Biomedical subjects

E Martín Oses

Publications and source records attributed to E Martín Oses.

10 recordsLinked to original sources

PubMed1999

[Results of a screening program for prostatic cancer].

OBJECTIVE: To set up the epidemiology of prostate cancer in the geographical area of Getafe, Madrid (Spain) and to detect curable prostate cancer. The results of screening 2.576 men are reported. PATIENTS & METHODS: Patients underwent digital rectal examination (DRE) and PSA determination. Patients with suspicious DRE or PSA greater than 4 ng/ml were further evaluated with transrectal ultrasonography (TRUS) and biopsy. The diagnostic performances of the tests or combinations of tests were determined. RESULTS: Mean age was 59.9 years (median 58 years). Ninety-four patients (3.6 per cent) had abnormal DRE while PSA was higher than 4 ng/ml in 169 patients (6.5% of the total). 6.8 biopsies were needed to prove one cancer. The higher sensitivity corresponded to the PSA (93%). The test of greatest specificity was the rectal examination (97%). Positive predictive value raised to 78.9% when both DRE and PSA were abnormal. Advanced tumor stages were more common (39.4%) than in previous experiences. CONCLUSIONS: PSA should be the first diagnostic test when screening for prostate cancer. Neither the DRE nor the TRUS have any place in patients with PSA below 4 ng/ml. In summary we can't encourage screening programs for prostate cancer so far.

Aged↗

PubMed1998

[Results of transrectal echography in the study of female urinary stress incontinence].

The development of echographic transducers allows now to study Female Urinary Exertional Incontinence (FUEI) using different approaches (vaginal, perineal and transrectal). A total of 122 transrectal echographies were performed. Based on the clinical symptoms: 14 patients are continent, 15 report micturition urgency, 11 micturition urgency plus FUEI, and 82 FUEI. All parameters Xrest, Yrest, AUVPrest, Xexertion, Yexertion, AUVPexertion, X', Y', AUVP' were measured. Three groups were defined: Group I, normal ultrasound diagnosis; Group II, vesical neck hypermobility; Group III, FUEI using Kolmogorov-Smirnov's test, the data fits a standard distribution curve and the results were analyzed through a variance analysis and Newman-Keul's test. During Valsalva's manoeuvre, patients with FUEI show greater caudal mobility of the vesical neck which becomes more significant as the degree of FUEI increases. Dorsal mobility is also greater in patients with FUEI although this parameter is of no use to quantify the degree of FUEI. Posterior urethro-vesical angle variability only discriminates patients with no FUEI from those with a higher degree of FUEI.

Female↗

PubMed1998

[Does some relation exist in the size and histological composition of the prostate?].

OBJECTIVE: To determine if the histological composition of the prostate-the proportion of glands and stroma-depends on its size. METHODS: Prostate volume was determined by abdominal US; transurethral biopsy of the prostate was performed in 22 patients (mean age 64.8 years) with BPH or bladder tumor. Morphometric analysis of a fragment of the prostate was performed using light and electron microscopy. The stroma-epithelial ratio (SER) and the density of prostatic vascularization (DPV), and the nuclear and cellular areas of 5 epithelial cells in each case, were determined. The ratio of the sum of granular to cellular areas (secreto-cellular ratio), and the nuclear-cytoplasmic ratio (NCR) were determined. The pearson coefficient and linear regression equation that best correlated the prostate volume and the rest of the variables. RESULTS: The mean SER was 4:1 and the DPV was 15.18 vessels/mm2. The cellular and nuclear areas were 79.6 and 21.2 mu2, respectively. The secreto-cellular ratio was 0.083 and the NCR was 0.28. The prostate volume showed no mathematical relationship with SER (r = 0.016, p = 0.9) or DPV (r = 0.026, p = 0.9). Only a random association between the US prostate volume and the cellular and nuclear areas, and the secreto-cellular and NCR could be observed. CONCLUSION: The histological composition of the prostate cannot be determined by the US prostate volume.

Aged↗

PubMed1997

[Limitations of ultrasonography in the clinical course monitoring of bladder tumors].

Ultrasonography is a fairly innocuous test in the follow-up of bladder tumours. Its results, however, can not be superposed to those of cystoscopy. This study aims to identify the risk factors for failure of transabdominal ultrasonography in the FU of bladder tumors. The influence of the primary tumour, sex and age of patients on the ability of ultrasonography to detect relapses was analyzed. Chi square and Student's t tests were used to associate the characteristics of primary tumours and patients to the results of ultrasonography. Student's t test was used to estimate the effect of diagnostic oversight in terms of annual recurrence rate and progression. The characteristics of primary tumours where relapse was detected or overlooked had no influence on the results of ultrasound follow-up as neither did age and sex. No differences were detected in recurrence rate of patients with anticipated (0.57) or overlooked (0.58) tumours. Although differences in progression rates (4.76% and 9% for overlooked and identified tumours, respectively) were substantial, they did not reach statistical significance. There are no features in the original tumour or the patient to anticipate the failure of ultrasound monitoring. Multiple and/or small relapses are overlooked more frequently that single and/or large ones, and tumours located in lateral walls, base and dome may be unnoticed. In spite of oversights, alternate ultrasound/cystoscopic monitoring does not compromise the outcome of the disease.

Aged↗

PubMed1997

[Analysis of the reliability of ultrasonic estimates of the posturination+ residue].

OBJECTIVES: The most precise procedure for the measurement of residual urine volume is bladder catheterization; nevertheless, it takes real associated morbidity. Our objective is to define the accuracy of bladder ultrasonography when residual volume estimation is performed. METHODS: Thirty patients were studied. Ultrasound estimation of residual volume was undertaken with Simpson's method V = (pi/6) x L x T x AP. Obtained values were contrasted with the post-catheterization registered ones. RESULTS: The mean ultrasound estimated residual urine volume was 82.1 ml., versus 156.5 after catheterization. The mean difference was 74.4 ml. (significant, p < 0.001). Correlation coefficient was 0.93. Regression equation was calculated, a well as the corrected formula that, according to the outputs of our study, offers greater reliability in the estimate of the aforementioned volume. Ultrasound sensitivity when proper estimation of volumes equal or greater to 100 cc. is carried out was only 47%, opposite to the elevated specificity (100%) for this purpose. CONCLUSIONS: Transabdominal ultrasound underestimates, to a large extent, the values of residual urine volume. We consider that ultrasound estimation of residual volume constitutes an alternative to be kept in mind; nevertheless, the formula to calculate this volume through bladder diameters introduces an important error and so, it should be corrected.

Adult↗

PubMed1997

[Antimicrobial prophylaxis in urology].

UNLABELLED: Antimicrobial prophylaxis in surgery has proven to be effective in controlled randomized trials. Usage in Urology is known at least since the '30s although its effectiveness has only become known since 1979. METHODS: Review of literature related to surgical antibiotic prophylaxis, more specifically urological surgery, basically from 1991 to 1995, but without overlooking those papers that have become classics due to their impact. RESULTS AND CONCLUSIONS: Efficacy of antimicrobial prophylaxis in urological surgery is nowadays beyond all doubt. Usage is indicated in the presence of sterile urine and dosage must be short, in single dosis in the immediate pre-operative or within 24 hours after the procedure. However, there is a number of issues that deserve to be treated in more detail for better understanding. Those are the establishment of adequate prophylactic regimes in renal transplantation and the use of antimicrobials based on their pharmacokinetic characteristics to optimize the prophylactic purpose.

Anti-Bacterial Agents↗

PubMed1997

[Inguinal hernia containing the urinary bladder. Description of a case].

OBJECTIVE: Hernial pathology has a high incidence in the adult population. However, involvement of the urinary tract system in a hernial process constitutes an uncommon finding. This rare condition is analyzed in the present article. METHODS/RESULTS: A case of an inguinal hernia containing urinary bladder is described. No complications were found and surgical treatment was not required. CONCLUSIONS: Inguinal bladder hernia is rare and usually has no associated complications and the symptoms are scanty. Diagnosis is established by ultrasound and cystography. Treatment is by surgery, although in many cases this condition requires no treatment.

Adult↗

PubMed1996

[Usefulness of cystomanometry in the assessment of urinary irritative symptoms].

OBJECTIVES: To analyze the value of cystometry in evaluating patients with irritative voiding symptoms with no remarkable previous medical history. METHODS: 79 patients (24 males, 55 females; mean age 49.6 years) with irritative voiding symptoms and no remarkable previous medical history comprised the study. The patients underwent physical and neurourological examination. The urodynamic assessment included uroflowmetry, filling cystometry, pressure/flow study (and urethral pressure in some cases). Uninhibited detrusor contractions were registered. RESULTS: Cystometry failed to detect involuntary detrusor contractions in 68 of the 79 patients (86.1%) with no relevant medical history. Detrusor instability was not found in 41 of 52 women (78.9%) with irritative voiding symptoms and stress incontinence without neurological disease. Involuntary contractions were not observed in 14 of 16 patients (87.5%) with irritative symptoms with a diagnosis of infravesical obstruction. On the other hand, 33 of 68 patients (48.5%) with irritative complaints and a history of neurologic disease showed no hyperreflexia. A statistically significant difference was found between this latter group of patients and those with no remarkable previous medical history (p < 0.001). CONCLUSIONS: Our results indicate that filling cystometry is of little value in the assessment of patients with irritative voiding symptoms and no remarkable previous medical history, but is more useful in patients with irritative symptoms and neurological disease. Careful history-taking and physical examination should detect the underlying problem in the majority of patients.

Adult↗

PubMedDate not supplied

[Complete urethral duplication in a girl].

Urethral duplication is a very rare malformation which occurs almost exclusively in males. Associated genital and urinary malformations are frequent, and the approach in symptomatic cases in surgical management. This paper presents one case of a full double urethra in a 9-year old girl with repeat urinary infections and incontinence. The accessory urethra was surgically removed using perianal and abdominal access. Evolution has been favourable with disappearance of symptomatology.

Child↗

PubMedDate not supplied

[Relationship between a benign fibroepithelial polyp and a pelvic nephroblastoma: report of a case].

The purpose of this paper is to report one case of left pyelic Wilms' tumour in a 17-year old male patient. Pre-operative diagnosis was complicated by a background of prior surgery on the same kidney due to a benign fibroepithelial polyp. The possible concomitences are analyzed while the relevance of an extensive pathoanatomical study to avoid possible diagnostic errors is emphasized.

Adolescent↗