The use of a whole inactivated PRRS virus vaccine administered in sows and impact on maternally derived immunity and timing of PRRS virus infection in piglets.

Background: Porcine reproductive and respiratory syndrome virus (PRRSV) vaccination is usually based on administering periodically PRRS modified live virus (MLV) in sows throughout their life. Using this schedule, transfer of maternally derived antibodies to the offspring is limited. The aim of the present study was to test the concept of priming with an MLV and boosting with a commercial inactivated virus vaccine in sows to reduce PRRSV incidence and improve productivity. Methods: On two farms, all the sows were vaccinated with a MLV vaccine at week 8 of gestation. Then two groups were designated, one group was re-vaccinated in the third week prior to farrowing and using a commercial inactivated vaccine (the PG group). The second group was the control group (C). Assays for PRRSV infection and productive parameters were evaluated. Results: For both farms, the incidence of PRRSV was lower at 6 weeks of age in PG than in C (p < 0.05). At weaning the proportion of PRRSV seropositive piglets was higher for PG as well (p < 0.05). The litters from C sows from both farms showed a higher pre-weaning mortality (odds ratio, C vs. PG = 1.18 ± 0.09; p < 0.05). Conclusions: Administration of the vaccine in sows before farrowing was safe and associated with reduced incidence of PRRSV in piglets up to 6 weeks of age.

Targeting the 3CLpro and RdRp of SARS-CoV-2 with phytochemicals from medicinal plants of the Andean Region: molecular docking and molecular dynamics simulations.

Given the highly contagious nature of SARS-CoV-2, it has resulted in an unprecedented number of COVID-19 infected and dead people worldwide. Since there is currently no vaccine available in the market, the identification of potential drugs is urgently needed to control the pandemic. In this study, 92 phytochemicals from medicinal plants growing in the Andean region were screened against SARS-CoV-2 3 C-like protease (3CLpro) and RNA-dependent RNA polymerase (RdRp) in their active sites through molecular docking. The cutoff values were set from the lowest docking scores of the FDA-approved drugs that are being used to treat COVID-19 patients (remdesivir, lopinavir, and ritonavir). Compounds with docking scores that were lower than cutoff values were validated by molecular dynamics simulation with GROMACS, using root mean square deviation (RMSD), root mean square fluctuation (RMSF), radius of gyration (Rg), and intermolecular hydrogen bonds (H-bonds). Furthermore, binding free energies were estimated using the MM-PBSA method, and ADMET profiles of potential inhibitors were assessed. Computational analyses revealed that the interaction with hesperidin (theoretical binding energies, ΔGbind = -15.18 kcal/mol to 3CLpro and ΔGbind = -9.46 kcal/mol to RdRp) remained stable in both enzymes, unveiling its remarkable potential as a possible multitarget antiviral agent to treat COVID-19. Importantly, lupinifolin with an estimated binding affinity to 3CLpro higher than hesperidin (ΔGbind = -20.93 kcal/mol) is also a potential inhibitor of the 3CLpro. These two compounds displayed suitable pharmacological and structural properties to be drug candidates, demonstrating to be worthy of further research.Communicated by Ramaswamy H. Sarma.

Absorption and Distribution of Toltrazuril and Toltrazuril Sulfone in Plasma, Intestinal Tissues and Content of Piglets after Oral or Intramuscular Administration.

Piglet coccidiosis due to Cystoisospora suis is a major cause of diarrhea and poor growth worldwide. It can effectively be controlled by application of toltrazuril (TZ), and oral formulations have been licensed for many years. Recently, the first parenteral formulation containing TZ in combination with iron (gleptoferron) was registered in the EU for the prevention of coccidiosis and iron deficiency anemia, conditions in suckling piglets requiring routine preventive measures. This study evaluated the absorption and distribution of TZ and its main metabolite, toltrazuril sulfone (TZ-SO2), in blood and intestinal tissues after single oral (20 mg/kg) or single intramuscular (45 mg/piglet) application of TZ. Fifty-six piglets were randomly allocated to the two treatment groups. Animals were sacrificed 1-, 5-, 13-, and 24-days post-treatment and TZ and TZ-SO2 levels were determined in blood, jejunal tissue, ileal tissue, and mixed jejunal and ileal content (IC) by high performance liquid chromatography (HPLC). Intramuscular application resulted in significantly higher and more sustained concentrations of both compounds in plasma, intestinal tissue, and IC. Higher concentrations after oral dosing were only observed one day after application of TZ in jejunum and IC. Toltrazuril was quickly metabolized to TZ-SO2 with maximum concentrations on day 13 for both applications. Remarkably, TZ and TZ-SO2 accumulated in the jejunum, the primary predilection site of C. suis, independently of the administration route, which is key to their antiparasitic effect.

Efficacy of injectable toltrazuril-iron combination product and oral toltrazuril against early experimental infection of suckling piglets with Cystoisospora suis.

BACKGROUND: Toltrazuril is frequently administered for the metaphylactic control of piglet cystoisosporosis. In a previous study, the efficacy of parenteral toltrazuril (45 mg/piglet, Group Forceris®) applied on the 2nd day of life (dol), and of oral toltrazuril (20 mg/kg of body weight, Group Baycox®) applied on the 4th dol was evaluated in an experimental model with Cystoisospora suis infection on the 3rd dol (late infection, LI). In a follow-up study, efficacy and safety were evaluated against infections with C. suis on the 1st dol (early infection, EI). Parameters included oocyst excretion and faecal consistency, body weight development, bacteriological examinations and animal health. RESULTS: All control piglets (n = 12) shed oocysts and had diarrhoea, while parasite excretion was completely suppressed in both treatment groups (n = 13 each) and diarrhoea was reduced to a single animal (Forceris® group), resulting in significant differences for these parameters between the treated groups and the controls without significant differences among the treatment groups. No treatment-related adverse events were noted. Body weight gain was reduced in the control group during the acute phase of infection, resulting in significantly lower body weight on the 15th dol. Sows and piglets shed high numbers of Escherichia coli. Clostridium perfringens type A was only detected in low amounts in pooled litter samples. In comparison to the LI study oocyst shedding was more intense in the control animals in EI, while diarrhea was more frequent in LI. In both infection models a high efficacy of toltrazuril in the control of parasitological and clinical outcomes of experimental C. suis infection could be demonstrated. Since in the LI study high numbers of Cl. perfringens type A were detected, it is hypothesized that colonization with these opportunistic pathogens has synergistic effects with C. suis and may explain variable clinical outcomes in untreated animals as well as the sporadic occurrence of diarrhea in toltrazuril-treated piglets. CONCLUSIONS: Parenteral and oral toltrazuril administered on the 2nd or 4th dol is safe and effective against experimental infections with C. suis on the 1st to 3rd dol. The clinical outcome of experimental infections seems influenced by bacterial coinfections.

[Eosinophilic cystopathy in association with infiltrative transitional cell carcinoma]. / Asociación de cistopatia eosinofilica con carcinoma transicional vesical infiltrante.

OBJECTIVES: To report a case of eosinophilic cystopathy associated to infiltrative transitional-cell carcino ma of the bladder in an adult. METHODS: We describe the case of a 79-year-old wo man who complains of meso and hipogastric pain since several months before, and to whom a parietal thickening of the bladder was detected by means of abdominal CT scan during the diagnostic work up for a digestive disease indicated by the Internal Medicine Service. Cistoscopy confirmed that finding, together with areas of greater endoluminal protrusion. Cold biopsy showed an inflammatory in filtrate with eosinophilic component. Transurethral resection was indicated. RESULTS: The pathological assessment was compatible with high-grade infiltrative transitional carcinoma of the bladder. The patient developed multiple lung metastases and died five months after surgery. CONCLUSIONS: Reports describing the coincidence of both entities are infrequent. We emphasize the importance of a correct filiation of apparently "pseudotumoral" endoluminallesions.

Asociación de cistopatia eosinofilica con carcinoma transicional vesical infiltrante / Eosinophilic cystopathy in association with infiltrative transitional cell carcinoma

OBJETIVOS: Presentación de un caso de cistopatía eosinofílica asociada a carcinoma vesical infiltrante de células transicionales en adulto.MÉTODO: Describimos el caso de una paciente mujer de 79 años que refiere dolor meso e hipogástrico de varios meses de evolución, y a la que se detecta en escáner abdominal un engrosamiento parietal vesical durante el estudio de descarte de patología digestiva por parte del Servicio de Medicina Interna. La cistoscopia permitió confirmar dicho hallazgo, junto a zonas de mayor protrusión endoluminal. La biopsia fría mostró la existencia de infiltrado inflamatorio con componente eosinofílico. Se indicó resección transuretral. RESULTADOS: El estudio anatomopatológico resultó compatible con carcinoma transicional vesical infiltrante de alto grado. Desarrollo de metástasis pulmonares múltiples y éxitus de la paciente cinco meses después de la cirugía.CONCLUSIONES: Infrecuencia de las descripciones de aparición coincidente de ambas entidades referidas. Destacamos la importancia de una correcta filiación de lesiones endoluminales aparentemente “pseudotumorales”(AU)

OBJECTIVES: To report a case of eosinophilc cystopathy associated to infiltrative transitional-cell carcino ma of the bladder in an adult.METHODS: We describe the case of a 79-year-old wo man who complains of meso- and hipogastric pain since several months before, and to whom a parietal thickening of the bladder was detected by means of abdominal CT scan during the diagnostic work up for a digestive disease indicated by the Internal Medicine Service. Cistoscopy confirmed that finding, together with areas of greater endolu minal protrusion. Cold biopsy showed an inflammatory in filtrate with eosinophilic component. Transurethral resection was indicated.RESULTS: The pathological assessment was compatible with high-grade infiltrative transitional carcinoma of the bladder. The patient developed multiple lung metastases and died five months after surgery.CONCLUSIONS: Reports describing the coincidence of both entities are infrequent. We emphasize the importance of a correct filiation of apparently “pseudotumoral” endoluminal lesions(AU)

Outcomes of maximal androgen blockade in prostate cancer patients at a health area with type 2 reference hospital. Part 2. Quality of life: application of EORTC QLQ-PR25 instrument and global results. Quality-of-life adjusted survival. Pharmaceutical expenses and cost-utility.

OBJECTIVES: To study quality of life in patients from the health area of Zamora diagnosed of prostate adenocarcinoma between 2000-2005 treated with maximal androgen blockade (MAB). To evaluate the pharmacoeconomics of the treatment. METHODS: Basal, 12-month, 24-month and 36-month application of the health-related quality of life measurement instrument EORTC QLQ-C30 to the population sample (n= 111), as well as a control sample (n= 100). Comparative study of outcomes: between groups; between different time measurements in MAB patients; and inter-categories/ -intervals of some variables in patients with hormonal deprivation therapy (third year of follow-up). Analysis of health-related quality of life global outcomes (QLQ-C30 + QLQ-PR25). Description of the pharmaceutical expenses in androgen blockade patients. Cost-utility analysis by means of quality-adjusted life years (QALYs) obtained using preference-based weighted index from the EUROQOL 5-D tool. RESULTS: Hot flushes and sexual field worsening as mean expressions related to hormonal suppression. Treated patients had worse subjective perception of health condition and quality of life, in opposition to non-tumoral individuals. Positive bone scan, was a negative-influence factor on quality of life. Most patients undergoing MAB needed cost-utility figures of less than 5000 Euros/ QALY. CONCLUSIONS: There was a negative initial repercussion of MAB on quality of life, although tinged according to the different fields studied. The economic impact of this therapy on overall pharmaceutical expenses is relative.

Outcomes from the use of maximal androgen blockade in prostate cancer at health area with reference hospital type 2 (1st part). Quality of life: application of EORTC QLQ-C30 instrument.

OBJECTIVES: To analize the influence that maximal androgen blockade (MAB) exerts on quality of life in patients from the health area of Zamora diagnosed of prostate adenocarcinoma between 2000-2005. METHODS: Basal, 12-month, 24-month and 36-month application of the health-related quality of life measurement instrument EORTC QLQ-PR25 to the population sample (n= 111), as well as a control sample (n= 100). We performed a comparative study of the outcomes between groups; between various time measurements in MAB patients; and inter-categories/ intervals of some variables in patients with hormonal deprivation therapy (third year of follow-up). RESULTS: Cognitive and symptomatic fields were affected in patients with MAB at some specific time points. No field showed a significant constant worsening through the period of study for hormonally deprivated patients. A recovery is seen in the sociofamiliar field. Less academic level in MAB patients represents a distinguishing factor leading to worse outcomes in the health-related quality of life parameters analyzed here. CONCLUSIONS: There is a negative initial repercussion of MAB on quality of life, although tinged according to the different fields studied.

Resultados del uso en cáncer de próstata del bloqueo androgénico completo en área de salud del Hospital de Referencia Tipo 2 (2ª Parte). Calidad de Vida: Aplicación del instrumento EORTC QLQ-PR25 y resultados globales. Supervivencia ajustada a la calidad de vida, gasto farmacéutico y coste-utilidad / Outcomes of maximal androgen blockade in prostate cancer patients at a health area with Type 2 Reference Hospital (2nd part). Quality of life: application of EORTC QLQ-PR25 instrument and global results. Quality-of-life adjusted survival. Pharmaceutical expenses and cost-utility

OBJETIVO: Estudiar la calidad de vida en los pacientes diagnosticados entre los años 2000-2005 de adenocarcinoma de próstata en el área de salud de Zamora tratados con bloqueo androgénico completo (BAC). Repercusión farmacoeconómica.MÉTODOS: Aplicación basal, al mes 12, mes 24 y mes 36, del instrumento de medición de calidad de vida relacionada con la salud EORTC QLQ-PR25 a la muestra poblacional (n= 111) citada, así como a una muestra de sujetos control (n= 100). Estudio comparativo entre ambos grupos; entre las diferentes determinaciones temporales para los pacientes con BAC; e inter-categorías/ -intervalos de determinadas variables en pacientes con terapia de deprivación hormonal (tercer año de seguimiento). Análisis de los resultados globales de calidad de vida relacionada con la salud (QLQ-C30 + QLQ-PR25). Descripción del gasto farmacéutico en bloqueo androgénico. Análisis coste-utilidad a través del cálculo de los años de vida ajustados a la calidad (AVACs) obtenidos mediante el uso de los índices de ponderación preferencial correspondientes al instrumento EuroQol 5-D.RESULTADOS: Aparición de sofocos y deterioro de la esfera sexual como manifestaciones más significativas relacionadas con la hormonosupresión. Peor percepción subjetiva del estado general de salud y calidad de vida en pacientes tratados, frente a los sujetos no neoplásicos. La positividad gammagráfica, como factor de influencia negativa sobre la calidad de vida. La mayor parte de los pacientes sometidos a BAC presentan cifras de coste-utilidad menor de 5000 Euros/ AVAC.CONCLUSIONES: Repercusión negativa inicial del BAC sobre determinados aspectos calidad de vida, aunque matizable en función de cada esfera estudiada. Relativización del impacto económico de dicho tratamiento sobre el gasto farmacéutico total(AU)

OBJECTIVES: To study quality of life in patients from the health area of Zamora diagnosed of prostate adenocarcinoma between 2000-2005 treated with maximal androgen blockade (MAB). To evaluate the pharmacoeconomics of the treatment.METHODS: Basal, 12-month, 24 –month and 36-month application of the health-related quality of life measurement instrument EORTC QLQ-C30 to the population sample (n= 111), as well as a control sample (n= 100). Comparative study of outcomes: between groups; between different time measurements in MAB patients; and inter-categories/ -intervals of some variables in patients with hormonal deprivation therapy (third year of follow-up). Analysis of health-related quality of life global outcomes (QLQ-C30 + QLQ-PR25). Description of the pharmaceutical expenses in androgen blockade patients. Cost-utility analysis by means of quality-adjusted life years (QALYs) obtained using preference-based weighted index from the EUROQOL 5-D tool.RESULTS: Hot flushes and sexual field worsening as mean expressions related to hormonal suppression. Treated patients had worse subjective perception of health condition and quality of life, in opposition to non-tumoral individuals. Positive bone scan, was a negative-influence factor on quality of life. Most patients undergoing MAB needed cost-utility figures of less than 5000 Euros/ QALY.CONCLUSIONS: There was a negative initial repercussion of MAB on quality of life, although tinged according to the different fields studied. The economic impact of this therapy on overall pharmaceutical expenses is relative(AU)

Resultados del uso en cáncer de próstata del bloqueo androgénico completo en área de salud del Hospital de Referencia Tipo 2 (1ª Parte). Calidad de Vida: aplicación del instrumento EORTC QLQ-C30 / Outcomes from the use of maximal androgen blockade in prostate cancer at health area with reference hospital type 2 (1st part). Quality of life: application of EORTC QLQ-C30 instrument

OBJETIVOS: Analizar la influencia que ejerce sobre la calidad de vida el bloqueo androgénico completo (BAC) en los pacientes diagnosticados entre los años 2000-2005 de adenocarcinoma de próstata en el área de salud de Zamora y sometidos a dicha terapia.MÉTODOS: Aplicación basal, al mes 12, mes 24 y mes 36, del instrumento de medición de calidad de vida relacionada con la salud EORTC QLQ-C30 a la muestra poblacional (n= 111) citada, así como a una muestra de sujetos control (n= 100). Estudio comparativo de los resultados entre ambos grupos; entre las diferentes determinaciones temporales para los pacientes con BAC; e inter-categorías/ -intervalos de determinadas variables en pacientes con terapia de deprivación hormonal (tercer año de seguimiento).RESULTADOS: Las esferas cognitiva y sintomática resultaron afectadas de forma temporal puntual en los pacientes con BAC. No se aprecia ninguna esfera que mantenga un deterioro significativamente constante a lo largo del periodo de estudio en los pacientes con deprivación hormonal. Se verifica recuperación en la esfera sociofamiliar. El menor nivel de estudios cursados por los pacientes en tratamiento con BAC, constituye un factor de diferenciación de cara a la obtención de peores resultados en los parámetros de calidad de vida relacionada con la salud aquí analizados.CONCLUSIONES: Repercusión negativa inicial del BAC sobre determinados aspectos calidad de vida, aunque matizable en función de cada esfera estudiada(AU)

OBJECTIVES: To analize the influence that maximal androgen blockade (MAB) exerts on quality of life in patients from the health area of Zamora diagnosed of prostate adenocarcinoma between 2000-2005.METHODS: Basal, 12-month, 24-month and 36-month application of the health-related quality of life measurement instrument EORTC QLQ-PR25 to the population sample (n= 111), as well as a control sample (n= 100). We performed a comparative study of the outcomes between groups; between various time measurements in MAB patients; and inter-categories/ intervals of some variables in patients with hormonal deprivation therapy (third year of follow-up).RESULTS: Cognitive and symptomatic fields were affected in patients with MAB at some specific time points. No field showed a significant constant worsening through the period of study for hormonally deprivated patients. A recovery is seen in the sociofamiliar field.Less academic level in MAB patients represents a distinguishing factor leading to worse outcomes in the health-related quality of life parameters analyzed here.CONCLUSIONS: There is a negative initial repercussion of MAB on quality of life, although tinged according to the different fields studied(AU)

[Mullerianosis of the urinary bladder: a rare entity]. / Mullerianosis vesical: una entidad infrecuente.

OBJECTIVES: To report a new case of bladder mullerianosis. METHODS: We present the case of a 30 year old female patient with history of miscarriage, who refers voiding dis-turbances with menstruations. Vaginal ultrasound showed an exophytic bladder lesion, which was confirmed by cistoscopy. Endoscopic resection was indicated. RESULTS: The pathological study of tissues obtained showed mixed glandular structures with predominant tubaric-like type, in association with endometrial- and endocervical-like elements. No evidence of endoscopic relapse after one year of follow-up. CONCLUSIONS: We contribute with a new case of bladder mullerianosis. We emphasize the scarcity of its published reports. We support the option of an endoscopic surgery for these patients.

Mullerianosis vesical: una entidad infrecuente / Mullerianosis of the urinary bladder: a rare entity

OBJETIVO: Descripción de un nuevo caso de mullerianosis vesical.MÉTODO: Presentamos el caso de una paciente mujer de 30 años con antecedentes de aborto, que refiere molestias miccionales coincidiendo con las menstruaciones. Una ecografía vaginal demostró la existencia de lesión exofítica vesical, confirmada posteriormente por cistoscopia. Se indicó resección transuretral.RESULTADOS: En el estudio histopatológico de los tejidos obtenidos se objetivó un componente glandular mixto de tipo predominantemente tubárico, con elementos endometriales y endocervicales asociados. No evidencia de recidiva endoscópica tras un año de seguimiento.CONCLUSIONES: Aportamos un nuevo caso de mullerianosis vesical. Destacamos el escaso número de casos publicados. Defendemos la opción quirúrgica endoscópica en estas pacientes(AU)

OBJECTIVES: To report a new case of bladder mullerianosis.METHOD: We present the case of a 30 year old female patient with history of miscarriage, who refers voiding dis-turbances with menstruations. Vaginal ultrasound showed an exophytic bladder lesion, which was confirmed by cistoscopy. Endoscopic resection was indicated.RESULTS: The pathological study of tissues obtained showed mixed glandular structures with predominant tubaric-like type, in association with endometrial- and endocervical-like elements. No evidence of endoscopic relapse after one year of follow-up.CONCLUSIONS: We contribute with a new case of bladder mullerianosis. We emphasize the scarcity of its pu-blished reports. We support the option of an endoscopic surgery for these patients(AU)

Revisión sobre carcinoma vesical de células pequeñas / Small cell bladder carcinoma

Small cell carcinoma comprises 0.5%-0.7% of the total amount of malignant tumors from the urinary bladder. There are three main theories regarding its histogenesis: derivation from some particular neuroendocrine cells; metaplasia which starts from other high-grade malignant neoplasms; or stem cells origin. Clinical manifestations, imaging, and cistoscopy have no specificity. Three histopatological types have been described, sometimes coexisting with another different local neoplasm (usually transitional carcinoma). The anatomicopathological diagnosis relies on immunohistochemical techniques which detect the expression of several markers. Up to 94% and 56%- 67% of the cases present at diagnosis, muscular invasion and metastases, respectively. Mean five-year survival is 8%. Prognosis has been generally linked to the present clinical stage, although there is probability of pre-diagnosis micrometastases, even with apparent confined disease. Surgery without complementary therapy has provided unsatisfactory outcomes. The most generalized option is a combination of surgery plus cysplatinbased chemotherapy. Association of radiotherapy with antineoplastic agents (without radical surgery), as an attempt for bladder preservation, also seems to offer reliability

El carcinoma de células pequeñas supone 0.5% a 0.7% del total de los tumores malignos de la vejiga urinaria. Existen tres teorías principales acerca de su histogénesis: derivación a partir de determinadas células neuroendocrinas; metaplasia surgida a partir de otras neoplasias malignas de alto grado, u origen a partir de una célula madre pluripotencial. Las manifestaciones clínicas, pruebas de imagen y cistoscopia resultan inespecíficas. Se han descrito tres tipos histopatológicos, que coexisten a veces con otra neoplasia local diferente (generalmente carcinoma transicional). El diagnóstico anatomopatológico se apoya en técnicas inmunohistoquímicas de detección de la expresión de determinados marcadores. Hasta en un 94% y 56% a 67% de los casos presenta invasión muscular y metástasis, respectivamente, en el momento del diagnóstico. La supervivencia media a cinco años es del 8%. El pronóstico se vincula clásicamente con el estadio clínico presente, aunque existe probabilidad de micrometástasis previas al diagnóstico, incluso en enfermedad aparentemente confinada. La cirugía sin tratamiento complementario ha proporcionado resultados insatisfactorios. La opción más generalizada es la combinación de cirugía y quimioterapia basada sobre todo en el cisplatino. La combinación (sin cirugía radical) de radioterapia y administración de agentes antineoplásicos en un intento de preservación vesical parece ofrecer asimismo resultados satisfactorios

[Bladder leiomyosarcoma: case report]. / Leiomiosarcoma vesical: aportacion de un nuevo caso.

OBJECTIVES: To report a new case of bladder leiomyoma in an adult. METHODS: 64-year-old female patient consulting for a four-month hematuria diagnosed of a bladder intraluminal tumor on ultrasound during a routine gynecologic revision. Cystoscopy confirmed the presence of the tumor. Transurethral resection was indicated. RESULTS: Pathology reported a definitive diagnosis of leiomyosarcoma. Anterior pelvic exenteration was subsequently performed. On one year follow-up there is no evidence of disease. CONCLUSIONS: We emphasize the rarity of these neoplasias. We comment on their main characteristics, pointing out the importance of immunohistochemical staining for the definitive histological diagnosis. We refer the therapeutic options described in the literature.

Leiomiosarcoma vesical: aportación de un nuevo caso / Bladder leiomyosarcoma: case report

OBJETIVO: Presentación de un nuevo caso de leiomiosarcoma vesical en adulto.MÉTODO: Describimos el caso de una paciente mujer de 64 años que refiere hematuria de cuatro meses de evolución,y a la que se detecta ecográficamente durante revisiónginecológica rutinaria una neoformación intraluminal vesical. La cistoscopia permitió confirmar la existencia de dicha lesión. Se indicó resección transuretral de la misma.RESULTADOS: El estudio anatomopatológico permitió un diagnóstico definitivo compatible con leiomiosarcoma. Se procedió en un segundo acto quirúrgico a la realización de exanteración pélvica anterior. No evidencia de recidiva tras un año de la cirugía.CONCLUSIONES: Destacamos la infrecuencia de este tipo de neoplasias. Comentamos las principales característicasde las mismas, señalando la importancia de las técnicas de inmunohistoquímica de cara a su diagnóstico histológico definitivo. Hacemos referencia a las posibilidadesterapéuticas descritas en la literatura

OBJECTIVES: To report a new case of bladder leiomyoma in an adult. ;;METHODS: 64-year-old female patient consulting for a four-month hematuria diagnosed of a bladder intraluminal tumor on ultrasound during a routine gynecologic revision. Cystoscopy confirmed the presence of the tumor. Transurethral resection was indicated. ;;RESULTS: Pathology reported a definitive diagnosis of ;;leiomyosarcoma. Anterior pelvic exenteration was subsequently performed. On one year follow-up there is no evidence of disease. ;;CONCLUSIONS: We emphasize the rarity of these ;;neoplasias. We comment on their main characteristics, ;;pointing out the importance of immunohistochemical ;;staining for the definitive histological diagnosis. We refer the therapeutic options described in the literature

[Giant bladder hernia associated with bilateral incipient obstructive uropathy]. / Hernia vesical inguinoescrotal gigante con uropatía obstructiva bilateral incipiente asociada.

OBJECTIVES: To report one case of giant inguinal scrotal bladder hernia associated with incipient bilateral obstructive uropathy. METHODS: We report the case of a 54-year-old male patient presenting with two-time interrupted voiding, with the need of scrotal compression to complete voiding. Physical examination showed a great left inguinal scrotal hernia with significant post void residual before compression. Serum creatinine was 1.7 mg/dl. Voiding cystourethrogram and intravenous urography confirmed the diagnosis of bladder hemia with mild hydronephrosis. Inguinal hernioplasty with bladder hernia reduction was indicated. RESULTS: Morphologically and functionally satisfactory. Clinical and analytical normalization. CONCLUSIONS: We emphasize the rarity of bilateral supravesical obstructive uropathy secondary to bladder hernia. We concur with other authors in the validity of conservative reconstructive surgery in cases such as the one reported.

[Giant retroperitoneal cystic lymphangioma in adults]. / Unfangioma quístico retroperitoneal gigante en adulto.

OBJECTIVES: To report one case of retroperitoneal cystic lymphangioma in an adult patient. METHODS: We describe the case of a 70 year-old female patient who complained of periumbilical pain and progressive increases of abdominal perimeter over a few months. Physical examination showed a great abdominal mass; CT scan confirmed its cystic nature. The indication of surgery was established. RESULTS: complete lesion excision. Pathology report showed the definitive diagnosis of cystic lymphangioma. No evidence of disease after one year. CONCLUSIONS: We emphasize that it is an unfrequent type of retroperitoneal neoplasias in the adult age. We concur with other authors in the importance of complete excision.

Hernia vesical inguinoescrotal gigante con uropatía obstructiva bilateral incipiente asociada / Giant bladder hernia associated with bilateral incipient obstructive uropathy

OBJETIVO: Presentación de un caso de herniavesical ínguinoescrotal con uropatía obstructiva bilateralincipiente asociada.MÉTODO: Describimos el caso de un paciente varón de54 años que refiere micción en dos tiempos, con necesidadde compresión escrotal para completar la misma. Laexploración física evidenció una gran hernia ínguinoescrotalizquierda, con resíduo postmiccional ecográfico significativopre-compresión de la misma. Se objetivó creatininasérica= 1,7 mg/ dL. El diagnóstico de hernia vesicalcon discreta hidronefrosis se confirmó con cistouretrografíamiccional y urografía intravenosa. Se indicó reducción herniariamás hernioplastia inguinal asociada.RESULTADOS: Morfofuncionalmente satisfactorios. Normalizaciónclínica y analítica.CONCLUSIONES: Destacamos la infrecuencia de la uropatíaobstructiva supravesical bilateral secundaria a herniavesical. Coincidimos con otros autores en la validez de lacirugía conservadora reconstructiva para casos como eldescrito

OBJECTIVES: To report one case of giant ;;inguinal scrotal bladder hernia associated with incipient ;;bilateral obstructive uropathy. ;;METHODS: We report the case of a 54-year-old male ;;patient presenting with two-time interrupted voiding, with ;;the need of scrotal compression to complete voiding. ;;Physical examination showed a great left inguinal scrotal ;;hernia with significant post void residual before compression. ;;Serum creatinine was 1.7 mg/dl. Voiding cystourethrogram ;;and intravenous urography confirmed the diagnosis ;;of bladder hernia with mild hydronephrosis. Inguinal ;;hernioplasty with bladder hernia reduction was indicated. ;;RESULTS: Morphologically and functionally satisfactory. ;;Clinical and analytical normalization. ;;CONCLUSIONS: We emphasize the rarity of bilateral ;;supravesical obstructive uropathy secondary to bladder ;;hernia. We concur with other authors in the validity of conservative ;;reconstructive surgery in cases such as the one ;;reported

Linfangioma quístico retroperitoneal gigante en adulto / Giant retroperitoneal cystic lymphangioma in adults

OBJETIVO: Presentación de un caso de linfangiomaquístico retroperitoneal en adulto.METODO: Describimos el caso de una paciente mujer de70 años que refiere en los últimos meses dolor periumbilicaly sensación de aumento progresivo del perímetroabdominal. La exploración física evidenció una gran masaabdominal, confirmándose su carácter quístico en la tomografíaaxial computerizada. Se indicó cirugía.RESULTADOS: Extirpación completa de la lesión. El estudioanatomopatológico permitió un diagnóstico definitivocompatible con linfangioma quístico. No evidencia derecidiva tras un año de la intervención.CONCLUSIONES: Destacamos la infrecuencia de estetipo de neoplasias retroperitoneales en la edad adulta.Coincidimos con otros autores en la importancia de la exéresiscompleta en este tipo de entidades

OBJECTIVES: To report one case of ;;retroperitoneal cystic lymphangioma in an adult patient. ;;METHODS: We describe the case of a 70-year-old female ;;patient who complained of periumbilical pain and ;;progressive increases of abdominal perimeter over a few ;;months. Physical examination showed a great abdominal ;;mass; CT scan confirmed its cystic nature. The indication ;;of surgery was established. ;;RESULTS: complete lesion excision. Pathology report ;;showed the definitive diagnosis of cystic lymphangioma. ;;No evidence of disease after one year. ;;CONCLUSIONS: We emphasize that it is an unfrequent ;;type of retroperitoneal neoplasias in the adult age. We ;;concur with other authors in the importance of complete ;;excision