Advances in 3D bioprinting to enhance translational applications in bone tissue engineering and regenerative medicine.

Bone defects are due to trauma, infections, tumors, or aging, including bone fractures, bone metastases, osteoporosis, or osteoarthritis. The global burden of these demands research into innovative strategies that overcome the limitations of conventional autografts. In this sense, the development of three-dimensional (3D) bioprinting has emerged as a promising approach in the field of tissue engineering and regenerative medicine (TERM) for the on-demand generation and transplantation of tissues and organs, including bone. It combines biological materials and living cells, which are precisely positioned layer by layer. Despite obtaining some promising results, 3D bioprinting of bone tissue still faces several challenges, such as generating an effective vascular network to increase tissue viability. In this review, we aim to collect the main knowledge on methods and techniques of 3D bioprinting. Then, we will review the main biomaterials, their composition, and the rationale for their application in 3D bioprinting for the TERM of bone.

A comprehensive study of the academic benefits and practical recommendations to include resistance training programs in institutional education.

The connection between physical activity and cognitive function has become a focus of attention in educational research in recent years. Regular exercise has been shown to have significant positive effects on physical health, but it also appears to have a significant impact on cognitive function and academic performance. Of all the exercise modalities, resistance training has drawn interest for its ability to improve cerebral abilities in addition to physical well-being. However, there is limited available knowledge exploring the relationship between resistance training regimens and academic performance. This narrative review aims to investigate the underlying mechanisms linking resistance training to academic performance. Firstly, we will examine the biological mechanisms and psychosocial links that potentially connect resistance training to academic performance to find and describe the different mechanisms by which resistance training improves academic performance. In the next part of the work, we delve into the existing observational and intervention studies that have explored the relationship between resistance training and academic performance. Lastly, we provide practical recommendations for including resistance training in institutional education settings, emphasizing the need of dispelling myths and addressing barriers to increase participation as well as the relevance of considering key training variables and adaptation of protocols to developmental stages, always guided by a properly trained professional. Overall, the available evidence supports that resistance training provides potential benefits to the academic performance of youth students with many biological and psychosocial factors that explain this relationship. However, most of the studies are observational, and broader interventional studies are needed to understand and maximize the benefits of this type of physical exercise.

Satisfaction with and Use of Inhalation Devices in Patients with Bronchial Asthma.

Background: Greater patient satisfaction with his or her inhalation device is associated with better adherence to pharmacological therapy and better clinical outcomes, such as improved quality of life, greater asthma control, and fewer exacerbations. The objective of this study was to determine the satisfaction level of a group of patients diagnosed with bronchial asthma concerning their devices for inhalation of bronchodilators and glucocorticoids. Methods: This was a cross-sectional study of patients treated in the Colombian health system. Satisfaction with inhalation devices was evaluated with the Feeling of Satisfaction with Inhaler (FSI)-10 questionnaire. A score of ≥44 points indicated high satisfaction. Results: In total, 362 patients from 59 cities were identified, their median age was 55 years, and 74.6% were women. The FSI-10 average score was 44.6; 68.5% of patients showed high satisfaction, especially with pressurized metered-dose inhalers (pMDIs), and 63.4% did not use them with an inhalation chamber. Users of pMDIs (odds ratio [OR]: 1.80; 95% confidence interval [CI]: 1.05-3.10) and those who received training by medical specialists (OR: 2.29; 95% CI: 1.33-3.97) had high satisfaction, while patients who were older (40-64 vs. <40 years: OR: 0.38; 95% CI: 0.19-0.78 and ≥65 vs. <40 years: OR: 0.35; 95% CI: 0.15-0.81), resided in the Caribbean region (OR: 0.48; 95% CI: 0.29-0.81), and had a university education (OR: 0.54; 95% CI: 0.32-0.90) had lower satisfaction. Conclusions: The majority of patients with asthma used pMDIs without an inhalation chamber, and their overall satisfaction was higher than that of patients using other inhalation devices. Patients who received special training from medical specialists showed better satisfaction.

Clinical and Novel Biomarkers in Penile Carcinoma: A Prospective Review.

Penile carcinoma is a rare urological neoplasia in men compared to other more common tumors, such as prostate, kidney, or bladder tumors. However, this neoplasm continues to affect a large number of patients worldwide, with developing countries presenting the highest incidence and mortality rates. Important risk factors such as the human papilloma virus, a factor affecting a large number of patients, have been described; however, few studies have evaluated screening programs in populations at risk for this disease, which severely affects the quality of life of older men. The management of these patients is usually complex, requiring surgical interventions that are not without risk and that have a great impact on the functionality of the male reproductive system. In addition, in cases of disseminated disease or with significant locoregional involvement, patients are evaluated by multidisciplinary oncological committees that can adjust the application of aggressive neoadjuvant or adjuvant chemotherapy on numerous occasions without clear improvement in survival. Chemotherapy regimens are usually aggressive, and unlike in other urological neoplasms, few advances have been made in the use of immunotherapy in these patients. The study of serological and histological biomarkers may help to better understand the underlying pathophysiology of these tumors and select patients who have a higher risk of metastatic progression. Similarly, the analysis of molecular markers will improve the availability of targeted therapies for the management of patients with disseminated disease that would benefit prognosis. Therefore, the purpose of this article is to summarize the main advances that have occurred in the development of serological and histological markers and their therapeutic implications in patients diagnosed with penile carcinoma, explaining the limitations that have been observed and analyzing future perspectives in the management of this disease.

The Regulatory Role of Mitochondrial MicroRNAs (MitomiRs) in Breast Cancer: Translational Implications Present and Future.

Breast cancer is the most prevalent and incident female neoplasm worldwide. Although survival rates have considerably improved, it is still the leading cause of cancer-related mortality in women. MicroRNAs are small non-coding RNA molecules that regulate the posttranscriptional expression of a wide variety of genes. Although it is usually located in the cytoplasm, several studies have detected a regulatory role of microRNAs in other cell compartments such as the nucleus or mitochondrion, known as "mitomiRs". MitomiRs are essential modulators of mitochondrion tasks and their abnormal expression has been linked to the aetiology of several human diseases related to mitochondrial dysfunction, including breast cancer. This review aims to examine basic knowledge of the role of mitomiRs in breast cancer and discusses their prospects as biomarkers or therapeutic targets.

An unusual cause of respiratory failure in a colon cancer patient.

Permanent central venous catheters (CVC), such as Port-a-Cath®, Hickmann® or PICC®, are widely used in oncology patients for cancer treatment. Thrombosis is a frequent complication that should be ruled out, as it is associated with potentially severe infection and hemodynamic consequences. This is the case report of a male patient who was undergoing chemotherapy for colon cancer. The patient presented with an atrial mass secondary to a CVC-related organized thrombus located inside the atrial cavity. The mass was inducing a massive right-to-left intracardial shunt due to a persistent foramen ovale and signs of respiratory failure that required surgical intervention to remove the intracardial mass.

Immunogenicity and acceptance of influenza A (H1N1) vaccine in a cohort of chronic hepatitis C patients receiving pegylated-interferon treatment.

UNLABELLED: BACKGROUND #ENTITYSTARTX00026; AIMS: Individuals at risk of (H1N1) influenza A infection are recommended to receive vaccination. Chronic hepatitis C (CHC) patients receiving treatment might be at a higher risk of respiratory bacterial infections after influenza infection. However, there are no observational studies evaluating the immunogenicity, tolerance and acceptance of 2009 influenza A vaccine in CHC patients. METHODS: We evaluated the immunogenicity of influenza A vaccine (Pandemrix®) by using the hemagglutination inhibition (HI) titers method in a well defined cohort of CHC patients receiving or not receiving pegylated-interferon and ribavirin, and compared it with healthy subjects (controls). A group of patients with inflammatory bowel disease (IBD) under immunosuppression, thought to have a lower immune response to seasonal influenza vaccine, were also included as a negative control group. In addition, tolerance to injection site reactions and acceptance was assessed by a validated questionnaire (Vaccinees' perception of injection-VAPI-questionnaire). RESULTS: Of 114 subjects invited to participate, 68% accepted and, after exclusions, 72 were included. Post-vaccination geometric mean titers and seroprotection/seroconversion rates were optimal in CHC patients with ongoing treatment (n = 15; 232, CI95% 46-1166; 93%; 93%), without treatment (n = 10; 226, CI95% 69-743: 100%; 100%) and controls (n = 15;168, CI95% 42-680; 93%; 86%) with no differences between groups (P = 0.8). In contrast, IBD patients had a significantly lower immunogenic response (n = 27; 60, CI95% 42-680;66%;66%; P = 0.006). All the groups showed a satisfactory tolerance although CHC patients with ongoing treatment showed more local discomfort after vaccine injection. CONCLUSION: There appeared to be no differences between CHC patients and healthy controls in serological response and acceptance of (H1N1) influenza vaccination.

Uso de Internet entre los pacientes con enfermedades digestivas en un hospital general / Internet use among patients with gastrointestinal diseases in a general hospital

Introducción Internet ha supuesto un cambio radical en el acceso a la información médica. No se ha estudiado el acceso a webs médicas en los pacientes con enfermedades digestivas en nuestro medio. Objetivo Determinar el nivel de acceso y el uso de Internet como fuente de información médica de los pacientes con enfermedades digestivas en nuestro entorno. Material y métodos Se encuestaron 699 pacientes consecutivos, ingresados y de consultas externas intra y extrahospitalarias de Digestivo. Resultados Respondieron 671 pacientes (55% mujeres), rango de edad 18 a 88 años, media de 54 + 16. Usaban Internet el 36%. No hubo diferencias por sexos, pero sí por edad (86% los mayores de 30 años vs 6% los mayores de 70, p<0,005). Buscaron más información los pacientes del hospital que los extrahospitalarios (77 vs 54%, p<0,005). Los pacientes con enfermedad inflamatoria utilizaron más Internet que el resto (57 vs 33%, p>0,005, OR 2,710 IC 1,628-4,511). La información le pareció menos fiable que la del médico al 77% de los hombres y al 70% de las mujeres. Al 86% le gustaría usar el correo electrónico con su médico. El 89% consideraban Internet útil para resolver dudas, el 89% querían direcciones de salud y el 90% información periódica sobre su enfermedad. Los pacientes no universitarios demandaban más información periódica (p = 0,01) y sobre cómo buscar información médica (p = 0,03). Conclusiones Una tercera parte de los pacientes con enfermedades digestivas utilizan Internet para informarse acerca de su enfermedad. Los pacientes quieren mayor información de su médico sobre recursos de salud en Internet (AU)

Introduction The internet has provoked a radical change in access to medical information. Access to medical websites among patients with gastrointestinal diseases has not been studied in our environment. Objective To determine the level of access and use of internet as a source of medical information in patients with gastrointestinal diseases in our environment. Material and methods We surveyed 699 consecutive patients, who were admitted to hospital or who were from intra- and extrahospital outpatient gastroenterology clinics. Results Responses were obtained from 671 patients (55% women), aged from 18 to 88 years, (mean 54 +16). Thirty-six percent used the internet. There were no differences between men and women, but differences were found by age (86% >30 years vs 6%>70, p<0.005). More inpatients sought information than outpatients (77% vs 54%, p<0.005). Patients with inflammatory disease used the internet more than the remaining patients (57% vs 33%, p>0.005, OR 2.710 CI 1.628-4.511). Seventy-seven percent of men and 70% of women believed the information was less reliable than that provided by the physician. Eighty-six percent of patients would like e-mail contact with their physician. Eighty-nine percent thought the internet was useful to resolve doubts, 89% wanted the addresses of health sites and 90% wanted to receive periodic information on their disease. Patients without a university education wanted more periodic information (p = 0.01) and more information on how to search for medical information (p = 0.03).Conclusions One-third of patients with gastrointestinal diseases use the internet to obtain information on their disease. Patients require more information from their physician on internet health resources (AU)

[Internet use among patients with gastrointestinal diseases in a general hospital]. / Uso de Internet entre los pacientes con enfermedades digestivas en un hospital general.

INTRODUCTION: The internet has provoked a radical change in access to medical information. Access to medical websites among patients with gastrointestinal diseases has not been studied in our environment. OBJECTIVE: To determine the level of access and use of internet as a source of medical information in patients with gastrointestinal diseases in our environment. MATERIAL AND METHODS: We surveyed 699 consecutive patients, who were admitted to hospital or who were from intra- and extrahospital outpatient gastroenterology clinics. RESULTS: Responses were obtained from 671 patients (55% women), aged from 18 to 88 years, (mean 54 +16). Thirty-six percent used the internet. There were no differences between men and women, but differences were found by age (86% >30 years vs 6%>70, p<0.005). More inpatients sought information than outpatients (77% vs 54%, p<0.005). Patients with inflammatory disease used the internet more than the remaining patients (57% vs 33%, p>0.005, OR 2.710 CI 1.628-4.511). Seventy-seven percent of men and 70% of women believed the information was less reliable than that provided by the physician. Eighty-six percent of patients would like e-mail contact with their physician. Eighty-nine percent thought the internet was useful to resolve doubts, 89% wanted the addresses of health sites and 90% wanted to receive periodic information on their disease. Patients without a university education wanted more periodic information (p = 0.01) and more information on how to search for medical information (p = 0.03). CONCLUSIONS: One-third of patients with gastrointestinal diseases use the internet to obtain information on their disease. Patients require more information from their physician on internet health resources.

Conciliación e información de medicación al alta hospitalaria en un servicio de urología / Conciliation and medication information at the moment of hospital discharge in a service of urology

Analizar los resultados de un programa de conciliación e información de medicación al alta hospitalaria en un servicio de urología. Material y Método: Fueron incluidos los pacientes ingresados en el servicio de urología durante 2009 con mayor complejidad en su tratamiento domiciliario. Éste fue registrado, confirmándose previamente mediante una entrevista con el paciente la adherencia al mismo, así como problemas relacionados con la medicación habitual (PRMs). A partir de la epicrisis, se concilió la medicación prescrita con el tratamiento ambulatorio, resolviendo las discrepancias con el facultativo responsable. Por último, se entregó al paciente un cronopictograma con el listado completo de su medicación a partir del episodio asistencial y recomendaciones sobre su tratamiento con la explicación verbal del mismo. Realizamos una encuesta de satisfacción a los facultativos para conocer el conocimiento del programa y su valoración. Resultados: Se seleccionaron 260 pacientes, de los cuales en 102 (39 por ciento) se detectaron PRMs. Las discrepancias más frecuentes fueron: prescripción incompleta (28 por ciento), administración inadecuada (22 por ciento), medicamento no indicado (18 por ciento) y duplicidad (16 por ciento). Los PRM’s se clasificaron en orden a la severidad, de las 102 discrepancias: el 68 por ciento no habrían causado daño al paciente y el 32 por ciento habría requerido monitorización. La valoración global del programa fue muy positiva para los facultativos. Conclusión: La conciliación de medicación reduce los PRM’s, sobre todo en las transiciones asistenciales de los pacientes. Creemos que esta actividad asistencial debería realizarse de manera habitual en los hospitales, para aumentar la seguridad de los pacientes, en el marco de un sistema de reducción de riesgos para la salud y mejora de la calidad asistencial.

To analyze the results of a medication reconciliation and drug information program at discharge, in an urology department. Materials and Methods: Patients with more complexity in their home treatment, admitted in this facility during 2009, were included in the study. Preadmission regimens were recorded and the patients were asked about drug-related problems (DRP) and drug adherence. On the day of discharge, prescribed medication was reconciled with the outpatient treatment, resolving discrepancies with the prescribers. Finally, the patients were given a complete list of their medications and oral recommendations. We conducted a survey with physicians to enquire about their reconciliation program knowledge and their assessment. Results: 260 patients were selected, of which in 102 (42 percent) DRP were detected. The most frequent discrepancies were: incomplete prescription (28 percent), incorrect administration (22 percent), inappropriate medication (18 percent) and therapeutic duplication (16 percent ). The DRP were classified according to their severity, of the 102 discrepancies, 68 percent would not have caused harm to the patient and 32 percent would require monitoring. On the survey, about the overall evaluation of the program, it was highly regarded for the most of the physicians. Conclusion: Medication reconciliation reduces the DRP, especially at transition in healthcare of patients. We believe that activity should be carried out routinely in hospitals, to increase the patients safety, as part of a system to reduce health risks and improving the quality of care.

[Quality of life specific questionnaire for constipated patients: development and validation of CVE-20]. / Cuestionario específico de calidad de vida para pacientes con estreñimiento: desarrollo y validación del CVE-20.

BACKGROUND AND OBJECTIVE: Although constipation affects quality of life, questionnaires hardly exist for its evaluation. We aimed to develop and validate a questionnaire able to measure the quality of life in patients with constipation. PATIENTS AND METHOD: A Spanish multicenter study was performed in 2 stages: a) questionnaire development (open interview to patients with constipation, pilot questionnaire, quantitative and factorial analysis, Rasch analysis, and specific questionnaire design), and b) questionnaire validation in 136 patients. These patients were divided in 2 groups: a) reliability group (n = 55; no need to begin or change treatment; re-tested after 15 days), and b) sensibility to change group (n = 81; need to begin or change treatment; re-tested after 3 months). We collected clinical and socio-demographic data and we evaluated the quality of life through the general questionnaire EuroQoL-5D (EQ-5D) and the specific one, design in the previous stage (25 items). After that, we analysed feasibility, reliability and validity (of content, convergent and longitudinal). RESULTS: The trial questionnaire was obtained during the development stage and the results were 51 items that were later reduced to 25 in the validation stage. A total of 126 patients (93% women; mean age [standard deviation]: 43.4 [1] years) completed the study properly. The answer average time was 12 min. The content validity process reduced the questionnaire to 20 items (CVE-20) within 4 domains: emotional, general physical, rectal physical and social. The reliability was good in relation to the general punctuation (Cronbach alpha coefficient = 0.87), being in the different domains of 0.79, 0.73, 0.75 and 0.60, respectively. The construct validity showed a good correlation between the CVE-20 results and constipation severity. The CVE-20 score positively correlated with EQ -5D changes. The test and re-test reliability were good: interclass correlation coefficient = 0.89 (ranging from 0.80 to 0.88 in the different domains). The clinically relevant and minimal difference was 17 points (95% confidence interval, 11-23). The content validity showed a strong correlation between CVE-20 and constipation severity. CONCLUSIONS: The CVE-20 is the first specific questionnaire in Spanish language for constipated patients; it is valid, reliable, sensitive to changes and it meets the psychometric requirements to be applied in daily practice and clinical trials.

Which method should be the reference method to evaluate the severity of rheumatic mitral stenosis? Gorlin's method versus 3D-echo.

INTRODUCTION: Several studies have shown a wide variability among different methods to determine the valve area in patients with rheumatic mitral stenosis. Our aim was to evaluate if 3D-echo planimetry is more accurate than the Gorlin method to measure the valve area. METHODS: Twenty-six patients with mitral stenosis underwent 2D and 3D-echo echocardiographic examinations and catheterization. Valve area was estimated by different methods. A median value of the mitral valve area, obtained from the measurements of three classical non-invasive methods (2D planimetry, pressure half-time and PISA method), was used as the reference method and it was compared with 3D-echo planimetry and Gorlin's method. RESULTS: Our results showed that the accuracy of 3D-echo planimetry is superior to the accuracy of the Gorlin method for the assessment of mitral valve area. CONCLUSIONS: We should keep in mind the fact that 3D-echo planimetry may be a better reference method than the Gorlin method to assess the severity of rheumatic mitral stenosis.

[Idiopathic granulomatous orchitis: pathologic study of one case]. / Orquitis idiopática granulomatosa: estudio anatomopatológico de un caso.

OBJECTIVE: To report one case of idiopathic granulomatous orchitis, an extremely rare disease, in a 76-year-old patient. METHODS/RESULTS: The pathology department received a testicle with the clinical/radiological diagnosis of testicular tumor. The pathologic study showed absence of neoplasias and presence of morphological findings compatible with idiopathic granulomatous orchitis. CONCLUSIONS: The idiopathic granulomatous orchitis is an entity of unknown etiology, clinically or ultrasonographically not distinguishable from testicular neoplasias, the diagnosis of which is made after orchiectomy.

Orquitis idiopática granulomatosa. Estudio anatomopatológico de un caso / Idiopathic granulomatous orchitis. Pathologic study of one case

OBJETIVO: Presentar un caso de orquitis granulomatosa idiopática, patología extremadamente infrecuente, en un paciente de 76 años. MÉTODOS/RESULTADOS: Se recibe testículo derecho con diagnóstico clínico y ecográfico de tumor testicular. En el estudio anatomopatológico se observa la ausencia de celularidad neoplásica y se aprecia hallazgos morfológicos compatibles con orquitis granulomatosa idiopática. CONCLUSIONES: La orquitis idiopática granulomatosa es una entidad de etiología desconocida, ecográfica y clínicamente no distinguible de una neoplasia testicular, llegándose al diagnóstico tras la orquiectomía

OBJECTIVE: To report one case of idiopathic granulomatous orchitis, an extremely rare disease, in a 76-year-old patient. METHODS/RESULTS: The pathology department received a testicle with the clinical/radiological diagnosis of testicular tumor. The pathologic study showed absence of neoplasias and presence of morphological findings compatible with idiopathic granulomatous orchitis. CONCLUSIONS: The idiopathic granulomatous orchitis is an entity of unknown etiology, clinically or ultrasonographically not distinguishable from testicular neoplasias, the diagnosis of which is made after orchiectom

[Urological works and biography of Dr. Felipe Alcalá Santaella Nuñez (1927-1977). Historical documentary analysis]. / Obra urológica y biografía del doctor Felipe Alcala-Santaella Núnez (1927-1977). Análisis documental histórico.

OBJECTIVES: In the middle of the 20th century, Urology in Valencia was fully consolidated as a surgical speciality since Prof. Molla started it about the end of the 19th century; Dr. Felipe Alcala Santaella Nuñez stands out as the chairman of the Department of Urology of the "Hospital Provincial de Valencia", after his father Dr. Rafael Alcalá Santaella. He achieved to form a group of renowned professionals, some of which still are in active practice. METHODS: We reviewed all his scientific work and the journals it was published in, mainly Archivos Espaioles de Urologia, through the Department of Medical History of the University of Valencia. His biography was reconstructed using the "Biographic and Bibliographic History of Spanish Urology" by Drs. E. Maganto Pavón and M. Pérez Albacete, as well as direct interviews with family members. DISCUSSION: We emphasize the magnificent approach to the clinical presentations of tuberculosis he does in his doctoral thesis, analyzing its types by location, main features, and most adequate treatment. He also emphasized the importance of relapse in lithiasic patients and recommendations to be follow, as well as the condition of bladder neoplasias. CONCLUSIONS: We consider Dr. Felipe Alcalá Santaella Nuñez as a wide-experience-professional who mode solid contributions to the regional urology in his times, thanks to his excellent surgical abilities and dedication.

Obra urológica y biografía del doctor Felipe Alcalá-Santaella Núñez (1927-1977). Análisis documental histórico / Urological works and biography of Dr. Felipe Alcalá Santaella Núñez (1927-1977). Historical documentary analysis

OBJETIVO: A mediados del S. XX, con una Urología en Valencia ya plenamente consolidada como especializada desde que el Profesor Mollá iniciara tal menester a finales del S. XIX, encontramos al Dr. Felipe Alcalá-Santaella Núñez, quien destacó como jefe del servicio de Urología del Hospital Provincial de Valencia, sustituyendo a su padre, D. Rafael Alcalá Santaella. En dicho ámbito logró formar un grupo de profesionales de renombre en el ámbito nacional, algunos de los cuales todavía ejercen en la actualidad. MÉTODOS: Revisamos a través del Departamento de Historia de la Medicina de la Universidad de Valencia toda su obra científica y las revistas en la que ha sido publicada, fundamentalmente la revista Archivos Españoles de Urología. Su biografía ha sido reconstruida usando como fuente la obra Historia Biográfica y Bibliográfica de la Urología Española de los Dres. E. Maganto Pavón y M. Pérez Albacete, así como entrevista con familiares directos. RESULTADOS: Destaca el magnífico abordaje que hace en su tesis doctoral de las formas clínicas de la tuberculosis renal, donde analiza sus tipos según localización, principales características y terapéutica mas adecuada. Realza también la importancia de la recidiva en los enfermos litiásicos y las recomendaciones a seguir, así como, en otro trabajo, la misma condición de las neoplasias vesicales. CONCLUSIONES: Consideramos a Felipe Alcalá-Santaella Núñez como un profesional de amplio bagaje y de sólida aportación en la Urología Regional de sus tiempos, dadas, según quienes le conocieron personalmente, sus excelentes capacidades quirúrgicas y dedicación a su profesión

OBJECTIVES: In the middle of the 20th century, Urology in Valencia was fully consolidated as a surgical speciality since Prof. Molla started it about the end of the 19th century; Dr. Felipe Alcala Santaella Nuñez stands out as the chairman of the Department of Urology of the “Hospital Provincial de Valencia”, after his father Dr.Rafael Alcalá Santaella. He achieved to form a group of renowned professionals, some of which still are in active practice. METHODS: We reviewed all his scientific work and the journals it was published in, mainly Archivos Españoles de Urología, through the Department of Medical History of the University of Valencia. His biography was reconstructed using the “Biographic and Bibliographic History of Spanish Urology” by Drs. E. Maganto Pavón and M. Pérez Albacete, as well as direct interviews with family members. DISCUSSION: We emphasize the magnificent approach to the clinical presentations of tuberculosis he does in his doctoral thesis, analyzing its types by location, main features, and most adequate treatment. He also emphasized the importance of relapse in lithiasic patients and recommendations to be follow, as well as the condition of bladder neoplasias. CONCLUSIONS: We consider Dr.Felipe Alcalá Santaella Nuñez as a wide-experience-professional who made solid contributions to the regional urology in his times, thanks to his excellent surgical abilities and dedication

[Urologic work and biography of Prof. Rafael Alcalá Santaella (1896-1959). Historical document analysis]. / Obra urológica y biografía del Profesor Rafael Alcalá Santaella (1896-1959). Análisis documental histórico.

OBJECTIVES: We find that Urology at the end of the 20th century was a consolidated speciality as a result of years of evolution and development, and the studies and works of authors whose contributions are considered today the basements of our speciality. So we think that Urology should be understood with its historical references, because, as Aristotle said "... thinks are better understood when one has got to clearly see how they were formed..." Numerous specialists contributed to this; among them we can cite Prof. Rafael Alcala Santaella, the object of this bibliographic and scientific works compilation paper. METHODS: We reviewed all his scientific works. Original articles have been obtained from Medicina Ibera, Revista Española de Cirugía y Urología, and Cirugía, Urología y Ginecología. His most important urologic work is Clinic Urology (1942), divided in 3 volumes. For his biography we used the biographic and bibliographic historical source of Spanish urology over the 20th-century and direct family members interviews. RESULTS: He analyzed topics as important as voiding disorders and the study of urine pyuria. He gave special importance to the study of prostatic pathology, its diagnosis by means of cystourethrography, and the modification of surgical techniques, as well as the results of urinary diversions performed in his department. CONCLUSIONS: Due to his extensive scientific and technical contributions he is one of the most outstanding figures of Valencia's Urology over the first half of the 20th century, together with Rafael Molla Rodrigo and Nicasio Benlloch Giner.

pH response transcription factor PacC controls salt stress tolerance and expression of the P-Type Na+ -ATPase Ena1 in Fusarium oxysporum.

Fungi possess efficient mechanisms of pH and ion homeostasis, allowing them to grow over a wide range of environmental conditions. In this study, we addressed the role of the pH response transcription factor PacC in salt tolerance of the vascular wilt pathogen Fusarium oxysporum. Loss-of-function pacC(+/-) mutants showed increased sensitivity to Li(+) and Na(+) and accumulated higher levels of these cations than the wild type. In contrast, strains expressing a dominant activating pacC(c) allele were more salt tolerant and had lower intracellular Li(+) and Na(+) concentrations. Although the kinetics of Li(+) influx were not altered by mutations in pacC, we found that Li(+) efflux at an alkaline, but not at an acidic, ambient pH was significantly reduced in pacC(+/-) loss-of-function mutants. To explore the presence of a PacC-dependent efflux mechanism in F. oxysporum, we cloned ena1 encoding an orthologue of the yeast P-type Na(+)-ATPase ENA1. Northern analysis revealed that efficient transcriptional activation of ena1 in F. oxysporum required the presence of high Na(+) concentrations and alkaline ambient pH and was dependent on PacC function. We propose a model in which PacC controls ion homeostasis in F. oxysporum at a high pH by activating expression of ena1 coordinately with a second Na(+)-responsive signaling pathway.

Vejiga urinaria ortotópica tipo Studer: nuestra experiencia / Our experience with the Studer orthotopic urinary diversion

OBJETIVOS: Analizar la evolución, complicaciones y resultados funcionales de los pacientes sometidos a sustitución vesical tipo Studer. MÉTODOS: Realizamos una revisión de las historias clínicas de 6 pacientes (n=6) a los que se les practicó cistectomía radical por cáncer invasor de vejiga y neovejiga tipo Studer entre Enero del 96 y Febrero del 2000.Los 6 fueron varones con una edad media de 54,2 años y un seguimiento medio de 14 meses. El seguimiento incluye: T.A.C. abdominopélvico, radiografía de tórax, urinocultivos, bioquímica sanguínea, gasometría venosa y ecografía con valoración del residuo postmiccional. RESULTADOS: El tipo histológico más frecuente fue el Ca. Transicional. En la distribución por grados y estadios patológicos se comprueba que todos eran infiltrantes localizados en vejiga y de alto grado. Cuatro de ellos se encuentran libres de enfermedad, uno falleció por enfermedad metastásica y otro se encuentra en progresión con metástasis pulmonares múltiples a los dos meses de seguimiento estando actualmente en tratamiento quimioterápico. El tiempo medio de la cirugía fue significativamente superior al de la cirugía de la derivación urinaria no continente tipo "Bricker" (media: 7,2 horas versus 3,5 horas).Como complicaciones postoperatorias inmediatas hemos tenido: Ileo prolongado (superior a 7 días) en dos pacientes (40 por ciento), diarrea (superior a 3 días) en dos pacientes, ileo obstructivo por fecaloma en 1 paciente, acidosis metabólica-deshidratación en un paciente, seroma de la herida en un paciente e infección de la herida en 2 pacientes. Como complicaciones postoperatorias precoces y tardías: Incontinencia: 3 pacientes fueron incontinentes (diurna y/o nocturna) hasta 1 mes de retirada de la sonda.1 paciente fue continente desde el mismo momento que se le retiró la sonda (0 meses), 2 son actualmente incontinentes tras un seguimiento de dos meses (media de incontinencia: 1 mes). Infección de la herida: 2 pacientes. Impotencia: 6 pacientes CONCLUSIONES: El funcionalismo del reservorio a medio plazo es bueno, conservando el paciente la micción uretral espontánea con buena continencia. Creemos que para conseguir buenos resultados es preciso un seguimiento estricto por parte del urólogo además de proporcionar al paciente una información detallada de los cuidados postoperatorios (AU)