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Biomedical subjects

J Vicente

Publications and source records attributed to J Vicente.

At least 19 recordsLinked to original sources
PubMed1992

Upper tract urothelial tumor after transurethral resection for bladder tumor.

We present a retrospective review of 30 patients who developed upper urinary tract tumors (UUTT) after having been diagnosed and treated for a bladder neoplasm. The mean patient age was 63 years (range 54-72). An average of 4.8 (range 1-10) transurethral resections (TUR) had been performed for bladder cancer prior to the appearance of UUTT. The length of time elapsed between the initial bladder TUR and the subsequent diagnosis of UUTT was variable, with increased incidence in the first 24-72 months (63.3% of the cases). In 21 cases (70%) the bladder tumor was multiple and in 28 (93.3%) the tumor was recurrent. In those patients with unilateral vesicoureteral reflux, an increased incidence of UUTT was found in the refluxing renal unit. In patients with poorly differentiated (grade 3 and grade 2-3) bladder tumors, UUTT was of the similar grade of anaplasia in 75% of cases. These observations, together with those previously published in the literature, allow us to recommend the use of excretory urography (IVP) every 2 years during the first 6 years of follow-up in patients treated for recurrent and/or multiple bladder tumor. Thereafter, follow-up would depend upon the individual clinical situation.

Carcinoma, Transitional Cell↗
PubMed1992

Value of electrical dispersion as a cause of urethral stenosis after endoscopic surgery.

We have evaluated the incidence of iatrogenic urethral strictures in a prospective study of 125 patients with a diagnosis of initial, superficial bladder tumors (without prior urethral instrumentation) and who were treated with endoscopic surgery. A global incidence of 12% was found after 24 months of follow-up with the strictures detected a mean of 9.5 months after the endoscopic procedure. These patients were divided into two groups. Group 1 was treated using standard transurethral resection (TUR) and group 2 underwent Nd:YAG laser photocoagulation. Both populations of patients underwent cystoscopic controls every 4 months as part of our standard follow-up protocol in bladder tumors. In the group of patients who underwent diathermy using a 24-F sheath (85 patients), the percentage of stenosis was 16.4%. In the patients treated with laser via a 21-F panendoscope (40 patients), the incidence of postoperative urethral stenosis was only 2.5%. We believe that the electrical dispersion generated by the unipolar electric current as well as the caliber of the operating instruments are factors which may influence the development of iatrogenic endoscopic urethral strictures.

Aged↗
PubMed1992

Microscopic rice bodies in rheumatoid synovial fluid sediments.

To determine the clinical significance of the microscopic study of the synovial fluid (SF) sediment, 306 sediments were examined from 216 patients with the most frequently occurring acute and chronic arthropathies. The SF was obtained using a fine gauge needle. Microscopic rice bodies were seen in 53 (17.3%) of the samples studied. Forty-five (84.9%) of the samples in which rice bodies were observed were from patients with rheumatoid arthritis (RA) (p < 0.001); 34.9% of the 129 RA samples were found to contain rice bodies. The specificity of finding rice bodies in RA was 95.5%. Most rice bodies were composed of partly or totally hyalinized fibrinous material; in their interior, mononuclear cells were predominantly observed--most of them macrophagic in appearance. With less frequency the rice bodies exhibited central areas of fibrosis. Our results suggest that microscopic rice bodies are fibrinous particles derived from the entrapping of cells in the dense fibrin network present in inflammatory SF.

Arthritis, Rheumatoid↗
PubMed1992

[Castleman's disease. A multifactorial study].

A case of Castleman's disease (hialino-vascular subtype) in a female patient 15-years-old is considered. Clinically there were isolated lymphadenopathies which relapsed after surgery and absence of general syndrome. Histoimmunological and electron microscopic studies were performed as DNA rearrangement and cytogenetics in order to exclude genetic abnormalities and monoclonality of this disorder. The role of follicular dendritic component in discussed.

Adolescent↗
PubMed1992

[A nephrogenic adenoma during treatment with intravesical BCG].

Two patients who had undergone resection of a transitional cell bladder tumor presented with nephrogenic adenoma of the bladder during treatment with BCG. Nephrogenic adenoma presenting in the course of intravesical chemotherapy has been previously reported in 5 cases and can mimic tumor recurrence. Thus, we consider the present case to be of special interest.

Adenoma↗
PubMed1992

[Renal hemangiomas: a clinical case and review of the literature].

Renal haemangiomas, an unusual cause of renal haematuria, are benign vascular dysplasias of uncertain etiology. Usually asymptomatic, their clinical manifestation is a unilateral renal haematuria associated or not to obstructive urological disease through accumulation of clots in the urinary tract and arterial hypertension when associated to a major arteriovenous shunt. Arteriographic diagnosis is based on the size of the vascular malformation but the absence of findings in the arteriography does not eliminate the presence of small-sized haemangiomas or microhaemangiomas responsible for the renal chronic haematuria, also labelled as "essential haematuria", which sometimes can be diagnosed through endoscopic examination of the renal cavities. This report presents one case of renal haemangioma which appeared as a massive, sudden haematuria and prompted haemodynamic instability requiring haemotherapy. Following arteriographic diagnosis, selective transarterial embolization was undertaken with three modified Gianturco's metal helicoids, to which the patient responded favourably. The report includes a review of the clinical, pathological, diagnostic and therapeutical features of renal haemangiomas.

Adult↗
PubMed1991

Carcinoma in situ as a prognostic factor for G3pT1 bladder tumours.

G3pT1 bladder cancer has traditionally been regarded as a superficial tumour with a high risk of progression. We have studied 37 patients with initial G3pT1 bladder tumours treated between January 1981 and December 1985. They were divided into 2 groups according to the association with carcinoma in situ (Cis) at the time of diagnosis. Clinical behaviour was analysed at 5 years. The first group (without Cis) showed progression and recurrence rates similar to those of low grade, low stage bladder tumours. The second group (with Cis) had a similar rate of recurrence but their progression rate was 65%.

Aged↗
PubMed1991

Electrohydraulic and ultrasonic lithotripsy in 100 consecutive cases of primary ureteral stones.

We have performed, between May 1985 and December 1988, in situ lithotripsy in 100 consecutive cases of primary ureteral stones, using electrohydraulic lithotripsy in 33 patients and ultrasonic lithotripsy in the remaining 67. After using similar instruments and surgical techniques in both groups, we have comparatively evaluated the complications encountered and the results obtained. With the electrohydraulic lithotripsy we have obtained a complication rate of 42% (operative and postoperative) and favorable results in 72.7% of the patients; using ultrasonic lithotripsy, the complication rate was 10.4%, and favorable results were obtained in 92.5%. We conclude that, at least in our experience, ultrasonic lithotripsy is less invasive and more successful than electrohydraulic lithotripsy in the treatment of primary stone disease.

Calcium Oxalate↗
PubMed1991

Histological evaluation of superficial bladder tumors treated by Nd-YAG laser and transurethral resection.

Based on 3 study groups we have tried to analyze some concepts concerning the treatment of superficial bladder tumors by the Nd-YAG laser. In the first group of 34 superficial bladder tumors, we evaluated the accuracy of cold-cup biopsy in staging the tumor before treatment with the laser (100% for grade and 90% for stage). The possibility of identifying the tumoral grade in the lasered mass is 73%. In the second group of 53 random superficial bladder tumors we compared the effects of laser and transurethral resection (TUR) with regard to recurrence and progression after a 3-year follow-up: no significant differences are found between the treatments. In the third group the histologic changes in the bladder wall after treatment with the laser or TUR were evaluated by cold-cup biopsy (31 lasered cases and 24 resected cases) and by resector loop biopsy (11 lasered cases and 11 resected cases) between 12 and 24 months after treatment, without significant differences in terms of fibrosis.

Aluminum↗
PubMed1991

[Treatment of bladder endometriosis using the Nd-Yag laser].

The good results achieved in the treatment of gynecological endometriosis via laser laparoscopy prompted us to perform endoscopic Nd:Yag laser photocoagulation in the present case of symptomatic vesical endometriosis described herein. To our knowledge, this is the first reported case in the world literature.

Adult↗
PubMed1990

Neodymium:YAG laser treatment of bladder hemangiomas.

We present 3 cases of bladder hemangiomas, one single and two multiple, with a long-term history of recurrent hematuria, treated with endoscopic neodymium:YAG (yttrium, aluminum, garnet) laser photocoagulation, and obtaining good results.

Adolescent↗
PubMed1990

Phase II trial of carboplatin and tegafur (Ftorafur) as induction therapy in squamous-cell carcinoma of the head and neck.

Cisplatin and 5-fluorouracil by continuous infusion combination produces a high response rate in squamous-cell carcinoma of the head and neck (SCCHN). Carboplatin (CBDCA) is a cisplatin analogue with lower emetic potential and nephrotoxicity, although the myelosuppression potential is higher. Tegafur (ftorafur, FT) is an analogue of 5-fluorouracil. It is absorbed well in its oral form and has moderate gastrointestinal and hematologic toxicity. This clinical trial tested the association of CBDCA i.v. plus FT p.o. in patients with SCCHN who had not been previously treated. Twenty-one patients were evaluable for response; the overall response was 62% (33% complete response, 29% partial response). Toxicity was moderate in most of the patients, although there was a treatment-related death.

Administration, Oral↗
PubMed1990

Phase II trial of cisplatin and tegafur (Ftorafur) as initial therapy in squamous-cell carcinoma of the head and neck.

Cisplatin and 5-fluorouracil infusion combination produces a high response rate in squamous-cell carcinoma of the head and neck. Tegafur (Ftorafur) is an analog of 5-fluorouracil, and its oral form is well absorbed. This agent has a moderate toxicity. We report a study to determine the efficacy of the cisplatin (100 mg/m2, day 1) and tegafur (1,000 mg/m2 daily for 21 days) combination. Thirty-nine patients entered the study; 36 were evaluable for response. Overall response was 94%, with a 22% complete response. Toxicity was moderate. We conclude that the cisplatin and tegafur combination is active in untreated patients with head and neck cancer.

Administration, Oral↗
PubMed1990

Endoscopic urethrotomy versus urethrotomy plus Nd-YAG laser in the treatment of urethral stricture.

Between February 1987 and May 1988, 30 patients who presented with single, iatrogenic, annular strictures of the bulbar urethra were included in this prospective study. They were randomly divided into two groups; group 1: 15 patients who underwent direct-vision endoscopic urethrotomy (cold-knife incision at 12 o'clock) and group 2: 15 patients who underwent internal urethrotomy plus Nd-YAG laser. The results obtained were analyzed and compared at 1 and 2 years by clinical evaluation, uroflowmetry and retrograde-voiding urethrography. Group 1 obtained 80% good results at 1 year, falling to 60% at 2 years follow-up. Group 2 presented good results in 73.3% both at 1 and 2 years of follow-up.

Aged↗
PubMed1990

Intravesical formalin for the treatment of massive hemorrhagic cystitis: retrospective review of 25 cases.

Between 1980 and 1988 25 patients with massive bladder hemorrhage were treated with intravesical instillation of 4% formalin in 19 cases and 10% in the remaining 6 cases; the contact time was 15 min in 20 cases. The etiology of the hemorrhage was cyclophosphamide therapy (1 case), pelvic radiotherapy (15 cases) and infiltrating bladder cancer in the remaining 9 cases. In 10 cases, the instillation of formalin was performed in bladders with a prior supravesical diversion. Complications included 1 case of vesicorectal fistula, 1 case of uretero-hydronephrosis and 1 case of vesical extravasation of formalin when a concentration of 10% was used at a volume superior to 50 ml. The only complication seen with 4% formalin was 1 case of upper urinary tract dilatation. Good results were obtained in 88% of cases, who achieved correct hemostasis during a mean of 4 months.

Administration, Intravesical↗
PubMed1990

[Laser therapy of superficial tumors of the bladder].

Based on the treatment with Nd-YAG laser of 109 superficial bladder tumors (52 initial cases and 57 recurrences), herein we report on its indications, technical aspects, and clinical advantages. In order to evaluate the difference between laser therapy and TUR, three groups were studied to compare both techniques. 1) We evaluated the incidence of tumor recurrence in 27 cases submitted to laser therapy and 26 cases submitted to TUR. At 2 years no significant differences were observed relative to tumor recurrence or progression for both groups. 2) We evaluated bladder parietal involvement for each technique. All but one of 109 cases that had been submitted to laser therapy had preserved initial bladder capacity. Biopsies performed in areas post-laser therapy (31) and post-TUR (24), and with the resector loop in 22 cases, revealed no histologic difference between both groups (replacement fibrosis and elastic fibers). 3) We evaluated the incidence of urethral stenosis after laser therapy (22) and TUR (55). Urethral stricture was significantly lower (4.5%) for those treated with laser than for those treated by TUR (16.3%). On the basis of the overall (109 cases) and the partial (study groups) results, we consider laser treatment of superficial bladder tumors to be limited to single, less than 2-3 cms, or small, multiple initial or recurrent neoformations.

Evaluation Studies as Topic↗