphylococcus group. The treatment of such infections represents a challenge for the future mainly in the fields of control of antimicrobial resistance and vaccine development.

Bacteriuria↗
PubMed1998

Paraureteral extrusion of calculi after endoscopic pulsed-dye laser lithotripsy.

Laser lithotripsy has become an effective and low-morbidity procedure for the treatment of ureteral calculi. Nevertheless, ureteral endoscopy is not free of side effects and complications. Lithiasis extrusion is one of the early complications of this procedure, and usually, the diagnosis is carried out by means of urographic findings because it is not easily recognized during ureteroscopy. Between January 1990 and May 1996, a total of 1047 endoscopic lithotripsies with the pulsed-dye laser were performed in our department. The 3-month stone-free rate as a single treatment was 76.5%. We found 11 cases (1.05%) of calculi extrusion after ureteral endoscopic treatment. Only one case was diagnosed intraoperatively. The evolution after a mean follow-up period of 18 months (range 6-34 months) was satisfactory in all cases. No urinary extravasation, infection, or secondary ureteral strictures were found. According to the absence of side effects, it was considered unnecessary to remove the extruded calculi. Extrusion of noninfected calculi into the periureteral tissues after laser lithotripsy causes no significant consequences and can be successfully managed conservatively. Knowledge of this possible complication is the best way to avoid it. A careful technique and a low irrigant flow will be very helpful.

Adult↗
PubMed1995

Microsurgical penis replantation after self-mutilation.

The microsurgical reattachment of a penis following self-amputation by a psychiatric patient is discussed. This is the 15th case reported in the literature. We have reviewed the previous reports and outline the management of penis amputation. The importance of using microsurgical techniques in order to achieve better functional and cosmetic results is discussed.

Adult↗
PubMed1993

Urological manifestations of herpes zoster.

Herpes zoster is an infection caused by the varicella virus. Inflammatory reaction can involve the spinal cord and anterior horn cells causing varied neurological disorders including urological alterations. We reviewed 57 patients who suffered herpes zoster between 1984 and 1991. 15 of them (26%) showed urological manifestations: 2 cases acute urinary retention, 3 patients urinary incontinence and 10 cases had a cystitis-like syndrome. The clinical findings and diagnostic procedures are studied. The possible etiological mechanisms are discussed. The literature is reviewed.

Adolescent↗
PubMed1992

Diagnostic challenges of prostatic carcinoma.

The early detection and staging of prostatic carcinoma are challenging the diagnostic acumen of urologists. Mass screening programmes of asymptomatic men are not justified, as only a small number of cases are diagnosed when the tumour is confined to the prostatic capsule. Diagnostic work-ups of symptomatic men yield a similarly low rate of detection. The most extensively used diagnostic methods include digital rectal examination (DRE), transrectal ultrasound (TRUS) and prostate-specific antigen (PSA) assay. Although DRE is an inexpensive technique that improves early detection, its sensitivity and specificity are low. The specificity and sensitivity of TRUS are higher, but false-positive and false-negative rates are significant. In a study of 566 patients, the rates were 86% and 84%, respectively. A determination of PSA may be informative in the early stages of prostatic cancer, but confirmation of the results by other methods is necessary. Thus, there is no safe method to achieve early diagnosis and precise staging of prostatic carcinoma. Only clinical trials comparing all the different methods will help to establish the definitive role of each one.

Aged↗
PubMed1992

[Extracorporeal shockwave lithotripsy: an alternative treatment for lithiasis of caliceal diverticula].

Among all the patients treated in our Lithotrity Unit, 13 of them had lithiasis inside the calyceal diverticulum. They were all treated by extracorporeal shockwaves. In none of the cases complete expulsion of lithiasic mass was achieved. In 3 (23%) cases it was reduced to half. In 2 (15.3%), 75% of the initial mass remained; and in 8 (61.5%) stones were fragmented but none of their debris was eliminated. Out of all the patients who were symptomatic before starting treatment, only 36.6% become asymptomatic. Extracorporeal lithotrity is, therefore, an approach with limited results in the calyceal intradiverticular lithiasis.

Diverticulum↗
PubMed1992

[Abdominal echography to determine the weight of the prostate].

The relationship of post-operatively determined prostatic gland weight and that calculated prior the procedure, by means of abdominal ultrasound techniques using the "ellipsoid method", has been studied in 88 patients undergoing retropubic adenectomy. The regression line was nearly optimal, Y = 0.946 X + 2.295, and the correlation coefficient between both weight measures was r = 0.915. Abdominal ultrasound examinations are a simple, quick and safe means to evaluate prostate weight, prior to deciding the type of surgery (open adenectomy or transurethral resection) for prostate adenoma.

Abdomen↗
PubMed1991

Unusual foreign bodies in the urethra and bladder.

We report 8 cases of self-inserted unusual foreign bodies in the lower urinary tract, all being treated from 1976 to 1990. Three of them were located in the urethra and 5 in the bladder. Several objects were found (electric cable, tweezers, hairpin, drawing pin, pebbles, paper clip). In 4 cases the objects were inserted for masturbatory purposes. Five of the patients were psychologically ill or handicapped. The most common reason for consultation was dysuria, and the treatment procedures were endoscopy in 5 patients and cystotomy in the other 3.

Adolescent↗
PubMed1991

Urological complications associated to uterus didelphys with unilateral hematocolpos. A case report and review of the literature.

Complete duplication of vagina, cervix and uterus, with imperforate hemivagina and renal agenesis is a rare condition with less than 120 cases published. In those articles, urological complications are uncommon with only a 10% of the total. We report 2 cases of uterus didelphys with unilateral hematocolpos and ipsilateral renal agenesis with urological clinical complications. One of them presented a very rare onset complaining of acute urinary retention. The other patient was referred for difficulty in micturition and abdominal pain which is the most common symptom of this entity. A description of both cases and a literature review of this congenital complex syndrome and its urological complications are reported.

Adolescent↗
PubMed1991

Agenesis of seminal vesicles in infertile males: ultrasonic diagnosis.

We present the incidence of seminal vesicle agenesis and its association with deferens ductus agenesis in 141 males presenting with infertility. Transrectal ultrasonography was performed in every patient. Ten presented seminal vesicle agenesis (8 unilateral and 2 bilateral). Three had absence of the vas deferens on physical examination (3 of 7 with unilateral seminal vesicle agenesis and 1 of 2 with bilateral). Computed tomography confirmed the ultrasound findings. We emphasize the importance of the anomalies as a cause of infertility and the association with other genitourinary anomalies. Moreover, we state the necessity of transrectal ultrasound in the diagnosis.

Adult↗
PubMed1990

[Contribution of echography to the study of the andrologic patient].

Our experience in the ultrasonographic evaluation of the prostate and seminal vesicles in prostatitis and male infertility are reported herein. In our view, this noninvasive imaging technique must be performed before recurring to other methods that involve manipulation. Similarly, we discuss the possibilities of duplex Doppler in the diagnosis of vascular disorders in the male consulting for impotence. We believe this simple noninvasive imaging technique can significantly reduce the number of patients that may require cavernosometry and cavernosography.

Erectile Dysfunction↗
PubMed1990

[Volumetric and structural changes of prostatic carcinoma under hormonal treatment].

The evolution of the ultrasonographic images of 25 patients with advanced carcinoma of the prostate receiving antiandrogen (cyproterone acetate) and LH-RH analogue therapy were studied. Thirteen patients were on daily LH-RH analogue therapy while the remaining patients received a monthly depot dose. At 6 months, the ultrasound follow-up revealed a 20.4% reduction of the transverse and a 19.8% reduction of the anteroposterior diameter for the first patient group. Similar results were observed for the second group comprised of 12 patients who received depot therapy; a mean reduction of the diameters of 119.9% and 18.7%, respectively. At 6 months, 66% of the patients in the first group and 59% of the second group showed an improvement of ultrasound patterns. Infiltration of the seminal vesicles improved for both groups, 41% and 38% of patients, respectively. However, at 12 months this rose to 50% improvement for the group on the daily treatment regimen. The follow-up data after 6 months are as yet unavailable for the group on depot therapy. Transrectal ultrasound is an easy, reproducible method that is very useful in the follow-up of patients with advanced cancer of the prostate receiving hormone therapy.

Aged↗
PubMed1989

[Transrectal echography in the infertile male. Statistical study].

We evaluated the transrectal echo patterns in 140 infertile men using the following parameters: the transverse and anteroposterior diameters of the prostate, the presence of periprostatic venus plexus, and the transverse diameter of the seminal vesicles. Patients were classified according to data gleaned from semen analyses following the criteria recommended by the WHO. Microbiological analyses using the Meares and Stamey technics, as well as semen analyses, were performed in those patients who presented with leukospermia. These were considered a separate, homogeneous group classified as "inflammatory". The following patient groups comprised the study: azoospermia (18 patients), oligospermia (4), astenozoospermia (43), oligoastenozosermia (48), and inflammatory (27). Statistical analyses of the ultrasound data for the infertile males and those of the control group were performed using the Mann-Whitney U. test and compared. Data were statistically significant for the following parameters: the transverse diameter for the infertile males with azoospermia, the anteroposterior diameter of the prostate for those patients with leukospermia, and the periprostatic plexus for those in the oligoastenozoospermia and inflammatory patient groups.

Adult↗
PubMed1989

[Modification of the echographic pattern of carcinoma of the prostate treated with Lh-rh agonists].

We present the results of a study undertaken to assess the echo patterns and prostate size in 13 patients with prostatic carcinoma treated with Lh-rh agonists. The study revealed a gradual reduction of the anteroposterior and transverse diameters. After 12 months, these were 28% and 22% of their respective initial values. Furthermore, the prostatic echo patterns changed significantly in 66% of the patients, and infiltration of the seminal vesicle improved or became stable in 50%. These findings suggest that transrectal ultrasonography may be useful in the follow up of prostatic carcinoma patients receiving hormone therapy.

Aged↗