[Quality of life in patients with urinary incontinence]. / Calidad de vida en las pacientes con incontinencia urinaria.

OBJECTIVE: To assess the quality of life of female patients with urinary stress incontinence (USI) who were attended at the urology department of the University Hospital at Albacete. METHOD: Between November 2001 and December 2005, 126 patients with USI were surveyed in our hospital using the King's Health Questionnaire (KHQ), which is a specific instrument to measure the quality of life among female patients with urinary incontinence (UI). RESULTS: The mean age of patients was 57.09 años (SD: 9.57) and the mean BMI was 28.14 Kg/m2 (SD: 4.66). The mean evolution of UI was 114.48 months, with a median of 96 months. During the last week of the study period, a total of 73 women (57.94%) had more than 10 urine leaks a day. As regards the number of sanitary towels used a day, 82.5% (104 cases) stated they used less than 6. The urodynamic diagnosis was described as normal in 8 cases (6.3%), 16 cases (12.7%) were diagnosed as mixed urinary incontinence and, finally, 102 cases (81%) suffered genuine USI. The best scores were presented in the Personal Relationships scale with a mean score of 26.8, whereas the worse scores were noted in that of Impact of Urinary Incontinence, whose mean score was 82.96. Generally, the lowest scores (better quality of life) were obtained in the youngest age groups. Scores in the scales of General Health, Impact on daily activities, Impact on physical activity, Impact on social activity and Emotions, were significantly higher in patients who had undergone a histerectomy. Patients whose evolution of urinary incontinence was longer presented lower scores in the Personal Relationships scale (r=0.179; p=0.045). CONCLUSIONS: The quality of life of female patients with U.I. is affected, which limits both their physical activity and image. Their quality of life worsens with age, a greater extent of incontinence, greater urinary symptomatology and when episodes of urinary infection are associated.

[Transperitoneal laparoscopic adrenalectomy]. / Suprarrenalectomía laparoscópica transperitoneal.

OBJECTIVES: To present our results with transperitoneal laparoscopic adrenalectomy after completion of 70 procedures. MATERIAL AND METHODS: Between July 2002 and December 2010, transperitoneal laparoscopic adrenalectomy was performed in 70 patients with the following diagnoses: Conn syndrome (22 cases), nonfunctioning adenomas (18), Cushing syndrome (10), pheochromocytomas (7), myelolipomas (4), metastasis after treatment of primary nonadrenal tumors (6), ganglioneuroma (1), adrenal gland hematoma (1) and adrenal carcinoma (1). We describe the size, surgical and hospitalization times, blood loss, need for transfusion, surgical complications and rate of conversion to open surgery. RESULTS: Of 70 patients, 35 were men and 35 women (1:1) with a mean age of 58.2 years (range, 82.2- 29.1). The most common site was left (58%) compared to right (42%). The mean size of the surgical specimen was 5.11 cm, mean surgical time was 119.2 minutes (50-240) and mean operative bleeding was 140.6 (30-800) cc. Only 3 patients required blood transfusion. The mean time until oral feeding was 17 hours, and the mean hospital stay was 4.3 (2-15) days. Complications included 2 cases of surgical infections, 1 of prolonged paralytic ileus, and 1 of splenic laceration and 1 of intestinal perforation which both which required reconversion to open surgery (4.28%). CONCLUSIONS: Laparoscopic adrenalectomy is a safe procedure, with a low percentage of complications and a short hospital stay. The choice of this approach will depend on the surgeon's experience with the lesion etiology and size in each case.

[Idiopathic hypertrophic pachymeningitis: a case report]. / Paquimeningitis hipertrófica idiopática: a propósito de un caso.

INTRODUCTION: Hypertrophic pachymeningitis is a clinical condition that is caused by a diffuse or localised thickening of the dura mater. It predominantly affects males and manifests as chronic headache, with or without association to neurological manifestations, such as paralysis of the cranial nerves, cerebellar ataxia and neuro-ophthalmic complications. CASE REPORT: A 61-year-old male, with no relevant past history, who, one month before admission, had begun to suffer from right frontotemporal headache that irradiated to the ipsilateral orbital region and was more pronounced at night. A week later he was affected by a decrease in visual acuity in the right eye and two weeks later he noted the presence of right palpebral ptosis, while the headaches increased. The examination showed: right palpebral ptosis with global ophthalmoparesis with predominance of adduction and abduction, and diminished photomotor reflex in the right eye. The visual acuity of the right eye was reduced and the palpebral fissure was 0 in the right eye. The fundus oculi was normal. Infectious and non-infectious causations of meningitis were precluded. Magnetic resonance imaging revealed a diffuse thickening of the supratentorial and infratentorial meninges, as well as diffuse uptake of the paramagnetic substance; thickening of the mucus in both paranasal maxillary sinuses was also observed. A meningeal biopsy study confirmed the existence of hypertrophic pachymeningitis. Treatment was established with prednisone and the clinical symptoms improved. CONCLUSIONS: Idiopathic hypertrophic pachymeningitis is an underdiagnosed condition that must be taken into consideration in cases of patients with a history of subacute or chronic meningitis in which infectious and non-infectious causations have been precluded, and high-dose steroid treatment must be established.

Análisis de factores biopsicosociales de pacientes portadores de VIH atendidos en la Clínica Reina Sofía y la Fundación Eudes / Analysis of biopsychosocial aspects of carryng patients of VIH taken care of in the Reina Sofía Clinics and the Fundación Eudes

Este studio buscó evaluar los factores biopsicosociales (Laboral, Sexual, Personal, Familiar y social) de los portadores del VIH, asociados con las afecciones emocionales tanto del propio individuo como de su entorno. Para esto se utilizó un diseño no experimental, de tipo descriptivo-correccional, y se tomaron 43 sujetos voluntarios que asistían a programas de ayuda en la fundación EUDES y la Clínica Reina Sofía. Para efectos de la investigación se aplicó un instrumento realizado por las evaluadoras y validado por jueces expertos en el tema; Constaba de 27 ítems que medían diferentes áreas de ajuste del individuo. Se realizó un análisis descriptivo, seguidamente se evaluaron las diferencias mediante las pruebas de Mc Nemar,U. de Mann-whitney, Análisis de viranza de Kuskal-Wallis y Wilcoxon; finalmente se evaluó la relación de riesgo, con el fin de identificar las correccionales más significativas entre las áreas familiar, social y sexual, las cuales arrojaron los datos más relevantes. En lo que se refiere a la salud, el presente estudio muestra que el VIH no solamente puede ser tomado en el aspecto físico sino que los factores psicosociales son claves, mostrando que en la salud, el comportamiento juega un papel importante al tener un gran efecto en el bienestar físico y emocional del individuo.