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R Vela Navarrete

Publications and source records attributed to R Vela Navarrete.

At least 19 recordsLinked to original sources
PubMed1997

[Resolution with vascular endoprosthesis after first angioplasty failure in the treatment of post-transplant stenosis of the renal artery].

We report a case of renal artery stenosis after a living transplant kidney, treated successfully with percutaneous transluminal angioplasty (PTA) and vascular endoprosthesis. PTA is the initial treatment of choice for most patients with high grade transplant renal artery stenosis. Surgical revascularization is indicated if PTA cannot be done or is unsuccessful.

Adult↗
PubMed1996

[Kidney transplant from living donor. Experience at the Jiménez Díaz Foundation].

OBJECTIVES: To discuss the organizational and surgical aspects, results, remarkable events and some ethical considerations of the renal transplantation program with grafts from living donors at our institution over a 25-year period. METHODS: The renal transplant program of the Jiménez Diaz Foundation began in 1964 and the first kidney graft from a living donor was transplanted in 1968. Since then and until December 1993, 157 renal grafts from living donors have been transplanted. The donors were parents in 94, siblings in 55 and the spouse in 4 occasions. Moreover, two free kidneys and two grafts from nonrelated donors were transplanted. The surgical procedure was also similar; i.e., right nephrectomy through a supracostal lumbotomy to remove the kidney and transplantation in the right iliac fosa with anatomosis to cava and common iliac or hypogastric artery. Changes in the surgical technique warranted by the intraoperative findings were infrequent. The ureter was anastomosed to the bladder using an extra- or transvesical technique depending on the surgeon's experience. Harvesting and transplantation of the kidney graft were performed simultaneously by two surgical teams. RESULTS: There were no major complications in the donors or technical difficulties or errors during harvesting that might have compromised graft viability, although complications such as hemorrhage, urinary fistula, thrombosis and prolonged anuria were observed early postoperatively. The incidence of grafts lost specifically related with the technique was less than 3%. Nineteen recipients had died early postoperatively from acute rejection and sepsis. Recipient and graft survival were basically related with the degree of histocompatibility and the changing therapeutic strategy over the 25-year period. The best results were found in 33 transplants involving HLA identical siblings, with a five-year actuarial survival rate of 89%, a 10- and 15-year survival of 70% and a 22-year survival of 22%, followed by those who were haploidentical who had donor-specific transfusions and the haploidentical cases treated with cyclosporine. The poorest results were seen in the historical group of 52 transplant procedures performed between 1968 and 1981 who were treated with the classical medication. CONCLUSIONS: The good results achieved and the minimal risk to donors demonstrated by our experience over a period of 25 years support continuation of the renal transplantation program with grafts from living donors, as well as our approach of having two surgical teams working simultaneously.

Adult↗
PubMed1996

[Strategy changes in the treatment of ureteral lithiasis and nephritic colic].

Since lithotripters were first introduced to the clinical practice in 1980, extracorporeal shock wave lithotrite (ESWL) has been universally recognized as the first choice to resolve urinary tract lithiasis, ureteral calculi being the most susceptible lithiasic site for controversy. The urologist approach to the lithiasic patient has changed mainly as compared to that of ureteral calculi. These profound changes translate an undeniable advance of the extracorporeal procedures versus those of endourology, basically based on ESWL low morbidity. In those cases when lithiasis is found in a situation of nephritic colic, there is a real therapeutical chance with ESWL, thus leading to drug therapy losing its major role. We present 768 patients with ureteral lithiasis (1991-1994), 20-25% of which were examined for a nephritic colic. Once the colic situation is overcome in all instances, 35% will require a new lithotrite for complete lithiasic resolution. Overall, our rate of successful ureteral lithiasis resolution is 97% (30% need repeated session).

Adolescent↗
PubMed1994

[Cultural and linguistic validation, in Spanish, of the International Prostatic Symptoms Scale (I-PSS)].

Formal presentation of the cultural and linguistic validation, in Spanish, of the International Prostatic Symptoms Scale (I-PSS). The process for the official translation into Spanish of the questionnaire on prostatic symptomatology and quality of live derived from urinary symptoms, has followed a methodology common to several countries (UK, Italy, Norway, The Netherlands and Spain) which consisted in: translation into Spanish of the original American-English version published by the WHO in 1992, by two independent bilingual urologists; re-translation into English, checking any conceptual and semantic changes that had caused difficulties in the process of translation/re-translation; final choice of the text by an International Committee based both on the data provided by the above process and the experience of the Central Committee accrued over their relationships with the various National Committees. The resulting text was applied to 33 patients with prostate disease and 12 controls, individually recording any difficulty of interpretation and choice of answer observed for each of the questions. The final text herewith presented constitutes the official reference for the Spanish translation of the International Prostatic Symptoms Scale (I-PSS) which should be used for future symptomatic evaluations. The purpose of this cultural and linguistic validation is to secure that the application of these scales provides comparable and consistent numerical results in those countries where the translation has not been officially validated.

Cultural Characteristics↗
PubMed1993

[Ambulatory ureteral lithotripsy with "Modulith SL-20"].

Analysis of our experience in 'in situ' ambulatory shockwave extracorporeal lithofragmentation of ureteral stones in 104 patients seen in the Lithotrity Unit, Urology Service, Fundación "Jiménez Díaz". Using Modulith SL 20, a third generation lithotripter, 'in situ' disintegration was achieved in 82.69% of cases, 51.92% of which were fragmented in a single lithotrity session. As a first choice, no ureteral handling was used in any of the patients prior to lithotrity. In 9.62% of patients it was necessary to place a 'double J' by-pass catheter, due to the disease presenting with a septic picture. The patient's position was either dorsal or ventral decubitus depending on the lithiatic site, while location and focusing of the stones was done radiologically. All patients were treated ambulatory without hospitalization. Only 18% was given oral or i.v. anaesthesia. Fursemide 40 mg was administered to all patients shortly before starting the session. Each patient received an average of 3,200 shockwaves per session (14-18 Kv, average 16 Kv). Haematuria was the single and modest side effect that happened during the 24 hours following lithofragmentation in 30% of patients, while 20% reported slight discomfort at the time of eliminating the gritted stones. We conclude stating that 'in situ' shockwave extracorporeal lithotrity of ureteral stones with Modulith SL 20 allows for elective disintegration of ureteral stones in whatever location they are found, due to the patient's easy positioning. The simple location and focusing of ureteral stones has allowed us to treat and solve some cases of ureteral lithiasis at the precise moment of the nephritic colic painful emergency, thus speeding up and facilitating the resolution of the condition. Our results and our strategy imply a new change of direction in the management of these lithiasis, as opposed to the well established and historical doctrines in existence regarding stones with ureteral location.

Adult↗
PubMed1991

Percutaneous nephrolithotomy in transplanted kidney.

Renal transplant patients with urologic complications can be managed safely with percutaneous techniques. The development of renal calculi in transplanted kidneys is uncommon, but in these cases complications such as infection and urinary tract obstruction with impairment of graft function can occur. We report 2 cases managed successfully with percutaneous nephrolithotomy.

Adult↗
PubMed1989

[Transurethral resection and cancer of the prostate, an up-to-date view].

Current urological literature, which is mainly concerned with radical prostate surgery and new modalities of hormone therapy, seems to focus little interest on the indications and techniques of transurethral resection in patients with prostatic cancer. However, transurethral surgery still remains a procedure frequently resorted to in those patients in whom the indications and techniques warrant a critical evaluation. The reasons for performing endoscopic surgery (64%) and the complications observed in 50 consecutive cases that had been treated by the author are analyzed herein and the literature reviewed.

Humans↗
PubMed1984

[Urodynamic studies of the upper urinary tract. II. Pyelo-ureteral dilatation. Reversibility prediction test].

For the correct performance of upper urinary tract repairs, it is essential to use methods which provide the necessary information concerning the potential reversability of the dilatation. This article analyzes the physiopathological foundations on which these methods must be based, and comments on the different procedures in common practice, such as the concept of radiological tonicity, peroperative histology, and preoperative draining. Special mention is made of anterograde urometry associated with simultaneous dynamic radiology, which provide precise information concerning the intraluminal pressure and the muscularization of the ureteral wall.

Dilatation, Pathologic↗