Biomedical subjects

J C Regueiro López

Publications and source records attributed to J C Regueiro López.

At least 19 recordsLinked to original sources

PubMed2006

[Determination of free prostatic specific antigen cut point for the selection of patients in first prostate biopsy].

OBJECTIVES: Determine the cut point of free PSA rate for optimize the first prostate biopsy indication. MATERIAL AND METHODS: Prospective trial between june 2002-september 2004, We included patients in first prostate biopsy with normal rectal digital examen, total PSA between 3-10 ng/ml and normal transrectal prostate ultrasound. We realize descriptive stadistic analisis of variables age, total PSA, prostate volume and % free PSA and analitic stadistic analisis with ROC curves of variables total PSA and % free PSA for determine as of her predicts the best one rate of prostate cancer. RESULTS: We reclute 727 men with a mean age 62.91 years, total PSA mean 6.12 ng/ml, prostate volume mean 42.78 cc and % free PSA mean 15.22%. We had 106 prostate cancer, the prostate cancer rate in first biopsy was 14.6%; 77 cases had 1 lobe prostate cancer and 29 in 2 lobes. The most frecuent gleason was 6 (46 cases 43.4%) and the second gleason 7 (43 cases 40.6%). In the ROC curves analysis, total PSA had area under the curve 0.476 (p=0.3) and 0.611 (p=0.023) for % free PSA. The optime cut point for % free PSA in our trial was 19% (Sensibility 91.4% and Specificity 20%). The use of this cut point had allowed the saving us 138 biopsies (19.11%) with the lost one of diagnose of 10 cases of cancer of prostate. CONCLUSIONS: The use of the % free PSA is useful and allows in our region the best indication of the patients who are going to first biopsy of prostate, avoiding the accomplishment of unnecessary biopsies.

Biopsy↗

PubMed2003

[Review of cut-off points between stages T1 and T2 in the 1997 TNM classification of renal carcinoma].

OBJECTIVE: We retrospectively review the patients treated at our institution for renal cell carcinoma (RCC). We compare the patients classified in TNM state T1N0M0 in the 1997 revision with the 1992 one in order to determine survival differences. We divide patients in three size related groups and compare its survival rates. MATERIAL AND METHODS: We review 168 surgically treated patients. 72 of them were classified into T1N0M0 stage. We compare cancer-free survival in patients included in 1997 and 1992 T1 stage. We divide patients in three groups: 1-3 cm, 3-5 cm, 5-7 cm and compare respective cancer-free survival. RESULTS: There is a survival difference between T1(1997)-T2(1992) (p = 0.478). There is an inferior survival in size group 5-7 cm compared with 1-3 cm and 3-5 cm ones (p = 0.02/0.0465). CONCLUSIONS: In our patients, 1997 revision of T1 size supposes a descent of cancer-free survival compared with 1992 one. We consider a better stage limit under 5 cm, instead of actual 7 cm.

Aged↗

PubMed2002

[Encrusted pyelitis. Lithiasic disease with infectious etiology].

We report on two new cases of encrusted pielitis, a lithiasic disease of infectious ethiology--Corynebacterium of D group-. The clinic diagnostic is difficult and this disease develops in immunosuppressed patients, mainly in renal transplanted ones. One of our two cases is diagnosed in a patient with a transplanted kidney and the other one develops the disease within her native kidneys. We remark on the clinic features and therapeutic options.

Aged↗

PubMed2001

[Pneumocysts, unusual infective complication in diabetics].

We report on a case of fully gas-filled bladder with no evidence of intramural gas, fistula between bladder and gastrointestinal tract or instrumentation. The patient is diagnosed of a diabetic neurogenic bladder. We comment the causes of this rare finding and its relation with emphysematous cystitis.

Aged↗

PubMed2001

[Renal abscess in patients with HIV infection in the era of highly active antiretroviral therapy].

Renal abscess is a very rare complication of HIV infection, usually occurs in patients with severe immune deficiency. The immune status is the main factor that predict disease advancement. Highly activate antiretroviral therapy (HAART) improve the CD4 cell count. We present a case of renal abscess for Aspergillus niger in a HIV+ patient who complained of right flank mass and fever. We review relevant literature and the management of these patients.

Abdominal Abscess↗

PubMed2001

[Clinico-pathologic differences between bladder neoplasm with low malignant potential and low-grade carcinoma].

OBJECTIVE: To determine if the morphologic subgrouping of grade I bladder tumors between papillary neoplasm of low malignant potential and low grade papillary carcinoma is of clinical and survival value. MATERIAL AND METHODS: All 257 consecutive patients diagnosed of superficial bladder cancer between 1990 and 1995 in HU Reina Sofia of Cordoba were reviewed and further reclassified according to WHO/ISUP consensus classification of urothelial neoplasms of the bladder. Of the tumors 12 were urothelial papilloma, 51 were papillary neoplasm of low malignant potential, 43 were low grade papillary carcinoma Ta, 65 were low grade papillary carcinoma T1 and 37 were high grade papillary carcinoma. Eleven patients were reevaluated as T2 tumors and 38 (14.8%) were lost of control. All patients were reviewed with a follow-up at least of 5 years. We compare the results between groups with Fisher test and the risk factors for recurrence and progression are analyzed by multivariate analysis (Odds ratio). The survival function was calculated using Kaplan-Meier estimates and compared with the log-rank test. RESULTS: There are no differences between groups respect the age or sex distribution. The differences in the multiplicity are not significant and only the mean size is higher in papillary low grade carcinoma. About the risk factors for recurrence and progression of the disease, only is significative the tumor size. Rarely, the use of chemotherapy seems to play a role in the recurrence. There are no differences in recurrence and progression between the groups, although the percentages are always higher in the papillary low grade carcinoma group. CONCLUSIONS: There are enough clinical differences between the two groups and we consider them as distinct pathologic entities. Only the higher tumoral size is prognostic factor in each group. We think that the use of chemotherapy must be avoided in this low grade bladder tumors.

Carcinoma↗

PubMed2001

Treatment with sildenafil citrate in renal transplant patients with erectile dysfunction.

OBJECTIVE: To assess the safety and efficacy of sildenafil citrate in renal transplant patients with erectile dysfunction, as up to half of men with renal failure may be affected and only 60-75% recover potency after transplantation. PATIENTS AND METHODS: Fifty patients with erectile dysfunction and a functioning renal transplant were treated using sildenafil (mean age 54 years, mean time on dialysis 35 months, mean time from transplantation 20 months). The hypogastric artery was not used during transplantation in any patient. Sildenafil citrate was prescribed at doses of 25 or 50 mg depending on baseline creatinine values and on the response, and plasma levels of cyclosporin/FK506 were monitored. RESULTS: Thirty patients (60%) had a satisfactory response, with a mean time on dialysis of 23 months. Six patients (12%) did not take the sildenafil and in 14 (28%) the drug was ineffective. The mean time on dialysis in this group was 43 months. Six patients (12%) had side-effects that in no case led to withdrawal of treatment. Plasma levels of cyclosporin/FK506 remained within the safety and efficacy limits in all patients. CONCLUSIONS: Treatment with sildenafil citrate in renal transplant patients with erectile dysfunction is an effective and safe option, with few side-effects. Plasma levels of immunosuppressants are unchanged. The response was more effective in patients with a shorter time on dialysis, as penile vascular disease is less advanced.

Erectile Dysfunction↗

PubMed2000

[Cryptorchism and testicular cancer].

OBJECTIVE: This report insists on the higher risk of testicular cancer in cryptorchidism and indicates the more adequate management of this pathology. METHODS/RESULTS: We report a 27 years old patient with history of cryptorchidism, diagnosed of abdominal tumor in urgency. This tumor was a seminoma in intrapelvic testicle. CONCLUSIONS: The risk of developing testicular cancer in cryptorchidism is 3 to 10 times greater than in a patient with normally descended testes, and orchiopexy does not prevent the risk of malignancy. We underscore the need to follow these patients closely and recommend the orchiectomy in postpubertal patients.

Adult↗

PubMed2000

[Renal elimination of contrast after retrograde urethrocystography].

We describe a case report in which is shown an extensive extravasation of contrast media from urethra lumen following a retrograde urethrocystography. It is shown filling of cavernous system and, at once, iliac vessels and inferior cava. Later X ray plates demonstrates entire collecting system due to the renal contrast excretion.

Aged↗

PubMed2000

[Incidence of high grade prostatic intraepithelial neoplasia in urologic practice].

High grade (PIN AG) intraepithelial neoplasia of the prostate is a likely precursor of prostate adenocarcinoma (PA) because of their association. Since the risk to suffer PA increases in patients with no previous PIN AG, its finding requires an arduous search for PA. This paper reviews the incidence of PIN AG in 499 histological studies in prostate transrectal biopsies, prostate TUR and adenomectomy specimens and radical prostatectomy (RP) sections. Evaluation of data obtained, type of presentation and association to prostate carcinoma, indicating the approach taken in the various cases.

Aged↗

PubMed2000

[Wolfram syndrome. Urologic implications].

OBJECTIVES: We report on four new cases of Wolfram's Syndrome. We emphasize in urological aspects of this disease. PATIENTS AND METHODS: Three male siblings. The other patient is also a male, without familiar relation with the other ones. All four patients presents different levels of urological alterations, mainly urinary collecting system dilation and decrease in detrusor muscle contractility. CONCLUSIONS: Urological findings are cardinal aspects in Wolfram syndrome. Due to its high frequency and prognostic value in natural history of disease. Urological disease seems to be within a systemic neurological tissues affectation of etiology that remains unknown.

Adult↗

PubMed1999

[Bilharziasis and bladder cancer. A case report].

In our setting, the association between bilharziasis and bladder cancer is uncommon. However, the presence of recurrent haematuria in a patient from an endemic area of bilharziasis (east of Africa and Middle East), is highly suspicious of this disease. Lack of an adequate treatment by using anthelminthic drugs during the acute phase of disease, might lead to the onset of chronic bladder lesions and, on occasion, bladder cancer, of the epidermoid type in the majority of cases. Because of the high mortality and aggressivity of this type of cancer, an early diagnosis and appropriate treatment of acute lesions is mandatory. We report a 40-year-old black male from Senegal, presenting chronic bladder schistosomiasis and infiltrative epidermoid carcinoma of the bladder, diagnosed and treated in our department by palliative cystectomy.

Adult↗

PubMed1999

[Extragonadal germ tumor].

Extragonadal primary tumors are uncommon and account for 3 to 5% of all germ cells neoplasias. Preferentially found in middle line structures, such tumors are frequently in an advanced stage when diagnosed. Differentiation between primary extragonadal tumors and metastasis of testicular primary tumors is essential, but may be difficult in many instances.

Adult↗

PubMed1998

[Evaluation and treatment of closed renal trauma].

Renal trauma accounts for more than 50% of all genitourinary trauma cases, nearly 90% of them corresponding to blunt trauma. Incidence is higher in male (3:1 ratio); is more frequent between the second and third decades; and predominantly affects the left side. Our group analyzed 89 cases of blunt renal trauma seen in our service between 1983 and 1996 with the purpose of determining the choice imaging studies, indications and type of management. Based on severity, injuries were rated in 5 grades using the classification of the Organic Injuries Survey Committee (OIS) from the American Association of Surgery in Trauma (AAST). We analyzed the etiology, clinical findings, prior renal conditions, associated injuries, radiologic studies and treatment instituted. CAT was considered the choice diagnostic technique for trauma rating since it permits greater definition of renal injury grade, as well as the associated abdominal and thoracic injuries. Most renal traumas were mild in severity, and evolved favourably with conservative treatment. In renal trauma grades IV and V, surgery is the recommended therapeutic approach, always preferring the most conservative criteria.

Adolescent↗

PubMed1998

[Urologic complications of pancreas-kidney simultaneous transplantation].

Pancreas Transplantation (PT) is the only available therapy today for diabetes that allows an insulin-independent euglycemic state with complete normalization of glycosilated haemoglobin levels. Survival of patient, pancreatic graft and renal graft is 93%, 86% and 90% respectively at one year and 90%, 84% and 85% at three years. The most accepted method for exocrine drainage in most centres where simultaneous pancreas-kidney transplantation is being performed is vesical drainage. In spite of the improvements achieved in graft and patient survival, it is evident that a most frequent use of this type of technique involves a greater number of urological complications (repeat infections, haematuria, fistulae or leakage, reflux pancreatitis, urethral stenosis and disruption, dehydration and acidosis, previous diabetic bladder) and the familiarization of the urologist with this type of disease in immunodepressed patients. This paper reviews the current situation and illustrates the general approach regimes in our Pancreas-Kidney Transplantation Unit with regard to each complication.

Hematuria↗

PubMed1998

[Retrovesical hydatic cyst].

The hydatid disease is a common condition in endemic countries, generally involving the liver or the lungs. Genitourinary tract involvement is quite uncommon, and the organ most usually affected is the kidney. A retrovesical location is even more rare. The present paper contributes one case with no evidence of hydatidosis in any other abdominal organ and describes the diagnostic and therapeutic protocol followed.

Echinococcosis↗

PubMed1997

[Management of obstructive renal candidiasis. Report of a clinical case].

Neonatal renal candidiasis is a rare complication but serious, associated with prematurity, immunodeficiency, parenteral nutrition and other risk factors, with a mortality rate until 50%. We describe a neonate premature of 28 weeks who developed septicaemia by Candida, complicated with bilateral ureterohydronephrosis and intrapelvic fungus ball. The patient was managed by bilateral nephrostomy drainage and amphotericin B local irrigation, anyway with systemic amphotericin B together with oral fluconazol, needing subsequently bilateral open surgery and external drainage. The infection was eradicated, reaching the patient a gradual healing.

Candidiasis↗

PubMed1995

[Prognosis significance of prostatic markers in patients with prostatic adenocarcinoma undergoing total hormonal blockade].

Evaluation of the prognostic value of prostatic markers with regard to disease progression after endocrine therapy in patients with prostate carcinoma. A total of 51 patients (21 stage C, 5 stage D1 and 25 stage D2). Endocrine therapy consisted in complete hormonal blockade with flutamide and an LH-RH analog depot (leuprolide). PSA-PAP levels were determined both pre-treatment and during follow-up of patients using radioimmunometric techniques. Follow-up extended for 13 to 62 months (mean 30 months). Death due to progression happened in 24 of 51 patients. Previous PSA levels did not correlate to progression. Changes in PSA levels during treatment and time scope when they occurred were associated to subsequent evolution. Patients with PAP higher than 10 ng/ml at the beginning of therapy experienced higher progression rates (p < 0.05). Decrease of PSA levels by a percentage greater than 80% during the first quarter of treatment relative to initial figures was related to lower progression rates (p < 0.01). Maintenance of high levels in the first six months of treatment predicted a higher progression rate (p < 0.001). The study suggests a better prognosis for patients wit decreased serum PSA rates by a percentage of around 80% after one to three months treatment.

Acid Phosphatase↗