[Questionnaire for urological emergency room quality evaluation]. / Cuestionario de evaluación de la calidad asistencial en un servicio de urgencias urológicas.

INTRODUCTION: Quality is defined as an essential and distinguishing attribute of something, which allows to evaluate its worth. The quality evaluation has become something necessary during the last years. The assistencial quality should be something inherent to the offered service, including scientific and technical quality, management and quality noticed. A periodical assesment, as auto-evaluation or through an outsourcing, is a recommendable way to detect potential improvement items. MATERIAL AND METHODS: Using the EFQM,ISO 9001:2000 and Malcolm Baldrige model, and through the items from National Health System, a self-questionnaire of urological emergency room quality evaluation is proposed. CONCLUSION: A new self-questionnaire of urological emergency room quality evaluation is proposed.

[Severe cystitis and perivesical collection posterior to Mitomycin C immediate instillation in a patient with inadverted bladder perforation]. / Cistitis severa y colección perivesical posterior a instilación inmediata de Mitomicina C en paciente con perforación vesical inadvertida.

We present the clinical case of a 40 years male patient who, after a TURBt for non-muscle invasive recurrence with inadverted vesical perforation and Mitomycin C immediate instillation, come in his fourth postoperative day to the emergency room with severe irritative urinary symptomatology. An ultrasound was indicated, documenting a perivesical collection. The management was conservative with vesical drilling for 10 days and a puncture/drainage was necessary to solve it.

[Algorithm for the treatment of patients with obstructive uropathy secondary to prostate cancer]. / Algoritmo para el manejo de pacientes con uropatía obstructiva secundaria a cáncer de próstata.

BACKGROUND: One of the prostate cancer progression complications is the obstructive uropathy, by infiltration and compression of the distal ureteral section, that can entail to an acute renal insufficiency, with affectation of the quality of life and the survival of these patients. The treatment of prostate cancer with secondary ureterohidronefrosis is palliative and following the present tendencies, the positioning of a nephrostomy is considered. MATERIALS AND METHODS: A search was made in PUBMED and the most representative articles were reviewed. The algorithm was constructed with the daily routine clinical base, the protocol of our center and with the scientific evidence available in medical literature. RESULTS: An algorithm of decisions sets out to define the urinary derivation in patients with obstructive uropathy secondary to prostate cancer. CONCLUSIONS: The indication to place a nephrostomy in patients with obstructive uropathy secondary to prostate cancer must be approached individually, according to the general conditions and the quality of life of the patient with base in scales defined in literature (ECOG and Karnofsky) and in factors of good or bad prognosis, always considering ethical considerations and the consent of the patient and his family.

[Anti-hepatitis B vaccination in Campania. Final observations of a 3-year vaccination campaign, with special reference to infants born to HBsAg-positive mothers]. / La vaccinazione anti-epatite B in Campania. Osservazioni consuntive di 3 anni di campagna vaccinale, con particolare riguardo ai nati da madre HBsAg positiva.

The results obtained at the end of the first three years of a hepatitis B vaccination campaign in Campania, are reported. HEVAC-B and H-B-VAX proved innocuous and efficacious in producing anti-HBs. Newborn babies and children produced anti-HBs more often and with higher titres than adults. Titre 10 mUI/ml of anti-HBs persisted, in the responders for at least 36 months on average. AVH by HBV was observed in two adult non responders. Transplacental or delivery infection was observed in 9.3% of the babies born of HBsAg positive mothers and more often among babies born of HBeAg positive mothers. Infection by HBV was observed in 6.0% of the babies, in 4.0% of the children and in 12.0% of the adults, in spite of the production of anti-HBs. HB-antigenemia, was as a rule transitory, but sometimes fluctuating or persistent. Careful observation during a prolonged follow up is necessary for these subjects.

Role of delta infection in the progression to chronicity of acute HBsAg positive hepatitis.

A previous study of 159 consecutive cases of HBsAg+ acute viral hepatitis, observed from the onset of disease and seen between May 1977 and May 1980, revealed a higher frequency of evolution to chronicity in the region of Naples than that reported for other areas. This suggested that environmental factors might influence the chronically rate. We investigated 125 HBsAg+ acute hepatitis cases for whom sera were available: 35 patients who remained HBsAg+ at the two-year control (28 chronic hepatitis and 7 healthy carriers) and 90 who recovered and seroconverted HBsAg---- anti-HBs during follow-up. At the onset of disease, all patients who cleared HBsAg showed IgM anti-HBc positivity and 48 were also HBeAg positive; no patient was anti-delta positive. On the contrary of the 28 chronic cases only 7 were IgM anti-HBc+ (6 under 13 years old), while 21 were IgM anti-HBc- but anti-delta+. This study demonstrates that not all HBsAg+ acute hepatitis cases are due to HBV and that in our area, superinfection by the delta agent is responsible for most cases of chronic HBsAg positive hepatitis.

Small renal masses: incidental diagnosis, clinical symptoms, and prognostic factors.

Introduction. The small renal masses (SRMs) have increased over the past two decades due to more liberal use of imaging techniques. SRMs have allowed discussions regarding their prognostic, diagnosis, and therapeutic approach. Materials and methods. Clinical presentation, incidental diagnosis, and prognosis factors of SRMs are discussed in this review. Results. SRMs are defined as lesions less than 4 cm in diameter. SRM could be benign, and most malignant SMRs are low stage and low grade. Clinical symptoms like hematuria are very rare, being diagnosed by chance (incidental) in most cases. Size, stage, and grade are still the most consistent prognosis factors in (RCC). An enhanced contrast SRM that grows during active surveillance is clearly malignant, and its aggressive potential increases in those greater than 3 cm. Clear cell carcinoma is the most frequent cellular type of malign SRM. Conclusions. Only some SRMs are benign. The great majority of malign SRMs have good prognosis (low stage and grade, no metastasis) with open or laparoscopic surgical treatment (nephron sparing techniques). Active surveillance is an accepted attitude in selected cases.

Congenital retinal macrovessels: a "low visual acuity" case report with a 14-year follow-up.

We report a rare case of congenital retinal macrovessel with decreased visual acuity, with a 14-year follow-up. Both the clinical findings and the visual acuity remained unchanged throughout the follow-up period.

A multicommuted flow system for the determination of copper, chromium, iron and lead in lubricating oils with detection by flame AAS.

In this work, a flow analysis procedure for the determination of copper, chromium, iron and lead in lubricating oils using flame AAS as detection technique is described. The flow manifold was designed to implement the multicommutation approach and it comprised three 3-way solenoid valves controlled by a personal computer. The flow system presented allowed to process the oil samples to determine wear metals without any prior preparation. Aiming to assess accuracy the results were compared with those obtained by manual procedure using flame AAS. Applying the joint-confidence ellipse test, no significant difference at the 95% confidence level was observed. Other profitable features such as a sample throughput of 50 determinations per hour; relative standard deviations (n = 5) below 2% for Cu, and below 8% for Cr, Fe and Pb; and linear responses in the range 0-40ppm (w/w) (Cu, Fe) and 0-15ppm (w/w) (Cr, Pb) were also achieved.

Determination of insolubles in diesel lubricating oil by FIA-visible spectrometry.

Insolubles determination is one of the parameters usually recommended to evaluate the residual life of oil because their presence at elevated levels in diesel lubricating oil changes the viscosity, prematurely clogs filters and is one of the major factors in causing abrasive engine wear. The proposed method employs visible spectrophotometric detection in association with flow injection analysis. The results obtained by this method were compared with the ones obtained by Fourier transform infrared spectrometry (FT-IR) since this is the most employed method for insolubles determination. The proposed method presented a linear response from 0 to 3% (w/w) of insolubles in pentane (ASTM D-893). The sampling frequency was about 30 samplesh(-1), with a relative standard deviation (n=5) of 2.4% or better. Accuracy was evaluated analysing 98 real samples and the results obtained with the FIA-spectrophotometric method were plotted against those obtained by the FT-IR method by means of linear regression. Slope and intercept of the straight line obtained were compared with the theoretical values of 1 and 0 by means of the joint-confidence ellipse F-test. At the confidence level of 95% no evidence of a difference was found between both methods.