Pectus excavatum: the effect of tricuspid valve compression on cardiac function.

BACKGROUND: Pectus excavatum (PE) is a common congenital chest wall deformity with various associated health concerns, including psychosocial impacts, academic challenges, and potential cardiopulmonary effects. OBJECTIVE: This study aimed to investigate the cardiac consequences of right atrioventricular groove compression in PE using cardiac magnetic resonance imaging. MATERIALS AND METHODS: A retrospective analysis was conducted on 661 patients with PE referred for evaluation. Patients were categorized into three groups based on the degree of right atrioventricular groove compression (no compression (NC), partial compression (PC), and complete compression(CC)). Chest wall indices were measured: pectus index (PI), depression index (DI), correction index (CI), and sternal torsion. RESULTS: The study revealed significant differences in chest wall indices between the groups: PE, NC=4.15 ± 0.94, PC=4.93 ± 1.24, and CC=7.2 ± 4.01 (P<0.0001). Left ventricle ejection fraction (LVEF) showed no significant differences: LVEF, NC=58.72% ± 3.94, PC=58.49% ± 4.02, and CC=57.95% ± 3.92 (P=0.0984). Right ventricular ejection fraction (RVEF) demonstrated significant differences: RVEF, NC=55.2% ± 5.3, PC=53.8% ± 4.4, and CC=53.1% ± 4.8 (P≥0.0001). Notably, the tricuspid valve (TV) measurement on the four-chamber view decreased in patients with greater compression: NC=29.52 ± 4.6; PC=28.26 ± 4.8; and CC=24.74 ± 5.73 (P<0.0001). CONCLUSION: This study provides valuable insights into the cardiac consequences of right atrioventricular groove compression in PE and lends further evidence of mild cardiac changes due to PE.

(F)utility of preoperative pulmonary function testing in pectus excavatum to assess severity.

PURPOSE: The utility of pulmonary function testing (PFT) in pectus excavatum (PE) has been subject to debate. Although some evidence shows improvement from preoperative to postoperative values, the clinical significance is uncertain. A high failure-to-completion rate for operative PFT (48%) was identified in our large institutional cohort. With such a high non-completion rate, we questioned the overall utility of PFT in the preoperative assessment of PE and sought to evaluate if other measures of PE severity or cardiopulmonary function could explain this finding. METHODS: Demographics, clinical findings, and results from cardiac MRI, PFT (spirometry and plethysmography), and cardiopulmonary exercise tests (CPET) were reviewed in 270 patients with PE evaluated preoperatively between 2015 and 2018. Regression modeling was used to measure associations between PFT completion and cardiopulmonary function. RESULTS: There were no differences in demographics, symptoms, connective tissue disorders, or multiple indices of pectus severity and cardiac deformation in PFT completers versus non-completers. While regression analysis revealed higher RVEF, LVEF, and LVEF-Z scores, lower RV-ESV/BSA, LV-ESV/BSA, and LV-ESV/BSA-Z scores, and abnormal breathing reserve in PFT completers vs. non-completers, these findings were not consistent across continuous and binary analyses. CONCLUSIONS: We found that PFT completers were not significantly different from non-completers in most structural and functional measures of pectus deformity and cardiopulmonary function. Inability to complete PFT is not an indicator of pectus severity.

Schwanoma retroperitoneal maligno / Malignant retroperitoneal schwannoma

Presentamos un caso infrecuente de Schwanoma retroperitoneal maligno de diagnostico casual. Describimos sus manifestaciones clínicas, exploraciones diagnósticas, y el tratamiento utilizado (AU)

We present an uncommon case of retroperitoneal malignant schwannoma diagnosed accidentally. The clinical, diagnostic and therapeutic features are discussed (AU)

Papiloma invertido de tracto urinario superior / Inverted papilloma of the upper urinary tract

El papiloma invertido del tracto urinario superior es una lesión rara y considerada generalmente de comportamiento benigno. Presentamos dos casos de papiloma invertido de uréter, descubiertos tras estudio por infección urinaria alta y hematuria macroscópica respectivamente. Los dos asociaron carcinomas vesicales asincrónicos y sincrónicos durante su seguimiento, lo que nos obliga a realizar un seguimiento estricto (AU)

Inverted papilloma of the upper urinary tract is a rare tumor and generally considered to be a benign. We present two case of benign ureteral inverted papiloma. They were discovered after to study a upper urinary infection and a gross hematuria respectively. Both cases appear to be associated with asynchronous and synchronous bladder carcinoma, so it is very important a strict follow-up (AU)

Papiloma invertido vesical con recidiva en uretra prostática / Inverted papiloma of the bladder with recurrence inprostatic uretra

El papiloma invertido del tracto urinario es una lesión generalmente solitaria y con poca tasa de recidivas. Su comportamiento es desconocido, no estando aclarado su potencial de recidiva y/o progresión. Presentamos un caso de papiloma invertido vesical con recidiva en uretra prostática a los cuatro años de seguimiento. Revisamos aspectos etiológicos, clínicos, diagnósticos y de tratamiento así como la discusión actual sobre su potencial de malignización (AU)

Urothelial inverted papilloma is usually a solitary lesion with rare recurrences. Its behaviour is unclear, its potential for recurrence or progression is not well-known. We present a case of inverted papilloma of the bladder with recurrence in prostatic urethra after four years of follow-up. We review etiology, clinical presentation, diagnose, treatment and the present discussion about its malignancy ability (AU)

Obstrucción ureteral secundaria a enfermedad de Rosai-Dorfman / Ureteral obstructin secondary to Rosai-Dorfman disease

La obstrucción ureteral puede ser secundaria a múltiples causas. Presentamos un caso poco común dentro de la práctica urológica habitual, consistente en una forma de Histiocitosis denominada Enfermedad de Rosai-Dorfman, como origen de obstrucción ureteral extrínseca. En la presente comunicación describimos la forma de presentación, la metodología diagnóstica utilizada y el tratamiento propuesto (AU)

Ureteral obstruction can be secondary to a lot of reason. We present a uncommon case report of ureteral obstruction to Rosai-Dorfman disease. The form of clinic presentation is described, the diagnostic methods used and the therapeutic management

Liposarcoma retroperitoneal calcificado / Retroperitoneal liposarcoma uit calcification

Se presenta un caso acontecido en nuestro centro correspondiente a un liposarcoma retroperitoneal pleomórfico calcificado en forma de cáscara. Se describe la forma de presentación, los síntomas por los que consulta el paciente, los métodos diagnósticos utilizados y la alternativa terapéutica tomada ante este caso. Se discuten los posibles diagnósticos diferenciales a los que obliga este caso clínico (AU)

Case report of a retroperitoneal liposarcoma pleomorfico with calcification in diagnosed in our hospital. We comment on its clinical characteristics, diagnostic methods and treatment. We likewise comment the possible differential diagnoses (AU)

Enfermedad poliquística del adulto en riñón en herradura / Adult polycistic kidney in horseshoe kidney

Presentamos un caso poco común dentro de la práctica urológica habitual, consistente en la coincidencia en un mismo paciente de dos enfermedades renales congénitas asociadas: riñón poliquístico y riñón en herradura. Se describe la forma de presentación clínica, los métodos diagnósticos utilizados y el manejo terapéutico que se está realizando en este paciente (AU)

A case report of kidney polycistic and horseshoe kidney coincidence in the same patient. They are two congenital associated renal diseases uncommon for urologists. The form of clinic presentation is described, the diagnostic methods used and the therapeutic management (AU)

El cumplimiento terapéutico y la satisfacción con el tratamiento en pacientes afectos de infecciones del tracto urinario inferior y de vías respiratorias bajas tratados con Ciprofloxacino 500 mg sobres / Treatment compliance and satisfaction in patients with low urinary tract and low airways infections treated with Ciprofloxacin 500 mg envelopes

Introducción: El incumplimiento terapéutico constituye un problema sanitario de primer orden, en el que influyen factores como la confianza en el médico, la forma de administración y la dosificación del tratamiento, siendo muy importante la satisfacción del paciente con el tratamiento. Material y Método: Se presentan los resultados del cumplimiento terapéutico y satisfacción mediante el tratamiento de 3 estudios observacionales realizados en pacientes con infecciones de vías respiratorias bajas e infecciones del tracto urinario inferior que recibieron ciprofloxacino 500 mg en sobres. El cumplimiento terapéutico, porcentaje de sobres utilizados respecto al total de sobres prescritos, se considera como correcto entre el 80-110%. Los parámetros de satisfacción se cuantificaron como excelente, buena, normal, regular y mala. Resultados: El cumplimiento terapéutico fue superior al 80%. La valoración global del tratamiento fue calificada de excelente o buena por más del 80% de los pacientes y más del 85% de los médicos. La comodidad de la presentación se calificó de excelente o buena en más del 75% de los casos, la facilidad de utilización fue excelente o buena para más del 89% de los casos, y la facilidad para ingerir el fármaco fue excelente o buena para más del 69% de los casos. Discusión: La facilidad de utilización, la comodidad y la facilidad de deglución de un medicamento puede influir positivamente en el cumplimiento y en la satisfacción del paciente

Introduction: Treatment noncompliance is a first degree health problem, influenced by factors such as physician confidence, route of administration and treatment dosage, being very important the patient’ satisfaction with treatment. Material and Methods: The results of therapeutic compliance and treatment satisfaction from 3 observational studies carried out in patients with low airways infections and low urinary tract infection receiving ciprofloxacin 500 mg envelopes are presented. Therapeutic compliance, percentage of used envelopes compared to total prescribed envelopes, is considered correct within 80-110%. Satisfaction parameters were categorised as excellent, good, normal, regular and bad. Results: Therapeutic compliance was higher than 80%. Treatment global assessment was qualified as excellent or good by more than 80% of patients and more than 85% of physicians. Convenience of the presentation was qualified as excellent or good by more than 75% of cases, the ease of use was excellent or good in more than 89% of cases, and ease of swallowing was excellent or good in more than 69% of cases. Discussion: A medicine’s ease of use, convenience and ease of swallowing can positively influence patient’s compliance and satisfaction