[The urologist like family practice in aging patients].
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Aged↗
Biomedical subjects
F J Solé Balcells
Publications and source records attributed to F J Solé Balcells.
[The Internet in medicine. A help, a problem, a cause of errors...?].
The Internet has been a breakthrough for Professional Medical Training. Medline databases are increasingly being used by the scientific community at large. Patients have also started to use the Internet as a source of information on their illnesses, and look in the web for a second opinion. This paper shows the advantages derived for the patients from using the Internet as well as the risks involved from a poorly understood, even not scientifically validated information. The Urology Associations themselves should take responsibility of the web sites in a unambiguous way, by including evidence-based medicine, offering assistance to those patients who want to compare their specialist's opinion with that obtainable in the Internet, and with the doctors themselves directing those who show a real interest to the most suitable web sites.
Communication↗
[Post-nephrectomy duodeno-cutaneous fistula resolved with parenteral nutrition and octreotide (somatostatin analogue)].
After a right nephrectomy of ischemic kidney, a high-output duodenal fistula developed on the third postoperative day. Sixteen days of total parenteral nutrition were unsuccessful, so octreotide (a synthetic analogue of somatostatin) was added (0.1 mg subcutaneously every 8 hours). The output decreased progressively and the fistula closed completely 9 days thereafter.
Cutaneous Fistula↗
[From shock-waves even to ureterolithotomy: various practical cases].
The Puigvert Urology Centre in Barcelona reports the detailed results of five cases of ureteric stones all treated by first-line shock wave lithotripsy. Only one case obtained a positive result (after 4 sessions). In the other four cases, shock wave therapy had to be completed by ureteroscopy (1 case) or by open surgery (3 cases) to achieve cure.
Adult↗
[Gastrocystoplasty for renal insufficiency in adults].
Vesical substitution or augmentation with various segments from the gut is a frequent occurrence in urology. In the presence of normal renal function there are few or no metabolic disorders. In the presence of renal failure the most suitable gut segment is the stomach due to its characteristics of Cl- and ammonium excretion, smaller mucus formation, acid pH provided to the urine and because it allows easy ureteral regrafting. This article contributes one case of gastrocystoplastia in a patient with trigonal bladder and chronic renal failure, presenting reno-vesical TB.
Humans↗
Intensive chemotherapy in poor-prognosis nonseminomatous germ cell tumors of the testis.
Forty-one patients with poor-prognosis nonseminomatous germ cell tumors (NSGCT) of the testis were treated between 1980 and 1989. This group was defined by the presence of one of the following features: multiple large lung metastases, bone, liver or brain metastases, abdominal mass greater than 10 cm, abdominal mass greater than 5 cm with high serum concentration of the tumor markers [alpha-fetoprotein (alpha FP) greater than 500 kU/l or beta-subunit of human chorionic gonadotropin (beta HCG) greater than 1,000 IU/l) or very high serum tumor marker concentrations (alpha FP greater than 5,000 kU/l or beta HCG greater than 10,000 IU/l). The first 21 patients were treated with cisplatin, vinblastine, bleomycin (PVB) chemotherapy and the following 20 with an intense, alternating 6-drug chemotherapy consisting of cisplatin, bleomycin, vincristine, methotrexate, etoposide and ifosfamide (BOMP/EPI). Surgery of residual masses was performed when tumor markers were negative. Fifteen patients (71.4%) in the PVB group and 18 patients (85%) in the BOMP/EPI group remained disease-free at a median follow-up of 67 and 41 months, respectively. None of the resected masses in the BOMP/EPI group contained malignant disease whereas viable carcinoma was found in 5 of 14 (26.4%) patients in the PVB group. The toxicity of the BOMP/EPI regimen was severe but tolerable. Intensive chemotherapy regimen seems to be useful in this subset of patients, but randomised prospective trials comparing these with standard chemotherapy are necessary.
Adolescent↗
[English and Spanish nomenclature of catheters and other urological instruments].
We analyze names given to urologic devices that are apparently similar in English and Spanish but with different meanings. The translation of the commonest terms for instruments and some problematic words are reviewed. Although some of the equivalents are a convention, it is interesting to know the more widely used nowadays.
Terminology as Topic↗
[Early diagnosis of cancer of the prostate. Value of systemic screening and of diagnosis in incidental cancer (stage A)].
Currently, radical prostatectomy has resurged due to techniques that permit preservation of the erector nerves and the routine use of the Walsh technique. Consequently, much interest has been focussed on methodology and technology that permit early diagnosis of prostate cancer. Until recently, patients with stage A cancer of prostate were considered to require no treatment and only regular control was recommended. Because an 18% incidence of disease progression has been demonstrated for stage A1 tumors over a period of 8 years and three quarters of the patients die from cancer, the approach has currently changed and radical prostatectomy is now recommended for relatively young patients (aged +/- 60 years). Walsh reported that more than 90% of patients with stage A1 tumors had preserved sexual potency after radical prostatectomy and 100% were completely continent. Radical surgery is evidently warranted in patients with stage A2 cancer of the prostate. The problem arises however in correctly staging the cancer in patients over 60 years and clearly establishing whether the tumor is stage A1 or A2. Surgery is not advocated for stage A1 tumors whereas radical prostatectomy is an indication for those with stage A2 tumors. The latter is an indication for repeat transurethral resection for multiple biopsy, and ultrasound-guided mapping and biopsy of the prostate. These currently depend on the preference of the physician instituting treatment.
Humans↗
[Mortality and complications from cystectomy of bladder cancer].
The operative mortality and early and late complications were analyzed in 241 patients submitted to cystectomy for bladder cancer over a 7.5-year period. Of these, 92% were males and 8% females; mean patient age was 60 years. Preoperative radiotherapy of 2,500-6,000 rads was given to 114 patients. There were 33 (13.7%) operative deaths; the incidence being statistically significantly higher for those who had previously received radiotherapy. Early complications presented in 39% of the cases, and 44% had late complications. The complication rates were not influenced by preoperative radiotherapy.
Adult↗
[Urology of the future: a network].
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Computers↗