[Effectiveness and tolerability of zoledronic acid in the treatment of metastatic prostate cancer]. / Efectividad y tolerabilidad del acido zoledrónico en el tratamiento del cancer de próstata metastásico.

OBJECTIVES: To assess the effectiveness and tolerability of zoledronic acid in prostate cancer patients with bone metastases at the hormone-sensitive (HS) and hormone-independent (HI) stages. MATERIALS AND METHODS: A nationwide, observational, prospective, open and multi-centre trial was devised, with a total of 218 male patients diagnosed with prostate cancer at the HS stage (36%) or HI stage (64%) who were administered zoledronic acid (4 mg/IV/month for 6 months) in addition to their specific oncological treatment. Effectiveness was assessed by the following means: 1) Assessment of the improvement in pain and mobility; 2) Incidence and time to onset of skeletal-related events (SREs) and 3) Analysis of bone markers. Tolerability was assessed by means of registering the number and type of adverse effects. A satisfaction survey was carried out amongst the patients after the end of the trial. RESULTS: Out of the 218 patients, 170 (78%) were evaluable for effectiveness. A decrease in pain ratings at rest and during movement was observed in all patients, whether in the HS or HI groups (p < 0.0001). Improved mobility was observed likewise (p = 0.005), as was quality of life. The global incidence of skeletal events was 11.2%, with a time to onset of SREs of 10.7 months. There were no significant differences observed between HS vs. HI patients. Osteolysis markers (N-telopeptide) decreased significantly with the treatment across both the HS and HI groups. For safety reasons. 212 patients were evaluable (97.2%). The incidence of adverse drug reactions was 16% (34/212) and was found to be significantly higher in HS patients (22.4%) compared with HI patients (11.9%). Overall, the tolerability of zoledronic acid was good, with no significant morbidity in either group (HS and HI). 66% of the patients reported feeling satisfied or very satisfied. CONCLUSIONS: Zoledronic acid proved effective in the relief of pain, improving mobility and quality of life as well as reducing or delaying the occurrence of skeletal-related events in prostate cancer patients presenting metastatic bone disease, regardless of the phase, whether HS or HI, they found themselves in. Tolerability and patient satisfaction were rates as good.

Efectividad y tolerabilidad del ácido zoledrónico en el tratamiento del cancer de próstata metastásico / Effectiveness and tolerability oz zoledronic acid in the treatment of metastatic prostate cancer

Objetivos: Evaluar la efectividad y tolerabilidad del ácido zoledrónico en pacientes con cáncer de próstata y metástasis óseas en fase hormono sensible (HS) y hormono independiente (HI). Material y Métodos: Se diseñó un estudio de ámbito nacional, observacional, prospectivo, abierto, y multicéntrico, Se incluyeron un total de 218 varones diagnosticados de cáncer de próstata en fase HS (36%) o HI (64%) que recibieron, además del tratamiento oncológico específico, ácido zoledrónico (4 mg/IV/mes durante 6 meses). Se evaluó la efectividad mediante: 1) Evaluación de la mejoría del dolor y movilidad; 2) Incidencia y tiempo de aparición de eventos esqueléticos (TEE); y 3) Análisis de marcadores óseos. La tolerabilidad se estudió registrando el número y tipo de efectos adversos. Se realizó una encuesta de satisfacción al paciente tras finalizar el tratamiento. Resultados: De los 218 pacientes, 170 (78%) fueron evaluables para efectividad. En todos ellos, ya fueran del grupo HS o HI, se observó una disminución de la puntuación del dolor en reposo y en movimiento (p<0,0001), una mejora en la movilidad (p=0,005), y en la calidad de vida. La incidencia global de eventos esqueléticos fue del 11,2%, con un TEE de 10,7 meses. No hubo diferencias significativas entre los pacientes HS respecto a los HI. Los marcadores de osteolisis (N-telopéptido) descendieron significativamente con el tratamiento, tanto en los HS como HI. Para seguridad fueron evaluables 212 pacientes (97,2%). La incidencia de las reacciones adversas fue del 16% (34/212), siendo significativamente mayor en los pacientes HS (22,4%) con respecto a los HI (11,9%). Globalmente la tolerabilidad al ácido zoledrónico fue buena, sin morbilidad significativa entre ambos grupos (HS y HI).Un 66% de los pacientes contestaron sentirse satisfechos o muy satisfechos. Conclusiones: El ácido zoledrónico se mostró eficaz para aliviar el dolor, mejorar la movilidad y aumentar la calidad de vida y reducir o retrasarlos eventos esqueléticos en los pacientes con cáncer de próstata con enfermedad ósea metastásica sintomática, independientemente de la fase, HSo HI en que se encuentren. La tolerabilidad y la satisfacción de los pacientes fue buena (AU)

Objetives: To assess the effectiveness and tolerability of zoledronic acid in prostate cancer patients with bone metastases at the hormone-sensitive (HS) and hormone-independent (HI) stages. Materials and Methods: A nationwide, observational, prospective, open and multi-centre trial was devised, with a total of 218 male patients diagnosed with prostate cancer at the HS stage (36%) or HI stage (64%) who were administered zoledronic acid (4 mg/IV/month for 6 months) in addition to their specific oncological treatment. Effectiveness was assessed by the following means: 1) Assessment of the improvement in pain and mobility; 2) Incidence and time to onset of skeletal-related events (SREs) and 3) Analysis of bone markers. Tolerability was assessed by means of registering the number and type of adverse effects. A satisfaction survey was carried out amongst the patients after the end of the trial. Results: Out of the 218 patients, 170 (78%) were evaluable for effectiveness. A decrease in pain ratings at rest and during movement was observed in all patients, whether in the HS or HI groups (p<0,0001). Improved mobility was observed likewise (p=0,005), as was quality of life. The global incidence of skeletal events was 11.2%, with a time to onset of SREs of 10.7 months. There were no significant differences observed between HS vs. HI patients. Osteolysis markers (N-telopeptide) decreased significantly with the treatment across both the HS and HI groups. For safety reasons, 212 patients were evaluable (97.2%). The incidence of adverse drug reactions was 16% (34/212) and was found to be significantly higher in HS patients (22.4%) compared with HI patients (11.9%). Overall, the tolerability of zoledronic acid was good, with no significant morbidity in either group (HS and HI). 66% of the patients reported feeling satisfied or very satisfied. Conclusions: Zoledronic acid proved effective in the relief of pain, improving mobility and quality of life as well as reducing or delaying the occurrence of skeletal-related events in prostate cancer patients presenting metastatic bone disease, regardless of the phase, whether HS or HI, they found themselves in. Tolerability and patient satisfaction were rates as good (AU)

[Sudden anuria secondary to migration of aortic stent in a single kidney patient]. / Anuria súbita en paciente monorreno secundaria a migración de endoprótesis aórtica.

Percutaneous acces to manage infrarenal aortic aneurysm is a less aggressive technique, but it's not entirely risk free. The migration of stents isn't a frequent complication in that percutaneous technique. Urgent left renal revascularition, when anterior approach or autologous transplantation is not possible, is feasibily by a splenorenal shunt through a lumbar approach.

Anuria súbita en paciente monorreno secundaria a migración de endoprótesis aórtica / Sudden anuria secondary to migration of aortic stent in a single kidney patient

El manejo percutáneo de los aneurismas de aorta infrarrenal es una técnica menos agresiva, pero no está exenta de riesgos. La migración craneal de las endoprótesis es un proceso infrecuente en dicha técnica. Ante una revascularización renal izquierda de urgencia en que no se pueda tener acceso a una vía anterior o la posibilidad de un autotrasplante, una buena alternativa es la realización de unshunt esplenorrenal mediante un acceso lumbar (AU)

Percutaneous acces to manage infrarenal aortic aneurysm is a less aggressive technique, but it’s not entirely risk free. The migration of stents isn’t a frequent complication in that percutaneous technique. Urgent left renal revascularition, when anterior approach or autologous transplantation is not possible, is feasibily by a splenorenal shunt through a lumbar approach (AU)

[Nd-YAG laser photocoagulation of scrotal sebaceous cysts]. / Fotocoagulación con láser de Nd-YAG de quistes sebáceos escrotales.

Scrotum's sebaceous cyst is an usual pathology, not life threatening, but susceptible of infection, producing abscess with their associated cosmetic and psychological disturbance. The classical management is the complete excision, under local anaesthesia, to prevent its recidive. Until today, the use of de Nd-YAG laser for the management of the scrotum's sebaceous cysts as not been reported. We report a case of a young man with several scrotum's sebaceous cysts, treated successfully with the use of a Nd-YAG laser.

Fotocoagulacion con láser de Nd-YAG de quistes sebaceos escrotales / Phtocoagulation with Nd-YAG Laser of scrotum's sebaceous cysts

Los quistes sebáceos escrotales constituyen una frecuente patología, que si bien no es importante por sí misma, pueden infectarse ocasionando pequeños abscesos, con repercusión estética y psicológica en el paciente. El tratamiento clásico de los mismos es su exéresis con anestesia local, procurando extirpar la totalidad de los mismos, ya que de no actuar así, la recidiva es la norma. Hasta la fecha, el uso del láser de Nd-YAG en el tratamiento de los quistes sebáceos escrotales no ha sido descrito. Presentamos el caso de un paciente joven, con multitud de quistes sebáceos escrotales, que con la aplicación complementaria del láser de Nd-YAG se pudo controlar el problema de forma sencilla (AU)

Leiomioma vesical / Leiomyoma of the bladder

Presentamos un nuevo caso de leiomioma vesical en una paciente con clínica inespecífica, y en la que las pruebas de imagen preoperatorias no lo orientaron. El diagnóstico definitivo lo dio el estudio anatomopatológico de la pieza quirúrgica (AU)

[Selective embolization of post-traumatic renal pseudoaneurysm in monorenal patient]. / Embolización selectiva de pseudoaneurisma renal post-traumático en paciente monorreno.

Presentation of one case of a patient who presented two non-penetrating abdominal traumatism along a year period. In the first incident it was necessary to practice a left nefrectomy and in the second one the therapeutic opcion was a superselective embolization of a pseudoameurism communicated with urinary tract.

Embolización selectiva de pseudoaneurisma renal post-traumático en paciente monorreno / Superselective embolization of post-traumatic pseudoaneurysm renal un a monorrenal pacient

Presentamos el caso de un paciente que en el intervalo de un año había sufrido dos traumatismos abdominales no penetrantes. En el primer episodio fue necesario practicar nefrectomía izquierda y en el segundo la opción terapéutica llevada a cabo fue la embolización selectiva de un pseudoaneurisma comunicado a la vía urinaria (AU)

[Bladder leiomyoma]. / Leiomioma vesical.

A new case of leiomyoma of the bladder is presented in a patient with unspecific symptoms and the preoperatives patterns don't give to a certainty diagnosis. The conclusive diagnosis was obtained with pathoanatomical study of the quirurgic piece.

[Relationship between tumor recurrence and the expression of the p53 gene in primary superficial transitional carcinoma of the bladder]. / Relación entre las recidivas tumorales y la expresión del gen p53 en los carcinomas transicionales superficiales primarios de vejiga.

Contribution of 60 patients with primary surface transitional cell tumours of the bladder where nuclear expression of p53 protein was prospectively studied and compared to known prognostic factors in an attempt to find out its role in the development of relapses. An statistically significant relationship was found between the protein expression and cytology, tumoral multifocality, stage, relapse development and tumoral progression. It can be concluded that expression of this protein can be of use as relapse predictor.

Relación entre las recidivas tumorales y la expresión del gen p53 en los carcinomas transicionales superficiales primarios de vejiga / Relationship between tumoral relapses and p53 gen expresssion in primary surface transitional cell carcinoma of the bladder

Presentamos 60 casos de pacientes con tumores vesicales superficiales primarios de células transicionales, en los cuales hemos estudiado de forma prospectiva la expresión nuclear de la proteína p53, y la hemos comparado con factores pronósticos conocidos, intentando averiguar asimismo su papel en la aparición de recidivas. Se ha observado la existencia de una relación estadísticamente significativa entre dicha expresión y la citología, la multifocalidad tumoral, el estadio, la aparición de recidivas y la progresión tumoral. Podemos concluir que la expresión de esta proteína puede ser útil como factor predictor de las recidivas. (AU)

[Kidney annulment and bladder lithiasis secondary to ureteral catheter]. / Anulación renal y litiasis vesical secundaria a catéter ureteral.

We reported a case of a kidney annulment and bladder stone secondary a foreign body (ureteral stent). We review all the cases of urinary stone secondary a foreign bodies.

Anulación renal y litiasis vesical secundaria a catéter ureteral / Kidney annulment and bladder stone secondary and ureteral stent

Presentamos un caso de anulación renal y litiasis vesical secundaria a la presencia prolongada de un catéter ureteral.Revisamos los casos de litiasis urinaria secundaria a cuerpos extraños (AU)

[Expression of the tumor suppressor gene p53 in superficial transitional carcinoma of the bladder]. / Expresión del gen supresor tumoral p53 en los carcinomas transicionales superficiales de vejiga.

Presentation of 113 cases of transitional cells surface tumours of the bladder where p53 protein expression has been used and compared to known prognostic factors. The existence of a statistically significant relationship between this expression and the tumoral grade and stage in all studied groups has been noticed. It can be concluded that the expression of this protein can be useful as a new prognostic factor, even though it is still necessary to conduct more studies, basically prospective.

[Leiomyosarcoma originating in the renal vein. A special case]. / Leiomiosarcoma originado en vena renal. Un caso especial.

OBJECTIVES: An additional case of leiomyosarcoma of the renal vein is presented and the literature reviewed. METHODS/RESULTS: The patient had a history of hypertension. He and his brother were the first case of twins with bilateral retinoblastoma reported in the literature. The pathological findings were diagnostic of leiomyosarcoma of the renal vein. The clinical features, diagnosis and treatment are discussed. CONCLUSIONS: Leiomyosarcoma of the renal vein is an uncommon tumor which presents difficulties in making the preoperative diagnosis. A possible relationship may exist between this tumor type and the radiotherapy administered during childhood due to retinoblastoma.

[Transperineal drainage of prostatic abscess]. / Drenaje transperineal de un absceso prostático.

The availability of antibiotics has made prostatic abscess an uncommon disease. A case of prostatic abscess is described. The etiopathogenesis, clinical features, diagnosis and treatment of this disease entity are discussed.

[Extracorporeal piezogenerated shockwave lithotripsy. Our experience in 500 cases]. / Litotricia extracorpórea por ondas de choque piezogeneradas. Nuestra experiencia en 500 casos.

Between April 1987 and August 1988, 498 patients suffering renal or ureteral lithiasis, all of them with a 6 months or more follow-up period, have been treated in our Unit. Patients were treated in an ambulatory regime without need for anesthesia or analgesia. Up to 27% of the cases has surgical background for lithiasis. One hundred and twenty-six patients had a double J ureteral catheter placed prior to lithotripsy treatment. Fourty-four percent cases needed only one session, 25% two, 12% three and 18% more than three sessions. At the time of discharge 86% patients had no lithiasis or fragments less than 3 mm. Only 9% had fragments larger that 3 mm. It is our opinion than piezoelectric extracorporeal lithotripsy has been proven as a safe, effective and painless procedure in most renal lithiasis.

[Fistulization in xanthogranulomatous pyelonephritis. Presentation of 6 clinical cases and review of the literature]. / Fistulización en la pielonefritis xantogranulomatosa. Presentación de 6 casos clínicos y revisión de la literatura.

Fistulization is an uncommon complication in Xanthogranulomatous Pyelonephritis, but harmful for the adjacent organs. Owing to their rare localization we present 6 cases with scrotal skin, bronchi, colon and spleen fistulization.