[Primary localized amyloidosis of glans penis. A new case and review of the literature]. / Amiloidosis primaria localizada en glande peneano. Caso clínico y revisión de la literatura.

Primary localized amyloidosis urinary tract is rare. Localized amyloidosid only glands is a very rare entity. The clinical impression may resemble neoplastic disease but the diagnosis is confirmed by histochemical study. Biopsy of the lesion revealed dermal deposits of amorphous eosinophilic material. A case of patient with primary amyldosis of glands penis is reported. The literature is reviewed and the diagnostic and therapeutic options are discussed. This is the seventh reported case of localized amyloidosis of the glands penis.

[Penile cutaneous horn. A clinical case]. / Cuerno cutáneo peneano. Caso clínico.

Contribution of a case report of cutaneous horn of penis surgically treated with extensive resection of the implantation base. A well differentiated, microinvasive epidermoid carcinoma was histopathologically demonstrated on a hyperkeratosis squamous papilloma. Although underlying lesions to cutaneous horn are usually benign, malignant changes have been reported in up to one third of cases; surgical treatment should therefore include extensive resection of the implantation base.

[Results of external radiotherapy in localized cancer of the prostate]. / Resultados de la radioterapia externa en el cáncer de próstata localizado.

OBJECTIVE: External radiotherapy is considered to be a modality of treatment with a curative purpose for carcinoma de prostata. We have analysed a series of patients that received radical irradiation as treatment for tumor prostatic. We have the biochemical control results for these patients. We introduce the connection of the PSA nadir value (nPSA) and other prognostic variables with the survival free of biochemical failure. MATERIAL AND METHODS: Between January 1992 to January 1998, 46 patients with prostate cancer T1-3 NX M0 received external radiotherapy with a curative purpose. A number of 26 of these patients received treatment with androgen blockers. The answer to this treatment was established as a fall in PSA to levels equal/minor than 1.5 ng/ml. The biochemical relapse was established as three rises of PSA over the value of nPSA. RESULTS: We introduce the connection between nPSA and prognostic variables (clinic stage, gleason, PSA pretreatment y hormonal therapy). Three of these variables--clinic stage, Gleason grade and hormonal therapy--were the ones that showed a significantly connection with obtaining a low level of PSA. The 3-year actuarial BDFS was of 69.5%. The BDFS was of 84.3%, 9% and 6% for a value of nPSA of < or = 1 ng/ml, 1-2 ng/ml and > 2 ng/ml respectively (p < 0.05). CONCLUSION: Radiotherapy seems to be a good therapeutical option with patients suffering from localised prostate carcinoma. The nPSA value after radiation is a good early determinant of outcome.

[Cystic dysplasia in the seminal vesicle. Case report and literature review]. / Displasia quística en vesícula seminal. Caso clínico y revisíon de la literatura.

Contribution of one case report of cystic dysplasia of the seminal vesicle with ipsilateral renal agenesis in a 32 year-old male presenting with primary infertility. The seminograms showed moderate astenoteratospermia while in the abdominal-pelvic ultrasound there were changes in the right seminal vesicle and right renal agenesis, which was confirmed with further complementary tests: UIV, transrectal ultrasound, urethrocystoscopy, arteriography and renal scan.

[Pelvic lipomatosis: cause of bladder rupture]. / Lipomatosis pélvica: causa de estallido vesical.

We have a case of pelvic lipomatosis in a patient suffering from right flank pain and urinary syndrome. Before completing the diagnostic test, abdominal traumatism forced to perform a laparotomy of emergency. We found a great deal of retropubic mass with bladder rupture and thickened walls caused by perivesical fat. The anatomopathological diagnosis was pelvis lipomatosis. This is an unusual case of bladder rupture after slight traumatism.

[Bilateral synchronous renal cell carcinoma. Report of a case]. / Carcinoma de células renales bilateral sincrónico. Presentación de un caso.

The radical nephrectomy is considered to be the optional treatment for renal carcinoma. In the last years, the good results with partial resection shows conservadora surgery the most suitable treatment for well-localized bilateral renal tumours. In this cases dialysis is avoided, and the subsequent risk of immunological deficit and the higher possibility of metastasic illness are minimized. Nowadays, however, there seems to be some controversy over conservative surgery, concerning applications and technique of surgery to practice (partial resection vs. enucleation). We have a case of bilateral synchronic renal cell carcinoma where radical surgery on the left kidney was put into practice, as it presented a great tumour with multiples points corticals confirmed by PAAF and conservative surgery on the right kidney with enucleation of localized mass in the lower renal. The patient held normal renal function with a good quality of life for five years, finding out then, in one of the radiological tests, carcinoma relapse in the only kidney, that forced to radical surgery and to his inclusion in dialysis programme.

[Test with intracavernous injection of PGE1 in erectile dysfunction: our experience]. / El test de inyección intracavernosa con PGE1 en la disfunción eréctil: nuestra experiencia.

OBJECTIVES: To evaluate the answer and side-effects after the test of intracavernous injection of prostaglandin E1 in patients with erectile dysfunction. MATERIAL AND METHOD: In the last three years we have carried on 500 tests of intracavernous injection of prostaglandin E1 with the support of infirmary. The purpose was to train the patient and his partner on this technique. RESULTS: The more frequent cause of erectile dysfunction turned to have a vascular origin. In most of the cases, once that the technique has been learnt, the intracavernous injection has been carried on by the patient. The level of acceptance has reached a 85%, with a very low rate of complications. According with our protocol, the learning process has required of a media of 2 or 3 visits where the couple has been trained on this technique and the optim individual dose has been set. CONCLUSION: The intracavernous injection test carried on by an erectile dysfunction unit with the support of an infirmary team reach a high level of acceptance and efficiency. Although new medicine has appeared, we considered the objectification test of the erection with PGE1 very useful, easy-to-use and with low complication rate. It can also be used as a therapeutical option.

[Absorptive hypercalciuria type III or caused by renal loss of phosphates]. / Hipercalciuria absortiva tipo III o por pérdida renal de fosfatos.

Contribution of a retrospective series of 16 patients with type II absorptive hypercalciuria over a total of 1.041 patients undergoing metabolic study due to relapsing renal lithiasis. Clinical history of lithiasis, biochemistry prior to treatment and instituted therapy were examined in all cases. Stones composition, radiologic appearance of lithiasis and evolution of biochemical parameters after medical treatment with a mixture of phosphates were also studied.

[The hospital nursing discharge form. Establishing and validation of a standard formate]. / Alta de enfermería hospitalaria. Implantación y validación de un formato estándar.

The purpose of this article is to describe the design, application and validation process for a new hospital nursing medical discharge form. This process has three phases: FIRST PHASE: Redesigning the Document. In 1996, as a response to growing demands as well as the need to adapt to the requirements of data processing, all nursing documents in all hospital nursing files were updated following the recommendations of the Technical Commission. SECOND PHASE: Initial Application and Validation. The medical discharge form prepared in phase one was applied during the first trimester of 1997. The parties involved agreed to test this form until the end of the year in order to come to a consensus regarding its structure and content while at the same time determining its degree of comprehension and usefulness. THIRD PHASE: Editing and Final Format. The results of these analyses, together with revisions of criteria included in the NMDS and from the Conference on Hospital Discharge Abstract System, made it possible to draw up the final draft of this form which include nursing discharge criteria in the evaluation section. A pilot test was carried out in five hospital units to determine the validity of this form according to the same criteria of comprehension and usefulness. The results indicate a recommendation to eliminate the sections of medical diagnosis and medication upon discharge while to maintain the identification of the patient, the summary of his/her stay in the center, the description of the patient's case upon discharge and the treatment plan.

[Role of phosphate in recurrent calcium lithiasis. A current view]. / Papel del fosfato en la litiasis cálcica recidivante. Una visión actual.

OBJECTIVE: To analyze the biochemical impact of treatment with phosphates in patients with recurrent calcium lithiasis and hypercalciuria. METHODS: 20 patients were selected according to the following criteria: normal renal function, recurrent calcium nephrolithiasis, hypercalciuria, hypophosphatemia, normal calcium and low tubular phosphate reabsorption (TPR). The mean duration of treatment was 7.5 +/- 3.8 months. The pre and post-treatment phosphatemia, calciuria, phosphaturia and TPR were analyzed. The results were analyzed by the Wilcoxon statistical method. RESULTS: We found a moderate but significant decrease of calciuria (326.5 +/- 52-4 to 266.4 +/- 31.7 mg/24 h), while phosphatemia (2.21 +/- 0.09 to 2.52 +/- 0.30 mg/24 h) and TPR (65.7 +/- 6.3 to 71.3 +/- 4.1) increased significantly. Overall treatment was well-tolerated and no patient abandoned treatment. CONCLUSIONS: The short-term biochemical results obtained are similar to those reported in the literature. However, definitive conclusions cannot be made since treatment application is not standardized and studies that demonstrate its clinical efficacy are scanty.

[Evaluation through the EORTC questionnaires of long-term quality of life in patients with breast cancer in initial stages]. / Evaluación de la calidad de vida a largo plazo en pacientes con cáncer de mama en estadios iniciales mediante los cuestionarios de la EORTC.

BASIS: The objective of the present work is to evaluate the quality of life of a group of patients with breast cancer after a long follow-up time. METHODS: 104 patients with breast cancer in initial stages, of a total of 125 to whom the questionnaire was sent, have completed the general questionnaire QLQ-C30 and the module of the breast QLQ-BR23 of the EORTC in 2001, five years after their diagnosis. A subgroup of 48 patients had completed these questionnaires in 1996. The scorings of quality of life and the differences among the measurements of 2001 and 1996 have been evaluated, and groups organized according to the stage, the type of treatment, and the surgery have been compared. RESULTS: The scorings of quality of life are appropriate and similar in both periods (1996 and 2001). There are alterations in the sexual function and concern over the future. The differences between the type of surgery focus on the corporal image. There are not significant differences in the analyses according to the stage or according to the type of treatment. CONCLUSIONS: The scorings of quality of life indicate that the situation of these patients is satisfactory. The differences in the type of surgery are similar to the ones observed in the literature.