Biomedical subjects
S Bucar Terrades
Publications and source records attributed to S Bucar Terrades.
[Cyst of the seminal vesicle associated with renal dysgenesis and ipsilateral ectopic ureter. Apropos of 3 clinical cases].
We discuss the cystic pathology of seminal vesicles, and its relation with ureteral ectopy, as well as the therapeutic options for both entities. We present our experience in the resolution of three typical cases.
[Accidentally diagnosed hypernephromas. Retrospective study and evaluation of their importance in clinical practice].
Presentation of a retrospective study on 50 hypernephromas seen in our service, including an evaluation of those that were accidentally diagnosed. Nineteen of these were diagnosed by chance and 9 as a result of other investigations required for the study of a gastrointestinal disease, these studies being in most cases an ultrasound recording. Data obtained with this review allows us to compare these results with those from other authors, as well as to evaluate the relevance of such diagnoses in the daily clinical practice. The study concludes that the fact that these tumours are found in earlier stages is more than enough to raise questions on the way in which we could increase the number of this chance diagnosis.
[The therapeutic management of the rupture of a kidney graft].
From a consecutive series of 106 renal transplants, we present our experience on spontaneous renal allograft rupture. This complication appeared in 6 patients, which accounts for 5.6% of the overall group: four patients (66.6%) had acute rejection, two (33.3%) developed thrombosis of the renal vein (one of which coincided with rejection), and rupture was attributed to trauma in one patient (16.6%). Rupture was diagnosed within the first two weeks after transplant in five patients and on day 27 in one patient. The therapeutic approach was determined according to the cause of the rupture. In our view, nephrectomy is warranted in those cases with venous thrombosis and in acute rejection correction of hypovolemia and adequate immunosuppression are essential. Drainage of perirenal hematoma is the first step when conservative surgical treatment is required. We use three-dimensional renal corsetage with polyglycolic acid mesh (PAM) for hemostasis and to prevent expansion and fragmentation of the parenchyma. PAM is easy to handle and covers the kidney completely and uniformly. Two nephrectomies were carried out and in both cases thrombosis of the renal vein was diagnosed. PAM was placed in two cases: one with rejection and the other with trauma. The remaining two patients were managed conservatively due to the good response of rejection to immunosuppressor therapy and the patients response to medical treatment. There were no deaths and complications were observed in only one patient (16.6%). All patients with preserved transplant (66.6%) had a good course and renal function was preserved.
[Renal biopsy of nephrologic origin. Report of 283 biopsies].
Two techniques are utilized for renal biopsy (RB): open renal biopsy (ORB) and percutaneous renal biopsy (PRB). We reviewed 283 renal biopsies: 140 ORBs and 143 PRBs. The number of glomeruli obtained were 34.6 and 13.4, respectively. Sufficient biopsy material for the pathological analyses was obtained in 100% of the ORBs and 91% of the PRBs. These were diagnostic in 98.5% and 91%, respectively. The two groups were significantly different. Patients submitted to ORB had a worse general condition (analytically more uremic and anemic). The creatinine and urea values prior to RB were higher for the complicated ORB group versus the overall ORB group. Statistically, the complicated ORB group is related with hyperpotassemia and hypernatremia. The sodium values were higher and the urea values were lower for the complicated ORB group, although we believe the foregoing findings to have no clinical value. The remaining analytical studies were not different for the groups or subgroups of the present study.
[Surgical renal biopsies: technique, effectiveness and complications].
Retrospective study made on 140 renal surgical biopsies (RSB) performed throughout the past 4 years in our Unit. The technique's effectiveness and morbidity are emphasized and the surgical technique and type of anaesthesia described. The sample obtained was enough to perform an essay in 100% cases, and a diagnosis was reached in 98.5%. Thirty-nine patients (27.8%) presented complications, 13 (9.2%) of which were directly related to the surgical technique. No case required blood transfusion and no deaths were reported. The type of anaesthesia used was: local plus sedation in 104 (74.2%) cases, rachianaesthesia in 10 (7.1%) and general in 26 (18.5%). The same approach was used in all patients: minimal subcostal lumbotomy, using Wilde's forceps to obtain the samples. It is believed that RSB is a highly effective, low mortality procedure, easy and quick to perform, and suitable for selected patients.