Biomedical subjects
Publications and source records attributed to E Maganto.
We present a case of colovesical fistula secondary to vesical gangrene. Precipitating factors were diabetes and vesical distension caused by the obstruction of an indwelling catheter. This complication is an exceptional outcome in gangrenous cystitis and it requires emergency surgical treatment.
The value of urinary fibrinogen degradation products (EPD) as a biological marker of bladder cancer has been studied. An increase in FDP was found in 75% of bladder cancer patients, independent of the fact that they had active tumours or that they were disease free. A high correlation between the amount of the increase and the grade, local invasiveness, and risk of recurrence of the tumour has been established. The assessment of urinary FDP is considered as a valuable screening and follow-up test in patients with bladder neoplasms.
The evolution of 168 patients, 136 of which underwent bilateral lymphadenectomy is analyzed in this paper. In 126 cases it was possible to obtain all the data in order to define N within the T.N.M. rating. With regard to the remaining patients 10, of which we lack the anatomopathological report, and 32 which did not undergo lymphadenectomy, are included under item Nx. During follow-up, metastasis was diagnosed in 60% node-positive patients. We believe it to have been already present at the time of undergoing surgery. Survival was significantly higher in the group without node dissemination than in both negative-nodes and Nx groups. When assessing the nodular dissemination group, patients treated with 2000 rad prior to cystectomy showed higher survival rates: 36% vs 22% and 11% for groups treated with 4500 rad and no radiotherapy. respectively. Metastatic percentage, however, was lower for the group managed with surgery alone (50%) than those treated with pre-operative radiotherapy (73% and 67% with 2000 and 4500 rad, respectively), on the other side, it would seem a contradiction that a 2000 rad dosage should be more effective than a 4500 rad dosage for this group of patients, since theoretically, the latter is closer to the ideal dosage to eradicate the nodular disease. Since 3 of 5 patients have micrometastasis, which we are yet unprepared to detect, all positive-node patients should receive chemotherapy immediately after recovery from surgery.
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In this paper, we present a case of traumatic sectioning of the isthmus in a patient with multiple injuries, suffering from a horse-shoe-shaped kidney, which is extremely rare, according to the review of the literature which we have carried out. In view of the scanty incidence of kidney fusions and the difficulty sometimes involved in classifying them and in their surgical treatment, we shortly comment on the consequences which traumatisms may have on this kind of kidney malformation.
A study is made of 15 patients with monotopic coralliform stones, suffering from simultaneous, contralateral, renoureteral lithiasis. There are certain special features in these patients which we consider to be sufficient to distinguish them as a separate group amond cases of lithiasis in general and coralliform stones in particular. The high percentage of septic complications observed in these patients demand special treatment within the field of urinary lithiasis.
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