[Left supraclavicular adenopathy with a neuroendocrine pattern of unknown cause: prostatic carcinoma metastasis]. / Adenopatía supraclavicular izquierda con patrón neuroendocrino de causa desconocida: metástasis por carcinoma de próstata.

Contribution of a case report of a male patient presenting with single left supraclavicular adenopathy of initially unknown origin and histologic pattern of neuroendocrine nature, finally traced to the prostate. It is believed that in any male over 45 diagnosed with carcinoma of unknown origin in the supradiaphragm lymph nodes, prostate carcinoma metastasis should also be ruled out using PSA immunostaining and by measuring serum PSA, serum alkaline phosphatase and DRE.

[Bladder tumor in pregnancy]. / Tumor vesical durante el embarazo.

Diagnosis of tumours during pregnancy is quite unusual, considering the low frequency of neoplasias in this period (1/1000 pregnancies) as well as the low incidence of bladder cancer in patients under 30, which makes the coincidence of both phenomena quite uncommon. The paper contributes the case of a 28-year old female diagnosed with bladder cancer during her pregnancy.

[Report of a new case of small-cell carcinoma of the bladder and review of the literature]. / Aportación de un nuevo caso de carcinoma de células pequeñas de localización vesical y revisión de la literatura.

We report a case of small cell carcinoma of the urinary bladder in 71-year-old male patient. Oat cell of the urinary bladder is extremely uncommon, and up to date only 135 cases have been reported in word literature. Histologic, microscopic, and immunohistochemical characteristics are similar to oat cell carcinoma of the lung and other extrapulmonary oat cell carcinomas. We conclude this report with immunohistochemical study with PGP 9.5, neuron-specific enolase a synaptophisine.

[Four new cases of urothelial inverted papilloma]. / Cuatro nuevos casos de papiloma invertido urotelial.

Urothelial inverted papilloma account for 2.2% of all urothelial tumours. The preferred location is the bladder; they occur singly and are generally benign, although the majority of authors agrees in treating this entity as a tumour of low aggressiveness. The report contributes four cases of inverted papilloma, three in male patients and the fourth in a female. One was located in the renal pelvis. A revision is made of the etiology, clinical signs and symptoms, diagnosis and treatment, as well as their relationship to surface carcinoma, as it occurs asynchronously in one of the cases described.

[Spontaneous bladder perforation secondary to bladder candidiasis]. / Perforación vesical espontánea secundaria a candidiasis vesical.

Presentation of an spontaneous vesical perforation secondary to vesical candidiasis in a patient with in-dwelling catheter due to BPH. Analysis of etiological factors, clinical signs and symptoms, diagnosis and management of both entities.

Risk infection factors in the total hip replacement.

UNLABELLED: Infection is a complication that occurs in a considerable percentage of hip prostheses replacements, being in many cases necessary to retire them, which generates important health and economical problems. OBJECTIVES: To know the distribution of infection and its risk factors in total hip replacement. MATERIAL AND METHODS: A four year prospective study was developed in the rehabilitation and orthopedic center of 'La Paz' Hospital. A total of 873 patients were included. Patients were controlled by means of active epidemiological surveillance until the day of discharge, listing up their characteristics at admission and risk factors during their stay. A multivariant study was carried out to determine risk factors. RESULTS: Patients' average age was 63 years, 3.4% of them suffered from diabetes and there were no inmunocompromised patients. The percentage of wound infection during the four years was 6%, being reduced to 1.2% in the last year. The risk factors found in the multivariant study were: incorrect prophylaxis (OR: 3.85), wrong scaring (OR: 14.06), suffering more than one intervention (OR: 7.31) and a hospitalization period longer than 30 days (OR: 2.84). CONCLUSION: We think that special attention in the care of the surgical wound, as well as the correct use of prophylaxis, can significantly collaborate to the reduction of infection.

[Bladder neoplasms in patients under 40 years of age]. / Tumores vesicales en pacientes menores de cuarenta años.

The incidence, presentation and clinical evolution of vesical tumours diagnosed in our Centre over the last 10 years (1986-1995) in patients under forty are examined. This retrospective study included 19 of the 643 neoplasias treated during that period; 7 of these in patients under 30 and 12 in patients over 31. Haematuria was the most frequent reason for visiting the Centre. At the time of diagnosis, all cases were surface tumours and none progressed to the infiltrant stage. Tumours in patients over 30 are characterised by a higher histological grade and greater relapse rate versus those in patients under 30. Therefore, age may be a favourable prognostic factor in patients under 30 versus the older group who follow a course more similar to the remainder of usual patients. Diagnosis and treatment of these neoplasias should be just the same as for tumours in older patients.

[Nosocomial infection in BPH: economic costs and increase in hospital stay]. / Infección hospitalaria en HBP: costes economicos y aumento del tiempo de hospitalización.

We present a cohort study where 40 matched pairs of patient (infected and no infected) were included. All of the patients had prostatic benign hyperplasia and open surgery or thransuretral resection was developed. Infected patients stay 3 days more in the hospital and they cost 120.000 pts more than uninfected patients.

[Role of autotransfusion of pre-stored blood in benign prostate hyperplasia. Our experience]. / Papel de la autotransfusión predepósito en la cirugía de la H.B.P. Nuestra experiencia.

The essence of self-transfusion is the extraction of a patient's own blood for subsequent infusion to the same patient. The practice of this strategy has become particularly important from the moment the likelihood of AIDS virus transmission through transfusion with homologous blood products became known. This article presents our experience in both open and endoscopic BPH surgery over the period ranging from January 93 to December 94, and analyzes the health care and socioeconomic aspects of that experience.

[Bladder schistosomiasis: report of 2 new cases with different anatomoclinical features and review of the literature]. / Esquistosomiasis vesical: aportación de dos nuevos casos con presentaciones anatomo-clínicas diferentes y revisión de la literatura.

This paper reports two cases of vesical schistosomiasis in two black patients treated in this Service over the last three years. A description is made of the different anatomo-clinical presentations of these two cases, commenting on the characteristics of this disease, its pathogenesis, diagnosis and treatment, and stressing the slight increase in its frequency in our environment as a consequence of the increased migratory movements of people from endemic regions into our country.

[Calmette-Guerin bacillus in the prophylaxis of superficial bladder tumors. Our experience and our doubts]. / Bacilo de Calmette-Guerin en la profilaxis de los tumores superficiales de vejiga. Nuestra experiencia y nuestras dudas.

OBJECTIVE: This study was conducted to determine the efficacy of our BCG dose and schedule for prophylactic therapy in superficial bladder tumors. METHODS: Following complete TUR, 81 mg intravesical BCG were administered weekly for six weeks and for nightly another six times. The patients were evaluated every three months by cytology, cystoscopy and routine analysis. RESULTS: 21/25 patients completed the treatment. At 15.5 months median follow-up, 18/21 (85.7%) were disease-free, 2/21 (9.5%) had recurrence and 1/21 (4.7%) showed disease progression. CONCLUSIONS: BCG is the most effective prophylactic therapy for superficial bladder tumors currently available. The ideal dose, treatment schedule and its mechanism of action are as yet unknown.

[The role of vascular radiology in the diagnosis of "suspicious" images of the upper urinary tract]. / Papel de la radiología vascular en el diagnóstico de las imágenes "sospechosas" del tracto urinario superior.

Accurate diagnosis of "suspect" lesions from the Upper Urinary Tract (U.U.T.) is of major significance for implementing an appropriate treatment. There are many diseases and situations which may condition the occurrence of a suspect image, i.e., of a repletion defect of the U.U.T., in the U.I.V., the vascular imprints being just one of them. This paper contributes two cases where the suspect lesion was due to this cause and vascular radiology was decisive to reach a diagnosis.