Temporally-aware algorithms for the classification of anuran sounds.

Several authors have shown that the sounds of anurans can be used as an indicator of climate change. Hence, the recording, storage and further processing of a huge number of anuran sounds, distributed over time and space, are required in order to obtain this indicator. Furthermore, it is desirable to have algorithms and tools for the automatic classification of the different classes of sounds. In this paper, six classification methods are proposed, all based on the data-mining domain, which strive to take advantage of the temporal character of the sounds. The definition and comparison of these classification methods is undertaken using several approaches. The main conclusions of this paper are that: (i) the sliding window method attained the best results in the experiments presented, and even outperformed the hidden Markov models usually employed in similar applications; (ii) noteworthy overall classification performance has been obtained, which is an especially striking result considering that the sounds analysed were affected by a highly noisy background; (iii) the instance selection for the determination of the sounds in the training dataset offers better results than cross-validation techniques; and (iv) the temporally-aware classifiers have revealed that they can obtain better performance than their non-temporally-aware counterparts.

Discrete classification technique applied to TV advertisements liking recognition system based on low-cost EEG headsets.

BACKGROUND: In this paper a new approach is applied to the area of marketing research. The aim of this paper is to recognize how brain activity responds during the visualization of short video advertisements using discrete classification techniques. By means of low cost electroencephalography devices (EEG), the activation level of some brain regions have been studied while the ads are shown to users. We may wonder about how useful is the use of neuroscience knowledge in marketing, or what could provide neuroscience to marketing sector, or why this approach can improve the accuracy and the final user acceptance compared to other works. METHODS: By using discrete techniques over EEG frequency bands of a generated dataset, C4.5, ANN and the new recognition system based on Ameva, a discretization algorithm, is applied to obtain the score given by subjects to each TV ad. RESULTS: The proposed technique allows to reach more than 75 % of accuracy, which is an excellent result taking into account the typology of EEG sensors used in this work. Furthermore, the time consumption of the algorithm proposed is reduced up to 30 % compared to other techniques presented in this paper. CONCLUSIONS: This bring about a battery lifetime improvement on the devices where the algorithm is running, extending the experience in the ubiquitous context where the new approach has been tested.

Low energy physical activity recognition system on smartphones.

An innovative approach to physical activity recognition based on the use of discrete variables obtained from accelerometer sensors is presented. The system first performs a discretization process for each variable, which allows efficient recognition of activities performed by users using as little energy as possible. To this end, an innovative discretization and classification technique is presented based on the χ2 distribution. Furthermore, the entire recognition process is executed on the smartphone, which determines not only the activity performed, but also the frequency at which it is carried out. These techniques and the new classification system presented reduce energy consumption caused by the activity monitoring system. The energy saved increases smartphone usage time to more than 27 h without recharging while maintaining accuracy.

Detection of correct and incorrect measurements in real-time continuous glucose monitoring systems by applying a postprocessing support vector machine.

Support vector machines (SVMs) are an attractive option for detecting correct and incorrect measurements in real-time continuous glucose monitoring systems (RTCGMSs), because their learning mechanism can introduce a postprocessing strategy for imbalanced datasets. The proposed SVM considers the geometric mean to obtain a more balanced performance between sensitivity and specificity. To test this approach, 23 critically ill patients receiving insulin therapy were monitored over 72 h using an RTCGMS, and a dataset of 537 samples, classified according to International Standards Organization (ISO) criteria (372 correct and 165 incorrect measurements), was obtained. The results obtained were promising for patients with septic shock or with sepsis, for which the proposed system can be considered as reliable. However, this approach cannot be considered suitable for patients without sepsis.

[The usefulness of virtual endoscopy and CT urography in the diagnosis of upper urinary tract tumors]. / Utilidad de la endoscopia virtual y el Uro-Tc en el diagnóstico de tumores del tracto urinario superior.

OBJECTIVES: Upper urinary tract (UUT) tumors are a relatively low incidence pathology which often represents a diagnostic challenge for the urologist, because several imaging tests are usually necessary to achieve the final diagnosis. Over the last years CT scan has suffered a notable development and nowadays, with the arrival of new image processing hardware and software, it is possible to detect small urothelial lesions and to perform 3-D urinary tract reconstruction and virtual endoscopic navigation. METHODS: Between January 2004 and June 2005 we performed a total of 15 examinations in 15 patients for the study of asymptomatic hematuria of probable upper urinary tract origin. The technique included three phases to obtain images: basal phase, vascular phase and excretory phase. Processing and image analysis was performed by one radiologist. RESULTS: A total of 10 tumors were diagnosed, with pathological confirmation in all cases. We did not register any complication secondary to the technique, and all patients tolerated well the exam. CONCLUSIONS: The CT urography is a safe, well-tolerated, highly sensitive and efficient imaging test, very useful in the diagnosis of renal and UUT pathology. It may become the only imaging test performed in the study of asymptomatic hematuria and the test of choice for the study of urological tumoral pathology.

Utilidad de la endoscopia virtual y el uro-tc en el diagnóstico de tumores del tracto urinario superior / The usefulness of virtual endoscopy and CT urography in the diagnosis of upper urinary tract tumors

OBJETIVO: Los tumores del tracto urinario superior (TTUS) conforman una patología de incidencia relativamente baja que a menudo suponen un reto diagnóstico para el urólogo ya que, suelen ser necesarias varias pruebas de imagen para alcanzar el diagnóstico definitivo. En los últimos años la tomografía computerizada ha alcanzado un notable desarrollo, y gracias a la aparición de nuevo hardware y software de procesamiento de imágenes actualmente es posible detectar lesiones uroteliales de pequeño tamaño, así como realizar reconstrucciones tridimensionales del tracto urinario y navegación endoscópica virtual por el interior del mismo. MÉTODOS: Entre enero del 2004 y junio de 2005 hemos realizado un total de 15 exploraciones a 15 pacientes durante el estudio de hematuria asintomática de probable origen en el tracto urinario superior, todas ellas indicadas por el Servicio de Urología de nuestro hospital. La técnica incluyó tres fases en la adquisición de imágenes: fase basal, fase vascular y fase excretora. El procesado y análisis de las imágenes fue realizado por un solo radiólogo. RESULTADOS: Un total de 10 tumores fueron diagnosticados, obteniendo en todos los casos confirmación anatomopatológica. No registramos ninguna complicación derivada de la propia técnica, y todos los pacientes toleraron bien la exploración. CONCLUSIÓN: El Uro-TC es una prueba segura, bien tolerada, con una elevada sensibilidad y eficiencia, muy útil en el diagnóstico de la patología renal y del TUS, susceptible de ser utilizada en el futuro como única prueba de imagen radiológica en el estudio de hematuria asintomática y como prueba de elección en el estudio de patología tumoral urológica

OBJECTIVES: Upper urinary tract (UUT) tumors are a relatively low incidence pathology which often represents a diagnostic challenge for the urologist, because several imaging tests are usually necessary to achieve the final diagnosis. Over the last years CT scan has suffered a notable development and nowadays, with the arrival of new image processing hardware and software, it is possible to detect small urothelial lesions and to perform 3-D urinary tract reconstruction and virtual endoscopic navigation. performed a total of 15 examinations in 15 patients for the study of asymptomatic hematuria of probable upper urinary tract origin. The technique included three phases to obtain images: basal phase, vascular phase and excretory phase. Processing and image analysis was performed by one radiologist. RESULTS: A total of 10 tumors were diagnosed, with pathological confirmation in all cases. We did not register any complication secondary to the technique, and all patients tolerated well the exam. CONCLUSIONS: The CT urography is a safe, well- tolerated, highly sensitive and efficient imaging test, very useful in the diagnosis of renal and UUT pathology. It may become the only imaging test performed in the study of asymptomatic hematuria and the test of choice for the study of urological tumoral pathology

[Primary bladder neck obstruction in males]. / Obstrucción primaria del cuello vesical en el varon.

OBJECTIVES: To report our experience on the diagnosis and treatment of this rare type of infravesical functional obstruction. METHODS: Over the last ten years we diagnosed and treated 32 males with this entity. We evaluate previous treatments and time to diagnosis. Clinical, radiological, endoscopic, and urodynamic features are evaluated, as well as results obtained with the administration of alpha-adrenergic blockers and endoscopic transurethral incision of the bladder neck. RESULTS: Patient age ranged from 26 to 48 years (Mean 38.2). All patients presented significant long-lasting lower urinary tract symptoms, having received various non-specific treatments. Uroflowmetry showed a peak of mean flow of 9.8 +/- 3.2 cc/s, being the voiding detrusor pressure 98 +/- 25 cm H2O, with significant post void residual volume in 21 patients (188 +/- 62 cc). Medical treatment with alpha-adrenergic blockers only achieved significant subjective improvement in four patients. Twenty one patients underwent unilateral endoscopic bladder neck incision, obtaining objective and subjective improvements all of them. CONCLUSIONS: Endoscopic bladder neck incision is the treatment of choice of this dysfunction, being imperative to inform the patient of the risk of retrograde ejaculation as a postoperative sequel, since this entity appears in young males, for whom fertility may be a priority.

Obstrucción primaria del cuello vesical en el varón / Primary bladder nexk obstruction in males

OBJETIVO: Presentar nuestra experiencia en el diagnóstico y tratamiento de esta infrecuente modalidad de obstrucción funcional infravesical. MÉTODO: Durante los últimos 10 años hemos diagnosticado y tratado a 32 varones afectos de esta entidad. Se evalúan los diversos tratamientos previos recibidos así como el tiempo transcurrido hasta la realización del diagnóstico. Se valoran las manifestaciones clínicas, radiológicas, endoscópicas y urodinámicas así como los resultados obtenidos con la administración de bloqueadores alfa-adrenérgicos y con la incisión transuretral endoscópica del cuello vesical. RESULTADOS: La edad de los pacientes osciló entre 26 y 48 años (media 38,2). Todos ellos presentaban síntomas significativos del tacto urinario inferior de larga evolución, habiendo recibido diversos tratamientos inespecíficos. El estudio flujométrico evidenció un pico de flujo medio de 9,8 ± 3,2 cc/s, siendo la presión del detrusor durante el vaciado de 98 ± 25 cm H20, existiendo un residuo postmiccional significativo en 21 pacientes de 188 ± 62 cc. Con tratamiento médico mediante la administración de bloqueadores alfa-adrenérgicos únicamente obtuvimos mejorías subjetivas significativas en 4 pacientes. En 21 casos realizamos incisión unilateral endoscópica del cuello vesical, obteniendo mejorías objetivas y subjetivas en todos ellos. CONCLUSIONES: La incisión endoscópica del cuello vesical representa el tratamiento de elección de esta disfunción, siendo imperativo informar al paciente del riesgo de eyaculación retrógrada como secuela postoperatoria, ya que esta entidad ocurre en sujetos jóvenes, en los que la fertilidad puede ser una prioridad

OBJECTIVES: To report our experience on the diagnosis and treatment of this rare type of infravesical functional obstruction. METHODS: Over the last ten years we diagnosed and treated 32 males with this entity. We evaluate previous treatments and time to diagnosis. Clinical , radiological, endoscopic, and urodynamic features are evaluated, as well as results obtained with the administration of alpha-adrenergic blockers and endoscopic transurethral incision of the bladder neck. RESULTS: Patient age ranged from 26 to 48 years (Mean 38.2). All patients presented significant long-lasting lower urinary tract symptoms, having received various non-specific treatments. Uroflowmetry showed a peak of mean flow of 9.8+- 3.2 cc/s, being the voiding detrusor pressure 98+- 25 cm H2O, with significant post void residual volume in 21 patients (188+- 62 cc). Medical treatment with alpha-adrenergic blockers only achieved significant subjective improvement in four patients. Twenty one patients underwent unilateral endoscopic bladder neck incision, obtaining objective and subjective improvements all of them. CONCLUSIONS: Endoscopic bladder neck incision is the treatment of choice of this dysfunction, being imperative to inform the patient of the risk of retrograde ejaculation as a postoperative sequel, since this entity appears in young males, for whom fertility may be a priority

Acerca de la hidronefrosis sintomática en la gestante / Symptomatic hidronephrosis during pregnancy

OBJETIVO La hidronefrosis durante el embarazoes un fenómeno frecuente que afecta al 90% de las gestantes. Aunque habitualmente es asintomática,en un escaso porcentaje de pacientes se manifiesta clínicamente, precisando tratamiento. Con este estudio pretendemos poner de manifiesto nuestra experiencia en el diagnóstico y tratamiento de la uropatía obstructivasintomática en la mujer embarazada.MÉTODOS: Evaluamos retrospectivamente los resultadosobtenidos en 162 gestantes afectas de hidronefrosissintomática atendidas en nuestro servicio durante los últimos doce años.RESULTADOS: El tratamiento conservador fue eficaz en la gran mayoría de las pacientes, precisándose en 39 de ellas medidas mas agresivas; así, en 35 casos se realizó colocación de catéter doble J, en 2 pacientes nefrostomía percutánea y en otras 2 se practicó extracciónureteroscópica de litiasis ureteral.CONCLUSIONES: La etiología mas frecuente de hidronefrosissintomática durante el embarazo la ha constituidola compresión por el útero grávido seguida de la litiasis ureteral. Consideramos de elección el tratamiento conservador, reservando el cateterismo con doble J o la nefrostomía percutánea para casos refractarios. La ureteroscopia constituye una nueva alternativa diagnósticay terapéutica cuando fallan otras medidas menos agresivas

OBJECTIVES: Hydronephrosis is common during pregnancy, affecting 90% of pregnant women. It is usually asymptomatic, but a small percentage of patients show clinical symptoms requiring treatment. We want to report our experience in the diagnosis and treatment of symptomatic obstructive uropathy in pregnant women. METHODS: We retrospectively evaluate the results obtained in 162 pregnant women suffering symptomatic hydronephrosis who received care at our department over the last 12 years. RESULTS: Conservative treatment was effective in most patients, 39 patients required more aggressive therapy. Thirty-five patients underwent insertion of a double J catheter, 2 patients percutaneous nephrostomy, and another 2 ureteroscopy and extraction of ureteral lithiasis. CONCLUSIONS: The most frequent etiology of symptomatic hydronephrosis during pregnancy is external compression by the gravid uterus, followed by ureteral lithiasis. We consider conservative treatment as the treatment of choice, leaving ureteral double J catheter insertion or percutaneous nephrostomy for the refractory cases. Ureteroscopy is a new diagnostic and therapeutic option when other less aggressive measures fail

[Orthotopic bladder substitution in the treatment of interstitial cystitis]. / Sustitución vesical ortotópica en el tratamiento de la cistitis intersticial.

OBJECTIVES: To point out the efficacy of supra trigonal cystectomy with orthotopic substitution iliocystoplasty in the treatment of advanced interstitial cystitis (IC). METHODS: We study the results obtained in four women suffering IC nonrespondent to conservative treatment who underwent the procedure. All patients comply with classic diagnostic criteria of IC, presenting long-lasting symptoms, between 4 and 8 years (mean 5.6), and voiding frequency of near one-hour day and night. RESULTS: Mean postoperative follow-up was 32 months (18 to 56); post operative evaluation included clinical evaluation, ultrasound, urodynamic studies, and radiological tests. Suprapubic pain disappeared in all cases, as well as pre-op lower urinary tract symptoms, with good control of urinary frequency day and night being evident in the immediate postoperative period. All patients referred high satisfaction with the outcome. CONCLUSIONS: When conservative treatment fails, supratrigonal cystectomy with orthotopic neobladder substitution is a valid therapeutic option in IC patients who comply with classic diagnostic criteria.

Tratamiento quirúrgico ambulatorio de la incontinencia urinaria de esfuerzo femenina / Outpatient surgical treatment of female stress urinary incontinence

OBJETIVO: Evaluar los resultados obtenidosen el tratamiento quirúrgico ambulatorio de laincontinencia urinaria de esfuerzo genuina (IUE), durantelos cinco años de integración del Servicio deUrología en la Unidad de Cirugía Mayor Ambulatoria(UCMA) de nuestro Consorcio Hospital GeneralUniversitario de Valencia (CHGUV).MÉTODO: Entre enero de 2000 y diciembre de2004, hemos intervenido en la UCMA del CHGUV a26 pacientes (49-78; media 69,8 años) afectas deIUE, mediante la colocación de cabestrillo suburetral sintensión (TVT), realizado con anestesia local-sedación yen régimen estrictamente ambulatorio. Todas laspacientes fueron evaluadas mediante clínica y urodinamia,excluyéndose a las que presentaron algún tipo deprolapso concomitante genital, urinario o entérico y lasque no cumplían requisitos sociales para CMA. No seexcluyeron las que habían recibido con anterioridad alguna otra técnica quirúrgica antiincontinencia. Seevalúan los criterios de inclusión y alta, así como losresultados obtenidos y el grado de satisfacción mediantela elaboración de un cuestionario.RESULTADOS: En 22 pacientes (85%) se evidenció unaIUE pura y en 4 (15%) una mixta con predominio deesfuerzo. El 54% (14 pacientes) fueron ASA I, 8 (31%)ASA II y el 15% restante (4) ASA III bien compensada.La tolerancia a la intervención bajo anestesia local (20-30 ml. lidocaína al 1%) fue buena en todas las pacientes,habiéndose utilizado sedoanalgesia adicional (perfusiónde propofol y remifentanilo) en 10 de ellas (38%). El tiempo medio de intervención fue de 30 minutos(25-45) y el de permanencia en la UCMA hasta el altade 100 minutos (80-140). Todas fueron dadas de altatras la intervención. Ninguna precisó ingreso ni presentóretención urinaria tras la retirada de la sonda. Entodas desapareció la IUE. Tres pacientes presentaronurgencia miccional postoperatoria que respondieron alos anticolinérgicos orales. Los resultados obtenidosson superponibles a los alcanzados con anestesia epidurale ingreso, siendo el grado de satisfacción con eltratamiento recibido superior al 95%.CONCLUSIONES: El desarrollo de nuevos sistemasrevolucionarios en el tratamiento de la IUE ha simplificadola cirugía de esta entidad de tal manera quepodemos afirmar que un elevado porcentaje de pacientesafectas son candidatas a ser incluidas en un programade CMA, mejorando ostensiblemente la relacióncosto-eficacia, no disminuyendo por ello la calidadasistencial ni el grado de satisfacción de las pacientes

OBJECTIVES: To evaluate the results of the outpatient surgical treatment of genuine female stress urinary incontinence (SUI) over a five year period since the integration of the Department of Urology in the Ambulatory Surgery Unit at our hospital “Consorcio Hospital General Universitario de Valencia” (CHGUV). METHODS: Between January 2000 and December 2004 26 patients (ages 49-78; mean age 69.8 yr.) with the diagnosis of SUI underwent tension-free suburethral mesh sling (TVT) outpatient operations under local anesthesia-sedation at the ambulatory surgery unit of the CHGUV. All patients had clinical and urodynamic evaluation, excluding those presenting genital prolapse or non compliance with the social requirements for ambulatory surgery. Previous anti-incontinence surgery was not an exclusion criterion. We evaluate inclusion and discharge criteria, results and satisfaction degree measured by a questionnaire. RESULTS: 22 patients (85%) had genuine SUI and 4 (15%) had mixed UI with predominance of the stress component. 54% (14 ) of the patients were ASA I, 31% (8) ASA II, and 15% (4) well compensated ASA III. Operation tolerance under local anesthesia (20-30 ml 1% lidocaine) was good in all patients, having used additional sedation-analgesia (propofol-remifentanil IV perfusion) in 10 of them (38%). Mean operative time was 30 minutes (25-45) and stay at the unit discharge was 100 min. (80-140). All patients were discharged the same day. None of them required readmission or presented urinary retention after catheter removal. SUI disappeared in all of them. Three patients presented postoperative urge incontinence responsive to oral anticolinergic drugs. Our results are similar to those obtained with epidural anesthesia and hospital admission, being the degree of satisfaction with treatment higher than 95%. CONCLUSIONS: The development of new, revolutionary systems for the treatment of SUI has simplified the surgical treatment of this entity, so that we can say a high percentage of patients may be included in an ambulatory surgery program, significantly improving cost-efficacy without diminishment of health-care quality or patient satisfaction

Sustitución vesical ortotópica en el tratamiento de la cystitis intersticial / Orthotopic bladder substitution in the treatment of interstitial cystitis

OBJETIVOSPoner de manifiesto la eficacia de la cistectomía supratrigonal e ileocistoplastia de sustitución ortotópica en el tratamiento de la cistitis intersticial (CI) avanzada. METODOSSe estudian los resultados obtenidos en cuatro mujeres afectas de CI que no respondieron a medidas conservadoras y fueron tratadas mediante esta técnica quirúrgica. Todas las pacientes cumplían los criterios clásicos de la enfermedad, presentado todas ellas una sintomatología de larga evolución, que osciló entre los 4 y 8 años (media 5´6), y presentaban una frecuencia miccional prácticamente horaria, tanto diurna como nocturna. RESULTADOSEl seguimiento postoperatorio medio fue de 32 meses (rango de 18 a 56), habiéndose realizado evaluación postquirúrgica, tanto clínica como ecográfica, urodinámica y radiológica. En todos los casos desapareció el dolor suprapúbico así como la sintomatología miccional previa, controlando todas ellas la frecuencia miccional, tanto diurna como nocturna, siendo evidente la desaparición de los síntomas ya en el postoperatorio inmediato, refiriendo todas las pacientes un elevado índice de satisfacción con los resultados de su intervención. CONCLUSIONESEn pacientes afectos de CI que cumplen los criterios clásicos del diagnóstico de la enfermedad, cuando fracasan las medidas conservadoras, la cistectomía supratrigonal con sustitución vesical ortotópica constituye una opción terapéutica válida

OBJECTIVES: To point out the efficacy of ;;supra trigonal cystectomy with orthotopic substitution ;;iliocystoplasty in the treatment of advanced interstitial ;;cystitis (IC). ;;METHODS: We study the results obtained in four ;;women suffering IC nonrespondent to conservative ;;treatment who underwent the procedure. All patients ;;comply with classic diagnostic criteria of IC, presenting ;;long-lasting symptoms, between 4 and 8 years (mean ;;5.6), and voiding frequency of near one-hour day and ;;night. ;;RESULTS: Mean postoperative follow-up was 32 months (18 to 56); post operative evaluation included clinical evaluation, ultrasound, urodynamic studies, and radiological tests. Suprapubic pain disappeared in all cases, as well as pre-op lower urinary tract symptoms, with good control of urinary frequency day and night being evident in the immediate postoperative period. All patients referred high satisfaction with the outcome. CONCLUSIONS: When conservative treatment fails, supratrigonal cystectomy with orthotopic neobladder substitution is a valid therapetuic option in IC patients who comply with classic diagnostic criteria

[The treatment of hydrocele as ambulatory surgery]. / Tratamiento del hidrocele en cirugia mayor ambulatoria.

OBJECTIVES: To evaluate the results of this surgical treatment of hydrocele over the first four years of integration of the Urology Department in the Major Ambulatory Surgery Unit in our Hospital. METHODS: From January 2000 to July 2004 we have performed 167 hydrocelectomies as ambulatory surgery in 152 patients (15 cases bilateral) with ages ranging from 16-87 years (mean 52.6). All procedures were performed under local anesthesia, using between 10-15ml of 1% lidocaine. The Lord's vaginalis plication technique was employed in 92% of the cases, leaving resection techniques for the remaining 8%, which presented certain degree of enlargement of the tunica vaginalis. We evaluated inclusion and discharge criteria, results, and degree of satisfaction by means of a questionnaire. RESULTS: Results are equivalent to those of inpatient surgery. Only one patient required admission to the hospital due to a postoperative complication, which was clearly independent of the ambulatory character of the process. Satisfaction with treatment was higher than 95%. CONCLUSIONS: Almost all patients with hydrocele are candidates to ambulatory surgery, significantly improving the cost-efficacy rate, without diminishing the quality of care or patient satisfaction.

Tratamiento del hidrocele en cirugía mayor ambulatoria / The treatment of hydrocele as ambulatory surgery

OBJETIVO: Evaluar los resultados obtenidosen el tratamiento quirúrgico del hidrocele durantelos cuatro primeros años de integración del Servicio deUrología en la Unidad de Cirugía Mayor Ambulatoria(CMA) de nuestro Hospital.MÉTODO: Desde enero de 2000 hasta julio de 2004,hemos realizado 167 hidrocelectomías con carácterambulatorio a 152 pacientes (en 15 casos bilateral),con edades comprendidas entre 16 y 87 años (media52,6). Todos los pacientes fueron intervenidos bajoanestesia local, precisando entre 10 y 15 ml de lidocaínaal 1%. La técnica de plicatura vaginal de Lord fueempleada en el 92% de los casos, reservándose lastécnicas resectivas para el 8% restante que presentabancierto grado de paquivaginalitis. Se evalúan los criteriosde inclusión y alta, así como los resultados obtenidosy el grado de satisfacción mediante la elaboraciónde un cuestionario.RESULTADOS: Los resultados obtenidos son superponiblesa los de la cirugía con ingreso. Tan solo uno de lospacientes precisó ingreso por complicación postoperatoria,la cual fue claramente independiente del régimende ambulatorización del proceso. El grado de satisfaccióncon el tratamiento recibido ha sido superior al95%.CONCLUSIONES: La práctica totalidad de los pacientesafectos de hidrocele son candidatos a ser incluidosen un programa de CMA, mejorando ostensiblementela relación costo-eficacia, no disminuyendo por ello lacalidad asistencial ni el grado de satisfacción de lospacientes

OBJECTIVES: To evaluate the results of this surgical treatment of hydrocele over the first four years of integration of the Urology Department in the Major Ambulatory Surgery Unit in our Hospital. METHODS: From January 2000 to July 2004 we have performed 167 hydrocelectomies as ambulatory surgery in 152 patients (15 cases bilateral) with ages ranging from 16-87 years (mean 52.6). All procedures were performed under local anesthesia, using between 10-15ml of 1% lidocaine. The Lord’s vaginalis plication technique was employed in 92% of the cases, leaving resection techniques for the remaining 8%, which presented certain degree of enlargement of the tunica vaginalis. We evaluated inclusion and discharge criteria, results, and degree of satisfaction by means of a questionnaire. RESULTS: Results are equivalent to those of inpatient surgery. Only one patient required admission to the hospital due to a postoperative complication, which was clearly independent of the ambulatory character of the process. Satisfaction with treatment was higher than 95%. CONCLUSIONS: Almost all patients with hydrocele are candidates to ambulatory surgery, significantly improving the cost-efficacy rate, without diminishing the quality of care or patient satisfaction

[Genitourinary tuberculosis in the urologic works of Professor Rafael Mollá Rodrigo]. / La tuberculosis genitourinaria en la obra urológica del profe- sor Rafael Mollá Rodrigo (1862--1930). Análisis documental histórico de su obra.

OBJECTIVES: Professor Rafael Molla Rodrigo is considered by some the author who contributed with his scientific work and solid technique to consolidate Urology as a speciality in Valencia. Such importance is also perceived in a national level, as demonstrated by the fact that he belonged to the first board of the Spanish Association of Urology and contributed to its foundation in the two-year period 1910--1911, from his position of head of the department of Surgical Therapy and Operations at the Central University. Genitourinary tuberculosis is one of the most outstanding chapters of his extensive works. METHODS: We reviewed all his works, selecting all original articles about genitourinary tuberculosis. Original articles have been obtained from the journals Revista de Higiene y Tuberculosis, La Medicina Valenciana, Revista Valenciana de Ciencias Médicas y Policínica, and from his two most important books, Clinical Lessons In Urology and Clinical Lessons in Urology and Genitourinary Surgery. RESULTS: Throughout his work he analyzes features of relevance about this disease, such as diagnosis, about which he emphasizes the clinical and bacteriological difficulties, and treatment, which was only feasible by precocious nephrectomy. CONCLUSIONS: He dedicates a great part of his work to the study of this pathology and defends a precocious diagnosis in order to perform the only treatment that had demonstrated efficacy. He also exposes the symptoms and variety of clinical presentations, as well as diagnosis through separate kidney catheterization with the aim to determine unilateral involvement.

[Management of male sterility in patients taking anabolic steroids]. / Manejo de la esterilidad masculina en pacientes consumidores de esteroides anabolizantes.

OBJECTIVES/METHODS: To review the incidence of male infertility secondary to intake of anabolic products and our experience and outcomes with treatment. There is a variety of such substances (testosterone, nandrolone, stanozolol, etc.) in their intake may be unique or combinations, both orally or parenterally. Comparisons between patients and case series are difficult because of the hiding of this practice and various consumption practices and doses employed. RESULTS/CONCLUSIONS: Most of the patients recover normal spermatogenesis does by stopping intake of anabolic substances. The period of time until recovery is 6.35 months. Patients not recovering after six months were given tamoxifen 20 mg/24-hour, if having a normal or inhibited hypothalamus-hypophysis axis. Duration of abuse, doses, and anarchical consumption maderesponse to treatment with antiestrogen drugs or gonadotropins unpredictable in patients not responding to conservative treatment.

[Bladder squamous metaplasia: report of one case and bibliographic review]. / Metaplasia escamosa vesical, a propósito de un caso. Revisión de la uteratura.

OBJECTIVES: We report a new case of squamous metaplasia because of its interest and subtle differential diagnosis with other bladder pathologies. METHODS: We report the case of a male patient with history of previous neoplasia with an exophytic lesion of the bladder wall discovered on follow-up. Pathological diagnosis after TUR was bladder squamous metaplasia. RESULTS: Follow-up is performed by ultrasound, cystoscopy, and urine cytology in adherence to clinical guidelines due to the possibility of transformation into squamous cell carcinoma. CONCLUSIONS: Urothelium is able to develop non neoplastic transformations such as squamous metaplasia. The importance of such transformations depends on proper diagnosis and follow-up due to their ability to transform into a neoplastic process.

La tuberculosis genitourinaria en la obra urológica del profesor Rafael Mollá Rodrigo (1862-1930). Análisis documental histórico de su obra / Genitourinary tuberculosis in the urologic works of Professor Rafael Molla Rodrigo

OBJETIVO: El profesor Rafael Mollá Rodrigo está considerado por diversos autores, el autor que contribuyó con su obra científica y solidez técnica a consolidar la urología como especialidad en Valencia. Dicha importancia también se percibe a nivel nacional, como demuestra el hecho que perteneciese a la primera junta directiva de la Asociación Española de Urología y contribuyese a su fundación en el bienio 1910-1911, desde su cátedra de terapéutica quirúrgica y operaciones en la universidad central. La tuberculosis genitourinaria es uno de los capítulos más destacados de su extensa obra. MÉTODOS: Hemos revisado toda su obra, extrayendo todos los artículos originales en materia de tuberculosis genitourinaria. Los artículos originales han sido obtenidos de la Revista de Higiene y Tuberculosis, La Medicina Valenciana, Revista Valenciana de Ciencias Médicas y Policlínica, y de sus dos libros más importantes, Lecciones Clínicas de Urología y Lecciones Clínicas de Urología y Cirugía Genitourinaria. RESULTADOS: Analiza a lo largo de su obra aspectos tan relevantes como el diagnóstico, donde resalta las dificultades tanto clínicas como bacteriológicas y tratamiento de esta enfermedad, por entonces solo factible mediante la nefrectomía precoz. CONCLUSIONES: Dedica gran parte de su obra al estudio de esta patología y defiende un diagnóstico precoz para aplicar el único tratamiento que ha demostrado su efectividad. También expone la sintomatología y sus variadas formas clínicas, así como el diagnóstico a través del cateterismo de ambos riñones, con la finalidad de determinar la unilateralidad de la lesión (AU)

OBJECTIVES: Professor Rafael Molla Rodrigo is considered by some the author who contributed with his scientific work and solid technique to consolidate Urology as a speciality in Valencia. Such importance is also perceived in a national level, as demonstrated by the fact that he belonged to the first board of the Spanish Association of Urology and contributed to its foundation in the two-year period 1910-1911, from his position of head of the department of Surgical Therapy and Operations at the Central University. Genitourinary tuberculosis is one of the most outstanding chapters of his extensive works. METHODS: We reviewed all his works, selecting all original articles about genitourinary tuberculosis. Original articles have been obtained from the journals Revista de Higiene y Tuberculosis, La Medicina Valenciana, Revista Valenciana de Ciencias Médicas y Policínica, and from his two most important books, Clinical Lessons In Urology and Clinical Lessons in Urology and Genitourinary Surgery. RESULTS: Throughout his work he analyzes features of relevance about this disease, such as diagnosis, about which he emphasizes the clinical and bacteriological difficulties, and treatment, which was only feasible by precocious nephrectomy. CONCLUSIONS: He dedicates a great part of his work to the study of this pathology and defends a precocious diagnosis in order to perform the only treatment that had demonstrated efficacy. He also exposes the symptoms and variety of clinical presentations, as well as diagnosis through separate kidney catheterization with the aim to determine unilateral involvement (AU)