Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introducción: La neurorrestauración integral en la esclerosis múltiple mejora los déficits funcionales. Dentro de la atención de las personas con la enfermedad, se ha incluido la valoración de la calidad de vida relacionada con la salud, que es un elemento clave para la evaluación subjetiva de las influencias del estado de salud actual. Objetivo: Determinar la influencia de la neurorrestauración integral en la calidad de vida relacionada con la salud de los pacientes con esclerosis múltiple remitente-recurrente.Material y Métodos: Se realizó un estudio cuasi-experimental en 78 pacientes con esclerosis múltiple remitente-recurrente, tratados en el Hospital Universitario Clínico-quirúrgico Arnaldo Milián Castro de Santa Clara, en el periodo comprendido entre enero de 2014 a diciembre de 2020. Los pacientes se distribuyeron aleatoriamente en un grupo estudio y un grupo control, asignados por sorteo.Resultados: En cuanto a las actividades de la vida diaria mostró una media al final de la intervención de 95,89 para el grupo estudio; y para el grupo control de 81,28. Posterior a la intervención se evidenció una mejoría del funcionamiento de la calidad de vida relacionada con la salud del grupo estudio en los componentes de la escala en comparación con los controles.Conclusiones: se determinó como el desarrollo de intervenciones promueven el mayor bienestar posible de los pacientes con esclerosis múltiple remitente-recurrente a través de la neurorrestauración integral.

Objective: Investigate the microbiology and incidence of drug resistance in patients undergoing TURBT and to identify independent risk factors for UTI following surgery. Material & Methods : Retrospective observational study of prospectively collected data of 199 patients who underwent TURBT in a tertiary care center in Mexico City between 2017-2019. Baseline characteristics and microbiological data (frequency of isolated bacteria and antibiotic resistance pattern) were analyzed according to the presence of UTI following surgery. Binary logistic regression analysis was performed to identify independent risk factors for UTI. Results: A preoperative positive urine culture (PUC) was present in 28 patients (14%), the most common isolated pathogens were Escherichia coli(48%), Enterococcus faecalis(24%) and Proteus mirabilis(7%). UTI was documented in 20 patients after TURBT (10%), being E. coli(45%) the most common uropathogen which was resistant to Trimethoprim/Sulfamethoxazole(60%) and Ciprofloxacin(40%). Other common isolated pathogens were E. faecalis(27%) and P. mirabilis(9%). There was significant difference in the presence of a PUC before TURBT and necrosis (p=0.001). On the multivariate analysis the PUC before TURBT was associated with UTI after TURBT (OR7.04 [95%CI 2.11-23.29]). Limitations: Retrospective study with information limited to the clinical file. Originality: There is little information about UTI after TURBT in global literature, in Mexico there is no information, being this study unique in his kind. Conclusions: The incidence of UTI after TURBT was 10%. The strongest associated risk factor for UTI after TURBT was a preoperative PUC. The most common isolated uropathogen was E. coli. Trimethoprim/Sulfamethoxazole(60%) and Ciprofloxacin(40%) were the most resistant antibiotics for E. coli.

Abstract Description of the clinical case: A 59-year-old male with a history of lower urinary obstructive symptoms presented to the emergency department with a clinical picture of acute abdomen and hematuria of 10 days of evolution. Spontaneous bladder rupture associated with a complication of bladder diverticulum rupture was diagnosed. Relevance: Spontaneous bladder rupture is a rare condition that can be fatal. In general, this pathology presents with non-specific symptoms, so it is necessary to think about the diagnosis. The case of spontaneous bladder rupture is presented and how the diagnosis was reached, for timely treatment. Clinical implications: In a patient with a clinical picture of acute abdomen, nitrogen elevation and hematuria in the context of a history of bladder emptying problems, it is important to consider the diagnosis of spontaneous bladder rupture. Conclusions: Spontaneous rupture of a bladder diverticulum is a very rare entity that presents with nonspecific clinical symptoms and signs. Suspicion should be high when assessing a patient with an acute abdomen, elevated creatinine, and hematuria.

Abstract   Crossed renal ectopia is a rare congenital abnormality, where the ectopic kidney crosses the midline, and is located in a position contralateral to its normal position 1. It has a higher prevalence in men in relation to 2-3: 1to women 2, and it has a 3 times higher prevalence on the right side than on the left. Most of the cases are asymptomatic and the diagnosis is made when a pathology is established on the ectopic kidney, such as infections, lithiasis, tumors or other less frequent ones3. A case presentation of a 57-year-old male patient is made, in which the presence of the anatomical anomaly was incidentally discovered.   Objective: To present a clinical case report of a patient with a condition of Cross Renal Ectopia as an image study finding.   Material and methods: Descriptive study where complementary imaging studies are made, in relation to current condition.   Results: A patient with a condition of Cross Renal Ectopia was shown at the Tlalnepantla Regional Hospital ISSEMYM, presenting an incidence of less than 0.2% in frequency within the Mexican population.   frequency within the Mexican population. Keywords. Renal ectopia, abnormality, congenital, kidney, ureter, tomography, abdomen.

Abstract: We report the case of a 49-years-old man, who after orchiectomy is diagnosed of malakoplakia of the scrotal covers with intact testicle. The histopathology exam shows the pathognomonic Michaelis-Gutmann bodies involving scrotal covers, fibroadipose soft tissues and deep dermis. Malakoplakia is an unusual benign chronic inflammatory disease. Predominantly affects the genitourinary system in more than 60% of cases, therefore it is important for urologist to know it. In relation to a clinical case, and since this is the first case of scrotal malakoplakia with intact testicle, we perform a review of the published literature on this pathology.

  In the last years, novel imaging studies have surged for increase the sensitivity in early metastatic disease detection. the recognition of biological subgroups of men with newly diagnosed advanced prostate cancer for the management of the primary tumor to improve the overall survival in this patients considered fatal in the short or medium term with systemic disease managed just with androgenic hormonal suppression.

Objective: To compare the functional results in patients undergoing transurethral resection of the prostate (TURP), photovaporization of the prostate with GreenLight ® laser (FTV) and prostate enucleation with Holmium laser (HOLEP), for the treatment of benign prostatic obstruction at the Central Military Hospital. Material and methods: The international index of prostate symptomatology questionnaire (IPSS), Uroflowmetry (Qmax), pre and post void ultrasonography (PVR) were applied to patients undergoing TURP, VTF and HOLEP pre and postoperatory from January 2018 to March 2019. Shapiro-Wilks tests were analyzed for quantitative variables; parametric behavioral data were analyzed with ANOVA tests, and non-parametric data were analyzed with Mann-Whitney and Kruskal-Wallis U tests. GraphPad PRISM v7.0 statistical package was used. Results: 46 patients underwent to TURP, 62 to HOLEP and 17 to VFT were evaluated, removing those who did not achieve complete postoperative follow-up; describing the demographic characteristics, the most frequent comorbidities and the parameters evaluated preoperatively. At follow-up, HOLEP was slightly better than FTV or TURP; without finding statistical significance between the groups, observing an important improvement in the reference values of IPSS, Qmax and PVR after surgery in all populations. Conclusions: No superiority of any technique was proven in short-term postoperative functional results, so we propose to perform long-term studies, considering adding trans and postoperative parameters in order to demonstrate superiority of these techniques.

Resumen Descripción del caso clínico: Varón de 79 años, consultó por episodio de angioedema facial sin otra sintomatología. A la exploración física presentaba eritema en cara y cuello, angioedema peripalpebral y máculas eritematosas en el dorso de las manos. Se realizó biopsia de lesión cutánea compatible con pápula de Gottron y para descartar enfermedad sistémica urografía por tomografía computarizada observando ureterohidronefrosis izquierda grado III por posible neoplasia ureteral. Estudio de extensión negativo. Se realizó nefroureterectomía izquierda laparoscópica e instilación endovesical de Mitomicina C, con resultados anatomo-patológicos de carcinoma papilar urotelial de alto grado multifocal. El paciente presentó una evolución posquirúrgica favorable, con mejoría de las lesiones dérmicas, pero a los 7 meses desarrolló múltiples metástasis siendo éxitus. Relevancia: La asociación de dermatomiositis con neoplasias es bien conocida, pero son pocos los casos descritos con malignidad urológica. El cáncer ureteral con dermatomiositis amiopática es extremadamente raro. Implicaciones clínicas: Es importante realizar un tamizaje de cáncer en pacientes que cursan con dermatomiositis para así tratarlos y mejorar su pronóstico. Conclusión: La dermatomiositis es un síndrome paraneoplásico raro que se asocia al cáncer ureteral de manera muy infrecuente. El tamizaje de cáncer en estos pacientes es muy importante para mejorar el pronóstico. El tratamiento quirúrgico de este tumor supuso la desaparición de las alteraciones cutáneas.

Abstract Objective: To investigate the correlations between abdominal aortic calcifications (AAC) and the underlying urinary metabolic abnormalities in stone-formers (SF). Methods: Patients with a 24 h urinary panel and computed tomography scan were included. The Kauppila Score (KS) was used to quantitatively assess AAC; clinical data and stone information were also recorded. The Spearman correlation was utilized. Results: A total of 54 patients were included, the mean age was 46.4±11.2, 75.9% were female, and 59.3% had AAC. Hypertension and AAC were associated (p=0.026), and the KS was higher in patients with hypertension. Hypocitraturia (98.1%) and hypercalciuria (16.7%) were the most frequent urinary abnormalities, but they were unrelated to AAC (p>0.05). The 24 urinary panel, blood biochemistry, stone burden and hardness, and body mass index were not correlated to the KS (p>0.05). Limitations: This work had the following limitations:  its retrospective nature, a relatively small sample, and the lack of an automated informatics-based assessment of AAC. Conclusion: The link between cardiovascular diseases and kidney stones is still to be elucidated. Our finding differs from the other few studies reported on the literature, as no correlation was found between AAC and the urinary metabolic abnormalities in SF.