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R Villamón Fort

Publications and source records attributed to R Villamón Fort.

4 recordsLinked to original sources

[Value of prostate-specific antigen density and transitional-zone prostate-specific antigen density in the diagnosis of prostate cancer].

INTRODUCTION: With serum prostate specific antigen (PSA) levels of 4.1 to 10 ng/ml a significant number of patients are unnecessary subjected to biopsy. We try to determine if the calculation of prostate specific antigen density (PSAD) and prostate specific antigen density of the transition zone (PSADTZ) improve the capacity to discriminate between non-malignant disease and prostate cancer. METHODS: A prospective study including 314 males with PSA levels between 4.1 and 10 ng/ml is reported. Transrectal ultrasonography and prostatic biopsy were performed in all of them and total prostate and transition-zone volumes were calculated. PSA density and PSA density of the transition zone were calculated for each patient. Receiver operating characteristics (ROC) curves for PSA, PSAD and PSADTZ were constructed for all the patients and for those patients with digital rectal examination unsuspicous of malignancy, determining the sensitivity and specificity for several cutoff values. RESULTS: The area under the curve for both, PSAD and PSADTZ, were greater than for PSA (p < 0.05), without any significant differences between PSADTZ and PSAD. The cutoff value of greatest diagnostic efficiency for PSAD was 0.17 ng/ml/cc (71.4% sensitivity and 55.7% specificity), while it was 0.41 ng/ml/cc for DPSATZ (70% sensitivity and 61.5% specificity). For those cases of normal digital rectal examination, no differences were observed between PSA and PSAD but they were between PSA and PSADTZ. In any event, the area under ROC curves was always less than 0.7, and, in order to avoid a large number of biopsies (high specificity), a large number of cancers are left without diagnosis (low sensitivity). CONCLUSIONS: We conclude that PSAD and PSADTZ are not excessively useful for adequately discriminating between patients with prostate cancer and those with non-malignant disease, particularly when digital rectal examination is normal.

Adenocarcinoma↗

[Anterograde insertion of ureteral catheter].

We report twenty-four patients with urinary obstruction, in which twenty-seven antegrade ureteral stent (double J) insertions were attempted (in six patients the obstruction was bilateral and in three other patients we failed). In all of them access to the urinary tract was through a nephrostomy catheter, in seventeen cases we proceeded to insert the antegrade catheter immediately after percutaneous nephrostomy and in ten remaining cases we achieved in a second try after carrying nephrostomy and failing a conventional retrograde approach to ureteral stent insertion. We got a 90-per cent success rate. A case of perirrenal hematoma occurred after applying a nephrostomy. It was the only relevant complication. In conclusion we consider that the antegrade ureteral stent insertion is a good alternative when, under several circumstances, the conventional retrograde insertion fails.

Female↗

[Retroperitoneal germ cell tumor].

We report a case of retroperitoneal extragonadal germ-cell tumor in an 17 years old patient who presented with aedema and pain in left inferior extremity asociated with hemopthysis caused by pulmonar metastasis, who was treated with chemotherapy and resection of residual mass and pulmonary nodes. Dyagnosis was stableshed by fine neadle aspiration biopsy of the wass. We comment on the difficult of stableshing differential dyagnosis between retroperitoneal extragonadal germ-cell tumor and metastasis of a testicular tumor. Dyagnosis is stableshed by the finding of a histologically malignant germ-cell tumor with normal testis. We considered physical examination and ecographyc exploration enough for a correct dyagnosis.

Adolescent↗

[Percentage of tumor in prostatic biopsy cylinders as prognosis factor of organ-limited disease in candidates for radical prostatectomy].

UNLABELLED: The present study analyzes the prognostic influence of tumor percentage in cylinders of prostatic biopsy in this patient group. MATERIAL AND METHODS: Retrospective study of 68 patients with a diagnosis of adenocarcinoma, clinical stage T1-T2 who had undergone a radical prostatectomy from May 1997 to october 2000. Following preoperative parameters were analyzed: age, PSA, clinical staging, Gleason and six cylinders of ultrasonography-leaded transrectal prostatic biopsy, studying the amount of positive biopsies, the tumor percentage of the total amount of biopsies and the maximum percentage of tumor in one cylinder. Univariate (square-Chi, Student t) and multivariate (multiple logistic regression) analysis are performed in order to study the relationship of these parameters with the presence or not of an organ-located disease. RESULTS: An organ-located disease was shown at 44 patients through the piece of radical prostatectomy. The univariate analysis gave all studied parameters, except age, a prognostic value of the existence or not of an organ-located disease. In the multivariate analysis only the total percentage of biopsy tumors (p = 0.0002) and PSA (p = 0.005) behaved as independent prognostic factors. CONCLUSION: Tumor percentage in prostatic biopsy seems to be a factor with a high predictive value of an organ-located disease, possibly because it is an index of tumoral volume.

Aged↗