Ewing-like sarcoma bladder primary tumour: A case report and literature review.

Bladder primitive neuroectodermal tumors are extremely rare but are most frequent in older adult. 59-year-old man that complained of hematuria for the previous 24 h, urethral syndrome, and pain in the right renal fossa over the previous two weeks. No definitive management or treatment guidelines have been established. Hematuria is the most frequent symptom. Advanced age, metastasis, and incomplete tumor resection are determinants of a poor prognosis. Ewing-like bladder primary tumor is a rare entity with a poor prognosis, hence an aggressive treatment combining surgery and chemotherapy must be considered from the beginning.

Priapismo de alto flujo en población pediátrica: serie de casos y revisión de la literatura / High-flow Priapism in Pediatric Population: Case Series and Review of the Literature

Introducción: El priapismo consiste en una erección mantenida durante más de cuatro horas. Es una patología infrecuente en la población pediátrica, estimada en 0,3 a 1,5 por cada 100.000 niños al año. La secuencia diagnóstica incluye anamnesis, exploración física y ecografía doppler peneana (EcoDP). No siempre es necesaria la punción de cuerpos cavernosos para establecer el diagnóstico diferencial entre priapismo de alto y bajo flujo. El tratamiento de elección en la edad pediátrica no está bien definido.Material y métodosEstudio multicéntrico, retrospectivo, descriptivo de pacientes menores de 14 años con priapismo de alto flujo, entre los años 2010 y 2020. Revisión de la literatura.ResultadosUn total de siete pacientes fueron diagnosticados de priapismo de alto flujo. Ninguno requirió punción de cuerpos cavernosos. Se realizó un manejo conservador en todos ellos, dos pacientes necesitaron embolización arterial superselectiva por persistencia de la clínica.ConclusionesEl priapismo de alto flujo es una entidad muy infrecuente en la edad pediátrica por lo que es importante conocer el diagnóstico y manejo adecuados. Actualmente, la ecografía doppler suele ser suficiente para el diagnóstico, obviando el uso de la gasometría. El manejo inicial en niños es conservador, reservando la embolización para los casos refractarios. (AU)

Introduction: Priapism is a prolonged erection that lasts longer than four hours. It is a rare pathology in the pediatric population, with an estimation of 0.3-1.5 per 100,000 children per year. The diagnostic sequence includes clinical history, physical examination and penile Doppler ultrasound (PDUS). Puncture of corpora cavernosa is not always necessary to establish the differential diagnosis between high-flow and low-flow priapism. The treatment of choice in pediatric age is not well defined.Patients and methodsMulticentric, retrospective and descriptive study including patients under 14 years with high-flow priapism between 2010 and 2020. Literature review.ResultsA total of seven patients were diagnosed with high-flow priapism. None of them required puncture of the corpora cavernosa. Patients were treated with a conservative management, two patients required superselective arterial embolization due to persistent symptoms.ConclusionsHigh-flow priapism is a very rare entity in pediatric age; therefore, knowing the proper diagnosis and management is crucial. Currently, penile doppler ultrasound is enough for diagnosis in most cases and allows obviating the use of blood gas analysis. Children should be initially treated with a conservative management, reserving embolization for refractory cases. (AU)

High-flow Priapism in Pediatric Population: Case Series and Review of the Literature. / Priapismo de alto flujo en población pediátrica: serie de casos y revisión de la literatura.

INTRODUCTION: Priapism is a prolonged erection that lasts longer than four hours. It is a rare pathology in the pediatric population, with an estimation of 0.3-1.5 per 100,000 children per year. The diagnostic sequence includes clinical history, physical examination and penile Doppler ultrasound (PDUS). Puncture of corpora cavernosa is not always necessary to establish the differential diagnosis between high-flow and low-flow priapism. The treatment of choice in pediatric age is not well defined. PATIENTS AND METHODS: Multicentric, retrospective and descriptive study including patients under 14 years with high-flow priapism between 2010 and 2020. RESULTS: A total of seven patients were diagnosed with high-flow priapism. None of them required puncture of the corpora cavernosa. Patients were treated with a conservative management, two patients required superselective arterial embolization due to persistent symptoms. CONCLUSIONS: High-flow priapism is a very rare entity in pediatric age; therefore, knowing the proper diagnosis and management is crucial. Currently, penile doppler ultrasound is enough for diagnosis in most cases and allows obviating the use of blood gas analysis. Children should be initially treated with a conservative management, reserving embolization for refractory cases.

Evaluación de las nuevas técnicas quirúrgicas para tratar la incontinencia urinaria femenina / Evaluation of the new surgical techniques in the treatment of female urinary incontinence

Objetivo: Evaluar la eficacia y seguridad de distintas técnicas quirúrgicas con bandas para la IUF, realizadas entre febrero de 2000 y junio de 2004, así como el grado de satisfacción de las pacientes operadas en nuestro servicio. Material y métodos: Se ha realizado un estudio transversal, retrospectivo, analizando distintas variables en las 77 pacientes con IUF que fueron intervenidas en el Servicio de Obstetricia y Ginecología del Hospital General Universitario de Alicante. La evaluación objetiva (eficacia y efectos adversos) se obtuvo al revisar los controles realizados a los 2 y 6 meses y anualmente, teniendo en cuenta la exploración vaginal, las maniobras de Valsalva, el Q-test, el diario miccional, la valoración de síntomas hecha por la paciente e incluso la urodinámica, si se precisó. La evaluación subjetiva se realizó mediante una encuesta telefónica siguiendo el esquema de cuestionarios ya validados. Resultados: De las 77 pacientes, sólo en 60 (77,92%) pudieron valorarse los resultados objetivos en su historia clínica. Objetivamente se consideraron continentes al 59,74% (46/77) o el 76,66% (46/60) si no se contabilizan las no controladas. Subjetivamente, sólo contestaron 65 (84,41 %) pacientes, cuyas respuestas de «satisfacción» se situaron entre el 72,72% y el 86,14% (al excluir las que no respondieron). Las complicaciones fueron similares a otros grupos. Fue difícil establecer un análisis comparativo, ya que los criterios de seguimiento y evaluación son muy distin tos y apenas incluyen el componente subjetivo de la paciente, sin tener en consideración la repercusión en la calidad de vida, presentándose muy dispares y poco reproducibles. Conclusiones: Las intervenciones con bandas son eficaces y seguras, si bien la conclusión de su grado de recomendación debe deducirse de trabajos a largo plazo y donde se incluyan parámetros de calidad de vida en el seguimiento de la paciente. La introducción de nuevas técnicas quirúrgicas debe estar precedida por ensayos controlados y aleatorizados que muestren los resultados objetivos y subjetivos de éstas (AU)

Objective: Evaluation of the efficiency and safety of different surgical techniques with bands for urinary incontinence (VI) in the period February 2000-June 2004, and also the patient satisfaction post-operatively. Material and methods: We made a retrospective transversal study, analyzing different variables in 77 patients with UI who had surgery in the Obstetric and Gynaecology Department of the G.U. Hospital in Alicante. Objective evaluation (efficacy and adverse effects) was obtained on checking the follow up at 2 months, 6 months and annually. This consisted of vaginal examination, Val salva manoeuvre, Q-test, mictional diary, patient self evaluation of symptoms and urodynamics if necessary. Subjective evaluation was made by telephone with the questionnaire already in use. Results: Objective results could be valued in only 60 of the 77 patients (77.92%). We considered 59.74% to be objectively continent (46/77) or 76.66% (46/60) if we don't count those who were not controlled. Subjectively, only 65 patients (84.41 %) replied, their "satisfaction was between 72.72% and 86.14% (excluding those who did not reply). Complications were similar to other groups. It was difficult to establish a comparative analysis since criteria of followup and evaluation are very different. Normally they do not include a subjective component of the patient without taking into consideration her quality of life. They are disparate and reproducing them is of little value. Conclusions: The surgery with bands is effective and safe although its recommendation needs long term studies where the quality of life should be included. The introduction of new surgical techniques must be preceded by controlled and randomized studies including not only the objective but also the subjective results (AU)

Hypertension induction in Dahl rats.

There is experimental and epidemiologic evidence that some minerals and trace elements play a role in hypertension. We designed an experiment in which salt and water sources were manipulated to examine the possible impact of this relationship. A strain of rats (Dahl rats) known to become hypertensive with sodium chloride ingestion was used to study the effect of salt source and water source on the induction of hypertension. The group on tap water and table salt had blood pressures (184 mmHg +/- 19) significantly higher than every other group in the experiment. The experimental animals receiving tap water plus table salt had the highest blood pressure levels, although they consumed the lowest quantity of sodium. Analysis of the tap water samples showed "soft water" by analysis of calcium and magnesium concentration. This could adversely affect blood pressure. The relatively high magnesium concentration in sun evaporated sea salt may play a protective role in hypertension induction. The zinc and copper present in tap water may play an exacerbating role.