Randomized and Open Trial to Assess the Effectiveness of the Guided Pelvic Floor Exercises Pre-Radical Robotic Prostatectomy on the Improvement of Urinary Incontinence. Initial Results

Introduction and Objectives: Radical prostatectomy has an impact on urinary continence. Many factors are involved in continence. The objective of this study is evaluate the effect of guided Pelvic Floor Exercises prior to robotic radical prostatectomy (RRP) on the rate of urinary incontinence compared with written information. Material and Method: randomized study of 62 patients who are waiting for PRR. They were rondomized in two groups: experimental group (exercises guided by a physiotherapist) or a control group (written information). Primary objective was the continence rate measured by pad test and ICIQ-SF one month after the intervention, Secondary objectives were incontinence severity, quality of life with SF-36 and KHQ questionnaires and the correlation between incontinence and quality of life. Results: We found no differences in continence rate between groups after the intervention. We found differences in “emotional problems” and “personal relationships”, in favor of the control group. There is a correlation between the amount of urine leakage and age, urgency and all the domains of the KHQ questionnaire except general quality of life, as well as in the areas “energy/fatigue” and “social function” of the SF-36. Conclusions: Physiotherapist-guided exercises before RRP do not seem to offer advantages compared to written information, in terms of the incontinence rate and its severity one month after the surgery. Urinary incontinence is correlated with age, urgency, and deterioration in quality of life (AU)

Introducción y Objetivos: La prostatectomía radicaltiene un gran impacto en la continencia urinaria. Muchosfactores intervienen en la continencia. El objetivo de esteestudio es evaluar el efecto en la tasa de incontinencia deorina de los Ejercicios de Suelo Pélvicos guiados previos ala prostatectomía radical robótica (PRR), frente a la información escrita.Material y Método: Ensayo clínico en el que se incluyen 62 pacientes en lista de espera para PRR, aleatorizándolos a un grupo experimental (ejercicios guiados porfisioterapeuta) o control (información escrita). El objetivoprimario fue la tasa de continencia medida por test de compresa y el cuestionario ICIQ-SF al mes de la intervención,Fueron objetivos secundarios, la severidad de incontinencia, la calidad de vida con cuestionarios SF-36 y KHQ, y lacorrelación entre la incontinencia y la calidad de vida.Resultados: No encontramos diferencias en la tasade incontinencia entre los grupos tras la intervención. Encontramos diferencias en “problemas emocionales” y “relaciones personales”, a favor del grupo control. Existe correlación entre la cantidad de las pérdidas de orina y la edad,la urgencia miccional y todos los dominios del cuestionarioKHQ excepto la calidad de vida general, así como en lasáreas “energía/fatiga” y “función social” del SF-36.Conclusiones: Los ejercicios guiados por fisioterapeuta antes de PRR no parecen ofrecer ventajas frente ala información escrita, en la tasa de incontinencia y severidad de la misma al mes de la intervención. La incontinenciade orina se correlaciona con la edad, la urgencia miccionaly el deterioro en la calidad de vida. (AU)

Abdominal Aortic Aneurysm Complicated With Aorto-Left Retroaortic Renal Vein Fistula.

We present the case of a male with a fistula from an infrarenal aortic aneurysm to the left renal vein resolved with an endovascular prosthesis. Few cases have been reported in the literature.

Specificity of performance adaptations to a periodized judo training program / / Especificidad de las adaptaciones de un programa periodizado de judo / / Especificidade das adaptações de desempenho aprograma periodizado de treinamento de judô

Objective: Judo is a combat sport characterized by high-intensity intermittent efforts. To suit high competitive demand, the training periodization should be adopted to improve judo athletes performance. Thus, the objective of the present study was to monitor the changes in different variables during judo training periodization. Method: Ten male adult judo athletes were evaluated 18 weeks apart, in the beginning of preparatory period and one week before the main competition of the competitive period. During this observational study, the variables considered were: body composition, upper and lower-body anaerobic power and capacity, lower-body muscle power, upper and lower-body aerobic power, maximal and strength endurance, and judo specific performance. Paired Student’s t test was used to compare variables across periods. Results: In the end of this period, athletes presented a significant increase in upper-body anaerobic power (pre = 535 ± 74W; post = 617 ± 81W; 15%) and capacity (pre = 344 ± 29W; post = 402 ± 38W; 17%), lower-body anaerobic power (pre = 778 ± 77W; post = 882 ± 130W; 13%), isometric (pre = 31 ± 17 s; post = 43 ± 15 s; 39%) and dynamic grip strength endurance (pre = 7 ± 5 rep; post = 11 ± 5 rep; 57%), upper-body aerobic power (pre = 113 ± 25W; post = 122 ± 29W; 8%), and row 1RM (pre = 85 ± 23 kg; post = 92 ± 26 kg; 8%). The body composition, judo specific performance, handgrip strength, bench-press 1RM, row and bench-press number of repetitions at 70% 1RM, and lower-body muscle power were maintained. Athletes presented a decrease in lower-body aerobic power (pre = 235 ± 62W; post = 209 ± 43W; 11%). Conclusion: The results of the present study indicated that the changes during a periodized judo program were specific to the match demand, although not all variables improved across this period (AU)

Objetivo: El judo es un deporte de combate caracterizado por intervalos de esfuerzos de elevada intensidad. Para soportar la elevada demanda competitiva, la periodización del entrenamiento debe ser utilizada para mejorar el desempeño de los atletas de judo. Por tanto, el objetivo del presente estudio fue evaluar los cambios, en diferentes variables, durante la periodización del entrenamiento de judo. Método: Diez atletas de judo varones fueron evaluados con 18 semanas de intervalo, en el inicio del período preparatorio y una semana después de la principal competición del período competitivo. Durante este estudio observacional, las variables consideradas fueron: composición corporal, potencia y capacidad anaeróbica de miembros superiores e inferiores, potencia muscular de miembros inferiores, potencia aeróbica de miembros superiores e inferiores, fuerza máxima, resistencia de fuerza y la performance en un test específico para el judo. El test t de Student para datos pareados fue utilizado para comparar las variables durante el período de entrenamiento. Resultados: Al final de ese período, los atletas presentaron aumento significativo en la potencia (pre = 535 ± 74W; post = 617 ± 81W; 15%) y en la capacidad (pre = 344 ± 29W; post = 402 ± 38W; 17%) anaeróbicas de miembros superiores, potencia anaeróbica de miembros inferiores (pre = 778 ± 77W; post = 882 ± 130W; 13%), resistencia de fuerza isométrica (pre = 31 ± 17 s; post = 43 ± 15 s; 39%) y dinámica de golpeo (pre = 7 ± 5 rep; post = 11 ± 5 rep; 57%), potencia aeróbica de miembros superiores (pre = 113 ± 25W; post = 122 ± 29W; 8%), y fuerza máxima de l RM (pre = 85 ± 23 kg; post = 92 ± 26 kg; 8%). La composición corporal, el desempeño en el test específico, la fuerza de preensión manual, la fuerza máxima en el press de banca y de 1RM, el número de repeticiones en el press de banca a 70% 1RM y la potencia muscular de miembros inferiores no experimentaron cambios. Los atletas presentaron una disminución en la potencia aeróbica de miembros inferiores (pre = 235 ± 62W; post = 209 ± 43W; 11%). Conclusión: Los resultados indican que los cambios durante el ciclo del programa de entrenamiento de judo fueron específicos a la demanda del combate competitivo, aunque algunas variables no cambiarán en ese período (AU)

Objetivo: O judô é um esporte de combate caracterizado por esforços intermitentes de elevada intensidade. Para lidar com a demanda competitiva, a periodização do treinamento deve ser adotada para melhorar o desempenho de atletas de judô. Assim, o objetivo do presente estudo foi monitorar as mudanças em diferentes variáveis durante o treinamento periodizado de judô. Método: Dez atletas de judo adultos foram avaliados com intervalo de 18 semanas, no começo do período preparatório e uma semana antes da principal competição do período competitivo. Durante esse estudo observacional, as variáveis consideradas foram: composição corporal, potência e capacidade anaeróbias de membros superiores e inferiores, potência muscular de membros inferiores, potência aeróbia de membros superiores e inferiores, força máxima, resistência de força e desempenho específico do judô. O teste t de Student foi utilizado para comparar as variáveis entre os períodos. Resultados: Ao final deste período os atletas apresentaram aumento significante na potência (pré = 535 ± 74 W; pós = 617 ± 81 W; 15%) e capacidade anaeróbias de membros superiores (pré = 344 ± 29 W; pós = 402 ± 38 W; 17%), potência anaeróbia de membros inferiores (pré = 778 ± 77 W; pós = 882 ± 130 W; 13%), resistência de força isométrica de pegada (pré = 31 ± 17 s; pós = 43 ± 15 s; 39%), resistência de força dinâmica de pegada (pré = 7 ± 5 rep;pós = 11 ± 5 rep; 57%), potência aeróbia de membros superiores (pré = 113 ± 25 W; pós = 122 ± 29 W; 8%) e 1RM na remada (pré = 85 ± 23 kg; pós = 92 ± 26 kg; 8%). A composição corporal, o desempenho específico ao judô, a força máxima isométrica de preensão manual, o 1RM no supino, o número de repetições a 70% de 1RM na remada e no supino e a potência muscular de membros inferiores foram mantidas. Os atletas apresentaram decréscimo na potência aeróbia de membros inferiores (pré = 235 ± 62 W;pós = 209 ± 43 W; 11%). Conclusão: Os resultados do presente estudo indicam que as mudanças durante um programa periodizado de treinamento de judô foram específicas à demanda da luta, embora nem todas as variáveis tenham melhorado ao longo do período analisado

Chronic clenbuterol treatment compromises force production without directly altering skeletal muscle contractile machinery.

Clenbuterol is a ß2 -adrenergic receptor agonist known to induce skeletal muscle hypertrophy and a slow-to-fast phenotypic shift. The aim of the present study was to test the effects of chronic clenbuterol treatment on contractile efficiency and explore the underlying mechanisms, i.e. the muscle contractile machinery and calcium-handling ability. Forty-three 6-week-old male Wistar rats were randomly allocated to one of six groups that were treated with either subcutaneous equimolar doses of clenbuterol (4 mg kg(-1) day(-1) ) or saline solution for 9, 14 or 21 days. In addition to the muscle hypertrophy, although an 89% increase in absolute maximal tetanic force (Po ) was noted, specific maximal tetanic force (sPo) was unchanged or even depressed in the slow twitch muscle of the clenbuterol-treated rats (P < 0.05). The fit of muscle contraction and relaxation force kinetics indicated that clenbuterol treatment significantly reduced the rate constant of force development and the slow and fast rate constants of relaxation in extensor digitorum longus muscle (P < 0.05), and only the fast rate constant of relaxation in soleus muscle (P < 0.05). Myofibrillar ATPase activity increased in both relaxed and activated conditions in soleus (P < 0.001), suggesting that the depressed specific tension was not due to the myosin head alteration itself. Moreover, action potential-elicited Ca(2+) transients in flexor digitorum brevis fibres (fast twitch fibres) from clenbuterol-treated animals demonstrated decreased amplitude after 14 days (-19%, P < 0.01) and 21 days (-25%, P < 0.01). In conclusion, we showed that chronic clenbuterol treatment reduces contractile efficiency, with altered contraction and relaxation kinetics, but without directly altering the contractile machinery. Lower Ca(2+) release during contraction could partially explain these deleterious effects.

Resultados del trasplante renal de donante vivo en receptores pediátricos, con injertos obtenidos por laparoscopia / Results of living donor kidney transplant in pediatric recipients, with graft obtained by laparoscopy

Objetivo. Analizar los resultados del trasplante renal de donante vivo relacionado (TDVR) en nuestro centro. Pacientes y método. Entre diciembre de 2005 y 2008 se han realizado en nuestro centro 34 trasplantes renales en receptores pediátricos, de los que 7 (20,58%) han sido TDVR con injertos obtenidos por vía laparoscópica. El donante fue la madre en 4 casos y el padres entres. La edad media de los donantes fue de 43 años (38-48) y la de los receptores de 12,5 años (9-17). Cuatro fueron un primer trasplante (uno (..) (AU)

Objective. Analyze the results of the living related donor kidney transplant (LRDKT) in our center. Patients and methods. Between December 2005 and 2008, 34 kidney transplants in pediatric recipients were performed in our center, 7(20.58%) of which were LRDKT with grafts obtained via laparoscopy. The donor was the mother in 4 cases and the father in 3. Mean age of the donors was 43 years (38-48) and of the recipients 12.5 years (9-17).Four were a first transplant (one of them planned) and three (..) (AU)

[Results of living donor kidney transplant in pediatric recipients, with graft obtained by laparoscopy]. / Resultados del trasplante renal de donante vivo en receptores pediátricos, con injertos obtenidos por laparoscopia.

OBJECTIVE: Analyze the results of the living related donor kidney transplant (LRDKT) in our center. PATIENTS AND METHODS: Between December 2005 and 2008, 34 kidney transplants in pediatric recipients were performed in our center, 7 (20.58%) of which were LRDKT with grafts obtained via laparoscopy. The donor was the mother in 4 cases and the father in 3. Mean age of the donors was 43 years (38-48) and of the recipients 12.5 years (9-17). Four were a first transplant (one of them planned) and three retransplantations. RESULTS: Cold ischemia time was < 2 hours in every case while warm ischemia did not show significant differences with the cadaveric donor transplant. None had initial graft dysfunction. No vascular complications occurred, but there was a urinary fistula secondary to ureteral necrosis, resolved with a new reimplantation. Survival of the patient and graft is 100%, superior to that of the cadaveric grafts within the same period. Current mean plasma creatinine is 0.8 mg/dl (0.7-1.39) and mean creatinine clearance is 80 cc/min/1.73 m2 (75-90). No donor had surgical complication and all maintain good kidney function. CONCLUSIONS: The short term results of the LRDKT with grafts obtained by laparoscopy in our center are similar to those described by groups with large experience, which makes it possible to continue offering it with guarantee.

[Ureteral meatotomy associated with vesicostomy, a possible urinary derivation?]. / Meatotomía ureteral asociada a vesicostomía, una posibilidad de derivación urinaria?

AIM: To show our experience in urinary derivation by ureteral meatotomy associated with vesicostomy. METHODS: We reviewed uni or bilateral ureteral meatotomy associated with vesicostomy carried out in our institution between 1989 and 2006. We report 20 patients (15 boys and 5 girls) with ages ranging from 1 month to 13-years-old (median 4,4-years-olds). Nine (45%) had neuropathic bladder, 6 (30%) posterior urethral valves and 5 (25%) vesicoureteral stenosis. RESULTS: Improvement of the ureteral dilatation controlled by ultrasound was demonstrated in 100% of the patients. Improvement of the renal function was observed in the group of patients (5) with renal failure. COMPLICATIONS: 2 bladder prolapses, 1 calculus and 1 postoperative bladder bleeding. CONCLUSIONS: Ureteral meatotomy associated with vesicostomy is an effective urinary derivation in children with obstructive urological conditions with an important dilatation in which ureteral reimplantation seems to be difficult. This derivation avoids bladder dysfunction and the management of the vesicostomy is comfortable by the use of a bag or the nappies.

[Biofeedback and electrostimulation in the treatment of non monosymptomatic enuresis]. / Biofeedback y electroestimulación como tratamiento de la enuresis no monosintomática.

AIM: To show our experience with biofeedback and electrostimulation techniques in the treatment of non monosymptomatic enuresis. METHODS: We reviewed biofeedback and electrostimulation techniques in the treatment of complicated enuresis carried out in our institution between 1995 and 2000. We report 99 patients (65 girls and 34 boys) with ages ranging from 5 to 14 years old. A complete urodinamy study divided the patients into 5 groups: detrusor-sphincter dysfunction (DSD) (47 patients), detrusor overactivity (DO) (25 patients), urge syndrome (US) (15 patients), sphincter hypertony (SH) (10 patients) and "retentionist" bladder (RB) (2 patients). Success was defined as less than three wet nights in a month. Biofeedback and electrostimulation program was designed in 10 sessions per week (20 minutes each session) with SIGMAX-Biomedical software. Tibial electrostimulation with SANS-UroSurge equipment was indicated when biofeedback and electrostimulation techniques failed (12 sessions per week, 30 minutes each session). RESULTS. The success rate has been 78.9% in DSD group, 80% in DO group, 85% in US group, 75% in SH group, 100% in RB group. CONCLUSIONS: Effectiveness of biofeedback and electrostimulation techniques in the treatment of non monosymptomatic enuresis has been reported and seems to be permanent in time.

Meatotomía ureteral asociada a vesicostomía, ¿una posibilidad de derivación urinaria? / Ureteral meatotomy associated with vesicostomy, a possible urinary derivation?

Objetivo. Mostrar nuestra experiencia en la derivación urinaria mediante meatotomía ureteral uni o bilateral asociada a vesicostomía. Material y métodos. Hemos realizado un estudio retrospectivo sobre una serie de 20 pacientes (15 niños y 5 niñas), sometidos a meatotomíaureteral junto con vesicostomía cutánea en nuestro servicio, entre los años 1989 y 2006. La edad media fue de 4,4 años (1 mes-13años). Nueve pacientes (45%) presentaban vejiga neuropática (7 con reflujo vesicoureteral secundario), 6 niños (30%) válvulas de uretra posterior, 3 estenosis vésico-ureterales bilaterales y 2 unilaterales(25%).Resultados. En el 100% de los niños se observó disminución ecográfica de la dilatación ureteropielocalicial tras la derivación; 5 de los casos que presentaban alteración de la función renal, mejoraron tras la intervención, controlado mediante el aclaramiento de creatinina. Como complicaciones se produjo prolapso vesical por la ostomía en 2 pacientes, litiasis en 1 y sangrado vesical postoperatorio en 1.Conclusiones. La meatotomía ureteral asociada a vesicostomía cutánea es una opción válida en niños que presentan una uropatía obstructiva vesical o infravesical con importante dilatación del tracto urinario superior en los que la reimplantación ureteral no se considera que pueda tener éxito. Evita la desfuncionalización vesical y el manejo dela vesicostomía resulta cómodo con bolsa o pañal (AU)

Aim. To show our experience in urinary derivation by ureteralmeatotomy associated with vesicostomy. Methods. We reviewed unior bilateral ureteral meatotomy associated with vesicostomy carried outin our institution between 1989 and 2006. We report 20 patients (15boys and 5 girls) with ages ranging from 1 month to 13 years old (median4,4 years ols). Nueve (45%) had neuropathic bladder, 6 (30%) posterior urethral valves and 5 (25%) vesicoureteral stenosis. Results. Improvement of the ureteral dilatation controlled by ultrasound was demonstrated in 100% of the patients. Improvement of the renal function was observed in the group of patients (5) with renal failure. Complications: 2 bladder prolapses, 1 calculus and 1 postoperative bladder bleeding. Conclusions. Ureteral meatotomy associated with vesicostomy is an effective urinary derivation in children with obstructive urologicalconditions with an important dilatation in which ureteral reimplantation seems to be difficult. This derivation avoids bladder dysfunction and the management of the vesicostomy is comfortable by the use of a (..) (AU)

Paradoxical effects of endurance training and chronic hypoxia on myofibrillar ATPase activity.

This study aimed to determine the changes in soleus myofibrillar ATPase (m-ATPase) activity and myosin heavy chain (MHC) isoform expression after endurance training and/or chronic hypoxic exposure. Dark Agouti rats were randomly divided into four groups: control, normoxic sedentary (N; n = 14), normoxic endurance trained (NT; n = 14), hypoxic sedentary (H; n = 10), and hypoxic endurance trained (HT; n = 14). Rats lived and trained in normoxia at 760 mmHg (N and NT) or hypobaric hypoxia at 550 mmHg (approximately 2,800 m) (H and HT). m-ATPase activity was measured by rapid flow quench technique; myosin subunits were analyzed with mono- and two-dimensional gel electrophoresis. Endurance training significantly increased m-ATPase (P < 0.01), although an increase in MHC-I content occurred (P < 0.01). In spite of slow-to-fast transitions in MHC isoform distribution in chronic hypoxia (P < 0.05) no increase in m-ATPase was observed. The rate constants of m-ATPase were 0.0350 +/- 0.0023 s(-1) and 0.047 +/- 0.0050 s(-1) for N and NT and 0.033 +/- 0.0021 s(-1) and 0.038 +/- 0.0032 s(-1) for H and HT. Thus, dissociation between variations in m-ATPase and changes in MHC isoform expression was observed. Changes in fraction of active myosin heads, in myosin light chain isoform (MLC) distribution or in MLC phosphorylation, could not explain the variations in m-ATPase. Myosin posttranslational modifications or changes in other myofibrillar proteins may therefore be responsible for the observed variations in m-ATPase activity.

Biofeedback y electroestimulación como tratamiento de la enuresis no monosintomática / Biofeedback and electrostimulation in the treatment of non monosymptomatic enuresis

Objetivo. Mostrar nuestra experiencia con las técnicas de biofeedbacky electro estimulación en el tratamiento de la enuresis no monosintomática. Material y métodos. Se analizaron los datos de 99 niños atendidos entre 1995 y 2000 por enuresis no monosintomática con edades comprendidas entre 5 y 14 años (65 niñas y 34 niños). Se les realizó estudio urodinámico completo para definir a los pacientes en cinco grupos: disfunción vesicoesfinteriana (47 pacientes), hiperactividad de detrusor (25 pacientes), urgencia sensorial (15 pacientes), hipertonía de esfínter (10 pacientes) y vejiga “retencionista” (2 pacientes). Se consideró como éxito menos de 3 noches húmedas al mes. El biofeedbacky la electroestimulación consistieron en 10 sesiones semanales de20 minutos con el equipo SIGMAX-Biomedical. Se indicó estimulación tibial en patologías en las que fracasaron tratamientos anteriores(12 sesiones de 30 minutos con el equipo SANS de UroSurge).Resultados. El éxito al fin del tratamiento fue del 78,9% en la disfunción vesicoesfinteriana, del 80% en la hiperactividad del detrusor, del 85% en la urgencia sensorial, del 75% en la hipertonía de esfínter y del 100% en la vejiga “retencionista”.Conclusiones. Los llamados “tratamientos alternativos” como el biofeedback y la electro estimulación son eficaces en el tratamiento dela enuresis no monosintomática. Esta eficacia se mantiene en el tiempo y es independiente de la disfunción miccional hallada (AU)

Aim. To show our experience with biofeedback and electrostimulation techniques in the treatment of non monosymptomatic enuresis. Methods. We reviewed biofeedback and electrostimulation techniques in the treatment of complicated enuresis carried out in our institution between 1995 and 2000. We report 99 patients (65 girls and 34boys) with ages ranging from 5 to 14 years old. A complete urodinamy study divided the patients into 5 groups: detrusor-sphincter dysfunction(DSD) (47patients), detrusor over activity (DO) (25 patients), urge syndrome(US) (15 patients), sphincter hypertony (SH) (10 patients) and “retentionist” bladder (RB) (2 patients). Success was defined as less than three wet nights in a month. Biofeedback and electrostimulation program was designed in 10 sessions per week (20minutes each session)with SIGMAX-Biomedical software. Tibial electrostimulation with SANS-UroSurge equipment was indicated when biofeedback and electrostimulation techniques failed (12 sessions per week,30 minute seach session).Results. The success rate has been 78,9% in DSD group, 80% in DO group , 85% in US group, 75% in SH group, 100% in RB group. Conclusions. Effectiveness of biofeedback and electrostimulation echniques in the treatment of non monosymptomatic enuresis has been reported and seems to be permanent in time (AU)

Cambios recientes en la mortalidad por cáncer de próstata en España: estudio de tendencias en el período 1991-2005 / Recent changes in prostate cancer mortality in Spain. Trends analysis from 1991 to 2005

Objetivo: Describir la evolución de la mortalidad por cáncer de próstata en España en el periodo 1991-2005. Sujetos y métodos: Realizamos un análisis de tendencia de las tasas estandarizadas de mortalidad (población estándar Europea) mediante análisis de regresión “joinpoint”, el cual nos permite estimar el porcentaje de cambio anual de las tasas y localizar cambios significativos en la tendencia. Resultados: Las tasas de mortalidad estandarizada alcanza su máximo valor en 1996. El análisis “joinpoint” identifica dos periodos diferentes en la tendencia de las tasas estandarizadas: uno inicial de incremento entre 1991 y 1996 (2,1% de incremento anual) y un segúndo periodo comenzando en 1996, en el que las tasas descienden un -2,7% anual. Conclusión: La tendencia de la mortalidad por cancer de prostata en España es similar a la de otras áreas industrializadas, con un incremento en las tasas estandarizadas que sufren un descenso hacia el final de la década pasada. El descenso en la mortalidad por cáncer de próstata es ahora evidente en 14 de las17 Comunidades Autónomas. El incremento del cribaje oportunistico con PSA y una mejora en el tratamiento, posiblemente actuando en combinación, constituye la hipótesis más plausible (AU)

Objetive: To describe the evolution of prostate cancer mortality in Spain during the period 1991-2005. Subjects and methods: A trend analysis for age standardized mortality rates (European standard population) was performed, using joinpoint regression analysis, which allows estimation of the annual percent change of rates and to find significant changes in such trend. Results: Age standardized mortality rates in Spain reached their peak value in 1996. The joinpoint analysis identified two different periods in the trend of the age standardized rates: a first one of increase in rates between 1991 and 1996 (2.1% annual increase) and a second period starting in 1996, in which rates decline at an annual rate of 2.7%.Conclusion: The tendency of prostate cancer seen in Spain resembles that of industrialized areas, with an increase in its age standardized death rates that suffers a downturn by the end of the past decade. Mortality declines for prostate cancer are now evident in 14 out of the 17 Autonomous Communities. Increases in PSA screening and better treatment of early-stage disease, possibly acting in combination, remain plausible hypotheses (AU)

Combined effects of hypoxia and endurance training on lipid metabolism in rat skeletal muscle.

AIM: To determine whether endurance training can counterbalance the negative effects of hypoxia on mitochondrial phosphorylation and expression of the long chain mitochondrial fatty acid transporter muscle carnitine palmitoyl transferase 1 (mCPT-1). METHODS: Male Wistar rats were exposed either to hypobaric hypoxia (at a simulated altitude of approximately 4000 m, PIO(2) approximately 90 mmHg) or to normoxia (sea level) for 5 weeks. In each environment, rats were randomly assigned to two groups. The trained group went through a 5-week endurance training programme. The control group remained sedentary for the same time period. Muscle fatty acid oxidation capacity was evaluated after the 5-week period on isolated mitochondria prepared from quadriceps muscles with the use of palmitoylcarnitine or pamitoylCoA + carnitine. RESULTS: Chronic hypoxia decreased basal (V(0), -31% with pamitoylCoA + carnitine and -21% with palmitoylcarnitine, P < 0.05) and maximal (V(max), -31% with pamitoylCoA + carnitine, P < 0.05) respiration rates, hydroxyacylCoA dehydrogenase activity (-48%, P < 0.05), mCPT-1 activity index (-34%, P < 0.05) and mCPT-1 protein content (-34%, P < 0.05). Five weeks of endurance training in hypoxia brought V(0), mCPT-1 activity index and mCPT-1 protein content values back to sedentary normoxic levels. Moreover, in the group trained in hypoxia, V(max) reached a higher level than in the group that maintained a sedentary lifestyle in normoxia (24.2 nmol O(2). min(-1) . mg(-1) for hypoxic training vs. 19.9 nmol O(2) . min(-1) . mg(-1) for normoxic sedentarity, P < 0.05). CONCLUSION: Endurance training can attenuate chronic hypoxia-induced impairments in mitochondrial fatty acid oxidation. This training effect seems mostly mediated by mCPT-1 activity rather than by mCPT-1 content.

[Congenital lumbar hernia and bilateral renal agenesis]. / Hernia lumbar congénita bilateral y agenesia renal.

We report a new case of congenital lumbar hernia. This is first case reported of congenital lumbar hernia and bilateral renal agenesis. We review literature and describe associated malformations reported that would be role out in every case of congenital lumbar hernia.

Enuresis: micción no controlada / Enuresis: uncontrollable urination

La enuresis se define como una micción normal, inconsciente e involuntaria durante el sueño (día o noche), al menos una vez a la semana, a partir de los 5 años de edad. Se clasifica como enuresis monosintomática cuando no se encuentra una causa con que relacionarla, y síndrome enurético cuando se acompaña de otros síntomas urológicos. Se considera primaria si sucede desde siempre y secundaria si aparece tras un periodo de control. Se trata de un problema frecuente de consulta en la práctica pediátrica, y el 14,9% de los niños son catalogados como enuréticos a los 5 años de edad. Su etiología es multifactorial, implicándose factores genéticos, madurativos, psicológicos, alteraciones del sueño y despertar y hormonales. El enfoque diagnóstico es distinto según la edad del niño y si la consulta se realiza por primera vez, si se realiza en una de pediatría o en una consulta de urodinámica. El tratamiento debe ser combinado e individualizado según el caso, asociándose normas básicas con refuerzo positivo, entrenamiento vesical, alarmas, desmopresina, imipramina, anticolinérgicos, biofeedback y electroestimulación

Enuresis is defined as normal, unconscious and involuntary urine loss in children over the age of five years, that occurs at least once a week while they are sleeping (during the day or night). Monosymptomatic or uncomplicated enuresis is considered in the absence of other symptoms associated with the urogenital tract. Polysymptomatic or enuretic syndrome is associated with other urological symptoms. At five years of age, 14.9% of children wet the bed. Numerous etiologic factors (genetic, developmental, psychological, sleep-wake disorders, hormonal) have been proposed. The diagnostic approach varies depending on the age of the child and on the attending physician. Treatment must be individualized and combined, based on positive reinforcement systems, bladder training, bed-wetting alarms, desmopressin, imipramine, biofeedback and electrostimulation

Hernia lumbar congénita bilateral y agenesia renal / Congenital lumbar hernia and bilateral renal agenesis

Presentamos un nuevo caso de hernia lumbar congénita bilateral. Este es el primer caso que asocia una agenesia renal bilateral. Hacemos una revisión de la literatura y una descripción minuciosa de las malformaciones asociadas que deben descartarse ante un caso de hernia lumbar congénita

We report a new case of congenital lumbar hernia. This is first case reported of congenital lumbar hernia and bilateral renal agenesis. We review literature and describe associated malformations reported that would be role out in every case of congenital lumbar hernia