[Clinical efficacy of prostatic biopsy. Experience in our center from 1990 to 2002]. / Eficacia clínica de la biopsia prostática. Experiencia en nuestro centro 1990-2002.

INTRODUCTION: The prostate biopsy is the only valid tool to diagnose the existence of cancer of prostate. The indications of the biopsy, according with EAU, are the existence of high PSA, increased velocity PSA and a rectal suspicious tact. OBJECTIVES: validation of the utility of the prostate biopsy, to know the value of the PSA as a marker of prostate cancer in our way and to value the indication and efficiency of repeated biopsies. MATERIAL AND METHODS: we practice a manual review of the biopsies in our hospital, between the years 1990 and 2002. We study the level of PSA before the biopsy, number of prostatic cores and histologic information of the biopsy. A statistical descriptive and inferencial study has been performed by SPSS 12.0 package. RESULTS: The total number of biopsies registered was a 1202, with 36.96% of biopsy positive. The PSA before the biopsy (available in the biopsies realized between the year 1999 and 2002: 578 biopsies, 48.08% of the whole) was > 10 ng/ml in 55,88% of these patients, 4-10 ng/ml in 39.27% and 0-4 ng/ml in 4.84%. The average and PSA's median is of 19.09 (standard error: 1.87) and 10.6, respectively. The positividad of the biopsy increases with PSA's level: 48,61% with PSA > 10; 25.11% with PSA 4-10 and 21,4% in patients with PSA < 4. There was realized prostate rebiopsy (2 or more biopsies) in 132 patients (21.97% positive) 88,36% of the cancers was diagnosed in the first biopsy, and 6.62% in the second one (94,98% of the diagnoses of cancer of prostate carried out with the first 2 biopsies). CONCLUSIONS: The information obtained in the study by means of the descriptive analysis of our series meets in conformity the published in other studies and publications. There exists a need to increase the diagnostic profitability of the biopsy of prostate, for which we have introduced a protocol of biopsy under local anesthesia in order to be able to increase the number of obtained cylinders.

Eficacia clínica de la biopsia prostática. Experiencia en nuestro centro 1990-2002 / Clinical efficacy of prostatic biopsy. Experience in our center from 1990 to 2002

Introducción: La biopsia prostática es la única herramienta válida para diagnosticar la existencia de cáncer de próstata. Las indicaciones para su realización según la Asociación Europea de Urología son la existencia de PSA elevado, velocidad aumentada y la evidencia de un tacto rectal sospechoso. Objetivos: Valoración tanto de la utilidad clínica de la biopsia prostática, como del PSA como marcador de cáncer de próstata en nuestro medio y la indicación y eficacia de sucesivas biopsias. Material y Métodos: Efectuamos una revisión manual de las biopsias realizadas en nuestro servicio entre los años 1990 y 2002, valorando nivel de PSA previo a la biopsia, número de cilindros obtenidos y datos de la biopsia. Se llevó a cabo un estudio estadístico descriptivo mediante el programa estadístico SPSS 12.0. Resultados: Se han realizado 1202 biopsias en este periodo, con un porcentaje de positividad global del 36.96%. El PSA previo a la biopsia (disponible en las biopsias realizadas entre los años 1999 y 2002: 578 biopsias, 48.08% del total) era >10 ng/ml en el 55,88% de estos pacientes, 4-10 ng/ml en el 39.27% y 0-4ng/ml en el 4,84%. La media y mediana de PSA es de 19,09 (error típico: 1,87) y 10,6, respectivamente. La positividad de la biopsia aumenta con el nivel de PSA: 21,4% en pacientes con PSA<4; 25,11% con PSA 4-10 y 48,61% con PSA >10. Fue realizada rebiopsia prostática en 132 pacientes (21,97% positivas) El 88,36%de los cánceres fueron diagnosticados en la primera biopsia, y un 6,62% en la segunda (94,98% de los diagnósticos de cáncer de próstata se realizaron con las 2 primeras biopsias). Conclusiones: Los datos obtenidos en el estudio mediante el análisis descriptivo de nuestra serie se encuentran en concordancia con lo publicado en otros estudios y publicaciones. Existe una necesidad de aumentar la rentabilidad diagnóstica de la biopsia de próstata, para lo cual hemos introducido un protocolo de biopsia bajo anestesia local con el fin de poder aumentar el número de cilindros obtenidos (AU)

Introduction: The prostate biopsy is the only valid tool to diagnose the existence of cancer of prostate. The indications of the biopsy, according with EAU, are the existence of high PSA, increased velocity PSA and a rectal suspicious tact. Objectives: validation of the utility of the prostate biopsy, to know the value of the PSA as a marker of prostate cancer in our way and to value the indication and efficiency of repeated biopsies. Material and methods: we practice a manual review of the biopsies in our hospital, between the years 1990 and 2002. We study the level of PSA before the biopsy, number of prostatic cores and histologic information of the biopsy. A statistical descriptive and inferencial study has been performed by SPSS 12.0 package. Results: The total number of biopsies registered was a 1202, with 36.96 % of biopsy positive. The PSA before the biopsy (available in the biopsies realized between the year 1999 and 2002: 578 biopsies, 48.08 % of the whole) was> 10 ng/ml in 55,88 % of these patients, 4-10 ng/ml in 39.27 % and 0-4ng/ml in 4.84 %. The average and PSA’s median is of 19.09 (standard error: 1.87) and 10.6, respectively. The positividad of the biopsy increases with PSA’s level: 48,61 % with PSA> 10; 25.11 % with PSA 4-10and 21,4 % in patients with PSA <4. There was realized prostate rebiopsy (2 ó more biopsies) in 132 patients (21,97 % positive) 88,36 % of the cancers was diagnosed in the first biopsy, and 6.62 % in the second one (94,98% of the diagnoses of cancer of prostate carried out with the first 2 biopsies).Conclusions: The information obtained in the study by means of the descriptive analysis of our series meets in conformity the published in other studies and publications. There exists a need to increase the diagnostic profitability of the biopsy of prostate, for which we have introduced a protocol of biopsy under local anesthesia in order to be able to increase the number of obtained cylinders (AU)

Gastritis eosinofílica y estenosis hipertrófica de píloro / Eosinophilic gastritis and pyloric estenosis

Paciente intervenido quirúrgicamente de estenosis hipertrófica de píloro, con reaparición de clínica después de un período asintomático. El caso obliga a su estudio hasta llegar al diagnóstico de gastritis eosinofílica. Se realiza una revisión de esta entidad: síntomas, métodos diagnósticos y tratamiento. (AU)

[Gynecomastia and testicular tumor in children with Peutz-Jeghers syndrome]. / Ginecomastia y tumor testicular en niño afecto de síndrome de Peutz-Jeghers.

The rarity of both conditions and the precocity of its onset (4 years old) make the case of interest for pediatricians and pediatric surgeons. The finding of a testicular tumor poses same differences of criterium about its management.

[Abdominal cystic lymphangioma]. / Linfangioma quístico abdominal.

The cystic lymphangioma is a benign slow-growing tumor derived of the lymphatic vessels. It is presented with more frequency in the childhood and the great majority are diagnosed under 5 years of life. The most frequent localization is in head and neck, although they can be developed in any organ or soft tissue. The intraabdominal presentation is not very frequent (2-8%). The clinical presentation is very variable being the most frequent sign the appearance of an effect mass. The diagnosis of suspicion is radiological by means of abdominal ultrasonography and computed tomography. The treatment is surgical. The definitive diagnosis is always histologic. They can recidive. We present two abdominal cases that illustrate this pathology type.

[Bronchial mucoepidermoid carcinoma]. / Carcinoma mucoepidermoide bronquial.

We submit the case of a child afflicted with a mucoepidermoid bronchial tumor. The patient is a boy, aged seven, who after undergoing antibiotic treatment for six weeks because of a fever and atelectasia-condensation in the right lower lobe showed no signs of clinical improvement and was sent to our department to undergo further study and treatment. A bronchoscopy performed shows a polypoid mass that partially blocks the main bronchial tube a few milimiters under the access to the right upper lobe. A biopsy is carried out and the anatomopathological test shows there is a low degree epidermoid carcinoma. We decide to perform a lobectomy which for the tumor location and the lung condition has to be medium and lower right. We proceed to remove the adenopaty of hilium not affected by the tumor. The postoperative period develops without incidents. A check-up bronchoscopy performed three months later shows two polypoid masses in the right bronchial tube which, once a biopsy is performed, proved to be granulation tissue. Twelve months after undergoing surgery, the patient's condition is good, there is no evidence of tumor relapse and the breathing capacity is adequate, though there is an obstructive restrictive pattern in the espirometry. Even taking into consideration that lung tumors are extremely unusual, the epidermoid carcinoma is the one which most frequently occurs. The tumor's low malignancy is a sign that points to a good prognosis. Performing conservative surgery by means of bronchoplasty should be taken into account so as to keep the sequelae on the lung condition to a minimum, even though in this case the tumor location made it impossible.

Chronic intussusception associated with Yersinia enterocolitica mesenteric adenitis.

An unusual case of chronic intussusception, without any digestive sign, secondary to mesenteric lymphadenitis caused by Yersinia enterocolitica is reported. Operative reduction by taxis was performed but ileopexy and antibiotic treatment were also carried out to reduce chances of recurrent intussusception.

Localized intestinal perforation after intravenous indomethacin in a premature infant.

A female premature infant born after 27-week gestation developed a localized perforation of the terminal ileum six days after the administration of intravenous indomethacin for PDA closure. This complication has been reported after enteral and rectal administration of the drug. However, our clinical finding supports that these lesions in premature infants are not only related to the local effects of enteral indomethacin.