[Vascular complication of an acute pyelonephritis]. / Complication vasculaire d'une pyélonéphrite aiguë

This article reports a rare case of acute pyelonephritis with bacteriemia due to non-tiphoidal Salmonella associated with a mycotic aneurysm. The patient was a 75-year-old woman without histories of immunosuppression or urologic deformation. It was about a patient presenting a feverish access and urinary symptoms. Blood culture and urine culture showed Salmonella enteritidis; in spite of a prolonged antibiotic treatment, the multiple bacteriological explorations remained positive. The research for this infection source allowed the discovery of a thoracic aorta aneurysm with hypermetabolism in the PET-scan carrying the diagnosis of mycotic aneurysm. Urinary salmonellosis represents 0.07% (Tena et al., 2007 [1]) of the urinary tract infections. They are rarely found in healthy patients; their eradication can turn out to be difficult when the infection source persists.

A randomized comparison of the clinical and hormonal effects of two GnRH agonists in patients with prostate cancer.

OBJECTIVE: The aims of the study were (i) to compared the efficacy of the two long-acting GnRH agonists (GnRHa) triptorelin (Trp) and leuprolide (Leu) in men with prostate cancer and (ii) to assess the pattern of plasma testosterone levels following each injection of GnRHa. PATIENTS AND METHODS: 67 patients referred for prostate cancer not suitable for surgery were randomly allocated to two treatment regimens: 33 patients received 3.75 mg Trp i.m. at 4-week intervals for 3 months and 34 patients were treated with 3.75 mg Leu s.c. at the same rhythm of administration for 3 months. RESULTS: Clinical data at entry and assessed monthly during follow-up did not differ between the two groups. Plasma prostate-specific antigen (PSA) and testosterone were measured before, 24 and 72 h after each injection of GnRHa. During treatment, PSA dropped similarly in both groups. By month 2, testosterone was < 1.0 nmol/l in 77 and 48% of patients treated with Trp and Leu, respectively (p = 0.02). 24 and 72 h after GnRHa injection, 77 (Trp) and 56% (Leu) of patients had testosterone < 1.0 nmol/l (p < 0.05). CONCLUSIONS: The second and third injections of GnRHa were not followed by a significant increase in testosterone. Trp induced a higher decrease in testosterone than did Leu. The implications in terms of survival should, however, be studied in a larger and longer study.

[Use of LHRH agonists in the treatment of advanced cancer of the prostate]. / Utilización de agonistas de la LHRH en el tratamiento del cáncer de próstata avanzado.

The present article focuses on the usefulness of the LHRH analogues in the treatment of prostate cancer. The Author analyzes analogue obtention by amino acid substitution of natural LHRH to obtain compounds that may be 100 times more potent than natural LHRH and whose t 1/2 reach 7.6 h. He reports that Prof. Schally (1970 Nobel Prize in Medicine) has recently demonstrated the existence of D-Trp-6-LHRH in tumoral cells; thus, the action of this analogue not only consists in decreasing the sex hormones to castration levels but it also has a direct action. However, further studies are warranted in order to elucidate the effects of the foregoing findings in the clinical setting. The reasons for resorting to surgical castration or castration by analogues in the treatment of advanced prostatic cancer are put forward.

A new case of pyelic fusion.

The quite uncommon case of a girl with two kidneys drained by one single pelvis and one ureter is reported and a review of the literature is presented.

The influence of vesical distension on the urethral resistance to flow: a possible role for prostaglandins?

The possible role of prostaglandins in the mediation and/or modulation of the urethral response to vesical distension was investigated in female dogs. Three criteria for the possible involvement of these mediators have been investigated. Indomethacin could block the reduction of urethral resistance observed during vesical distension. Intra-arterial infusion of exogenous prostaglandin E2 resulted in a dose-dependent reduction in the urethral resistance to flow. Moreover, a significant release of prostaglandin E2 in the venous blood during the course of vesical distension could be demonstrated. The functional significance, mechanisms of release and mode of action of these highly active lipids are discussed.

Study on the efficiency of electric stimulation of the pelvic floor.

The continuous electric stimulation of the anal sphincter leads to the onset of a very quick fatigue of the muscle, with a progressive decrease of the amplitude of contraction after 15 min of stimulation. Under the same experimental conditions intermittent stimulation leads to a sustained contraction amplitude. Ts and Tr combinations that can give efficiency rates of contraction above 80 per cent were defined. The results of this study could be applied when intermittent electric stimulation of the pelvic floor is indicated for the treatment of anal or urinary incontinence.

The influence of vesical distension on urethral resistance to flow: the collecting phase.

Using female dogs, changes in the urethral pressure profile in response to vesical distension were studied. It was noted that during the collecting phase there was an increase in the amplitude of the profile tracing. These experiments revealed that this increase is not mediated through an autonomic reflex and does not reflect a significant enhancement of alpha-adrenergic activity. These changes are mainly due to increased tension of the urethral muscle, secondly to detrusor stretch.

The influence of vesical distension on urethral resistance to flow: the expulsion phase.

The influence of vesical distension of the urethral pressure profile was studied in female dogs, using a model in which the bladder and urethra were separated. There was a reduction in the urethral resistance involving its smooth and striated muscle components. This reduction was completely blocked by ganglion blocking agents. Atropine did not influence these changes. Propranolol could only partially block this reflex. The other possible mechanisms that could be involved were discussed.

[Urethral profile: study of a technique (author's transl)]. / Le profil uréral. Etude d'une technique

The different methods used for the measurement of urethral resistance were critically reviewed. Experimental studies were carried out to standardize pressure profile measurements. A catheter with 8 side holes was found to give the best results. The various parameters which can influence the measure were studied. Strict specifications of the procedure are proposed.

Urethral pressure profile. Standardization of technique and study of reproducibility.

The different methods utilized for measurement of urethral resistance were critically reviewed. Using dogs, experiments were done to standardize the pressure profile measurement. A catheter with eight side holes measureing 0.34 mm. each was found to give the best results. The various parameters which can influence the procedure were analyzed. Strict specifications are proposed to be utilized for such a procedure.