RESUMO
INTRODUCTION AND OBJECTIVES: With the advances of technology, the incidence of renal cancer has increased, but the stage at the time of diagnosis has decreased. In selected patients nephron sparing surgery can be made but there are patients who have important comorbidities and therefore they are not candidates to surgical management. For them, there are new minimally invasive procedures that use different types of energy to perform ablation of the neoplastic tissue; one of which is radiofrequency ablation. This article reports the initial experience with this therapeutic modality in a reference center of Mexico City. METHODS: Four patients with 5 renal masses of 3 cm or less, and with significant comorbidities that exclude the possibility of surgery, underwent radiofrequency ablation under fluoroscopic guidance. RESULTS: Five renal tumors in four patients were treated with radiofrequency ablation in a period of 18 months. No major complication during the procedure was reported, mean follow- up was of 12 months and they keep a good oncologic control. CONCLUSIONS: Radiofrequency ablation is a safe and reproducible therapeutic option for patients with incidental renal masses below 3 cm. We need more follow up to compare oncologic control with the gold standard, surgery.
Assuntos
Ablação por Cateter , Neoplasias Renais/cirurgia , Idoso , Idoso de 80 Anos ou mais , Humanos , México , Pessoa de Meia-Idade , Encaminhamento e Consulta , População UrbanaRESUMO
Erectile dysfunction is a very prevalent disease, associated with chronic diseases mainly from the cardiovascular system. Better understanding of penile physiology has permitted the development of new drugs which offers each type of patient a specific and directed treatment. In the future, more basic and clinical research will surely result in better drugs. This article is intended to give insight to modern physiological concepts and apply them to a better understanding of therapeutic options available nowadays.
Assuntos
Disfunção Erétil , Ereção Peniana/fisiologia , Disfunção Erétil/epidemiologia , Disfunção Erétil/etiologia , Disfunção Erétil/terapia , Fibrose , Previsões , Humanos , Masculino , Pênis/irrigação sanguínea , Pênis/inervação , Pênis/patologia , Fatores de RiscoRESUMO
OBJECTIVE: To describe the clinical, morphological and inmunophenotypic characteristics and followup of testicular non Hodgkin lymphomas seen in a referral center. METHODS: We reviewed the cases of testicular lymphoma seen from 1987 to 1997. We obtained data of laboratory tests, radiological findings, clinical course, treatment and new immunohistochemical studies (CD45, CD20, CD43, Epstein-Barr virus latent membrane protein and antibodies UCHL-1). We performed a blind analysis to identify the morphological variables associated to the clinical course. The Fisher exact test was used for statistical significance identification. RESULTS: 53 patients with testicular tumors were seen. Four of them were lymphomas (7.5%) with a mean age of 47 years (range 33-73) and two of the four had AIDS. A comparative analysis showed major local invasion of surgical margins and systemic progression in the AIDS cases. Immunohystochemical testing showed that the neoplasia was formed by B cells negative for Epstein-Barr virus latent membrane protein. The two patients without AIDS showed no evidence of the disease after 64 and 144 months of followup. The AIDS cases died one and three months after the diagnosis of testicular lymphoma was made. CONCLUSIONS: The four cases of testicular lymphoma were of B cell lineage without immunohystochemical expression for Epstein-Barr virus latent membrane protein. There was a more aggressive clinical course in the cases associated with AIDS.