B cells from Patients with Rheumatoid Arthritis Show Conserved CD39-Mediated Regulatory Function and increased CD39 Expression After Positive Response to Therapy.

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by progressive joint destruction associated with increased pro-inflammatory mediators. In inflammatory microenvironments, exogenous ATP (eATP) is hydrolyzed to adenosine, which exerts immunosuppressive effects, by the consecutive action of the ectonucleotidases CD39 and CD73. Mature B cells constitutively express both ectonucleotidases, converting these cells to potential suppressors. Here, we assessed CD39 and CD73 expression on B cells from treated or untreated patients with RA. Neither the frequency of CD73+CD39+ and CD73-CD39+ B cell subsets nor the levels of CD73 and CD39 expression on B cells from untreated or treated RA patients showed significant changes in comparison to healthy controls (HC). CpG+IL-2-stimulated B cells from HC or untreated RA patients increased their CD39 expression, and suppressed CD4+ and CD8+ T cell proliferation and intracellular TNF-production. A CD39 inhibitor significantly restored proliferation and TNF-producing capacity in CD4+ T cells, but not in CD8+ T cells, from HC and untreated RA patients, indicating that B cells from untreated RA patients conserved CD39-mediated regulatory function. Good responder patients to therapy (R-RA) exhibited an increased CD39 but not CD73 expression on B cells after treatment, while most of the non-responder (NR) patients showed a reduction in ectoenzyme expression. The positive changes of CD39 expression on B cells exhibited a negative correlation with disease activity and rheumatoid factor levels. Our results suggest modulating the ectoenzymes/ADO pathway as a potential therapy target for improving the course of RA.

Alfonso de la Peña Pineda y el Intercambio urológico por correspondencia / Alfonso de la Peña Pineda and the Urology exchange by correspondence

Introducción: Los hermanos Alfonso y Emilio de la Peña Pineda propusieron en 1943 crear un sistema de comunicación por correspondencia como en Norteamérica, idea bien aceptada por los urólogos españoles, y que llevó por título Intercambio urológico por correspondencia. Material y métodos: Lectura minuciosa y análisis pormenorizado del contenido de 1944 a 1953, con un promedio de 3 páginas tamaño folio de cada ejemplar. Resultado: Se enviaron 105 números que contienen 234 comunicaciones urológicas, firmadas por 67 urólogos españoles, 2 portugueses y un cirujano general, 39 son traducciones de la publicación similar norteamericana. La temática corresponde a casos personales curiosos o raros, sobre situaciones o problemas de la enfermedad urológica más habitual en la época, de los que únicamente destacan una veintena de artículos. En general el contenido es de poca utilidad e interés, motivo por el que decreció paulatinamente la colasiiboración hasta desaparecer. Conclusión: La propuesta fue respondida mayoritariamente por quienes mantenían relación con la cátedra de Urología de la Facultad de Medicina de Madrid, dirigida por Alfonso de la Peña. La temática cifrada en casos clínicos personales, faltos de interés en su mayoría, llevó a disminuir paulatinamente la aportación de comunicaciones hasta su cese. Sobresalen únicamente unos pocos artículos. El mayor valor del trabajo lo constituye recoger y analizar el contenido de la que sea muy probablemente la única colección completa existente, ya que al no ser editada por imprenta y ser su distribución solo como correspondencia no se ha encontrado en las bibliotecas públicas

Introduction: In 1943, the brothers Alfonso and Emilio de la Peña Pineda proposed creating a communication system by correspondence as in North America, an idea welcomed by Spanish urologists, a system that was named the Urology Exchange by Correspondence. Material and methods: A thorough reading and detailed analysis was conducted of content from 1944 to 1953, with an average of 3 pages of folio size of each copy. Result: A total of 105 issues containing 234 urological presentations were sent, signed by 67 Spanish urologists, 2 Portuguese urologists and 1 general surgeon. Thirty-nine of these presentations were translations of a similar U.S. publication. The subject matter corresponded to curious or rare personal cases, concerning conditions or problems of the most common urological diseases in that era, of which only 20 of those articles stand out. In general, the content is of little use and interest, which prompted the gradual decline in the collaboration until it disappeared. Conclusion: The proposal was answered mostly by those who had a professional relationship with the chair of Urology of the Faculty of Medicine of Madrid directed by Alfonso de la Peña. The subject matter of the personal case studies, most of which lacked importance, lead to the gradual decline in the contribution of presentations until its eventual end. Only a few articles stand out. The study's major value consists of collecting and analysing the content of what is highly likely the only complete collection in existence, given that it was not edited for printing and was distributed only as correspondence and cannot therefore be found in public libraries

Alfonso de la Peña Pineda and the Urology exchange by correspondence. / Alfonso de la Peña Pineda y el Intercambio urológico por correspondencia.

INTRODUCTION: In 1943, the brothers Alfonso and Emilio de la Peña Pineda proposed creating a communication system by correspondence as in North America, an idea welcomed by Spanish urologists, a system that was named the Urology Exchange by Correspondence. MATERIAL AND METHODS: A thorough reading and detailed analysis was conducted of content from 1944 to 1953, with an average of 3 pages of folio size of each copy. RESULT: A total of 105 issues containing 234 urological presentations were sent, signed by 67 Spanish urologists, 2 Portuguese urologists and 1 general surgeon. Thirty-nine of these presentations were translations of a similar U.S. publication. The subject matter corresponded to curious or rare personal cases, concerning conditions or problems of the most common urological diseases in that era, of which only 20 of those articles stand out. In general, the content is of little use and interest, which prompted the gradual decline in the collaboration until it disappeared. CONCLUSION: The proposal was answered mostly by those who had a professional relationship with the chair of Urology of the Faculty of Medicine of Madrid directed by Alfonso de la Peña. The subject matter of the personal case studies, most of which lacked importance, lead to the gradual decline in the contribution of presentations until its eventual end. Only a few articles stand out. The study's major value consists of collecting and analysing the content of what is highly likely the only complete collection in existence, given that it was not edited for printing and was distributed only as correspondence and cannot therefore be found in public libraries.

The effect of household poverty on tuberculosis.

pSETTING: Households in Malawi, Mongolia, Myanmar, the Philippines, Rwanda, Tanzania, Viet Nam and Zambia.OBJECTIVE To assess the relationship between household socio-economic level, both relative and absolute, and individual tuberculosis (TB) disease. DESIGN: We analysed national TB prevalence surveys from eight countries individually and in pooled multicountry models. Socio-economic level (SEL) was measured in terms of both relative household position and absolute wealth. The outcome of interest was whether or not an individual had TB disease. Logistic regression models were used to control for putative risk factors for TB disease such as age, sex and previous treatment history. RESULTS: Overall, a strong and consistent association between household SEL and individual TB disease was not found. Significant results were found in four individual country models, with the lowest socio-economic quintile being associated with higher TB risk in Mongolia, Myanmar, Tanzania and Viet Nam. CONCLUSIONS: TB prevalence surveys are designed to assess prevalence of disease and, due to the small numbers of cases usually detected, may not be the most efficient means of investigating TB risk factors. Different designs are needed, including measuring the SEL of individuals in nested case-control studies within TB prevalence surveys or among TB patients seeking treatment in health care facilities.

Tres tesis sobre estenosis de uretra / Three Theses on Urethral Disease

Objetivo: Dar a conocer la existencia de tres tesis doctorales sobre estenosis de uretra, presentadas en la Universidades de París y Montpellier por autores españoles. Material y métodos: De los estudiantes canarios que durante el siglo XIX y comienzos del XX estudiaron medicina en Francia destacamos tres que tienen en común el haber elegido el mismo tema para la presentación de su tesis doctoral. Resultados: Analizamos brevemente sus biografías, haciendo especial referencia al contenido de sus tesis doctorales. Conclusiones: La estenosis de uretra fue una patología muy citada durante el periodo estudiado por su alta incidencia. Distinguimos los cambios terapéuticos que se aportaron en las tres tesis estudiadas (AU)

Objective: To inform about three doctorate theses on urethral stenosis, presented in the University of Paris and Montpellier by Spanish authors. Material and methods: Of the Canary Island students who studied medicine in France during the XIX century and beginning of the XX century, three stand out for having chosen the same subject for presentation of their doctorate thesis. Results: We briefly analyze their biographies, placing special emphasis on the content of their doctorate thesis. Conclusions: Urethral stenosis was a very mentioned disease during the period studied due to its high incidence. We distinguish the therapeutic changes contributed in the three theses studied (AU)

[Three theses on urethral disease]. / Tres tesis sobre estenosis de uretra.

OBJECTIVE: To inform about three doctorate theses on urethral stenosis, presented in the University of Paris and Montpellier by Spanish authors. MATERIAL AND METHODS: Of the Canary Island students who studied medicine in France during the xix century and beginning of the xx century, three stand out for having chosen the same subject for presentation of their doctorate thesis. RESULTS: We briefly analyze their biographies, placing special emphasis on the content of their doctorate thesis. CONCLUSIONS: Urethral stenosis was a very mentioned disease during the period studied due to its high incidence. We distinguish the therapeutic changes contributed in the three theses studied.

Isolation of pectin-enriched products from red beet (Beta vulgaris L. var. conditiva) wastes: composition and functional properties.

The present work was dedicated to the development of an extraction process for red beet (Beta vulgaris L. var. conditiva) by-products that preserves the high molecular weight of the macromolecules with the primary aim of waste upgrading. Our study concerns the extraction of pectin-enriched products with potential thickening properties for their usage in food formulation, as well as with some healthy physiological effect, by using citrate buffer (pH = 5.2) either alone or with enzymes (hemicellulase or cellulase) active on cell wall polysaccharide networks. Considering that red beet tissue contains ferulic acid, which cross-links pectin macromolecules through arabinose residues to anchor them into the cell wall, an alkaline pretreatment was also evaluated in order to perform polysaccharide hydrolysis in the cell wall network to accomplish higher renderings. Chemical composition and yield, as well as the in vitro glucose retention exerted by the isolated fiber products were finally analyzed.

[An analysis of our experience in cryopreservation of semen from cancer patients]. / Análisis de nuestra experiencia en la criopreservación del semen en pacientes oncológicos.

OBJECTIVE: To analyze the characteristics of patients with oncological problems who were users of the sperm bank, as well as use of cryopreserved semen. MATERIALS AND METHODS: A retrospective analysis was made of all cryopreserved semen samples from males diagnosed with cancer from April 1992 to October 2007 at the province of Las Palmas. RESULTS: One hundred and one male patients with cancer were referred to the sperm bank before cancer therapy. Eighty percent of them were contacted by telephone. Mean freezing age was 25 years. Forty-one percent of patients had testicular tumors. Thirty-three percent had no prior biological children. Only one patient had known fertility problems before treatment. Sixty-seven percent of patients were warned by the healthcare team about the possibility of infertility at the time of cancer diagnosis. Only 1% of samples were not adequate for cryopreservation. The frozen sample was used by 4% of the patients. When patients were asked about future use of semen, 63% of them wanted to continue with semen cryopreservation, as compared to 17% who had no interest in having offspring in the future. CONCLUSION: The number of fertile patients who cryopreserve semen is extremely low. It is very important that the healthcare team warns patients of potential infertility after treatment. A high proportion of patients have valid samples for cryopreservation, but semen is used by a low number of patients. A high proportion of patients want to maintain their semen frozen.

Análisis de nuestra experiencia en la criopreservación del semen en pacientes oncológicos / An analysis of our experience in cryopreservation of semen from cancer patients

Objetivo: analizar las características de los pacientes con problemas oncológicos, usuarios del banco de semen, así como el uso del semen criopreservado. Material y métodos: de forma restrospectiva se han analizado todas las muestras de semen criopreservadas de varones con el diagnóstico de cáncer, entre abril de 1992 y octubre del 2007, en la provincia de Las Palmas. Resultados: fueron remitidos al banco de semen 101 varones con tumores, previo tratamiento oncológico. Se contactó por vía telefónica con el 80%. La edad media de congelación fue de 25 años. El 41% de los pacientes padecían de tumores testiculares; no tenían hijos biológicos previos el 33%. Sólo un paciente tenía problemas de infertilidad previo al tratamiento. En el momento del diagnóstico del cáncer el equipo sanitario advirtió al 67% de los pacientes de la posibilidad de infertilidad. Sólo el 1% de las muestras no fue apta para la criopreservación. Se usó la muestra congelada en el 4% de las muestras, y cuando se les preguntaba sobre el uso futuro del semen el 63% de los pacientes deseaba continuar con el criopreservado, frente al 17%, que no mostraba interés por tener descendencia en el futuro. Conclusión: el número de enfermos en edad fértil que criopreservan el semen es extremadamente bajo. Advertir a los pacientes de la posibilidad de infertilidad tras el tratamiento, por parte del equipo sanitario, es de una vital importancia. Hay un alto porcentaje de pacientes con muestras válidas para criopreservación, un escaso número de pacientes hacen uso del semen, aunque existe un alto porcentaje de pacientes con deseo de continuar con su semen congelado(AU)

Objective: To analyze the characteristics of patients with oncological problems who were users of the sperm bank, as well as use of cryopreserved semen. Materials and methods: A retrospective analysis was made of all cryopreserved semen samples from males diagnosed with cancer from April 1992 to October 2007 at the province of Las Palmas. Results: One hundred and one male patients with cancer were referred to the sperm bank before cancer therapy. Eighty percent of them were contacted by telephone. Mean freezing age was 25 years. Forty-one percent of patients had testicular tumors. Thirty-three percent had no prior biological children. Only one patient had known fertility problems before treatment. Sixty-seven percent of patients were warned by the healthcare team about the possibility of infertility at the time of cancer diagnosis. Only 1% of samples were not adequate for cryopreservation. The frozen sample was used by 4% of the patients. When patients were asked about future use of semen, 63% of them wanted to continue with semen cryopreservation, as compared to 17% who had no interest in having offspring in the future. Conclusion: The number of fertile patients who cryopreserve semen is extremely low. It is very important that the healthcare team warns patients of potential infertility after treatment. A high proportion of patients have valid samples for cryopreservation, but semen is used by a low number of patients. A high proportion of patients want to maintain their semen frozen(AU)

[Renal artery aneurysm. Laparoscopic nephrectomy, ex-vivo reconstruction and autotrasplantation]. / Aneurisma de arteria renal. Nefrectomía laparoscópica, reconstrucción en banco y autotrasplante.

We report a case of severe hypertensive patient with poor response regardless 5 drugs, that is diagnosed with right renal artery aneurysm, during the study of his HTN. Conservative surgery was performed by extracting laparoscopic kidney graft,ex-vivo pedicle reconstruction, followed by transplant in right iliac fossa utilizing the ilioinguinal incision used for the extraction, without need for two incisions. We perform a brief discussion of surgery indications of surgery in these patients.

Aneurisma de arteria renal. Nefrectomía laparoscópica, reconstrucción en banco y autotrasplante / Renal artery aneurysm. Laparoscopic nephrectomy, ex-vivo reconstruction and autotransplantation

Se presenta un caso de paciente hipertenso severo con mala respuesta a pesar de 5 fármacos, el cual es diagnosticado de aneurisma en arteria renal derecha, durante el estudio de su HTA. Se realiza cirugía conservadora renal haciendo extracción laparoscópica del injerto, reconstrucción en banco del pedículo, y posterior trasplante en fosa ilíaca derecha aprovechado la incisión ilioinguinal empleada para la extracción, sin necesidad de dos incisiones. Se realiza breve discusión de indicaciones de la cirugía en estos pacientes (AU)

We report a case of severe hypertensive patient with poor response regardless 5 drugs, that is diagnosed with right renal artery aneurysm, during the study of his HTN. Conservative surgery was performed by extracting laparoscopic kidney graft, ex-vivo pedicle reconstruction, followed by transplant in right iliac fossa utilizing the ilioinguinal incision used for the extraction, without need for two incisions. We perform a brief discussion of surgery indications of surgery in these patients (AU)

[Clinical-pathology relationship in bladder cancer]. / Relación clinico-patólogica en cáncer vesical.

OBJECTIVES: Analyze the role of the Computerized Axial Tomography (TAC) like image study of pre-surgery stadification, in the subjected patients to radical cystectomy, for the treatment of muscle infiltrate bladder cancer. METHODS: Retrospective study of cohorts on 63 subjected patients to radical cystectomy for bladder cancer, in oneself service, between january of 1995 and december of 2.005. The capacity of the TAC was determined for the stadification bladder (pT), node (pN) and the results were compared, with the obtained ones in the pathological anatomy after the radical cystectomy, acording to TNM clasification. The possible impact of this image technique was evaluated in the change of surgical attitude in these patients. RESULTS: The estimate of bladder affectation with TAC was correct in 28.6%, sub-estadificate in 50.8%, and up-estadificate in 20.6%. The TAC for the bladder possesses a lower sensibility the more outpost it is this affectation. It specificity is higher the more advanced locally is the cancer, oscillating among 44% in the pT2 and 94% in the pT4. Regarding the estadification node, it is correct in 73.5% of all cases, although this percentage depends almost exclusively on the patients with negative node (N -). These data offer us a sensibility of 28%, specificity of 55%, positive predictive value of 68% and negative predictive of 67%. SUMMARY: The impact of the TAC in the clinical estadification of the infiltrate bladder cancer is relatively low. The biggest benefit is obtained in patient with suspicion of advanced illness. Its limitation to this group would suppose a significant reduction of costs, with low risk of an inappropriate surgical handling.

[Early biochemical failure after radical prostatectomy for prostate cancer. Impact factors?]. / Recidiva bioquímica precoz tras prostatectomía radical retropúbica por cáncer de próstata. Factores implicados. Influye el tiempo de espera entre biopsia y cirugía?

UNLABELLED: Does delay from biopsy to surgery have any influence? OBJECTIVES: To determine wether WT may impact on the EBF (before one year) alter RRP in our series, and to study other factors that may impact on this issue. MATERIAL AND METHODS: We study 310 RRP. Inclusion criteria are: one year follow up, no hormonal manipulation neither previous radiotherapy. Patients are divide in two groups attending WT. Group A < 90 days (n: 148), Group B > 90 days (n: 162). We study EBF (2 or more PSA determinations >= 0.2 ng/ml), and the impact of previous PSA, biopsy Gleason, Gleason of the specimen (G), pT stage (pT), and WT. T of Student or W of Wilcoxon are used to determine the homogeneity of the two groups. Chi Square of Pearson to compare the two group's EBF and pT attending to WT and EBF attending to pT. U of Mann Whitney is used to study EBF attending to G. Multivariate logistic regresion (LR) is used to study the impact of the variables on EBF. RESULTS: There are no differences between the two groups in age (p<0.129), PSA (p<0.479), biopsy's Gleason (p<0.913). There are no differences in EBF nor in pT attending to WT. Significant statystical differences are founded in EBF attending to pT and G. T3 tumors have more chance of recurrence than T2. EBF is more frecuent as G increases. In logistic regresion of the global serie, independent variables for progression are: Previous PSA and pT. Nor biopsy's Gleason nor specimen's Gleason, nor WT, impact on the EBF. CONCLUSIONS: Biopsy Gleason and WT do not impact on EBF. WT do not impact on pT. In our serie differences on EBF are lead by previous PSA and pT. Also Gleason of the especimen seems to impact on EBF, but in lower proportion, with no significance in multivariate analysis.

Relación clinico-patólogica en cáncer vesical / Clinical-pathology relationship in bladder cancer

Objetivos: Analizar el papel de la Tomografía Axial Computerizada (TAC) como estudio de estadificación prequirúrgica, en los pacientes sometidos a cistectomía radical, para el tratamiento del carcinoma vesical infiltrante. Métodos: Estudio de cohortes retrospectivo sobre 63 pacientes sometidos a cistectomía radical por carcinoma urotelial de vejiga, en un mismo servicio, entre enero del 1995 y diciembre del 2005. Se determinó la capacidad de la TAC para el estadiaje vesical, ganglionar y se compararon los resultados, con los obtenidos en la anatomía patológica tras la cistectomia radical, según la clasificación TNM, actual. Se evaluó el posible impacto de esta técnica de imagen en el cambio de actitud quirúrgica en estos pacientes. Resultados: La estimación de afectación perivesical con TAC fue correcta en 28,6%, subestadiada en 50,8%, y sobreestadiada en 20,6%. La TAC para el estadiaje perivesical posee una sensibilidad más baja cuanto más avanzada es dicha afectación. Su especificidad es más elevada cuanto más avanzado localmente sea el tumor, oscilando entre 44% en los pT2 y el 94% en los pT4. En lo referente al estadiaje ganglionar, es correcto en 73,5 % de los casos, aunque este porcentaje depende casi exclusivamente de los pacientes con ganglios negativos (N-). Estos datos nos ofrecen una sensibilidad del 28%, especificidad de 55%, valor predictivo positivo de 68% y predictivo negativo de 67%. Conclusiones: El impacto de la TAC en el estadiaje clínico del cáncer vesical infiltrante es relativamente bajo. El mayor beneficio se obtiene en pacientes con sospecha de enfermedad avanzada. Su limitación a este grupo supondría una significativa reducción de costes, con bajo riesgo de un manejo quirúrgico inapropiado (AU)

Objectives: Analyze the role of the Computerized Axial Tomography (TAC) like image study of pre-surgery stadification, in the subjected patients to radical cystectomy, for the treatment of muscle infiltrate bladder cancer. Methods: Retrospective study of cohorts on 63 subjected patients to radical cystectomy for bladder cancer, in oneself service, between january of 1995 and december of 2.005. The capacity of the TAC was determined for the stadification bladder (pT), node (pN) and the results were compared, with the obtained ones in the pathological anatomy after the radical cystectomy, acording to TNM clasification. The possible impact of this image technique was evaluated in the change of surgical attitude in these patients. Results: The estimate of bladder affectation with TAC was correct in 28,6%, sub-estadificate in 50,8%, and up estadificate in 20,6%. The TAC for the bladder possesses a lower sensibility the more outpost it is this affectation. It specificity is higher the more advanced locally is the cancer, oscillating among 44% in the pT2 and 94% in thepT4. Regarding the estadification node, it is correct in 73,5% of all cases, although this percentage depends almost exclusively on the patients with negative node (N -). These data offer us a sensibility of 28%, specificity of 55%, positive predictive value of 68% and negative predictive of 67%. Summary: The impact of the TAC in the clinical estadification of the infiltrate bladder cancer is relatively low. The biggest benefit is obtained in patient with suspicion of advanced illness. Its limitation to this group would suppose a significant reduction of costs, with low risk of an inappropriate surgical handling (AU)

Recidiva bioquímica precoz tras prostatectomía radical retropúbica por cáncer de próstata. Factores implicados. ¿Influye el tiempo de espera entre biopsia y cirugía? / Early biochemical failure radical prostatectomy for prostate cancer. Impact factors?

Objetivos: Estudiar diferentes factores que pueden influir en la recidiva bioquímica precoz (RBP) (primer año tras cirugía), tras prostatectomía radical retropúbica (PRR). Material y métodos: Estudiamos 310 PRR. Criterios de inclusión: al menos un año de seguimiento, ausencia de bloqueo hormonal o radioterapia previa. Los pacientes fueron divididos inicialmente en 2 grupos según el tiempo de espera. Grupo A <90días (n: 148), Grupo B > 90 días (n: 162). Estudiamos RBP (2 o más determinaciones de PSA >= 0,2 ng/ml) y la influencia del PSA previo, el Gleason de la biopsia, el Gleason del espécimen, estadio pT, y tiempo de espera. Para estudiar la homogeneidad existente entre los dos grupos usamos la t de Student o W de Wilcoxon. Estudiamos la RBP y el estadio pT en los dos grupos usando la chi cuadrado de Pearson, que también nos sirve para estudiar en los dos grupos la RBP en relación al estadio pT. El test de la U de mann-Whitney lo usamos para estudiar en la serie global la RBP según el Gleason del espécimen. Por último se realiza una Regresión logística multivariante para estudiar la influencia de todas las variables en la RBP en la serie global. Resultados: No encontramos diferencias entre los dos grupos en edad (p< 0,129), ni PSA (p< 0,479), ni Gleason de biopsia(p<0,913). No se encontraron diferencias en RBP ni en estadio pT según el tiempo de espera. Hallamos diferencias estadísticamente significativas en RBP si estudiamos estadio pT y Gleason de la pieza. Los T3 tienen más incidencia de recurrencia que losT2 y hay más incidencia de RBP según aumenta el Gleason de la pieza. En la regresión logística de la serie global las variables independientes de progresión son: PSA previo y estadio pT. Ni el Gleason de la biopsia ni el Gleason del espécimen, ni el tiempo de espera entre biopsia y cirugía influyen en la RBP. Conclusiones: El Gleason de la biopsia y el tiempo de espera no influyen en la RBP. El tiempo de espera tampoco influye en el estadio T final. En nuestra serie las diferencias en RBP vienen dadas por el PSA previo y pT. El Gleason del espécimen parece influir en la RBP, pero en menor proporción sin significado en el análisis multivariante (au)

Objectives: To determine wether WT may impact on the EBF (before one year) alter RRP in our series, and to study other factors that may impact on this issue. Material and methods: We study 310 RRP. Inclusion criteria are: one year follow up, no hormonal manipulation neither previous radiotherapy. Patients are divide in two groups attending WT. Group A < 90 days (n: 148), Group B > 90 days (n: 162). We study EBF (2 or more PSA determinations >= 0.2 ng/ml), and the impact of previous PSA, biopsy Gleason, Gleason of the specimen (G), pT stage (pT), and WT. T of Student or W of Wilcoxon are used to determine the homogeneity of the two groups. Chi Square of Pearson to compare the two group’s EBF and pT attending to WT and EBF attending to pT. U of Mann Whitney is used to study EBF attending to G. Multivariate logistic regresion (LR) is used to study the impact of the variables on EBF. Results: There are no differences between the two groups in age (p< 0.129), PSA (p< 0.479), biopsy´s Gleason (p<0.913). There are no differences in EBF nor in pT attending to WT. Significant statystical differences are founded in EBF attending to pT and G. T3 tumors have more chance of recurrence than T2. EBF is more frecuent as G increases. In logistic regresion of the global serie, independent variables for progression are: Previous PSA and pT. Nor biopsy´s Gleasonnor specimen´s Gleason, nor WT, impact on the EBF. Conclusions: Biopsy Gleason and WT do not impact on EBF. WT do not impact on pT. In our serie differences on EBF are lead by previous PSA and pT. Also Gleason of the especimen seems to impact on EBF, but in lower proportion, with no significance in multivariate analysis (AU)

Uropatía obstructiva bilateral secundaria a hernia vesical masiva / Bilateral ureterohydronephrosis secondary massive vesical hernia

La hernia vesical no es una patología infrecuente, aparece entre el 0,3 y 3% según los autores. La aparición de hernia vesical masiva constituye una rareza. Presentamos un nuevo caso de fracaso renal secundario a hernia vesical inguinoescrotal con uropatía obstructiva bilateral, analizando la presentación clínica, el esquema diagnostico y el tratamiento de estas hernias (AU)

Bladder hernia is not a rare pathological condition, with a frequency between 0,3 and 3%. Massive bladder hernia is less frequent an very rarely ureterohydronephrosis with this pathology. We will present a case a renal failure secondary to inguinoscrotal bladder hernia with bilateral obstructive uropathy and an analyzed the clinical presentation, the diagnosis and the treatment for those hernias (AU)