[Ambulatory blood pressure monitoring, adult and pediatric population. A narrative review]. / Monitorización ambulatoria de la presión arterial en adultos y población pediátrica. Una revisión narrativa.

Hypertension has become a central risk factor for the development of cardiovascular disease, underscoring the importance of its accurate diagnosis. Numerous studies have established a close relationship between elevated systolic (SBP) and diastolic (DBP) blood pressure and an increased risk of cardiovascular event (CVE). Traditionally, blood pressure (BP) measurements performed in clinical settings have been the main method for diagnosing and assessing hypertension. However, in recent years, it has been recognized that BP measurements obtained outside the clinical setting, using self-monitoring blood pressure (SMBP) and ambulatory blood pressure monitoring (ABPM), offer a more realistic perspective of patients' daily lives and therefore provide more reliable results. Given the evolution of medical devices, diagnostic criteria, and the increasing relevance of certain components of ABPM in the prediction of adverse cardiovascular outcomes, a comprehensive update that is practical for daily clinical practice is required. The main objective of this article is to provide an updated review of ABPM, focusing on its importance in the evaluation of hypertension and its impact on public health in Colombia. In addition, it will discuss the implications of changes in diagnostic thresholds and provide concrete recommendations for the effective implementation of ABPM in clinical practice, allowing health professionals to make informed decisions and improve the care of their patients.

[Iliotibial band friction syndrome due to bioabsorbable pins in ACL reconstruction]. / Síndrome de fricción de la cintilla iliotibial posterior a reconstrucción del ligamento cruzado anterior con pines transversos bioabsorbibles.

Injuries of the anterior cruciate ligament are currently treated primarily with the use of hamstring graft with a wide range of different techniques and fixation systems for anterior cruciate ligament in reducing patient morbidity. We report the case of a female patient aged 42 that suffered an anterior cruciate ligament rupture and was treated with anterior cruciate ligament reconstruction with hamstring autograft with femoral fixation with bio-absorbable cross-pin and tibial fixation with bio-absorbable screw. The patient presented lateral knee pain that was diagnosed one year after the operation as an iliotibial band friction syndrome. Imaging studies were performed. X-rays and magnetic resonance imaging demonstrated adequate fixation of the anterior cruciate ligament with the presence of migration and rupture of the proximal bio-absorbable cross-pin. It was decided to remove the bio-absorbable cross-pin fragment in a second surgical procedure after which the patient went back to her daily activities and sports without pain and with stability stable knee.

Las lesiones del ligamento cruzado anterior (LCA) hoy en día son tratadas principalmente con injerto de isquiotibiales y una amplia gama de técnicas y sistemas de fijación del LCA en busca de una menor morbilidad del paciente. Se reporta un caso de una paciente de 42 años que sufrió ruptura de LCA, tratada con reconstrucción de LCA con injerto autólogo de isquiotibiales, fijación femoral con pines transversos bioabsorbibles y fijación tibial con tornillo bioabsorbible. La paciente evolucionó con presencia de dolor en región lateral de rodilla, diagnosticado como síndrome de fricción de la banda iliotibial un año posterior a la cirugía. Se realizaron estudios de imagen que incluyeron rayos X y resonancia magnética (RM) donde se observó adecuada fijación del LCA con presencia de migración y ruptura del pin proximal bioabsorbible. Se decidió extraer el fragmento del pin bioabsrobile en un segundo tiempo quirúrgico y la paciente regresó a sus actividades cotidianas y deportivas sin dolor y con una adecuada estabilidad.

Gangrena de Fournier. Caso clínico y revisión de literatura / No disponible

La gangrena de Fournier es una condición grave que se presenta mayormente en varones a raíz de lesiones infecciosas perineales y en pacientes con factores de riesgo predisponentes. Los gérmenes implicados son bacilos gram negativos, cocos gram positivos y anaerobios, comensales de la zona perineal. El diagnóstico es clínico, encontrando desde lesiones eritematosas hasta necrosis junto con crepitación, y se confirma con pruebas de imagen, principalmente TC que es la prueba de referencia y nos muestra la extensión de la lesión. El pronóstico de supervivencia se calcula con el índice de severidad de la gangrena de Fournier que incluye parámetros analíticos y funcionales. El manejo consiste en tratamiento médico con antibióticos y desbridamiento quirúrgico urgente de las lesiones necróticas. Luego de la fase aguda se puede realizar cirugía reconstructiva de las zonas desbridadas con posterior rehabilitación para recuperación de la función. Entre otras opciones terapéuticas encontramos el cierre asistido por vacío, la aplicación de miel y la oxigenoterapia hiperbárica (AU)

Fournier's gangrene is a serious condition that occurs mostly in males following perineal infectious lesions and in patients with predisposing risk factors. Germs involved are gramnegative bacilli, positive cocci and anaerobes, located on perineum. The diagnosis is clinical, from erythematous lesions to necrosis with crepitus. Diagnosis is confirmed mainly with CT and shows the extent of the injury. The prognosis for survival is calculated using the Severity Index Fournier's gangrene which includes analytical and functional parameters. Management is medical treatment with antibiotics that requires emergency surgical debridement of necrotic lesions. After the acute phase can be performed reconstructive surgery of debrided areas with subsequent rehabilitation for functional recovery. Other therapeutic options are the vacuum-assisted closure, application of honey and hyperbaric oxygen therapy (AU)

Nuevo enfoque de la uretroplastia en estenosis corta de uretra bulbar / New approach to urethroplasty in bulbar urethral stricture

La uretroplastia termino-terminal es el tratamiento habitual en las estenosis cortas de la uretra bulbar. Esta técnica lleva implícita, en la mayoría de casos, la sección de las arterias bulbares que dan suministro de sangre al cuerpo esponjoso y uretra bulbomembranosa. La técnica de uretroplastia dorsal bulbar sin resección del pedículo bulbocavernoso con cierre romboidal, utilizando el concepto de Heineke-Mikulicz, fue descrita por Andrich y Mundy en 2003 . Sus resultados son similares a la uretroplastia término-terminal con menos trauma quirúrgico. Se presenta un caso clínico y datos de nuestra experiencia inicial con esta nueva técnica de uretroplastia para el tratamiento de la estenosis bulbar corta de la uretra bulbar (AU)

The end-to-end urethroplasty is the usual treatment for short strictures of the bulbar urethra. This technique implies, in most cases, the section of the bulbar arteries that feed blood to the spongy body and bulbomembranous urethra. The technique of dorsal bulbar urethroplasty without resection of the pedicle with rhomboid closing using the Heineke-Mikulicz concept was described by Andrich and Mundy in 2003. Their results are similar to the end to end urethroplasty with the advantage of less surgical trauma. A clinical case and data of our initial experience with this new technique of urethroplasty for the treatment of short bulbar strictures of the bulbar urethra is presented (AU)

Celdopatía prostática incrustante: a propósito de un caso / Encrusted prostatitis: a report of a case

Presentamos un caso clínico de celda prostática incrustada de litiasis, a la que denominamos celdopatía incrustante, raramente reportada en la literatura, que comparte características fisiopatológicas con la cistitis alcalina incrustante, descrita desde inicios del siglo XX. Ambas presentan síntomas urinarios irritativos, hematuria, orina alcalina y necrosis tisular por debajo de una capa de calcificación, asociada a bacteria ureolítica, en su mayor parte. El tratamiento de la celditis, cistitis, y pielitis incrustante incluye antibióticos específicos, acidificación urinaria y escisión endoscópica de las lesiones calcificadas (AU)

We report a case of an encrusted prostatic celdopathy fouling or encrusted prostatitis, rarely reported, that accordingly to literature reviwed, seems to share physiopathological features with alkaline encrusted cystitis, described from the early twentieth century. Both cause irritative urinary symptoms, haematuria, alkaline urine and tissue necrosis below a layer of calcification, this associated to ureolytic bacteria, mostly. The treatment of encrusted prostatitis, cystitis, and pyelitis includes specific antibiotics, urinary acidification and endoscopic excision of the calcified lesions (AU)

Fistula uretrorectal post prostatectomia radical: reparación vía perineal con interposición del músculo gracilis. Caso clinico / Post radical prostatectomy fistula: perineal repair with gracilis muscle interposition. Clinical case

Existen diversas técnicas quirúrgicas para la solución de las fístulas uretrorectales debidasa cirugía prostática. La plastia con interposición de músculo gracilis vía perineal es una técnica eficaz. Se presenta un caso clínico de fístula uretrorectal post prostatectomía radical y su resolución por vía perineal con músculo gracilis (AU)

There are several surgical techniques for the solution of uretrorectales fistulas due to prostate surgery. Plasty with gracilis muscle interposition perineal approach is an effective technique. We report a case of fistula uretrorectal post radical prostatectomy and perineal resolution with gracilis muscle (AU)

Quiluria. Presentación de un caso y revisión de la literatura / Chyluria. Case report and literature review

La quiluria, se deriva del paso anómalo de linfa al sistema urinario por fistulización. Su principal causa es la filariasis, una infección parasitaria causada en el 90% por el nemátodo Wuchereria bancrofti, aunque paralelamente existen diversas etiologías como enfermedades granulomatosas, infecciones, tumores o yatrogenia postquirúrgica. Su diagnóstico es clínico al observar la orina densa de color blanco y su confirmación se realiza al encontrar triglicéridos, quilomicrones y proteínas elevadas en orina. El tratamiento se realiza de manera individualizada y varía desde un manejo conservador con medidas higiénico dietéticas, esclerosis de las fístulas con instilaciones piélicas de povidona yodada, N-butil 2- cianoacrilato o nitrato de plata hasta procedimientos quirúrgicos de diversa índole. Se presenta el caso deuna paciente mujer de 60 años que inicia quiluria tras someterse a una cirugía pélvica (AU)

Chyluria, is the clinical manifestation of a fistulous process between the lymphatic and urinary systems. It is often due to parasitic infections, principally filarial roundworms of the genera Wuchereria bancrofti. Although other causes such as granulomatous diseases, urinary tract infections, tumors or iatrogenic can be present. Diagnosis is made by clinical evidence of chyluria and detection of elevated triglyceride and proteins levels in urine samples. Treatment options are individualized and can vary from medical management, sclerotherapy with povidone iodine, silver nitrate or N-butyl-2-cyanoacrylate, to surgical approaches. We present a case of a 60 years old women ho presented chyluria after pelvic surgery (AU)

Hidatidosis renal tratada con nefrectomía abierta: a propósito de un caso / Renal hydatidosis treated with open nephrectomy: report of a case

INTRODUCCIÓN: La hidatidosis o equinococosis es una enfermedad parasitaria que afecta al riñón de forma excepcional. El diagnóstico se basa en pruebas serológicas y radiológicas como la TAC. Conviene realizar un buen diagnóstico diferencial y distinguir otras tumoraciones quísticas renales. MATERIAL Y MÉTODOS: A partir de un caso clínico, se revisa la sistemática diagnóstica y las opciones de tratamiento de la hidatidosis renal. RESULTADOS: La TAC es la prueba de imagen más eficaz. La serología no es demasiado útil. La nefrectomía total extraperitoneal es el tratamiento de elección. Debe ser precedida de tratamiento escolicida. Otras opciones son la cirugía parcial y la punción percutánea. CONCLUSIONES: La hidatidosis renal es una rara enfermedad que precisa diagnóstico preciso (TAC). Cuando es sintomática el tratamiento es la nefrectomía. La laparoscopia, retroperitoneoscopia o la punción percutánea se han practicado en casos aislados (AU)

INTRODUCTION: Hydatid disease or echinococcosis is a parasitic disease that affects the kidney by way of exception. The diagnosis is based on serology and radiological tests such as CT. It should make a good differential diagnosis and distinguish other renal cystic tumors. MATERIAL AND METHODS: From a case report, we review the diagnosis and treatment options for renal hydatidosis. RESULTS CT is the imaging more efficient. Serology is not very useful. Concerning the treatment, extraperitoneal nephrectomy is the gold standard. Other options include partial surgery and percutaneous puncture. Medical treatment with Scolicides is applied before and after surgery. CONCLUSIONS: Renal hydatid disease is a rare condition that requires accurate diagnosis (TAC). When it is symptomatic nephrectomy is required. Laparoscopy, retroperitoneoscopy and percutaneous punction have been practiced in isolated cases (AU)

Hiperplasia benigna de próstata: valoración inicial y tratamiento médico. Revisión a partir de guías clínicas internacionales y ensayos clínicos multicéntricos / Benign prostatic hyperplasia: initial assessment and treatment. Review from international clinical guidelines and multicenter clinical trials

INTRODUCCIÓN: La hiperplasia benigna de próstata (HBP) es una enfermedad prevalente en varones adultos de más de 45-50 años, aunque no siempre presenta manifestaciones clínicas. La aparición de síntomas del tracto urinario inferior (STUI) puede estar relacionada con la HBP en muchos casos. MATERIAL Y MÉTODOS: Se realiza una revisión de artículos relevantes sobre abordaje diagnóstico y terapia médica en HBP, así como ensayos clínicos publicados en los últimos años: MTOPS y PLESS y combAT. RESULTADOS: Para establecer la relación entre STUI y HBP es necesario realizar un buen interrogatorio al paciente (IPSS) y realizar una serie de exploraciones complementarias como análisis de sangre, con PSA, análisis de orina, ecografía y flujometría miccional. Una vez establecido el diagnóstico existen diversas opciones de tratamiento médico en función del IPSS, volumen protático y valor de PSA, avalados por diversos ensayos clínicos (AU)

INTRODUCTION: Benign prostatic hyperplasia (BPH) is a prevalent disease in male adults aged 45-50 years, although not always clinical manifestations are present. The occurrence of lower urinary tract symptoms (LUTS) can be related to BPH in many cases. MATERIAL AND METHODS: A review of relevant articles on medical diagnostic and therapeutic approach in BPH, and clinical trials published in recent years: (MTOPS, PLESS and combAT) was performed. RESULTS: To establish the relationship between LUTS and BPH is necessary to make a good anamnesis of the patient (IPSS) and additional tests such as blood tests with PSA, urianalysis, ultrasound and urinary flow measurement. Once the diagnosis there are several medical treatment options in terms of IPSS, prostate volume and PSA value, backed by several clinical trials (AU)

Uretroplastia con injerto de mucosa bucal a nivel dorsal bulbar tipo Barbagli / Urethroplasty with buccal mucosa graft at dorsal bulbar level type Barbagli

La estenosis de uretra sigue siendo un tema controvertido y no existe consenso universal en cuanto a su tratamiento. Las técnicas de uretroplastia con parche de material autólogo prometen ser una alternativa efectiva en las estenosis bulbares mayores a 3 y 4 cms, con una tasa de éxito que alcanza los 85-90% con tasas de restenosis de menos de 10%, pero aún quedan por valorar los resultados a largo plazo. Se presenta el caso de un paciente con estenosis de uretra bulbar de 34 cms. De etiología traumática, intervenido de uretroplastia con parche de mucosa bucal según técnica de Barbagli (AU)

Urethral strictures remains a controversial subject with no universal consensus regarding its treatment. Urethroplasty techniques with autologous material seem to represent an effective choice in bulbar strictures over 3-4 cms, with a 85-90% rate of success and less than 10% restemosis rates but still long term follow up is needed. We present the case of a patient with a 3 cms. Bulbar stricture of traumatic etiology in wich a buccal mucosa graft urethoplasty was performed according to the Barbagli procedure (AU)

Fournier's gangrene: a monographic urology center experience with twenty patients.

BACKGROUND: Fournier's gangrene (FG) is a fatal synergistic infectious disease with necrotizing fasciitis of the perineum and abdominal wall along with the scrotum and penis in males and the vulva in females. The aim of this study was to share our experience in the management of this infectious disease. METHODS: A retrospective chart review was performed in 20 patients with a diagnosis of FG between January 1991 and December 2007. Patient's age, source and predisposing factors, microbiological findings, duration of hospital stay, treatment modalities, and outcome were analyzed. RESULTS: The mean age of the patients was 53.9 +/- 9.56 (range 23-71) years. The source of gangrene was urinary in 5 patients, perirectal in 5, cutaneous in 1, and unknown in 9 patients. The main predisposing factors included diabetes mellitus in 9 patients (45%) and immunosuppression in 5 patients (25%). The mean duration of hospital stay was 39 +/- 10 (range 6-62) days. Although early intervention and intensive treatment were carried out, 4 patients died with an overall mortality of 20% as a result of septicemia complications. The mortality rate was higher in elderly patients and those with diabetes mellitus, but it was not statistically significant. Regarding the mortality rate, duration of symptoms, number of debridements, culture results and source of infection were not found to be significant factors. CONCLUSIONS: FG is still a severe disease. Management of this infectious entity must be aggressive. Despite the use of contemporary effective antibiotic treatment, aggressive debridements, and state-of-the-art intensive-care conditions, FG still has high mortality and morbidity rates.

[Cartilage repair: cell-based techniques]. / Reparación del cartílago articular: técnicas basadas en cultivos celulares.

INTRODUCTION: The field of cartilage repair continues to advance after cell based and single-stage chondrocyte transplantation technologies. These strategies have been widely used in developed countries, and clinical, histologic and functional outcomes are of special interest. OBJECTIVE: To describe evidence of cartilage repair techniques by means of a literature review. RESULTS AND DISCUSSION: Cartilage restoration through osteochondral allografting or autologous chondrocyte implantation (ACI) had proven efficacy, but technical and biologic limitations to these procedures exist. However, newer second-generation and third-generation cell-based technologies are being developed and tested clinically with purposes of decreasing operative morbidity, the ability to use a single-stage approach, and improve the viability and durability of cartilage repair tissue. These techniques can be used for treatment of important chondral defects in young patients and elite athletes, but well-designed randomized clinical trials should be done to confirm the value of these procedures.

[Results of arthroscopic debridement and lavage in patients with knee osteoarthritis]. / Resultados obtenidos con la limpieza articular artroscópica de rodilla en pacientes con osteoartritis.

INTRODUCTION: Knee osteoarthritis (OA) is a degenerative process that affects people over 50 years old and is an important cause of disability. Treatment options include non-operative and operative modalities. Arthroscopic lavage and debridement may be the first choice to consider in patients between 45 and 65 years with early OA. MATERIAL AND METHODS: We conducted a self-controlled clinical trial with deliberate maneuver assignment. Thirty nine patients between 38 and 68 year of age with clinical and radiographic knee OA were included. Patients underwent arthroscopic lavage and debridement between January of 2001 and December 2003. Preoperative and postoperative evaluation was performed using the HSS knee score as well as questions that evaluated patient satisfaction and subjective function. Statistical analysis using one tailed Student's t-test was performed. Significance was considered with ap value of < 0.0001. RESULTS: Thirty-three patients completed the evaluation. Six patients were lost to follow-up. Mean age of patients was 53 (38 to 68). Mean preoperative HSS score was 54.9 and average postoperative score was 74.8. Thirty-one out of 33 patients (93%) were satisfied and reported good subjective function after the operation. Twenty five of these patients presented Outerbridge grade II-III cartilage defects and 6 patients presented grade IV lesions. Twenty nine of the 33 patients (87.8%) referred improvement to perform their daily-living activities and 4 patients did not improve. Thirty two out of 33 patients would recommend the operation. DISCUSSION: Arthroscopic debridement and lavage improves function and satisfaction in patients with grade II and III of OA. Patients with severe chondral lesions (grade IV) also improved to a lesser extent. Thus, arthroscopic debridement and lavage is a good treatment alternative in young patients with early OA.

Nefroureterectomía en pacientes con sustitución ureteral / Nephrourecterectomy in a patient with ureteral substitution

Presentamos el caso clínico de una paciente de 26 años de edad con antecedentes de sustitución ureteral izquierda con íleon, por traumatismo abdominal en la infancia que requirió cirugía urgente y posterior cirugía antirreflujo; que consulta a nuestro centro por infecciones del tracto urinario de repetición. Se incluye una revisión de la literatura de la sustitución ureteral con íleon (AU)

We report a clinical case of a 26 years old patient with a left ureteral replacement with ileum in the chidhood due to an abdominal trauma –requiring an urgent surgery- and an anti-reflux surgery; who consults to our center complaining of recurrent urinary tract infections. A literature review of ureteral replacement with ileum is done (AU)

Development and validation of a computer program to design and calculate ROPS.

In Spain, there are more than 250,000 tractors built before 1980, when it became mandatory for all new tractors to be equipped with a rollover protective structure (ROPS). A similar situation is found in the European Union, but the situation is worse in the U.S. and in developing countries. Directive 2003/37/EEC establishes that tractors over 800 kg weight can be homologated by using the OECD standard code for the official testing of protective structures on agricultural and forestry tractors (static test), called Code 4. A ROPS attachable to the rear axle of different tractor models has been designed, and a computer program for the calculation of the ROPS design has been developed. The program, named ESTREMA, is available at: www.cfnavarra.es/insl. Using this program, it has been possible to design a ROPS for the Massey Ferguson model 178 tractor, one of the most common tractor models without a ROPS in Spain. After the tractor was equipped with the designed ROPS, it was tested at the Spanish Authorized Station for testing ROPS and passed the homologation test (OECD Code 4), the main results being a maximum distortion of 21.3 cm when the absorbed energy was 5437 N and the maximum force applied was 34 kN during loading from the side. The ROPS was improved, redesigned, and remounted on the tractor, the tractor was tested in a real overturn, and no part of the structure intruded on the driver's clearance zone during the test. In conclusion, the ESTREMA program worked correctly, and the designed ROPS was able to pass the authorized test and provide adequate protection to the operator during a real overturn.

Salmonella contamination during production of cantaloupe: a binational study.

Six cantaloupe farms and packing plants in South Texas (950 cantaloupe, 140 water, and 45 environmental samples), including the Rio Grande Valley area, and three farms in Colima State, Mexico (300 cantaloupe, 45 water, and 15 environmental samples), were sampled to evaluate cantaloupe contamination with Salmonella and Escherichia coli during production and processing. Samples collected from external surfaces of cantaloupes, water, and the environments of packing sheds on cantaloupe farms were examined for the presence of Salmonella and E. coli. Of a total of 1,735 samples collected, 31 (1.8%) tested positive for Salmonella. Fifteen Salmonella serotypes were isolated from samples collected in Texas, and nine from samples collected in Colima. Two serotypes (Poona and Oranienburg) that have been associated with three large Salmonella outbreaks in the United States and Canada linked to the consumption of contaminated cantaloupe were found in water samples collected at four farms (three from the United States). Susceptibility of Salmonella isolates to 10 antimicrobials was evaluated by disk diffusion. Eighty-eight percent of the isolates from the United States and Mexico were pansusceptible to the antimicrobials tested; eight isolates from the United States demonstrated an intermediate susceptibility to streptomycin and only two isolates were resistant to the same antimicrobial. From Mexico, four isolates showed an intermediate susceptibility to streptomycin and one isolate was resistant to nalidixic acid and streptomycin. Repetitive sequence-based PCR analysis of Salmonella isolates helped to trace potential sources of Salmonella contamination in source water and in subsequent water samples obtained after the filtration systems of U.S. and Mexican cantaloupe farms. No differences could be seen between the levels of Salmonella contamination in melons from both countries.

[Living donor nephrectomy for kidney transplantation. Experience in the first two years]. / Nefrectomía laparoscópica de donante vivo para trasplante renal. Los dos primeros años de experiencia.

OBJECTIVES: Laparoscopic surgery offers potential advantages in terms of diminishment of postoperative pain, shorter hospital stay, faster convalescence, and better cosmetic results. These advantages may increase kidney donation, making donation be accepted by more candidates. We report our first 2 years' experience with laparoscopic donor nephrectomy METHODS: Between March 2002 and February 2004 we performed 38 laparoscopic living donor nephrectomies for kidney transplantation. The technique of choice was the transperitoneal laparoscopic approach with four trocars, usually three of them from the start of the procedure--two 10-12 mm and one 5 mm--, and a 6.5 cm perumbilical midline incision for kidney retrieval at the end of the procedure. RESULTS: Receptor and donor survivals were 100%. Graft survival was 97.6%. There was not any case of delayed graft function. Donor: Mean operative time was 161 minutes (115-260). Mean estimated blood loss was 270 ml (100-1200). Three patients required blood transfusions, 2 units of packed red blood cells each. Mean hospital stay was 5.1 days (3-11). Mean warm ischemia time was 3.2 min. (2-10). Conversion to open surgery was necessary in four cases. Receptor: there have been three significant complications requiring surgical repair: one case of low arterial flow, one vesico ureteral leak, and one midurethra stenosis. Initial renal function: mean serum creatinine at one month was 147mmol/l, with a trend to improve to 126 mmol/l at one year, which is considered optimum. First postoperative day mean serum creatinine was 192mmol/l and the nadir was on second postoperative day with a value of 152mmol/l. CONCLUSIONS: We believe laparoscopic living donor nephrectomy is a real alternative to open surgery because it offers better recovery to the donor with the same capacity to preserve renal function in the receptor.

Endometriosis ureteral / Ureteral endometriosis

La endometriosis ureteral es una patología poco frecuente (1 por ciento de la endometriosis). Su forma de presentación es a menudo silente, de manera que el diagnóstico puede resultar complicado: Las técnicas de imagen y la laparoscopia exploradora pueden resultar de utilidad para el diagnóstico. El tratamiento está basado en terapia hormonal y en la resolución de la obstrucción ureteral (AU)

Fibrosis retroperitoneal. Presentación de un caso clínico / Retroperitoneal fibrosis. A clinical case

Se presenta el caso clínico de un paciente con ureterohidronefrosis izquierda secundaria a fibrosis retroperitoneal, manejado inicialmente con sonda de nefrostomia que posteriormente se cambió por catéter doble J. El tratamiento médico fue con corticoides, que se disminuyeron progresivamente hasta ser suspendidos. A los 10 meses de tratamiento, se comprobó mediante tomografía axial computadorizada (TAC) la resolución de la placa fibrosa retroper itoneal. Ante estos hallazgos, ; el catéter doble J fue retirado endoscópicamente.Se discuten las :causas, el diagnóstico por imagen y los distintos tratamientos médicos y quirúrgicos de esta enfermedad poco frecuente y de etiología incierta (AU)

Endoscopic approach of the overinfected urachal cyst.

The overinfected urachus cyst presents itself in quite different forms. In spite of the accuracy of ultrasound and abdominal CT scan, sometimes the diagnosis of this urachal abnormality is imprecise and even misleading. This article describes the transvesical endoscopic drainage of an infected urachal cyst with optimum result upon the treatment of this condition.