RESUMEN
Brazilian patients with benign prostatic hyperplasia were randomised in a 12-week, double-blind, double-dummy study to receive doxazosin gastrointestinal therapeutic system (GITS) 4 mg q.i.d. (n = 82) or tamsulosin 0.4 q.i.d. (n = 83). Primary endpoints were the absolute and percentage change from baseline in symptoms measured by International Prostate Symptom Score (IPSS). Secondary endpoints included IPSS, quality-of-life (QOL) question from the IPSS, and questions 6 and 7 of the Sexual Function Abbreviated Questionnaire (SFAQ) at weeks 4 and 12. Doxazosin GITS and tamsulosin improved IPSS with no significant differences between groups at week 12. During weeks 4-8, tamsulosin-treated patients demonstrated a slower improvement (p < 0.001) in IPSS than doxazosin GITS-treated patients. The proportion of satisfied patients was observed earlier with doxazosin GITS (p = 0.006) vs. tamsulosin. At week 12, the proportion of patients with little or no difficulty at ejaculation (Q6 of SFAQ) was higher in the doxazosin GITS group (p = 0.019). Both treatments were well tolerated.
Asunto(s)
Antagonistas Adrenérgicos alfa/uso terapéutico , Doxazosina/uso terapéutico , Hiperplasia Prostática/tratamiento farmacológico , Sulfonamidas/uso terapéutico , Anciano , Preparaciones de Acción Retardada , Método Doble Ciego , Quimioterapia Combinada , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Calidad de Vida , Tamsulosina , Resultado del TratamientoRESUMEN
UNLABELLED: This study evaluated 1-year graft function and survival among kidney transplantations from deceased donors using thymoglobulin (Thymo) as an induction strategy. PATIENTS AND METHODS: Fifty-seven percent of patients were men and overall mean age was 42 +/- 15 years. Cold ischemia time was 20.1 +/- 4.8 hours. The primary outcome was defined as survival not censored for death after 1 year. The secondary outcome was defined as a comparison of function and survival among patients who received more or less then six doses of Thymo. RESULTS: Four patients experienced acute rejection episodes and the other three died during follow-up. One-year graft survival was 91% with a mean serum creatinine of 1.28 +/- 0.43 mg/dL. Cytomegalovirus infection occurred in 56%. Forty-two (64%) patients displayed acute tubular necrosis of mean duration of 6.89 +/- 7.48 days. Patients who received lower doses showed better serum creatinine values 3 months (1.45 vs 1.86 mg/dL, P = .013) and 12 months (1.05 vs 1.50 mg/dL, P = .04). The difference was probably due to acute tubular necrosis that produced a RR of 1.7 (P = .02; CI 1.04-2.97) when compared with patients with Scr values above 1.30 mg/dL. When censored for death, graft survival was not different between the two groups (< or =6 doses 93% vs >6 doses 97%, P = .43). CONCLUSION: Immunologic induction with Thymo produced excellent graft survival after 1 year with preservation of graft function. Delayed graft function was the most important determinant of graft function after 1 year.
Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Cadáver , Supervivencia de Injerto/fisiología , Trasplante de Riñón/fisiología , Donantes de Tejidos , Suero Antilinfocítico , Creatinina/sangre , Estudios de Seguimiento , Rechazo de Injerto/epidemiología , Supervivencia de Injerto/efectos de los fármacos , Humanos , Trasplante de Riñón/inmunología , Trasplante de Riñón/mortalidad , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Análisis de Supervivencia , Factores de TiempoRESUMEN
A 64-year-old woman presented with recurrent gross hematuria and intermittent left-sided pain. A CT scan revealed an 8-cm mass in the left moiety of a horseshoe kidney. A laparoscopic transperitoneal approach was employed to control the vessels and release the left moiety of the kidney and a hand-assisted approach was performed for isthmectomy using compression of normal parenchyma and monopolar electrocautery. Additional sutures were applied externally in isthmus through hand-assisted incision to enhance hemostasis. The patient was discharged on postoperative day 4 with no complications and no relapse after a 1-year follow-up. We conclude that our technique is safe, cheap and effective for this complex clinical entity.
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Laparoscopía , Femenino , Humanos , Persona de Mediana EdadRESUMEN
Paratesticular fibrous pseudotumors are rare, and less than 10% of them affect the epididymis. We report a case of testicular trauma that progressed to a painless palpable tumor in the right hemiscrotum with increased local volume. Orchiectomy followed by anatomic-pathologic examination revealed a paratesticular fibrous pseudotumor. The best treatment is scrotal exploration and frozen biopsy. On confirmation of the diagnosis, only the tumor and the tunica vaginalis are resected. Should the benign nature not be possible to determine, orchiectomy is the procedure of choice. We also reviewed published reports for this possibility in the differential diagnosis of testicular masses.
Asunto(s)
Enfermedades Testiculares/diagnóstico por imagen , Biomarcadores/análisis , Biopsia , Epidídimo/patología , Humanos , Masculino , Persona de Mediana Edad , Orquiectomía , Escroto/lesiones , Enfermedades Testiculares/patología , Enfermedades Testiculares/cirugía , UltrasonografíaRESUMEN
CONTEXT: Since the first percutaneous nephrostomy performed by Goodwin in 1954, technical advances in accessing the kidneys via percutaneous puncture have increased the use of this procedure and thus the complications too. Among these complications, digestive tract damage is not common. DESIGN: Case report. CASE REPORT: We report a duodenal lesion that was corrected using surgical exploration and we touch on the therapeutic options, which may be conservative or interventionist. We chose conservative treatment, which has been approached in diverse manners in the literature.
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Duodeno/lesiones , Nefrostomía Percutánea/efectos adversos , Anciano , Femenino , Humanos , ReoperaciónRESUMEN
Cancer of the uterine cervix has been related to HPV infection, based on clinical and laboratory data. The high recurrence rate in couples undergoing treatment for HPV infection points to a probable viral reservoir, either in subclinical lesions or in male internal genital organs. We have evaluated 31 men, all sexual partners of women with HPV infection. Eleven patients (35.5%) had related lesions: 4 (12.9%) with condyloma acuminatum; 5 (16.1%) with lesions revealed by magnified examination after reaction with 5% acetic acid and 2 (6.5%) with condyloma and subclinical lesions. A short-term follow-up confirmed a successful treatment with podophyllin.
Asunto(s)
Condiloma Acuminado/etiología , Papillomaviridae , Infecciones por Papillomavirus/transmisión , Parejas Sexuales , Infecciones Tumorales por Virus/transmisión , Neoplasias del Cuello Uterino/etiología , Adulto , Condiloma Acuminado/diagnóstico , Sondas de ADN de HPV , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infecciones por Papillomavirus/diagnóstico , Infecciones Tumorales por Virus/diagnósticoRESUMEN
Ten patients with recurrent nephrolithiasis and hypercalciuria were given rice bran during 60 days. Hypercalciuria was reduced in all patients in an average of 40%. Urinary magnesium was reduced in 28% and oxalate excretion was increased in 28%. The rate of decrease of urinary calcium was 65% in the absorptive type and 33% in the renal type of hypercalciuria.
Asunto(s)
Calcio/orina , Oryza , Cálculos Urinarios/dietoterapia , Adulto , Calcio/sangre , Oxalato de Calcio/orina , Niño , Femenino , Humanos , Magnesio/orina , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Cálculos Urinarios/orinaRESUMEN
We describe a child with dermatomyositis and calcified necrosis in the middle third of both ureters. Histopathological examination showed vasculitis associated with ureteral necrosis and calcification. These findings together with a similar previous report in the literature have prompted us to correlate dermatomyositis in childhood with ureteral necrosis and to anticipate specifically a lesion in the middle third of the ureter because of the relative lack of blood flow in that segment.
Asunto(s)
Dermatomiositis/patología , Uréter/patología , Niño , Dermatomiositis/complicaciones , Femenino , Humanos , Necrosis , Vasculitis/etiologíaAsunto(s)
Neoplasias de la Corteza Suprarrenal/complicaciones , Síndrome de Cushing/etiología , Virilismo/etiología , Adolescente , Neoplasias de la Corteza Suprarrenal/patología , Neoplasias de la Corteza Suprarrenal/cirugía , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Estadificación de NeoplasiasRESUMEN
A case report of a 27-year-old male with segmental priapism of the left proximal corpus cavernosum is presented. Treatment consisted in evacuation and irrigation of the corpus.