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1.
Eur. j. anat ; 23(6): 393-403, nov. 2019. graf, ilus, tab
Artigo em Inglês | IBECS | ID: ibc-185082

RESUMO

Hepatitis C is a widely distributed problem all over the world, especially Egypt. Chronically infected people develop serious liver disease and now it is the most common cause for liver transplantation. Recently, a new regimen, sofosbuvir (sovaldi), alone or with combinations as sovaldi-ribavirin, was approved for treating this disease. There are limited studies that explore the effects of these drugs on the reproductive organs, and hence affection of male fertility while using these drugs. This study aims to throw more light on whether sovaldi or sovaldi-ribavirin causes testicular damaging effects in the adult male albino rats. We investigated the effect of this regimen in a dose equivalent to that used in the human (41 mg/kg once daily orally for sovaldi and 41 mg/kg twice daily orally for ribavirin) for consecutive 5 and 10 days. There was highly significant decrease in testosterone hormone level and marked degenerative changes in the seminiferous tubules and the testicular interstitium, with increase in collagen deposits in sovaldi treated rats, and in a more extensive manner in sovaldi-ribavirin treated rats. There was a significant increase of deoxyribonucleic acid (DNA) fragmentation in the treated groups after 10 days. However, there was a non-significant difference in DNA fragmentation in the treated groups after 5 days when compared with control. Immuno-histochemistry detection of caspase-3 showed significant increase in its expression in the treated groups after either 5 or 10 days. This denoted the specificity of caspase-3 immunohistochemistry technique in the detection of early apoptotic changes. It was concluded that sovaldi and sovaldi ribavirin induced gonado toxic effects through induction of DNA fragmentation via up regulation of caspase-3, and that the resulting damaging effects increased with longer duration of drug in take


No disponible


Assuntos
Animais , Ratos , Sofosbuvir/administração & dosagem , Hepatite C/induzido quimicamente , Hepatite C/veterinária , Testículo/efeitos dos fármacos , Ribavirina/administração & dosagem , Disruptores Endócrinos/administração & dosagem , Sofosbuvir/toxicidade , Imuno-Histoquímica , Projetos de Pesquisa , Eletroforese/métodos
2.
Eur. j. anat ; 23(4): 289-300, jul. 2019. ilus, graf, tab
Artigo em Inglês | IBECS | ID: ibc-183003

RESUMO

Many artemisinin-based combination therapies (ACTs) have been approved for malaria treatment, yet reports indicate that some ACTs pose reversible testicular toxicity; however there is no comparative study of these ACTs on the testes in a curative malarial model. We investigated the ameliorative activity of six ACTs on Plasmodium berghei (PB) induced perturbations in testicular antioxidants, serum testosterone levels, sperm motility and the testes microanatomy. Forty male Swiss mice were divided into 8 groups of 5 each: Group 1 normal control (NC), uninfected and untreated, received placebo; group 2 was parasitized non-treated (PNT), while groups 3 - 8 received PB inoculum intraperitoneally. Initial parasitemia was established after 72 hours. Groups 3 - 8 thereafter received oral therapeutic doses of artesunate/amodiaquine (PBAA), artesunate/mefloquine (PBAM), artesunate/sulfadoxine-pyrimethamine (PBASP), artemisinin-piperaquine (PBAP), dihydroartemisinin/piperaquine (PBDP) and artemether/lumefantrine (PBAL) per kg body weight respectively. final parasitemia was performed 24 hours after last treatment, and animals euthanized. Result for parasitemia level was significantly (p < 0.05) declined in ACT-treated groups, except PBASP compared with PNT. Enzymatic antioxidants were significantly (p < 0.0001) altered in ACT-treated groups compared to PNT. Non-enzymatic antioxidants were significantly (p < 0.0001) increased in PBDP compared to NC and PNT. Progressive sperm motility significantly (p < 0.0001) declined in PNT, PBASP, PBAP and PBDP groups compared to NC. Testosterone showed decreasing trend in PBAP compared to PNT, and severe testicular distortions were demonstrated in PNT, PBASP, PBAP and PBDP. This study concludes that therapeutic doses of AA, AM and AL moderately protects against the deleterious effects of Plasmodium berghei-induced testicular toxicity in Swiss mice


No disponible


Assuntos
Animais , Camundongos , Artemisininas/administração & dosagem , Plasmodium berghei/efeitos dos fármacos , Testículo/anatomia & histologia , Testículo/efeitos dos fármacos , Motilidade Espermática/efeitos dos fármacos , Antioxidantes/toxicidade , Artesunato/administração & dosagem , Projetos de Pesquisa , Testosterona/análise , Ensaio de Imunoadsorção Enzimática , Testículo/patologia
4.
Eur. j. anat ; 23(1): 1-7, ene. 2019. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-181625

RESUMO

HAART has brought relief to many living with HIV/AIDS, decreasing morbidity and mortality rates. In spite of these benefits, the treatment has been associated with reproductive disorders. This study is aimed at investigating the effects of Naringenin (Nar) on the expression of testicular 3ß-Hydroxysteroid dehydrogenase (3ß HSD) in HAART-treated Sprague-Dawley rats. 30 adult male Sprague-Dawley rats were randomly divided into six groups. The rats were fed with 30 mg/kg of HAART (Efavirenz+Embtricitabine+Tenofovir), 40mg/kg and 80 mg/kg of Nar and a combination of both HAART and Nar for a period of 70 days. Thereafter, the animals were euthanized and the testes processed. The results showed a significant decrease (p<0.05) in the expression of 3ß HSD in the HAART group compared to controls. However, the co-treatment of HAART with 40 mg/kg Nar increased significantly (p<0.05) the expression of 3ß HSD, compared to HAART and control. The relative volume fraction also showed significant increase (p<0.05) in germinal epithelium, lumen and Leydig cells of animals treated with 80 mg/kg Nar, and HAART+40 mg/kg Nar compared to control and HAART respectively. In conclusion, HAART is causes a deficiency in testicular 3ß HSD, thereby limiting spermatogenesis. However, co-treatment with 40 mg/kg Naringenin increases testicular 3ß HSD expression and enhances spermatogenesis


No disponible


Assuntos
Animais , Ratos , Testículo/anatomia & histologia , Terapia Antirretroviral de Alta Atividade/veterinária , 3-Hidroxiesteroide Desidrogenases/metabolismo , Flavanonas/química , Flavanonas/farmacologia , 3-Hidroxiesteroide Desidrogenases/análise , Ratos Sprague-Dawley/anatomia & histologia , Imuno-Histoquímica , Testículo/efeitos dos fármacos , 3-Hidroxiesteroide Desidrogenases/efeitos dos fármacos
5.
Eur. j. anat ; 22(6): 497-507, nov. 2018. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-182117

RESUMO

This study examined the curative effects of aqueous zest extract of Citrus sinensis and Cisplatin (CIS)-induced testicular degeneration. Sixteen male Wistar rats (10 to 12 weeks old) weighing 306-238 g were used in this study. The animals were divided as follows: Group A was treated orally with 2.5 ml/kg body weight/daily; Group B was treated with a single dose of 10 mg/kg body weight; Group C and D rats were given a single dose of 10 mg/kg body weight of cisplatin and then treated orally with 10 and 40 mg/kg body weight of aqueous zest extract of Citrus sinensis. The procedure lasted for 8 weeks.Results showed a significant (p< 0.05) decrease in final body weight, testis weight, testis weight/body weight ratio, normal sperm morphology (p<0.01) and a significant decrease in tubular diameter (p > 0.01), perimeter (p > 0.01 and) and length (p > 0.001), width (p >0.05) and increase (p > 0.05), germinal epithelia height, cross-sectional area, number of profiles per unit area and numerical density of seminiferous tubules. Rats that were treated with CIS alone without pre-treatment or post-treatment with extract showed marked degeneration and atrophied seminiferous tubules with absence of late stage germ cells. There was also a reduction in PAS-positive materials of the rats treated with Cisplatin. These parameters were however ameliorated in the groups that were post-treated with the aqueous zest extract of Citrus sinensis. This could have been as a result of its antioxidant and free radical scavenging potentials


No disponible


Assuntos
Animais , Masculino , Ratos , Cisplatino/efeitos adversos , Citrus sinensis , Testículo/patologia , Estresse Oxidativo/efeitos dos fármacos , Cisplatino/administração & dosagem , Antineoplásicos/efeitos adversos , Testículo/anatomia & histologia , Imuno-Histoquímica/métodos , Infertilidade/etiologia , Sêmen/fisiologia
6.
Cir. plást. ibero-latinoam ; 44(3): 297-301, jul.-sept. 2018. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-180030

RESUMO

Introducción y Objetivo: La región escrotal presenta unas características especiales que otorgan una adecuada protección y termorregulación testicular. La etiología de su defecto puede ser múltiple, siendo la causa más frecuente la gangrena de Fournier. Hasta el momento actual se han descrito múltiples opciones reconstructivas, no obstante no se ha llegado a encontrar un método ideal. El objetivo de este estudio es evaluar los efectos de la reconstrucción escrotal mediante colgajo de músculo gracilis o injerto de piel parcial sobre la función hormonal testicular y la satisfacción del paciente. Material y Método: Desde enero de 2006 hasta marzo de 2016, 19 pacientes fueron sometidos a reconstrucción de defecto escrotal en nuestra unidad mediante cobertura con injerto de piel parcial o colgajo de gracilis pediculado. En todos los casos el defecto fue secundario a gangrena de Fournier. Estudiamos las características de los pacientes y medimos su función hormonal testicular, así como su satisfacción tras la reconstrucción al cabo de 5 ±3.6 años de postoperatorio. Resultados: De los 19 pacientes intervenidos, incluimos 11 en el estudio: 5 con reconstrucción mediante colgajo muscular de gracilis pediculado con injerto de piel parcial y 6 mediante injerto de piel parcial. No apreciamos diferencias entre los grupos respecto a los valores de función hormonal testicular. No obstante, observamos diferencias a favor de la reconstrucción mediante colgajo de gracilis pediculado respecto a satisfacción (93 frente a 60 puntos), sensación de protección (98 frente a 68 puntos), influencia en la actividad sexual (20% frente a 80%) y sensibilidad táctil grosera del área reconstruida (80% frente a 0%). Conclusiones: La reconstrucción de defecto escrotal mediante colgajo de gracilis. en nuestra muestra, ofreció un mejor resultado estético y una mayor satisfacción del paciente que la reconstrucción mediante injertos de piel parcial. Además, no observamos diferencias notables entre las dos técnicas reconstructivas respecto a la función hormonal testicular de los pacientes


Background and Objective: The scrotal area presents special characteristics that allow the protection and thermal regulation of testicles. The etiology of scrotum defect can be multiple, being the most frequent cause Fournier's gangrene. Multiple reconstructive options have been described, nevertheless it has not yet been reached an ideal method. This study was designed to evaluate the effects of scrotal reconstruction, using gracilis muscle flap or skin graft, on testicular hormonal function and patient satisfaction. Methods: From January 2006 to March 2016, 19 patients underwent a reconstruction of scrotum defect in our unit through covering by skin graft or pedicled gracilis flap. In all cases the defect was due to Fournier's gangrene. The characteristics of the patients were studied and testicle hormonal function as well as satisfaction after the reconstruction were assessed, with a mean follow-up of 5 ± 3.6 years. Results: From 19 operated patients, 11 were included in the survey: 5 patients were reconstructed through pedicled gracilis muscle flap with skin graft and 6 by means of split thickness skin graft. There were no differences between the groups with regard to the values of testicular hormonal function. Nevertheless, differences were observed in favor of the reconstruction by pedicled gracilis flap regarding to satisfaction (93 versus 60 points), feelings of protection (98 versus 68 points), effects on sexual activity (20% versus 80%) and tactile rude sensibility of the area reconstructed (80% versus 0%). Conclusions: Reconstruction of scrotum defect through pedicled gracilis flap turned out to be in our sample a better aesthetic result and a higher satisfaction of the patient that the reconstruction by means of skin grafts. However, no differences were found regarding testicular hormonal function


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Idoso , Escroto/anormalidades , Escroto/cirurgia , Retalhos Cirúrgicos , Transplante de Pele/métodos , Períneo/cirurgia , Testículo/anormalidades , Testículo/cirurgia , Estudos Retrospectivos , Gangrena de Fournier/complicações , Gangrena de Fournier/cirurgia , Complicações Pós-Operatórias
7.
Eur. j. anat ; 22(4): 367-369, jul. 2018. ilus
Artigo em Inglês | IBECS | ID: ibc-179100

RESUMO

An uncommon drainage of the left testicular vein (LTV) was observed during a routine cadaver dissection, where a lateral division of the LTV was found to drain into an abdominal (anterior) tributary of the second lumbar vein. Adequate knowledge of the LTV anatomical variation presents clinical importance in renal transplantation, renal and testicular vein surgeries, testicular color Doppler imaging, testicular venography, and others retroperitoneal therapeutic and diagnostic procedures. Therefore, surgeons, especially those who work in the retroperitoneal space, must be aware of left testicular vein abnormalities, which may be encountered during surgery


No disponible


Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Testículo/irrigação sanguínea , Drenagem/métodos , Abdome/irrigação sanguínea , Espaço Retroperitoneal , Gônadas/irrigação sanguínea , Cadáver , Testículo/cirurgia , Veias Renais/anatomia & histologia
8.
Eur. j. anat ; 22(3): 241-256, mayo 2018. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-179064

RESUMO

The purpose of this investigation was to characterize an unusual case of stage III testicular germ cell tumor (TGCT) in a 31-year-old male with metastases to nodes, bone, viscera and brain, and to understand all possible routes of metastatic disease. Testicular cancer (TC) has an increasing incidence worldwide, and its etiology, risk factors and pathogenesis are not completely understood. Medical records were reviewed, and the cadaveric specimen evaluated by physical examination and gross dissection. Paraffin embedded tissue sections of the primary tumor were stained with Hematoxylin and Eosin (H&E) for histological study. To examine metastatic spread, pre- and post-mortem digital radiologic image acquisition was done using x-ray films, and high- resolution CT Scans and MRI Scans. Image analysis, multi-planar reformatting, and three- dimensional (3-D) reconstruction were done on radiographic series. Dissection showed masses bilaterally from the apex through the lung base; masses on the internal thoracic wall, and hepatomegaly and splenomegaly with multiple tumor masses. Testicular parenchyma was composed of primitive germ cells that formed glomeruloid or embryonal-like structures, as well as areas with a micro-cystic histologic pattern and areas of fibrous dysplasia. Medical imaging 3- D video radiographic dissection was notable for a 38.45 mm diameter, mid-brain tumor; extreme hepatomegaly with numerous tumors, lung tumors, a large penetrating tumor of the left ilium, and multiple tumors throughout both lungs and the thoracolumbar spine (T5-S1). This study provides insight into the histology and metastatic spread of TGCT that is essential for clinicians to understand in the evaluation and treatment of TC patients


No disponible


Assuntos
Humanos , Masculino , Adulto , Neoplasias Testiculares/diagnóstico por imagem , Células Germinativas/ultraestrutura , Neoplasias Primárias Desconhecidas , Neoplasias Testiculares/fisiopatologia , Testículo/anatomia & histologia , Testículo/ultraestrutura , Cadáver , Dissecação/métodos , Tumor do Seio Endodérmico
9.
Eur. j. anat ; 22(2): 89-102, mar. 2018. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-172183

RESUMO

Bisphenol-A (BPA) is widely used in the environment. The objective of this study was to investigate the histological reproductive toxicity of BPA in the adult male albino rats. Forty-five adult male albino rats were divided into 3 groups. Group I received normal saline orally daily (negative control); Group II received corn oil (0.5 ml/day) orally daily (positive control, and Group III were treated with BPA in a dose of 25 mg/kg B.W dissolved in corn oil for 30 days orally. Specimens from the testis, epididymis, prostate and seminal vesicles were collected for light microscopic examination. Blood samples were collected for serum testosterone level assessment. BPA caused histopathological alterations in the epithelium and connective tissues of all organs. Results of the serum testosterone level statistical analysis showed a highly significant decrease in BPA-treated group (III) as compared to the control groups (I & II). The epithelium of the accessory sex glands (prostate and seminal vesicles) responds to BPA by proliferative differentiation. The mean area percentage of collagen fibers stained with Masson's trichrome measured in the stroma of all organs was significantly increased. Also, there was a significant increase in the area percentage of positive inducible nitric oxide synthase (iNOS) immunoreactions in all organs. In conclusion, BPA induced DNA oxidative damage via iNOS activity in all reproductive organs


No disponible


Assuntos
Animais , Masculino , Ratos , Bis-Fenol A-Glicidil Metacrilato/uso terapêutico , Fenômenos Reprodutivos Fisiológicos , Testículo/anatomia & histologia , Próstata/anatomia & histologia , Glândulas Seminais/anatomia & histologia , Bis-Fenol A-Glicidil Metacrilato/toxicidade , Testículo , Próstata , Glândulas Seminais , Projetos de Pesquisa , Imuno-Histoquímica , Imuno-Histoquímica/veterinária , Análise de Variância , Ratos Wistar/anatomia & histologia
10.
Rev. toxicol ; 35(2): 89-94, 2018. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-176870

RESUMO

Se evaluó el efecto toxico del ibuprofeno y meloxicam en la estructura histológica del testículo y calidad seminal de ratas albinas (Rattus norvegicus) variedad Sprague Dawley. Se utilizaron 18 ratas machos de 250 a 300 gramos de peso corporal y de 5 meses de edad, asignados en 3 grupos: grupo 1 control, grupo 2 con una dosis de 120 mg·kg⁻¹·día⁻¹ de ibuprofeno, grupo 3 con una dosis de 1 mg·kg⁻¹·día⁻¹ de meloxicam. Las tabletas de ibuprofeno y meloxicam se diluyeron en agua destilada hasta obtener la concentración previamente establecida, el grupo control recibió solo suero fisiológico. El tratamiento se administró por vía oral usando jeringas de 1 mL provistas de una cánula de intubación oro-esofágica. Concluidos los 30 días, todas las ratas machos fueron eutanizadas con cloroformo comercial y se procedió a extraer los testículos y el epidídimo de cada grupo. El análisis histológico se observó una disminución significativa en la altura de la pared del tubo seminífero así como el diámetro de los mismos; daños severos en las células germinales, congestión vascular intersticial; aumento del tejido conjuntivo, disminución en el número y alteración de la morfología de los espermatozoides en comparación con el grupo control


The toxic effect of ibuprofen and meloxicam on the histological structure of the testes and seminal quality of albino rats (Rattus norvegicus) variety Sprague Dawley was evaluated. Eighteen male rats of 250 to 300 grams body weight and 5 months of age were used, assigned in 3 groups: group 1 control, group 2 with a dose of 120 mg·kg⁻¹·day⁻¹ ibuprofen, group 3 with a dose of 1 mg·kg⁻¹·day⁻¹ meloxicam. Ibuprofen and meloxicam tablets were diluted in distilled water to the previously established concentration, the control group received only physiological serum. Treatment was administered orally using 1 mL syringes provided with a oral-esophageal intubation cannula. At the end of the 30 days, all male rats were euthanized with commercial chloroform and the testes and epididymis were removed from each group. Histological analysis showed a significant decrease in seminiferous tube wall height and diameter; severe damage to germinal cells, interstitial vascular congestion; increased connective tissue, decreased number and morphology of spermatozoa compared to the control group


Assuntos
Animais , Ratos , Ibuprofeno/toxicidade , Análise do Sêmen , Testículo , Anti-Inflamatórios não Esteroides/toxicidade , Inibidores de Ciclo-Oxigenase/toxicidade , Ratos Sprague-Dawley , Testículo/ultraestrutura , Estudos de Casos e Controles , Teratozoospermia/induzido quimicamente
11.
Rev. int. androl. (Internet) ; 15(4): 141-148, oct.-dic. 2017. tab, ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-166859

RESUMO

Objetivo. El objetivo de nuestro trabajo es evaluar la cuantificación del volumen testicular mediante segmentación en resonancia magnética (RM) y compararla con la fórmula propuesta por Lambert en ecografía (0,71×ancho×alto×largo), que es el método utilizado como referencia. Material y métodos. Se realiza un estudio prospectivo de pacientes que acuden a la consulta de urología. Se estudian un total de 27 pacientes (49 testículos) con una edad media de 38,7±11,0años (rango: 21 a 58años). Se determina en todos ellos la volumetría mediante los dos métodos expresando los valores en cm3. El análisis estadístico se desarrolló en el paquete estadístico SPSS versión 19 para Windows y STATA. Resultados. El volumen medio testicular utilizando la fórmula de Lambert es de 25,3cm3, y con el método de segmentación es de 18,1cm3. El coeficiente de correlación lineal de Pearson entre ambos métodos es de 0,91. Sin embargo, la fórmula de Lambert proporciona valores sistemáticamente superiores, como muestra el análisis de Bland y Altman. Conclusiones. La técnica de segmentación con RM permite un cálculo fiable del volumen testicular (AU)


Objective. To determine the capability of segmentation by magnetic resonance imaging (MRI) in the quantification of testicular volume and to compare it with the formula proposed by Lambert (0.71×width×height×length), which has been used as a reference method. Material and methods. A prospective study of patients attending the urology is made. A total of 27 patients (49 testes) were included with a mean age of 38.7±11.0years (range: 21-58years). The volume was determined in both methods. All parameters were expressed as mean and standard deviation in cm3. Statistical analysis was conducted using SPSS version 19 for Windows and STATA. Results. The mean testicular volume using Lambert's formula was 25.3cm3 and with the segmentation MRI it was 18.1cm3. A strong correlation was found between the methods with a Pearson's coefficient of 0.91. However, Lambert's formula provided consistently higher values as it was revealed by Bland and Altman's analysis. Conclusions. MRI segmentation technique allows a reliable calculation of testicular volume (AU)


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Testículo/fisiologia , Testículo , Titulometria/métodos , Fatores de Risco , Imagem por Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética/instrumentação , Espectroscopia de Ressonância Magnética/métodos , Estudos Prospectivos , Titulometria/estatística & dados numéricos , Análise Estatística
12.
Rev. int. androl. (Internet) ; 15(4): 165-168, oct.-dic. 2017. ilus
Artigo em Espanhol | IBECS | ID: ibc-166863

RESUMO

La neoplasia testicular intratubular es una lesión premaligna testicular asociada a tumores germinales primarios gonadales y extragonadales. La prevalencia de neoplasia testicular intratubular en pacientes infértiles llega al 2% en diferentes estudios. Presentamos el caso de un paciente azoospérmico con diagnóstico incidental de neoplasia testicular intratubular bilateral en la biopsia testicular realizada durante la recuperación quirúrgica de espermatozoides. En pacientes infértiles, las técnicas de recuperación espermática deben incluir el estudio anatomopatológico de parénquima testicular para descartar enfermedad maligna asociada. Los pacientes con alteración de la espermatogénesis tienen mayor riesgo de presentar otras alteraciones del desarrollo gonadal (neoplasias, hipogonadismo, entre otros) en el contexto de un síndrome de disgenesia testicular (AU)


Testicular intraepithelial neoplasia is a premalignant lesion associated to gonadal and extragonadal germ cell tumors. Testicular intraepithelial neoplasia prevalence in infertile men has reached 2% in some studies. This report presents the case of an azoospermic man with an incidental diagnosis of bilateral testicular intraepithelial neoplasia after testicular sperm extraction. In infertile men, sperm retrieving techniques have to include histological analysis of testicular tissue, to discard any chance of malignant component. Patients with spermatogenesis alterations have an increased risk to present other disruptions in gonadal development (neoplasms, hypogonadism, among others) in the context of testicular dysgenesis syndrome (AU)


Assuntos
Humanos , Masculino , Adulto , Neoplasias Testiculares/complicações , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/cirurgia , Infertilidade Masculina/complicações , Espermatogênese , Biópsia , Azoospermia/complicações , Azoospermia/diagnóstico , Imuno-Histoquímica/métodos , Fotomicrografia/métodos , Testículo/patologia
13.
Rev. int. androl. (Internet) ; 15(2): 78-81, abr.-jun. 2017. ilus
Artigo em Espanhol | IBECS | ID: ibc-162809

RESUMO

Los tumores paratesticulares son poco frecuentes: suponen menos del 5% de las neoplasias intraescrotales. El mesotelioma testicular es un tumor raro paratesticular de la línea de células no germinales. Presentamos el caso de un varón de 69 años de edad que consulta por tumoración testicular derecha y al que, tras exploraciones complementarias, se realiza orquiectomía radical con resultado anatomopatológico de mesotelioma de túnica albugínea (AU)


Paratesticular tumors are rare, less than 5% of intrascrotal neoplasms. Testicular mesothelioma is a rare paratesticular not germ cell tumor. We report the case of a 69 year-old man after attending Urology consultation due to the appearance of a right testicular tumor. He is diagnosed of mesothelioma of tunica albuginea after surgical treatment by radical right orchiectomy (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Mesotelioma/patologia , Mesotelioma/cirurgia , Mesotelioma , Neoplasias Testiculares/patologia , Orquiectomia/métodos , Escroto/patologia , Escroto , Testículo/patologia , Testículo , Imuno-Histoquímica
14.
Actas urol. esp ; 41(3): 146-154, abr. 2017. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-161696

RESUMO

Introducción: El modelo de referencia para los tumores de células de Leydig todavía se considera la orquiectomía radical, pero la cirugía conservadora de testículo en conjunción con la congelación intraoperatoria de secciones ha sido recientemente tratada con resultados prometedores. Adquisición de evidencia: Se identificaron estudios mediante búsquedas en bases de datos electrónicas y exploración de las listas de referencias de los artículos. Se llevó a cabo una búsqueda bibliográfica que abarca el período comprendido entre enero de 1980 a diciembre 2012 mediante las bases de datos PubMed/MEDLINE y EMBASE. Se consideraron las búsquedas adicionales a mano de las listas de referencias de los estudios incluidos, opiniones, metaanálisis y guías sobre el manejo quirúrgico de TCL de los testículos. Síntesis de evidencia: El presente análisis se basa en un total de 13 estudios que cumplían con los criterios de inclusión predefinidos. Un total de 247 participantes se incluyeron en los 13 estudios examinados en esta revisión sistemática. Ciento cuarenta y cinco fueron tratados con orquiectomía radical y 102 con TSS. En el grupo de cirugía radical 7 estudios informaron del seguimiento de los pacientes que va desde 6 a 249 meses. En el grupo de TSS 10 estudios informaron del seguimiento de los pacientes que va desde 6 a 192 meses. La congelación de secciones se realizó en un total de 96 pacientes. La sensibilidad fue del 87,5%. Ninguno de los pacientes tratados con TSS presentó una recurrencia metastásica, mientras que en los pacientes tratados con orquiectomía radical 3 pacientes presentaron recurrencia metastásica. Nuestro análisis añade información completa a las recientes directrices internacionales, que es altamente recomendable realizar un procedimiento de preservación de órganos en cada lesión intraparenquimatosa pequeña. Conclusiones: Los resultados confirman el curso favorable de TCL tratados con TSS. Los resultados obtenidos son alentadores y el concepto es atractivo para convertirse en el tratamiento estándar en todos los pacientes, y no solo en las personas afectadas por la (sub) fertilidad o con testículo solitario


Introduction: The gold standard for Leydig cell tumours (LCTs) is still considered radical orchidectomy, but testis sparing surgery (TSS) in conjunction with intraoperative frozen section (FSE) has been recently attempted with promising results. Acquisition of evidence: Studies were identified by searching electronic databases. A bibliographic search covering the period from January 1980 to December 2012 was conducted using PubMed/MEDLINE and EMBASE database. Studies were excluded if they were single case reports, meeting abstracts and conference proceedings. Synthesis of evidence: The present analysis is based on a total of 13 studies that fulfilled the predefined inclusion criteria. A total of 247 participants were included in the 13 studies examined in this systematic review. 145 were treated with radical orchiectomy and 102 with TSS. In the radical surgery group, the follow-up varied from 6 to 249 months). In the TSS group, the follow-up varied from 6 to 192 months. Frozen section was performed in a total of 96 patients. Sensitivity was 87.5%. None of the patients treated with TSS presented a metastatic recurrence, while in patients treated with radical orchiectomy three patients presented with metastatic recurrence. In selected cases radical surgery appears excessive and the potential for a shift to TSS as the standard management is gathering momentum. Conclusions: The results confirm the favourable course of LCT treated with TSS. The results obtained are encouraging and the concept is attractive to become the standard therapy in all patients and not only in people affected by (sub)fertility or with solitary testis


Assuntos
Humanos , Masculino , Tumor de Células de Leydig/cirurgia , Orquiectomia/tendências , Recidiva Local de Neoplasia/complicações , Recidiva Local de Neoplasia/cirurgia , Preservação de Tecido/métodos , Testículo/patologia , Testículo/cirurgia
15.
Rev. int. androl. (Internet) ; 14(4): 148-152, oct.-dic. 2016. ilus
Artigo em Inglês | IBECS | ID: ibc-157591

RESUMO

Introduction. Thoracolumbar junction syndrome (TLJS) occurs as a result of a minor intervertebral dysfunction at the thoracolumbar junction, and causes pain in the low back, hip, groin, testicles and lower abdomen. Likewise the case hereunder, TLJS can often be confused with other pathologies that may cause these symptoms and leading to misdiagnosis and false treatment. Case report. A sixty-one year old man complained of pulsatile right testicle pain and low back pain after the instrumentation at L2-L5 level for spondylolisthesis. For his insistent complains, his right testicle was removed surgically and medical treatment was given for low back pain but his complains did not relieved. Physical examination revealed severe limitation of the lumbar spine, and pain in all directions. Posteroanterior pressure at the T12-L1 and L4-5 intervertebral spaces, at the T12 spinous processes and transverse pressure against the lateral aspect of the T12 spinous process were painful. Pinch and roll test and pressure over the right trochanteric and pubic region were painful. According to these findings, we diagnosed the patient as a TLJS but we could not apply diagnostic T12 periapophyseal joint block because the patient did not accept this intervention, manipulation could not be applied because of the instrumentation at the thoracolumbar spine. The spinal mobilization therapy to the thoracolumbar segment was applied gently and gabapentin was started at a low dose of 300mg/day, and increased gradually to 2400 mg/day. Exercise program and daily living activities were organized. His symptoms improved after 3 months of treatment. It was observed that the general well-being has continued after two years of follow up. Conclusion. Thoracolumbar junction syndrome is a pathology that should be considered in the differential diagnosis of testicular pain (AU)


Objetivo. El síndrome de unión toracolumbar (TLJS de sus siglas en inglés) se produce como consecuencia de una disfunción intervertebral menor en la unión toracolumbar, y causa dolor en la zona baja de la espalda, la cadera, la ingle, los testículos y el abdomen inferior. Como en el caso que se presenta, el TLJS puede confundirse a menudo con otras patologías que pueden causar estos síntomas, conduciendo a un diagnóstico erróneo y tratamiento equivocado. Caso. Un hombre de 61 años refería dolor pulsátil en el testículo derecho y dolor en la zona baja de la espalda después de la instrumentación para espondilolistesis a nivel de L2-L5. Por su insistente queja, fue sometido a orquiectomía derecha y se indicó tratamiento médico para el dolor de la zona baja de la espalda, a pesar de lo cual las molestias persistieron. Un examen físico bien hecho reveló una importante limitación de la columna lumbar y el dolor en todas las direcciones. La presión posteroanterior en los espacios intervertebrales T12-L1 y L4-L5, apófisis espinosas T12 y la presión transversal contra la cara lateral de la apófisis espinosa T12 eran dolorosas. El signo del pellizco o enrollamiento y la presión sobre la región del trocánter derecho y región púbica eran dolorosos. De acuerdo con estos hallazgos, se diagnosticó al paciente como un TLJS, pero no pudo aplicarse el diagnóstico por bloqueo periapofisario T12 porque el paciente no aceptó esta intervención; la manipulación no pudo aplicarse debido a la instrumentación de la columna dorsolumbar. La terapia de movilización espinal para el segmento toracolumbar se aplicó cuidadosamente y se instauró tratamiento con gabapentina a una dosis baja de 300mg/día, la cual fue incrementándose gradualmente hasta 2.400mg/día. Se organizó un programa de ejercicios y actividades de la vida diaria. Sus síntomas mejoraron después de 3 meses de tratamiento. Se observó que el bienestar general ha continuado después de 2 años de seguimiento. Conclusión. El TLJS es una patología que debe ser considerada en el diagnóstico diferencial del dolor testicular (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Doenças Testiculares/complicações , Dor/complicações , Dor/etiologia , Espondilolistese/complicações , Espondilolistese/terapia , Orquiectomia/métodos , Orquiectomia , Anti-Inflamatórios não Esteroides/uso terapêutico , Testículo , Testículo/patologia , Diagnóstico Diferencial , Dor Lombar/complicações , Dor Lombar/etiologia , Tratamento por Radiofrequência Pulsada/métodos
16.
Clin. transl. oncol. (Print) ; 18(12): 1187-1196, dic. 2016. tab
Artigo em Inglês | IBECS | ID: ibc-158634

RESUMO

Testicular cancer represents the most common malignancy in males aged 15-34 years and is considered a model of curable neoplasm. Maintaining success, reducing treatment burden, and focusing on survivorship are then key objectives. Inguinal orchiectomy is the first recommended maneuver that has both diagnostic and therapeutic aims. Most patients are diagnosed with stage I disease (confined to the testicle). Close surveillance and selective, short-course adjuvant chemotherapy are accepted alternatives for these cases. In patients with more advanced disease (stages II and III), 3-4 courses of cisplatin based chemotherapy (according to IGCCCG risk classification) followed by the judicious surgical removal of residual masses represent the cornerstone of therapy. Poor-risk patients and those failing a first-line therapy should be referred to specialized tertiary centers. Paclitaxel-based conventional chemotherapy and high-dose chemotherapy plus autologous hematopoietic support can cure a proportion of patients with relapsing or refractory disease (AU)


No disponible


Assuntos
Humanos , Masculino , Adolescente , Adulto Jovem , Adulto , Germinoma/diagnóstico , Germinoma/tratamento farmacológico , Germinoma/cirurgia , Teratoma/complicações , Teratoma/terapia , Estadiamento de Neoplasias/métodos , Orquiectomia/métodos , Seminoma/diagnóstico , Seminoma/terapia , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/terapia , Testículo/anatomia & histologia , Testículo/patologia , Estadiamento de Neoplasias/instrumentação , Biomarcadores Tumorais/análise , Prognóstico
17.
Cir. pediátr ; 29(4): 175-179, oct. 2016. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-162216

RESUMO

Objetivos. Analizar en función de la técnica empleada para tratamiento de varicocele, la recurrencia, alivio sintomático y crecimiento testicular en pacientes pediátricos y adolescentes. Material y métodos. Estudio descriptivo retrospectivo de 69 pacientes pediátricos y adolescentes diagnosticados de varicocele tratados en nuestro centro mediante abordaje abierto según técnica de Ivanissevich (TI), Palomo (TP) y embolización percutánea (EP) entre 2000- 2014. Las variables fueron edad, síntomas, volumen testicular diferencial (VD), técnica empleada, recurrencia, mejoría sintomática y VD tras el tratamiento. Se evaluó la asociación entre variables cualitativas (test de Chi cuadrado o prueba exacta de Fisher). Resultados. Se estudiaron 69 pacientes con mediana de edad de 14 años (7-19). Se realizó EP a 37 pacientes (53,6%), TP a 23 (33,3%) y TI a 9 (13%). Presentaron recurrencia 16 (23,2%), de ellos el 80% habían sido tratados mediante EP. Once pacientes tenían dolor al diagnóstico (15,9%), tras el tratamiento 100% de los tratados mediante EP presentaron alivio, mientras que en ninguno de los tratados mediante TI o TP mejoró el dolor. Al diagnóstico 37 pacientes (53,6%) presentaron hipotrofia testicular izquierda, en 28 casos el VD fue >20%. Tras el tratamiento, el VD se normalizó en 11 casos (39,2%). Conclusiones. La elección de la técnica terapéutica de varicocele en pacientes pediátricos y adolescentes debería depender de las características del paciente, presencia de síntomas, experiencia del centro y recurrencia previa. Independientemente de la técnica elegida el 39,2% de hipotrofias testiculares con DV >20% al diagnóstico alcanzaron la normalización del volumen testicular tras el tratamiento


Objectives. To analyze, depending on the technique employed, recurrence, symptomatic improvement and testicular growth following treatment of testicular varicocele. Material and Methods. Descriptive retrospective study of 69 pediatric and adolescent males diagnosed with varicocele treated in our center by open technique according Ivanissevich technique (IT), Palomo (PT) and percutaneous embolization (PE) between 2000-2014. Variables analyzed were age, symptoms, differential testicular volume (RV), employed technique, recurrence, symptomatic improvement and RV after treatment. Association between qualitative variables was evaluated (chi-square test or Fisher’s exact test). Results. 69 patients with a median age of 14 years (7-19) were studied. PE was performed in 37 patients (53,6%), PT in 23 (33,3%) and IT in 9 (13%). Recurrence occurred in 16 patients (23,2%), 80% of them had been treated with PE. Eleven patients had pain (15.9%), there was improvement in 100% of patients treated with PE, but none of those treated by PT or IT improved. At diagnosis, 37 patients (53.6%) had decreased testicular volume (left testicular hypotrophy), in 28 cases the RV was >20%. After treatment, the RV was normalized in 11 cases (39,2%). Conclusions. The choice of therapeutic technique in pediatric varicocele should be based on patient characteristics, symptoms, experience center for embolization and previous recurrence. Regardless of the chosen technique, 39,2% of testicular hypotrophy with VD >20% present at diagnosis normalized after treatment


Assuntos
Humanos , Masculino , Criança , Adolescente , Varicocele/cirurgia , Testículo/crescimento & desenvolvimento , Embolização Terapêutica/métodos , Varicocele/reabilitação , Estudos Retrospectivos , Recidiva , Complicações Pós-Operatórias , Dor Crônica/reabilitação
18.
Pediatr. aten. prim ; 18(71): e97-e99, jul.-sept. 2016. ilus
Artigo em Espanhol | IBECS | ID: ibc-156609

RESUMO

El dolor escrotal agudo es una entidad clínica que en un porcentaje elevado de casos va asociado a una necesidad de actuación médica urgente como es la torsión testicular. La ecografía testicular ayuda en el diagnóstico y debido a su mayor uso en las últimas décadas se están realizando hallazgos accidentales como las microlitiasis testiculares. Suele ser un proceso benigno, pero está descrita su asociación con tumores testiculares, por lo que se recomienda un seguimiento clínico y ecográfico periódico (AU)


Acute scrotal pain is a clinical entity that in a high percentage of cases is associated with an urgent need for medical intervention such as testicular torsion. Testicular ultrasound helps diagnosis and incidental findings, as the testicular microlithiasis, are found due to the increased use of ultrasound in recent decades. It is a benign condition, but it has been found associated with testicular tumors, so periodic clinical and ultrasound monitoring is recommended (AU)


Assuntos
Humanos , Masculino , Pré-Escolar , Calcinose/complicações , Calcinose/cirurgia , Calcinose , Escroto/patologia , Escroto , Testículo/patologia , Testículo , Manejo da Dor/métodos , Dor/etiologia , Dor , Eritema/complicações , Eritema/diagnóstico , Eritema , Ultrassonografia Doppler/instrumentação , Ultrassonografia Doppler/métodos , Ultrassonografia Doppler
20.
Rev. clín. med. fam ; 9(2): 131-134, jun. 2016. ilus
Artigo em Espanhol | IBECS | ID: ibc-155710

RESUMO

Presentamos el caso de un hombre de 33 años de edad que consulta por aumento de tamaño del testículo derecho de tres meses de evolución sin otra sintomatología. El cáncer de testículo es un tumor relativamente raro que representa alrededor del 1-1,5 % de los cánceres masculinos. Principalmente afecta a hombres jóvenes en la tercera o cuarta década de la vida. El diagnóstico se basa fundamentalmente en la sospecha clínica, la ecografía testicular y el examen sérico de marcadores (AU)


We present the case of a 33 year-old man with an enlargement of the right testicle during the last three months without any other symptoms. Testicular cancer is a relatively rare tumour that represents about 1-1.5 % of male cancers. It mainly affects young men in the third or fourth decade of life. Diagnosis is principally based on clinical suspicion, testicle ultrasound and serum marker test (AU)


Assuntos
Humanos , Masculino , Adulto , Neoplasias Testiculares/complicações , Neoplasias Testiculares , Biomarcadores/análise , Seminoma/complicações , Seminoma , Orquiectomia/métodos , Seminoma/cirurgia , Testículo/patologia , Testículo , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde , Radiografia Torácica
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