PubMed Health⌕ Search

Biomedical subjects

E Espejo Maldonado

Publications and source records attributed to E Espejo Maldonado.

At least 19 recordsLinked to original sources

[Survival prognostic factors valuation on a series of 202 patients with surgical treatment of renal cell carcinoma].

OBJECTIVES: To describe renal cell carcinoma prognostic factors and set up the relationship with survival rates in this neoplasm. Likewise we show epidemiologic, clinical, diagnosis and therapeutic facts. MATERIAL AND METHOD: We review 202 patients underwent surgical treatment for renal cell carcinoma and the following features were recorded: gender, age and presenting symptoms, especially incidentally discovered tumors; tumor-related factors like TNM tumor stage, tumor grade and venous involvement: therapy-related recorded were surgical techniques and cytokine-based therapy. RESULTS: 60% of the patients showed organ-confined disease, 10% of patients with renal cell carcinoma presented with nodal positive disease and 7% with systemic metastases. 42% of patients presenting incidental tumor, with survival rates substantially better than that for symptomatic patients. 42% of patients with nodal positive disease presented systemic metastases at diagnosis, and 30% at surveillance. Systemic metastases presented a particularly poor prognosis for patients with renal cell carcinoma, with 12-months survival rates that 0%. Patients with cytokine-related therapy for metastatic disease presented 24-months survival rates that 20%. CONCLUSIONS: Renal cell carcinoma remains a major source of mortality, basically at advanced disease (nodal positive disease or systemic disease), without a clear improvement of survival rates despite the newer therapy modalities.

Adolescent↗

[Long-term results of end-to-end urethroplasty].

OBJECTIVE: We evaluated long term results of end-to-end urethroplasty. MATERIAL AND METHODS: We reviewed 40 patients with bulbar urethral stricture of diverse origin: iatrogenic 40%, traumatic 15%, infectious 2% and unknown 40%. In 17 cases internal urethrotomy was made previously. The radiological study with retrograde and voiding cystogram revealed a bulbar location in all cases and a length inferior to 1 cm in 13 cases, between 1-2 cm in 26 cases and 2-3 cm in 1 case. The maximum flow rate varied between 3-13 ml/s. The absence of bacteriuria was valued by means of preoperating culture. The average time of pursuit was 45 months (12-142 months). The stricture was considered resolute when not appear compatible radiological or functional finds of failure. RESULTS: In 37 cases (92%) the results were satisfactory, without secondary surgical procedure. After surgery maximum flow-rate varied between 18-45 ml/s. In two patients with failure, internal urethrotomy was decisive. In this case the stricture origin was traumatic. The third patient with failure was finally chosen to make new end-to-end urethroplasty, with good later result. CONCLUSIONS: End-to-end urethroplasty is a highly decisive technique for bulbar urethral stricture. The preoperating diagnosis is based on the radiological study (retrograde and voiding cystogram). The postoperating control must be based on clinic and uroflow study. Traumatic stricture repair showed worse results. In cases of failure, internal urethrotomy allows to complement successful results of end-to-end urethroplasty.

Adolescent↗

[The Burch technique in the surgical treatment of stress urinary incontinence in women. Assessment of results and analysis of failure causes].

OBJECTIVE: To present our experience with the Burch procedure in the treatment of female urinary stress incontinence (USI) and the assessment of the causes of failure with this technique. MATERIAL AND METHODS: From January 1987 to june 1997 this technique was applied to 157 patients with USI. The mean age of these women was 54.2 years (30-76) and the mean follow-up was 50.24 months. Physical examination, urethral profile and the severity of the USI were not considered in the indication of the procedure. RESULTS: After three months, we had total continence or improvement in 80.7%. This rate decreased to 76% after one year. From the second year it was 70%, maintained to fifth year. Considering the severity of incontinence, in patients with mild-moderate grade, we obtained good outcomes after 5 years in 87%. If there was associated detrusor alterations, the rate decreased to 51.8%, and with a bad urethral profile, decreased to 42.4%. CONCLUSIONS: The Burch procedure is useful in the treatment of USI but requires a good selection of the patients.

Adult↗

[Ureterohydronephrosis secondary to a cyst of retroperitoneal mesentery].

Retroperitoneal primary cysts are rare clinical entities. A contribution is made of one case presenting this condition with repercussion on the excretory route. Ultrasound and computerized axial tomography studies suggest the diagnosis but this is confirmed through laparotomy. Choice treatment is enucleation, typically easy because of the minimal adherence to surrounding structures. Recurrence is rare and malignancy practically non-existent.

Aged↗

[Genital rhabdomyosarcoma. Diagnostic and therapeutic considerations. Apropos of a case of cavernous origin].

A case of perineal rhabdomyosarcoma possibly originating in the corpus cavernosum penis is reported. Treatment was by surgery first followed by chemotherapy. The poor outcome prompted us to review the literature on the diagnosis and treatment of this condition. We can conclude from data published elsewhere that rhabdomyosarcoma localized to the GU tract is a tumor that is amenable to treatment by chemotherapy combined with radiotherapy in most of the cases. When planning treatment, diagnosis must be well-established histologically and staging must be precise in order to avoid unwarranted radical surgery.

Adolescent↗

[Seasonal effect of age, sex and drinking water composition on nephritic colic].

The influence of the season, age, sex and composition of the drinking water on the incidence of kidney colics in patients of different villages, attended at the "San Cecilio" Clinical Hospital in Granada, is assessed. The average, of kidney colics per 1.000 inhabitants was 4.2% with 51.27% in females and 48.73% in males. We found that in the summer months the frequency of kidney colics was double that in the winter months, which may be due to a relative D hypervitaminosis, a greater intake of oxalates or a relative dehydration. No influence of the calcium, magnesium, chlorine and sulphate contents of the water, was detected. In some villages, a high calcium and magnesium content in the water, posed problems for the urolithogenic prophylaxis in some patients.

Adolescent↗