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Biomedical subjects

M Esteban Fuertes

Publications and source records attributed to M Esteban Fuertes.

44 records · Page 3Linked to original sources

[Usefulness of carcinoembryonic antigen in transitional cell carcinoma of the bladder].

Carcinoembryonic antigen (CEA), described by Gold and Freedman, was the first fetal tumor antigen isolated in tumor homogenates. The present study investigated the biological behaviour of CEA in superficial transitional cell carcinoma of the bladder, deep localized and disseminated. The study comprised 100 subjects; 30 carefully-selected healthy subjects comprised the first group and 70 patients with a diagnosed transitional cell carcinoma of the bladder comprised the second group. Serum CEA was determined by enzyme immunoassay (CEA, EIA, Roche). Our results suggest that serum CEA determination affords no diagnostic benefit in this type of malignant tumor.

Carcinoembryonic Antigen↗

[Reliability of the estimate of post-voiding bladder volume with ultrasound. Comparison of 2 ultrasonography methods].

OBJECTIVES: To determine the reliability of the postvoiding volume measurement of two US methods. METHODS: A comparative study of transabdominal and portable ultrasound (Bladderscan model) in the selected and non-selected modes was conducted in 96 patients (54 males, 42 females; mean age 59.92 yrs). RESULTS: Conventional US had the lowest failure rate (26.99%). The failure rate was 41.66% for the selected mode and 57.77% for the non-selected mode. The main failure of transabdominal ultrasound was a defect failure. The non-selected mode had a defect and excess failure. The selected mode had a defect failure. There was and inverse relationship between the residual volume and the failure rate of the non-selected mode of the Bladderscan model. The failure rate was higher for males vs females in the non-selected mode. The possible sources of failure are analyzed. CONCLUSION: Conventional transabdominal ultrasound is currently the most reliable ultrasound method.

Aged↗

[Value of the shape of the flowmetry curve in the study of prostatism].

OBJECTIVE: To determine the relation of the urinary flow curve morphology of free flowmetry with the status of lower urinary tract dynamics. METHODS: A mathematical model was designed to fit the urinary flow curves to two models: a symmetrical and an asymmetrical model. Based on these models we analyzed the relationship between the presence or absence of obstruction and the type of model which better adjusted the urinary flow curves in a series of 85 males. RESULTS: The urinary flow curves corresponding to absence of obstruction adjusted significantly better to a symmetrical model than those corresponding to bladder outlet obstruction. No correlation was observed between the type of curve and bladder contractibility or type of urinary obstruction. CONCLUSIONS: There is a relationship between the form of the urinary flow curve and bladder obstruction. In the absence of obstruction, the urinary flow curves are more symmetrical.

Adult↗

[Correlation coefficient of urodynamic data used in prostatism].

OBJECTIVE: To determine the usefulness of different urodynamic data and their relationship. METHODS: 105 adult males with prostatism were evaluated urodynamically. Data were obtained utilizing the Abrhams and Griffiths and the Schaeffer models. RESULTS: Our results show that the urinary flow rate correlates directly with bladder contractibility and inversely with the urethral resistance parameters. CONCLUSIONS: The urethral resistance was produced by two independent factors: a factor which resists initiation of voiding, measured by the opening pressure according to the Schaeffer model; a second factor which opposes maintenance of voiding, measured by the PURR curvature of the Schaeffer model and by the slope of the Abrhams and Griffiths model. Bladder contractibility was related to pressure at maximum flow rate of the Schaeffer model.

Adult↗

[Changes in the urethral pressure profile after vaginal electrostimulation in the treatment of stress urinary incontinence].

OBJECTIVE: To assess the changes in urethral pressure measurement after vaginal electrostimulation for the treatment of genuine urinary stress incontinence. METHODS: A clinical study, cystometry and urethral pressure profile were conducted on 15 female patients with urinary stress incontinence. RESULTS: The clinical results showed that electrostimulation was effective in 60% of the patients. The maximum urethral pressure and the functional urethral length increased after electrostimulation (from 47.72 +/- 16.47 cm H2O to 58.27 +/- 14.09 cm H2O, and from 3.9 +/- 1.56 cm to 5.25 +/- 1.69 cm, respectively). There was no relationship between the clinical improvement and the increment of both parameters. However, the increase of the maximum urethral pressure was higher in patients with improvement of incontinence (from 42.5 +/- 3.53 cm H2O to 49.65 +/- 11.26 cm H2O). CONCLUSIONS: Electrostimulation increases both the maximum urethral pressure and the functional urethral length. However, there is no relationship between these parameters and the effects of electrostimulation on urinary incontinence.

Aged↗

[Neuroandrologic considerations in impotent patients with Peyronie's disease].

OBJECTIVE: To asses the neuroandrologic profile of impotent patients with Peyronie's disease. METHODS: We conducted a pharmacological erection test and a study of the neuroandrologic profile of 13 impotent patients with Peyronie's disease. Eight patients hhad associated conditions and no associated disease was demonstrated in the remaining 5 patients. The neuroandrologic profile was based on bulbocavernous EMG, S2-S4 evoked potentials, somatosensorial potentials of pudendal nerve, cavernous smooth muscle electromyography (SPACE), sympathetic skin response, and cystometrogram. RESULTS: SPACE was altered in all the cases. In the patients with no associated disease, all other data of the neuroandrologic profile were normal. Patients with associated conditions demonstrated more alterations in all other data of the neuroandrologic profile and significant differences were observed in 7 cases. No differences in the type of alterations of SPACE were observed in 7 cases. No differences in the type of alterations of SPACE were observed between both groups. CONCLUSION: The impotence associated with Peyronie's disease could be due to an intrinsic lesion of the erectile smooth muscle.

Aged↗

[Characterization of the DURR (dynamic urethral resistance relation] in the study of function lower urinary tract symptoms in the male].

OBJECTIVES: To determine the type and to quantify the DURR phenomena in the male. METHODS: We conducted a clinical and urodynamic study in 31 male patients with functional lower urinary tract symptoms. RESULTS: DURR is produced by two types of mechanisms: urethral rigidity and contraction of the urethral wall. The patients with DURR produced by rigidity showed a higher score for irritative urinary symptoms. The patient with DURR produced by the contraction of the urethral wall had greater urodynamic consequences (increased opening pressure and PURR curve). The obstructive urinary symptoms were more intense when the DURR presented in the second phase of voiding (after reaching the maximum flow). CONCLUSIONS: The DURR phenomena have clinical and urodynamic consequences in males with functional lower urinary tract symptoms; therefore their type and quantity should be adequately determined.

Adult↗

[Occlusive urethral systems: can they constitute an alternative in the management of female stress incontinence?].

OBJECTIVE: To determine the utility of the urethral plug in the management of female stress urinary incontinence. METHODS: A prospective clinical study was conducted in 20 female patients with stress urinary incontinence in order to evaluate the efficacy of a new urethral plug. The mean age was 59.6 +/- 6.2 years (range 40-66). The study design included 3 visits (4 weeks). The results were considered "positive" when urinary incontinence decreased and the patient referred a subjective sensation of improvement, and "negative" if otherwise. RESULTS: Positive results were demonstrated in 8 patients (40%). Ten patients (50%) refused to continue, mainly due to urinary tract infection in 7 cases (35%), difficulties in plug use (loss of plugs, anomalous urethral anatomy, cystocele,...) in 6 cases (30%) and urethral mucosa irritation in one case (5%). No plug migrated into the bladder. The initial urinary incontinence grade in the positive cases were: minor in 4 (50%), mild in 2 (25%) and severe in 2 (25%). We found no statistical relationship between the urinary incontinence grade and clinical results. The patients used a median of 5 plugs per day. Of the 10 patients who completed the study, 5 (50%) refused to continue using the plug and 5 (50%) decided to continue using the plug in combination with electrostimulation and/or pelvic floor exercises. CONCLUSIONS: The use of the urethral plug in the management of female stress urinary incontinence is not an alternative to surgical treatment or pelvic floor rehabilitation. However, it could be useful for patients who are unwilling or unfit for surgery. Finally, the urethral plug is an alternative to the use of collecting systems or devices in female stress urinary incontinence.

Adult↗