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Biomedical subjects

F J Burgos Revilla

Publications and source records attributed to F J Burgos Revilla.

At least 19 recordsLinked to original sources

[Prognostic significance of PIN and Atypical Small Acinar Proliferation on transrectal ultrasound-guided prostate biopsy].

OBJECTIVE: To review the incidence of PIN and Atypical Small Acinar Proliferation (ASAP) on first biopsy, the risk to find cancer on following biopsies and what is the importance given to this findings, analizing how frequently and how long after the initial finding this patients are rebiopsied. METHOD: We selected 6000 patients who underwent TRUS biopsy between 1994 and 2002. Patients with prior cancer diagnosis were not included. 861 of them underwent more than one biopsy, adding up to a total of 7127 biopsies. A descriptive study has been done including percentages and percentiles for qualitative variables, mean and median for continuous variables. RESULTS: Incidence of cancer on the first biopsy was 39,1%. PIN and ASAP are stable or slightly increase from 2 and 2,1% respectively on the first biopsy to more than 6% on the fourth and fifth ones. Mean time between biopsies when ASAP or PIN are the initial findings is 180 +/- 221,6 and 264 +/- 213,8 days respectively. Just 42 and 40% of patients with prior PIN or ASAP diagnose are rebiopsied. On subsequent biopsies 45 and 40% of cancers were respectively found. CONCLUSIONS: Presence of PIN or ASAP implies a higher cancer risk on subsequent biopsies; in spite of that, less than half of them are biopsied again. Performing two more biopsies or an amplified biopsy can find most of the tumors associated.

Adenocarcinoma↗

EAU guidelines on renal transplantation.

OBJECTIVES: To produce a guidelines text, on behalf of the European Association of Urology, providing insights in the issues surrounding renal transplantation. METHOD: A group of international experts in renal transplantation carried out a non-structured literature review on available medical databases and urological literature. RESULT: A guideline text is presented providing an overview of key issues involved in the patients' management such as assessment of donors, pre-transplant evaluation, techniques, management, post-transplant care, etc. CONCLUSION: The current text represents a consensus statement developed by a group of international experts in renal transplantation.

Graft Rejection↗

[Celsior's kidney preservation in renal transplantation. Our experience].

BACKGROUND: The goal of this research is to make a comparative analysis of acute tubular necrosis (NTA) incidence in function of preservation solution used: Wisconsin vs Celsior. METHODS: From January 1994 to December 2002, 229 kidney transplantation procedures were executed; 190 of them were perfused with Wisconsin (82.9%) and 39 with Celsior (17.1%). After checking the statistical homogeneity of both groups, we analysis comparatively the incidence of NTA and the evolution of serum creatinine in function of preservation solution utilized. RESULTS: There was not statistical significant difference in NTA incidence between Celsior (23%) and Wisconsin group (36%). We assessed that each group were comparable with regard to NTA incidence of subgroups with cold ischemia times longer 12 hours. Creatinine serum in Celsior group tended to be lower than Wisconsin group at 1, 3, 6 and 12 months posttransplantation (statistically significant difference, p<0.05) CONCLUSIONS: Kidney preservation in Celsior solution provides similar results to the ones obtained in Wisconsin solution in relation with NTA incidence and kidney function with the added advantage of a lower cost.

Adenosine↗

[Primary testicular lymphoma. Report of a new case and review of the literature].

Primary testicular lymphoma is an uncommon testicular tumour that accounts for no more than 9% of all testicular tumours in those series with higher incidence; testicular lymphoma as haematopoietic tumours are also rare accounting for just 1% of all lymphomas; but due to their highly malignant histopathology they may become highly aggressive tumours. Patient age at presentation is over 60 years old which makes it the most frequent tumour for this age group. There is no standard protocol to treat this malignancy due to lack of extensive series. We contribute one case and make a literature review discussing the current therapeutic trends for this disease.

Humans↗

[Extra-anatomic urinary diversion by subcutaneous catheter].

Percutaneous nephrostomy has been one of most used palliative method of urinary diversion to treat cronic renal failure in neoplasic patients. Psychological and social factors meke this measure to be rejected by some patients even sin situations where this is the only action that would make their survival longer. The utilization of ureteral stents provides benefits to a certain percentage of patients, not being possible its usage in all the occassions. Urinary subcutaneous diversion can be a simple and well tolerated alternative for the patient. The following clinic case describes and approach implementing a subcutaneous stent in a 60-y-old male with a severe ureteric obstruction after failed management by endoscopy or open surgery.

Humans↗

[Metastasis in renal graft of primary renal adenocarcinoma].

Acquired cystic renal disease (A.C.R.D.) is a risk factor for the development of renal carcinoma in the patient's own kidney after renal transplant (R.T.), development of a primitive tumor in the renal graft is infrequent, but the presence of metastasis of an epithelial tumor is very rare. This is the second case reported in the literature of metastasis of an epithelial tumor in the renal graft and the first case described of renal cell carcinoma metastasis (R.C.C.) in the renal graft. This paper describes the case of a patient with a normally functioning renal transplant and A.C.R.D. who develops RCC in his own kidney, with metastasis in the renal graft.

Adenocarcinoma↗

[Bladder malacoplakia with lymphatic involvement and an aggressive course].

Malacoplakia is an unusual chronical granulomatous disorder. In the urinary tract is more frequent in female, in 75 percent of cases involve the bladder. Pelvis extension of this disease is infrequent, and even less frequent is the involvement of pelvic and retroperitoneal lymph nodes. We present the second case in the literature of bladder malacoplakia with extravesical and pelvic node involvement.

Aged↗

[Ureteral stenosis after kidney transplantation: treatment with a self-expanding metal prosthesis].

OBJECTIVE: To determinate the efficacy in the treatment of ureteral estenoses after renal transplantation with metallic self-expandable stent. MATERIALS AND METHODS: From october of 1995 to april of 2002, 8 ureteral obstruction post renal transplantation have treated by means of implants of a metallic self-expandable stent (6 men and 2 women). The average time of pursuit was of 30 months (rank 2-53 months). In this work the severity and location of the estenosis are analysed, the method of implant of the stent, the permeability of the same one, the levels of creatinine pre and postimplant and the complications derived from the same one. RESULTS: The treatment was effective in the 100% of the patients (8/8), with an average reduction of the creatinine of 36% (rank 13.6%-59.6%). The complications were minimum and the hospital stay was short. CONCLUSIONS: In the patients with: chronic deterioration of the graft with short functional expectation, patient with high surgical risk and reestenosis after ureteral reimplantation by previous ureteral estenosis, the use of a metallic self-expandable stent, constitutes technique of election given its efficacy and low associate morbidity.

Adult↗

[Usefulness of endourologic catheters in the treatment of urinary lithiasis].

OBJECTIVE: To review the indications and complications of the use of endourological catheters in the treatment of urinary lithiasis and choice of catheter based on its physical and hydrodynamic characteristics and biocompatibility. METHODS: Data from our experimental and clinical studies, as well as those published in the literature are summarized. RESULTS: Polyurethane, C-flex and Percuflex catheters have the highest retaining capacity, while the silicone, Urosoft and Wiruthan catheters have the lowest. The tensile strength of polyurethane and copolymers is superior to that of silicone. The friction coefficient, which varies within the same material, influences the facility of catheter insertion. The number and size of the side vents are essential to catheter hydrodynamic behavior. Silicone is the most biocompatible material, followed by Urosoft. The polyurethanes and C-flex catheters cause important urothelial hyperplasia and edema of the lamina propia. CONCLUSIONS: The choice of endourological catheter should be individualized and based on the clinical indication. For prevention of obstruction from steinstrasse post-lithotripsy, a catheter with a high extraluminal flow and high retaining capacity is indicated to facilitate passage of stone fragments and to avoid catheter migration.

Biocompatible Materials↗

[Diffuse bladder hemangioma].

Contribution of a case report of diffuse bladder haemangioma developed since childhood, focusing on the diagnosis and management of these tumours and on the pathoanatomical analysis of the lesion. Literature review.

Adult↗

[Glandular cystitis. Endovesical steroid treatment].

OBJECTIVE: To report a case of cystitis glandularis, a proliferative disorder of the bladder mucosa whose incidence is estimated to be approximately 1%. METHODS/RESULTS: A case of diffuse cystitis glandularis in a male patient is presented. Intravesical steroid therapy achieved symptomatic resolution, although the proliferative mucosal lesions persist. CONCLUSION: There is currently no non ablative treatment that has been demonstrated to be effective in diffuse cystitis glandularis.

Administration, Intravesical↗

[Renal transplantation and urinary infection. Review].

Urinary infection (UTI) is the most frequent infection after renal transplantation (RT). The literature shows and incidence between 10-98%. The risk of associated bacteraemia is close to 12%. Gram- bacteria are the most frequent causal agents (70%), although gram+, mainly enterococcus and staphylococcus, candida and some other exotic germs such as Corynebacterium are also potential etiological agents. Certain factors present in the receptor during pre-RT, RT itself and post-RT condition the development and evolution of UTIs. Clinical signs and symptoms are multiple ranging from asymptomatic bacteriuria to graft's abscess or septic shock. Incidence in females (54%) is higher than in males (29%). Immunosuppressive regimes based on Cyclosporin (35%) show lower incidence of UTI than those based in Azathioprine (50%). Antibiotic prophylaxis with Co-trimoxazol reduces incidence of UTIs at post-RT and delays the time of appearance of the first UTI episode.

Humans↗

[Treatment of ureteral obstruction with auto-expandable metallic endoprosthesis].

OBJECTIVE: To evaluate the efficacy of Nitinol (Memotherm) self-expandible metal stents in the treatment of malignant and non-malignant ureteral obstruction in patients who are not eligible for surgery. METHODS: A total of 14 ureteral strictures (5 malignant, 9 non-malignant) in 13 patients were treated by the implantation of a Nitinol endoprosthesis. Eight were implanted by the antegrade and 6 by the retrograde route. A mean of 1.3 stents were implanted per patient. RESULTS: 85% of the stents were patent at a mean follow-up of 10.2 months (range 2-28). Four prostheses developed transient obstruction that was resolved by insertion of a double-J catheter for periods that ranged from 2 to 6 months. One stent required a permanent double-J catheter and another stent showed functional obstruction, although it was morphologically patent. CONCLUSION: The Nitinol self-expandible metal stent is effective in the treatment of malignant and non-malignant ureteral obstructions in patients who are not eligible for surgery due to the tumor stage or high surgical risk.

Adult↗

[The double-J ureteral catheter: its historical development and current status].

OBJECTIVE: To review the history of the development of the double-J ureteral catheter, a device that is necessary in current urological practice. METHODS/RESULTS: A review of the literature shows that although there are references on the use of the ureteral catheter before 1967, the history of its development began in that year, when Zimskind and co-workers designed and used the first self-retaining catheter that was inserted cystoscopically. However, it was not until 1978 when the double-J shape was adopted following the design of Finney. CONCLUSIONS: A review of the history of bioimplants development in the field of Urology shows that catheter design and its biomaterials have developed in parallel, in an attempt to create a device that functions well and one that is also well-tolerated by the body in order to reduce the catheter-related complications.

History, 19th Century↗