Positive correlation between the nuclear expression of GPER and pGLI3 in prostate cancer tissues from patients with different Gleason scores.

Prostate cancer (PCa) is the most prevalent cause of death in the male population worldwide. The G Protein-Coupled Estrogen Receptor (GPER) has been gaining relevance in the development of PCa. Hedgehog (Hh) pathway activation is associated with aggressiveness, metastasis, and relapse in PCa patients. To date, no studies have evaluated the crosstalk between the GPER and the Hh pathway along different group grades in PCa. We conducted an analysis of paraffin-embedded tissues derived from patients with different prognostic grade of PCa using immunohistochemistry. Expression and correlation between GPER and glioma associated oncogene homologue (GLI) transcriptional factors in the parenchyma and stroma of PCa tumors were evaluated. Our results indicate that GPER is highly expressed in the nucleus and increases with higher grade groups. Additionally, GPER's expression correlates with pGLI3 nuclear expression across different grade groups in PCa tissues; however, whether the receptor induces the activation of GLI transcriptional factors, or the latter modulate the expression of GPER is yet to be discovered, as well as the functional consequence of this correlation.

Characterization of Three Cases of Primary Hypogalactia in Jalisco, Mexico.

INTRODUCTION: Human lactation should be taken into account as an important issue for the international agenda. Despite advances in lactation information and knowledge, insufficient milk production is still a concern for mothers and health practitioners, including International Board Certified Lactation Consultants and others. Primary hypogalactia, or insufficient milk production is uncommon, but should be considered when there is poor weight gain and decreased urine output in infants despite good latch-on and suckling, or anatomic differences in the physical exam of the lactating breast. MAIN ISSUE: This case series presents three cases illustrating insufficient milk production resulting in infants who experienced significant dehydration and poor weight gain. MANAGEMENT: Primary hypoplasia was diagnosed by means of a thorough interview and physical examination that entailed a consultation with a physician who was also an International Board Certified Lactation Consultant. CONCLUSION: Awareness of an infant's feeding needs and proper evaluation of a child's health status is paramount if health care providers are to identify the important factors contributing to breastfeeding problems. In some instances, breastfeeding goals cannot be achieved, and then the provider's role becomes support in coming to terms with persistent insufficient milk production, and coordinating appropriate supplementation to meet each baby's nutritional needs.

Frequency of urinary pesticides in children: a scoping review.

Pesticides are any mix of ingredients and substances used to eliminate or control unwanted vegetable or animal species recognized as plagues. Its use has been discussed in research due to the scarcity of strong scientific evidence about its health effects. International literature is still insufficient to establish a global recommendation through public policy. This study aims to explore international evidence of the presence of pesticides in urine samples from children and their effects on health through a scoping review based on the methodology described by Arksey and O'Malley. The number of articles resulting from the keyword combination was 454, and a total of 93 manuscripts were included in the results and 22 were complementary. Keywords included in the search were: urinary, pesticide, children, and childhood. Children are exposed to pesticide residues through a fruit and vegetable intake environment and household insecticide use. Behavioral effects of neural damage, diabetes, obesity, and pulmonary function are health outcomes for children that are commonly studied. Gas and liquid chromatography-tandem mass spectrometry methods are used predominantly for metabolite-pesticide detection in urine samples. Dialkylphosphates (DAP) are common in organophosphate (OP) metabolite studies. First-morning spot samples are recommended to most accurately characterize OP dose in children. International evidence in PubMed supports that organic diets in children are successful interventions that decrease the urinary levels of pesticides. Several urinary pesticide studies were found throughout the world's population. However, there is a knowledge gap that is important to address (public policy), due to farming activities that are predominant in these territories.

Non-traditional risk factors of progression of chronic kidney disease in adult population: a scoping review.

Chronic kidney disease (CKD) has become a public health concern over the last several years. Nowadays developed countries spend around 3% of their annual health-care budget on patients with CKD. According to the scientific community the most remarkable risk factors for CKD are diabetes and hypertension. Unknown CKD etiology has been reported as a global phenomenon including uncommon risk factors such as: dehydration, leptospirosis, heat stress, water quality, and others. This study aims to report non-traditional risk factors for ESRD based on a scoping review methodology. The scoping review methodology described by Arksey and O'Malley was used by performing an extensive review of the information. A total of 46 manuscripts were reviewed. The non-traditional ESRD risk factors are depicted based on six categories. Gender and ethnicity have been considered as risk factors for ESRD. Erythematous systemic lupus (ESL) is reported as an important risk factor for ESRD. Pesticide use has been an significant risk factor due to its effects on human and environmental health. Some compounds commonly used in homes against insects and plants are related to ESRD. Congenital and hereditary diseases in the urinary tract have been studied as a cause of ESRD in children and young adults. End-stage renal disease is a major concern for public health on a global level. As it can be seen, non-traditional risk factors are several and have different etiologies. It is necessary to put the issue on the table and add it to the public agenda in order to find multidisciplinary solutions.

Rabies, the cause of fatal encephalitis.

To describe the clinical progression and medical protocols applied in a 41 year old man who was bited by a bat three months before. The patient did not ask for medical care until acute tremor and pain in the right thoracic limb and hydro-phobia started. For a history of a wild animal bite associated with a unique clinical condition, we suspected of rabies encephalitis, confirming the diagnostic by pathology after his death. This case ocurred in Guadalajara, Jalisco, México, in April, 2022. The last case of human rabies reported in Jalisco secondary to bat bite was almost 30 years ago. As an uncomon disease, medical personnel and facilities should be prepared to attend this sort of cases after clinical suspicion. For the present case, the medical history was the key for diagnosis. Rabies is a disease caused by the neurotropic virus belonging to the Rhabdoviridae family whose prognosis is bleak, with mortality close to 100% and therapeutic options limited. This case emphasizes the high mortality of rabies virus infection and the importance of increasing awareness and education to the public in general, with regard to applying the vaccine as post-exposure prophylaxis.

Incidence of fever and bleeding after percutaneous nephrolithotomy: a prospective cohort study.

OBJECTIVE: Despite relative agreement on the need for immediate peri-operative antibiotic prophylaxis in percutaneous nephrolithotomy (PCNL), there is no consensus regarding antibiotic use the days leading up to PCNL. This study aimed to report the incidence of complications during and after PCNL based on a cohort study design. MATERIAL AND METHODS: We included 101 patients in a prospective schedule for PCNL. Patients were divided into 2 groups. In the exposed patients (positive urine culture) the antibiotic was indicated according to the antibiogram report, 7 days before surgery, and 7 days after surgery, and in the non-exposed patient's intravenous antibiotic empirically was administered 8 h and 1 h before surgery. RESULTS: The incidence of complications for both groups was 19%. The exposed group presented complications in 27%, and 16% for the non-exposed. The relative risk of complications, in general, was 1.68 (95% CI, 0.77-3.6), the attributable risk was 11.09, and the percentage of attributable risk was 40.68%. CONCLUSIONS: The presence of positive urine culture is the main risk factor for the development of post-PCNL fever. Each treatment center needs to standardize its protocols to reduce the morbidity associated with surgery and to identify the main risk factors.

OBJETIVO: El objetivo de este estudio es reportar la incidencia de complicaciones durante y después de la nefrolitotomía percutánea (NLP) con base en un diseño de cohorte prospectivo. MATERIAL Y MÉTODOS: Se incluyeron 101 pacientes de forma prospectiva programados para NLP. Los pacientes fueron divididos en 2 grupos. En el grupo de expuestos (cultivo de orina positivo) el antibiótico se indicó según el reporte del antibiograma, 7 días antes y 7 días después de la cirugía. En los pacientes no expuestos (cultivo de orina negativo) se administró empíricamente antibiótico intravenoso 8 h y 1 h antes de la cirugía. RESULTADOS: La incidencia de complicaciones para ambos grupos fue del 19%. El grupo de expuestos presentó ­complicaciones en 27% mientras que para los no expuestos fue de 16%. El riesgo relativo de complicaciones en general fue de 1.68 (IC 95%, 0.77-3.6), el riesgo atribuible fue de 11.09 y el porcentaje de riesgo atribuible fue de 40.68%. CONCLUSIONES: la presencia de urocultivo positivo es el principal factor de riesgo para el desarrollo de fiebre post-NLP. Es importante que cada centro de tratamiento estandarice sus protocolos para reducir la morbilidad asociada con la cirugía e identificar los principales factores de riesgo.

Seasonal Urinary Levels of Glyphosate in Children From Agricultural Communities.

BACKGROUND: Glyphosate is one of the most commonly used pesticides in agricultural activities worldwide. For the last 20 years, its use has increased rapidly becoming a public health concern. The IARC classified glyphosate as probably carcinogenic; however, the reported evidence is not enough to establish a statement. OBJECTIVE: This work aimed to measure glyphosate levels in the urine of children from a single rural community in an endemic region of chronic kidney disease and malnutrition. METHODS: A cross-sectional study was carried out in a rural community in western Mexico. The study included 95 children between the ages of 6 and 16. A urine sample (first-morning spot) was obtained from children and processed to measure glyphosate levels using high-performance liquid chromatography coupled with tandem mass spectrometry. RESULTS: All samples tested positive for glyphosate levels. Urine glyphosate levels were related to the season and the age of the children. CONCLUSION: Glyphosate is present in children of all ages in the community even if they were not in direct contact with it. No toxicity cases were reported, nor were there other health problems related to glyphosate. However, more long-term studies should be done that provide a statement regarding the harmful effects that glyphosate has on public health.

The role of estradiol in the immune response against COVID-19.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the pathogen agent causing coronavirus disease (COVID)-19, which was declared a global pandemic in 2020. The spike protein of this virus and the angiotensin-converter enzyme (ACE)-2 in host cells in humans play a vital role in infection and in COVID-19 pathogenesis. Estradiol is known to modulate the actions of immune cells, and, therefore, the antiviral mechanisms of these cells could also be modified by this hormone stimulus. Even though estradiol is not considered a protective factor, evidence shows that women with high levels of this hormone have a lower risk of developing severe symptoms and an even a lower incidence of death. Understanding the mechanism of action of estradiol with regard to viral infections and COVID-19 is essential for the improvement of therapeutic strategies. This review aims to describe the effects that estradiol exerts on immune cells during viral infections and COVID-19.

Frequency and Risk Factors for Spontaneous Pneumomediastinum in COVID-19 Patients.

Background: Spontaneous pneumomediastinum (SPM) is an uncommon condition in COVID-19 patients. No information about outcome or risk factors is available at the time. The aim of this research is to report on the frequency and risk factors of spontaneous pneumomediastinum in COVID-19 patients. Materials and Methods: An unmatched case-control study was carried out in a tertiary health-care facility for patients with COVID-19. Electronic files were reviewed to identify patients with confirmed COVID-19 infection by RT-PCR. Univariate analysis was used to describe demographic data. Mean differences were calculated using the Mann-Whitney test. Frequency and odds ratios were calculated by standard operations. Results: A total of 271 patients were included in the study. Nine patients showed spontaneous pneumomediastinum and four of them presented associated spontaneous pneumothorax. The most common risk factors associated with poor outcomes in COVID-19 patients were not considered as risk factors for spontaneous pneumomediastinum development. Conclusion: Spontaneous pneumomediastinum is an uncommon clinical feature in COVID-19 patients. More research is necessary to formulate statements regarding prevalence, risk factors, and outcome.

Sensitizing the cytotoxic action of Docetaxel induced by Pentoxifylline in a PC3 prostate cancer cell line.

BACKGROUND: Prostate cancer is one of the most frequently diagnosed types of cancers worldwide. In its initial period, the tumor is hormone-sensitive, but in advanced states, it evolves into a metastatic castration-resistant tumor. In this state, chemotherapy with taxanes such as Docetaxel (DTX) comprises the first line of treatment. However, the response is poor due to chemoresistance and toxicity. On the other hand, Pentoxifylline (PTX) is an unspecific inhibitor of phosphodiesterases; experimental, and clinically it has been described as sensitizing tumor cells to chemotherapy, increasing apoptosis and decreasing senescence. We study whether the PTX sensitizes prostate cancer cells to DTX for greater effectiveness. METHODS: PC3 human prostate cancer cells were treated in vitro at different doses and times with PTX, DTX, or their combination. Viability was determined by the WST-1 assay by spectrophotometry, cell cycle progression, apoptosis, generic caspase activation and senescence by flow cytometry, DNA fragmentation and caspases-3, -8, and -9 activity by ELISA. RESULTS: We found that PTX in PC3 human prostate cancer cells induces significant apoptosis per se and increases that generated by DTX, while at the same time it reduces the senescence caused by the chemotherapy and increases caspases-3,-8, and -9 activity in PTX + DTX-treated cells. Both treatments blocked the PC3 cell in the G1 phase. CONCLUSIONS: Our results show that PTX sensitizes prostate tumor cells to apoptosis induced by DTX. Taken together, the results support the concept of chemotherapy with rational molecular bases.

Microbiological profile of urinary tract infections in a tertiary medical facility in Western Mexico: An update.

Urinary tract infections (UTIs) are one of the most important issues in modern medicine. In developing countries, the use of antibiotics is a common practice, and due to this, antibiotic resistance has increased. The objective of this research was to update and report on the microbiological profile of urinary tract infections based on the number of positive urine cultures (UCs), resistance, sensitivity, and the prevalence of bacterial strains. The results were obtained from the database of a tertiary medical facility in Western Mexico. The number of positive UCs was 1769 from inpatients and outpatients who were users of medical services in the hospital from January to December of 2017. The most commonly isolated microorganism was E. coli, with 1225 cases, of which 603 (49.2%) were ESBL (Extended-Spectrum Beta-Lactamase-producing bacteria) strains. The resistance rate of nitrofurantoin was 36.6%, and meropenem showed the most promising results with a resistance rate of only 7.1%. Resistances to quinolones and cephalosporins among the isolates investigated were 51%-67%. Based on our results, it is necessary to increase controls and to improve management protocols in order to achieve better medical practices by reducing antibiotic resistance.

Distribution and Effects of Estrogen Receptors in Prostate Cancer: Associated Molecular Mechanisms.

Estrogens are hormones that have been extensively presented in many types of cancer such as breast, uterus, colorectal, prostate, and others, due to dynamically integrated signaling cascades that coordinate cellular growth, differentiation, and death which can be potentially new therapeutic targets. Despite the historical use of estrogens in the pathogenesis of prostate cancer (PCa), their biological effect is not well known, nor their role in carcinogenesis or the mechanisms used to carry their therapeutic effects of neoplastic in prostate transformation. The expression and regulation of the estrogen receptors (ERs) ERα, ERß, and GPER stimulated by agonists and antagonists, and related to prostate cancer cells are herein reviewed. Subsequently, the structures of the ERs and their splice variants, the binding of ligands to ERs, and the effect on PCa are provided. Finally, we also assessed the contribution of molecular simulation which can help us to search and predict potential estrogenic activities.

Pentoxifylline Sensitizes Cisplatin-Resistant Human Cervical Cancer Cells to Cisplatin Treatment: Involvement of Mitochondrial and NF-Kappa B Pathways.

BACKGROUND: Cervical cancer continues to be a major public health problem worldwide, and Cisplatin is used as first-line chemotherapy for this cancer; however, malignant cells exposed to CISplatin (CIS) become insensitive to the effects of this drug. PenToXifylline (PTX) is a xanthine that sensitizes several types of tumor cells to apoptosis induced by antitumor drugs, such as Adriamycin, Carboplatin, and CIS. The effects of PTX on tumor cells have been related to the disruption of the NF-κB pathway, thus preventing the activation of cell survival mechanisms such as the expression of anti-apoptotic genes, the secretion of proinflammatory interleukins, and growth factors. OBJECTIVE: In this work, we studied the antitumor proprieties of PTX in human SiHa cervical carcinoma cells resistant to CIS. MATERIALS AND METHODS: SiHa and HeLa cervical cancer cells and their CIS-resistant derived cell lines (SiHaCIS-R and HeLaCIS-R, respectively) were used as in-vitro models. We studied the effects of PTX alone or in combination with CIS on cell viability, apoptosis, caspase-3, caspase-8, and caspase-9 activity, cleaved PARP-1, anti-apoptotic protein (Bcl-2 and Bcl-xL) levels, p65 phosphorylation, cadmium chloride (CdCl2) sensitivity, Platinum (Pt) accumulation, and glutathione (GSH) levels, as well as on the gene expression of GSH and drug transporters (influx and efflux). RESULTS: PTX sensitized SiHaCIS-R cells to the effects of CIS by inducing apoptosis, caspase activation, and PARP-1 cleavage. PTX treatment also decreased p65 phosphorylation, increased Pt levels, depleted GSH, and downregulated the expression of the ATP7A, ATP7B, GSR, and MGST1 genes. CONCLUSION: PTX reverses the acquired phenotype of CIS resistance close to the sensitivity of parental SiHa cells.

Erratum: Sierra-Diaz, E.; Celis-de la Rosa, A.J.; Lozano-Kasten, F.; Trasande, L.; Peregrina-Lucano, A.A.; Sandoval-Pinto, E.; Gonzalez-Chavez, H. Urinary Pesticide Levels in Children and Adolescents Residing in Two Agricultural Communities in Mexico. Int. J. Environ. Res. Public Health 2019, 16, 562.

The authors would like to update some important data in the manuscript. In Table 4, the pesticide means were reported in µg/mL, which is incorrect. The correct units are ng/mL (nanograms/milliliter). The same typographical inaccuracy applies for data in the fourth paragraph of the discussion (with minimal values of 0.0020 µg/mL and maximal values of 2.63 µg/mL), where the correct units are also ng/mL [1]. [...].

Urinary Pesticide Levels in Children and Adolescents Residing in Two Agricultural Communities in Mexico.

The use of pesticides in agricultural activities has increased significantly during the last decades. Several studies have reported the health damage that results from exposure to pesticides. In Mexico, hundreds of communities depend economically on agricultural activities. The participation of minors in this type of activity and their exposure to pesticides represents a potential public health problem. A cross-sectional study was conducted, in which urine samples (first-morning urine) were taken from children under 15 years of age in both communities. A total of 281 urine samples obtained in both communities were processed for the determination of pesticides with high-performance liquid chromatography together with tandem mass spectrometry. In 100% of the samples, at least two pesticides of the 17 reported in the total samples were detected. The presence of malathion, metoxuron, and glyphosate was remarkable in more than 70% of the cases. Substantial differences were detected regarding the other compounds. It is necessary to carry out long-term studies to determine the damage to health resulting from this constant exposure and to inform the health authorities about the problem in order to implement preventive measures.

Antibiotic resistance: Microbiological profile of urinary tract infections in Mexico.

OBJECTIVE: The objective of this study was to describe the prevalence, microbiological profile, bacterial resistance, and the sensitivity to antibiotics of microorganisms causing urinary tract infection (UTI) at a single-site tertiary referral hospital in the western region of Mexico. METHODS: A total of 5895 culture samples processed at the microbiology laboratory from August 1, 2014, to July 31, 2015, were analyzed. RESULTS: A total of 5895 samples for urine cultures (UC) were collected, of which 3363 were taken in women (57.05%) and 2532 in men (42.95%). A prevalence of 24% was calculated. From 1444 positive UC, 1512 microorganisms were isolated; the major etiological agent was Escherichia coli, representing 67.28% followed by Pseudomonas with 7.12%. With respect to fungi, Candida glabrata was found as the most common agent. Susceptibility to daptomycin and linezolid was 100%, and meropenem, 91.4%. Highest antimicrobial resistance was found for ampicillin (77.47%) and moxifloxacin (72.89%). Nearly 49% of E. coli strains and 27% of Klebsiella pneumoniae strains showed extended-spectrum beta-lactamase (ESBL) production. CONCLUSIONS: Bacterial UTI persists as one of the most common infections affecting all age groups and both genders. As in other countries, E. coli ranks first in Mexico, with 67.28%, and nearly 50% of the strains produce ESBL.

OBJETIVO: Describir la prevalencia, el perfil microbiológico, la resistencia y la sensibilidad a los antibióticos de microorganismos causantes de infecciones de vías urinarias en un centro de referencia de tercer nivel en el occidente de México. MÉTODO: Se realizó un estudio transversal que incluyó 5895 urocultivos procesados en el laboratorio de microbiología del 1 de agosto de 2014 al 31 de julio de 2015. RESULTADOS: De los 5895 urocultivos, 3363 correspondieron a mujeres (57.05%) y 2532 a varones (42.95%). De los 1444 resultados positivos, se aislaron 1512 microorganismos (prevalencia del 24%); el más común fue ­Escherichia coli, con un 67.28%, seguido por Pseudomonas con un 7.12%. Candida glabrata se reportó como el patógeno fúngico más frecuente. De manera general, la sensibilidad a la daptomicina y al linezolid fue del 100%, y al meropenem fue del 91.4%. La resistencia más alta se reportó para ampicilina y moxifloxacino (77.47 y 72.89%, respetivamente). Cerca del 49% y del 27% de las cepas de E. coli y Klebsiella pneumoniae mostraron producción de betalactamasas de espectro extendido. CONCLUSIONES: Las infecciones de vías urinarias persisten como una de las formas más habituales de infección y afectan a todos los grupos de edad. En México, al igual que en otros países, E. coli se coloca en primer lugar de frecuencia, con el 67.28%.

Prevalence of Albuminuria in Children Living in a Rural Agricultural and Fishing Subsistence Community in Lake Chapala, Mexico.

The occurrence of Chronic Kidney Disease (CKD) of unknown etiology in autochthonous child populations residing along the Lake Chapala lakeshore is endemic (Jalisco, México). The objective of this study was to determine the prevalence of albuminuria in the pediatric population and to measure the glomerular filtration rate in children with two positive albuminuria tests. Urinary albumin was measured in 394 children. Subjects with two or more positive albuminuria test donated blood samples for the determination of serum biomarkers. From a rural community with 565 children under the age of 17 years, 394 (69.7%) participated with first morning urine samples. A total of 180 children were positive (with two or more positive albuminuria tests). The prevalence of albuminuria among the children participating in the study was 45.7%. Of the 180 children with persistent albuminuria, 160 (88.9%) were tested for serum creatinine, urea, and cystatin C. The 68.1% of the children studied, were found in stages 3a and 3b of the Kidney Disease Improving Global Outcomes (KDIGO) classification (mean glomerular filtration rate (GFR) 51.9 and 38.4 mL/min/1.73 m² respectively). The lowest frequencies were for classifications 1 and 4. None of the subjects was classified as grade 5. The prevalence of albuminuria in children from this rural community is 3-5 times higher than reported in international literature. Regarding GFR, more than 50% of children studied are under 60 mL/min/1.73 m². It is a priority to find the causes of albuminuria and CKD in this Mexican region.

Non-Traditional Risk Factors of Albuminuria in the Pediatric Population: A Scoping Review.

The presence of albumin in urine has been used for more than four decades as a marker of renal and cardiovascular damage. Most of the information on this marker is related to adults. The prevalence of albuminuria in the pediatric population has been reported as being 2.2-12.8% in some countries. Most research in this field is related to albuminuria and diseases, such as diabetes and hypertension. Using the methodology described by Arksey and O'Malley in 2005, a scoping review was carried out to show that the presence of albumin in urine in the pediatric population might be associated with environmental, demographic, congenital, infectious, and non-infectious factors. The information collected is supported by 74 references present in PubMed. The results reveal the multiple causes associated with albuminuria in the pediatric population. This information can be very useful for clinical practice by adding knowledge about albuminuria behavior in children.

Urine TREM-1 as a marker of urinary tract infection in children.

Objective Triggering receptor expressed on myeloid cells (TREM)-1 is a receptor that is thought to improve recognition of patients with true infection. In this study, we investigated whether Triggering receptor expressed on myeloid cells (TREM-1) is present in urine samples from children with urinary tract infection (UTI) and in samples from healthy children. Methods A total of 128 samples met the inclusion criteria for the study. Urine samples were processed for culture and urinalysis as a regular protocol for patients with UTI. Samples were classified according to culture and urinalysis results. TREM-1 protein expression was detected with flow cytometry and sTREM-1 was assessed by ELISA. Results Flow cytometry showed detectable expression of TREM-1 in 100% of samples, UTI and non-UTI groups ( p < 0.001). Mean fluorescence intensity of TREM-1 was different between the groups ( p < 0.001). Levels of sTREM-1 were detected in patients with UTI, but not in non-UTI patients. Conclusions All of our patients (healthy and diseased) showed TREM-1 expression. However, TREM-1 levels in patients with UTI tend to be higher and are associated with increased neutrophils and cytokine activity induced by bacteria.

[Non-traumatic spontaneous retroperitoneal bleeding: the effect of an early and accurate diagnosis]. / Hemorragia retroperitoneal espontánea no traumática: efecto del diagnóstico preciso y oportuno.

BACKGROUND: Spontaneous sub-capsular or peri-renal haemorrhage (Wunderlich syndrome) is a rare condition that involves a diagnostic challenge. In many cases, bleeding leads to haemodynamic instability that may be life threatening. Therefore, it is important to have a high clinical suspicion for timely action. OBJECTIVE: This paper highlights the experience of the Urology Department of the Western National Medical Center of the Mexican Institute of Social Security. METHODS: Retrospective study of consecutive non-randomized sampling. The Emergency Service Registry was reviewed for all admissions from 1 January 2010 to 31 December 2013 to identify patients with non-traumatic spontaneous retroperitoneal haemorrhage. Patient charts were reviewed to determine sex, age, vital signs, laboratory and imaging results, associated diseases, management, and outcomes. RESULTS: A total of 11 patients met the inclusion criteria for the study. All patients were received in the Emergency Department referred from secondary care hospitals. None of them were referred with a diagnosis of spontaneous retroperitoneal haemorrhage. The diagnosis was made in 100% of patients with abdominal CT scan. All patients received urgent surgical management on the day of admission due to haemodynamic instability. Ten patients underwent nephrectomy. Histopathological findings included, among others, angiomyolipoma, renal carcinoma, and metastatic hepatocellular injury. CONCLUSIONS: Spontaneous retroperitoneal haemorrhage is a lethal condition if not detected on time. The abdominal CT scan is the most accurate diagnostic method for detection. Surgical management is necessary in patients with haemodynamic instability.