Biomedical subjects

M Leva Vallejo

Publications and source records attributed to M Leva Vallejo.

14 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

[Association of renal carcinoma and the exposure to ionizing radiation after the Chernobyl accident].

After the nuclear accident of Chernobyl, in the population of zones contaminated the malignant renal tumors was increased from 4.7 to 7.5 per 100,000 of total population. Cesium 137 (137Cs) constitutes 80-90% of the internal exposure of these people as well as eliminated through kidneys becomes an important risk factor. We present a case of a patient, residing in radiocontamined area, who consulted for abdominal pain and left flank mass. We review relevant literature and the management of these patients.

Accidents↗

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

[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↗

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

[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↗

PubMed1998

[Testicular epidermoid cyst].

OBJECTIVE: Benign tumors account for less than 1% of testicular tumors and the incidence is even lower in children. A rare case of epidermoid cyst of the testis in a child is described. The differential diagnosis and treatment options are discussed. METHODS/RESULTS: A case of unilateral epidermoid cyst of the testis in an 11-year-old boy is presented. The clinical and diagnostic aspects are discussed. Definitive diagnosis could be made only after surgical excision. CONCLUSIONS: Pathological analysis of the entire testis is warranted to make the definitive diagnosis of epidermoid cyst. However, preservation of the testis can be considered, particularly in those cases with bilateral involvement, if supported by solid, consistent diagnostic evidence, including intraoperative biopsy.

Child↗

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↗

PubMed1993

[Response of superficial bladder carcinoma to prophylacit treatment with mitomycin-C versus interferon. Preliminary study].

The efficacy of two protocols for the prevention of relapse using Mitomycin-C and alpha-Interferon in 56 patients with surface bladder carcinoma (stages Ta-T1) treated with TUR was compared in a prospective study. Relapse percentages and rates, related to the tumours' presentation characteristics (single, multiple, primary, recurrent), as well as their systemic and local toxicity, were evaluated. The study of statistical significance is made using the squared-chi test, and it is completed with a Fisher's test for groups containing few elements for accuracy. The results show no statistical differences (log rank p = 0.313) between the two groups of endovesical therapy, both confirming to be effective as adjuvant therapy to TUR in surface bladder tumours.

Administration, Intravesical↗

PubMed1992

[Complete androgenic blockade: myth or reality. Study and follow-up of 35 patients with advanced carcinoma of the prostate].

Retrospective evaluation of the efficacy of complete androgenic blockade started by Labrie et al. using therapy with leuprolide acetate in monthly dosage of 7.5 mg i.m. associated to flutamide at the usual dosage in 35 patients with prostate adenocarcinoma in C-D1-D2 stages, who had not been given prior anti-neoplastic therapy. Clinical and analytical control studies were carried out during therapy follow-up for a maximum time of 36 months. The objective response of adverse events that can be superimposed to previous studies carried out with analogs on daily administration was assessed. Castration levels achieved were maintained for the length of the study below 50 ng/dl. Correlation between tissue type, rated according to the Mostofi classification, evolution or degree of response obtained and preserved increase of tumour markers (PSA, PAP, LDH, Prolactin) was evaluated; the evolution observed in patients who maintained high values of markers was worse with the referred treatment.

Aged↗

PubMedDate not supplied

[Malignant fibrohistiocytoma of the bladder].

We report on new case of a rare vesical tumour. We result the importance of immunohistochemistry and ultrastructural study to support the diagnosis of malignant fibrous histiocytoma of the urinary bladder. There has been described another 16 cases of this tumour in the literature, however, only four of them -five with ours- reports an extensive immunohistochemical and ultrastructural study. The rarity of vesical localization of this tumour may delay its diagnosis. It must be supported by a immunohistochemistry and/or ultrastructural study, in order to differentiate from other tumours with fibrohistiocytoma-like pattern: leiomyosarcoma and sarcomatoid carcinoma of the bladder. After radical removal of tumour, adjuvant therapy is recommended both systemic chemotherapy and local radiotherapy, although survival rates are over 5.3 months after first therapeutical actuation.

Histiocytoma, Benign Fibrous↗