Coluria y pigmenturia / Choluria and pigmenturia

Orina oscura no siempre significa hematuria. Diversas situaciones clínicas y pigmentos orgánicos e inorgánicos pueden modificar el color amarillento pajizo de la orina normal. Conviene diferenciar a simple vista las diversas tonalidades cromáticas de la orina para no confundir las distintas situaciones clínicas que la provocan. La tirilla reactiva es la prueba inicial más eficaz para discriminar la hematuria de la hemoglobinuria/mioglobinuria, la bilirrubinuria y la coluria. En este trabajo se repasan las principales causas de orina oscura, coluria y pigmenturia (AU)

Dark urine does not always mean hematuria. Various clinical and organic and inorganic pigments can dye urine modifying the straw yellow color of normal urine. Should distinguish at a glance the various chromatic tones of urine in order not to confuse the different clinical situations that cause it. The dipstick test is the most effective initial test to discriminate hematuria and hemoglobinuria/myoglobinuria. This paper reviews the main causes of dark urine, choluria and pigmenturia (AU)

Predictive factors for successful laparoscopic splenectomy in immune thrombocytopenic purpura: study of clinical and laboratory data.

BACKGROUND: Laparoscopic splenectomy (LS) offers better short-term results than open surgery for the treatment of immune thrombocytopenic purpura (ITP), but long-term follow-up is required to ensure its efficacy. The remission rate after splenectomy ranges from 49 to 86% and the factors that predict a successful response to surgical management have not been clearly defined. The goal of this study was to determine the preoperative factors that predict a successful outcome following LS. METHODS: From February 1993 to December 2003, LS was consecutively performed in a series of 119 nonselected patients diagnosed with ITP (34 men and 85 women; mean age, 41 years), and clinical results were prospectively recorded. Postoperative follow-up was based on clinical records, follow-up data provided by the referring hematologist, and a phone interview with the patient and/or relative. Univariate and multivariate analyses were performed for clinical preoperative variables to identify predictive factors of success following LS. RESULTS: Over a mean period of 33 months, 103 patients (84%) were available for follow-up with a remission rate of 89% (92 patients, 77 with complete remission with platelet count > 150,000). Eleven patients did not respond to surgery (platelet count < 50,000). Mortality during follow-up was 2.5% (two cases not related to hematological pathology and one case without response to splenectomy). Preoperative clinical variables evaluated to identify predictive factors of response to surgery were sex, age, treatment (corticoids alone or associated with Ig or chemotherapy), other immune pathology, duration of disease, and preoperative platelet count. In a subgroup of 52 patients, we also evaluated the type of autoantibodies and corticoid doses required to maintain a platelet count > 50,000. Multivariate analysis showed that none of the variables evaluated could be considered as predictive factors of response to LS due to the high standard error. CONCLUSION: Long-term clinical results show that LS is a safe and effective therapy for ITP. However, a higher number of nonresponders is needed to determine which variables predict response to LS for ITP.

Síndormes de prostatitis y dolor pelviano crónico: revisión / Prostatic syndrome and chronic pelvic pain. A review

La prostatitis es un síndrome que se presenta con inflamación y/o infección de la próstata, disuria, síntomas obstructivos, dolor perineal, polaquiuria y eyaculodinia. Existen formas bacterianas y abacterianas. ES difícil diagnosticarla si no se trata de la forma bacteriana aguda., y resulta complicado diferenciar entre la prostatitis crónica bacteriana, la abacteriana y la prostatodinia, ya que sus síntomas pueden ser similares. Con esta revisión, pretendemos aclarar cuál es la clínica de cada una de estas formas, así como su diagnóstico y tratamiento

Prostatitis is a syndrome that presents with symptoms consistent with inflammation and/or infection of the prostate gland, including terminal dysuria, dysfunctional voiding, perineal pain, increased frequency of urination and pain ejaculation. There is bacterial and nonbacterial prostatitis. It is difficult to diagnose prostatitis unless it is the acute bacterial variety and it is difficult to differentiate among chronic bacterial prostatitis, nonbacterial prostatitis and prostatodynia, because symptoms and physical findings may be similar

Falso fungus ball simulando litiasis vesical / False fungus ball mimiking a vesical stone

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Carcinoma de uraco: revisión de la literatura. A propósito de un caso / Uracal carcinoma: review of the literature. A clinical case

El carcinoma de uraco es una patología vesical excepcional Su expresión morfológica más frecuente es el adenocarcinoma mucosecretor. Su localización exclusiva es la cúpula vesical y la línea media de cara anterior y posterior, pudiéndose extender hacia el espacio de Retzius. La clasificación de la extensión es la de Sheldon, ya que no existe una clasificación de la UlCC

Urachal carcinoma is an exceptional bladder patbology. lts most frequent morpbologic expression is mucous-secreting adenocarcinoma. It is located exclusively in the bladder dome and in tbe midline oftbe tbe anterior and posterior faces oftbe bladder; it may also extend forward to tbe Retzius space. As tbere is no UICC classification, tbe classification of tbe extension is Sheldon's