ABSTRACT
An association between gross motor competence (GMC) and academic achievement (AA) has been described, but the potential mechanisms behind this association are still unknown. It is not known either whether these mechanisms are similar for boys and girls. The aim of this study was to analyse whether the association between GMC and AA is mediated by executive functions (EFs), and to investigate whether this mediation differs by sex. This cross-sectional study involved 451 children aged 8 to 10 (234 girls; mean age 9.95 ± 0.59). The Movement Assessment Battery for Children-Second Edition (MABC-2), NIH Toolbox, and grades in language and mathematics were used to test GMC, EFs, and AA, respectively. Multifactorial structural equation model (SEM) was used to evaluate a possible relation between variables, controlling for confounders. The differences by sex were examined using a multi-group SEM approach. The results showed that EFs acted as a full mediator of the relationship between GMC and AA in boys (ß = 0.14, p = 0.012) but not in girls (ß = 0.10, p = 0.326). These results show that the benefit of GMC on AA is mediated by EFs in boys but not in girls. Nevertheless, these conclusions should be carefully considered due to the cross-sectional nature of the study.
Subject(s)
Academic Success , Child , Cognition , Cross-Sectional Studies , Educational Status , Female , Humans , Male , Sex CharacteristicsABSTRACT
BACKGROUND: It has been documented that anxiety and depression are prevalent in patients with asthma and are associated with greater frequency of exacerbations, increased use of health care resources, and poor asthma control. OBJECTIVE: To examine the association of asthma diagnosis with symptoms of depression/anxiety and asthma control not only at baseline but also over a 6-month period of specialist supervision. METHODS: We enrolled 3182 patients with moderate to severe asthma. All were evaluated with spirometry, the Asthma Control Test, and the Hospital Anxiety and Depression Scale at baseline and at 6 months. Treatments were decided by specialists according to published guidelines. RESULTS: At baseline, 24.2% and 12% of the patients were diagnosed with anxiety and depression, respectively, according to the Hospital Anxiety and Depression Scale. After 6 months, anxiety and depression improved, affecting 15.3% and 8.1% of patients, respectively (P < .001); mean FEV1 and asthma control also improved (FEV1 from 81.6% ± 20.9% to 86% ± 20.8%; Asthma Control Test score from 15.8 ± 4.7 to 19.4 ± 4.4; both P < .001). Patients with anxiety and depression used significantly more health care resources and had more exacerbations. A multivariate analysis showed that patients with anxiety, depression, and lower FEV1 (odds ratio, 0.20, 0.34, 0.62, respectively; P < .001) were independently associated with poor asthma control. A multiple linear regression analysis showed that anxiety had a nearly 4-fold greater influence over asthma control than depression (0.326/0.85 = 4.075). CONCLUSION: Under standardized asthma care and after a specific visit with the specialist, patients present significant improvement in these psychological disorders and exhibit better asthma control and functional parameters.
Subject(s)
Anxiety/epidemiology , Asthma/epidemiology , Depression/epidemiology , Adult , Anxiety/diagnosis , Asthma/physiopathology , Depression/diagnosis , Female , Forced Expiratory Volume , Humans , Male , Middle Aged , Severity of Illness IndexABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Sarcoma/complications , Sarcoma , Neoplasm Metastasis/diagnosis , Neoplasm Metastasis/physiopathology , Carcinoma, Renal Cell/complications , Carcinoma, Renal Cell , Sarcoma, Clear Cell/complications , Sarcoma, Clear Cell/pathology , Sarcoma, Clear Cell , Radiography, Thoracic/instrumentation , Radiography, Thoracic/methods , Radiography, Thoracic , Lung Neoplasms/complications , Lung Neoplasms/psychology , Lung NeoplasmsSubject(s)
Kidney Neoplasms/pathology , Lung Neoplasms/secondary , Sarcoma, Clear Cell/secondary , Aged , HumansABSTRACT
Renal cell carcinoma (RCC) has high metastatic potential, which requires early diagnosis to optimize the chance of cure. Metastasis of RCC to the head and neck region is less common and metastasis to the buccal mucosa is extremely rare. This phenomenon occurs mostly in patients with generalized dissemination, especially with lung metastases. In this article we report a case of buccal mucosa metastasis from RCC in a 65-year-old man who presented 19 years after undergoing a left radical nephrectomy for clear cell RCC. Surgical excision of the buccal lesion was performed without evidence of recurrence or new metastatic lesions after 6 years of followup. To our knowledge, this is the first case of metastasis to the buccal mucosa from a RCC reported in the literature.
ABSTRACT
Primary renal malignant fibrous histiocytoma is an extremely rare disease. There are neither clinical nor radiological signs to distinguish it from the most common renal cell carcinoma. Its prognosis is poor because of its tendency to locally recur and metastasize. Therefore, early diagnosis and proper treatment are very important. We present the case of a 66-year-old woman diagnosed with primary renal malignant fibrous histiocytoma who underwent partial nephrectomy. After 41 months' follow-up, there was no evidence of any recurrence. To our knowledge, this is the first reported case of conservative surgery for this kind of tumor.
ABSTRACT
OBJECTIVE: We report the case of a 61-year-old male with the incidental diagnosis of intrathoracic renal ectopia during the workup study for a possible lung mass. METHODS: We performed a bibliographic review on the incidence, origin, clinical presentation and diagnosis of this type of renal ectopia. RESULTS: Chest x-ray showed a left posterior mediastinum mass. Bronchoscopy was performed showing signs of extrinsic compression with absence of neoplastic cells. CT scan revealed a left intrathoracic ectopic kidney with diaphragmatic hernia. CONCLUSIONS: Intrathoracic renal ectopia is a very unfrequent finding, often asymptomatic, frequently an incidental diagnosis that does not require treatment.
Subject(s)
Kidney/abnormalities , Thorax , Congenital Abnormalities/diagnostic imaging , Humans , Male , Middle Aged , RadiographyABSTRACT
Objetivo: Se presenta el caso clínico de un varón de 61 años diagnosticado de manera incidental de ectopia renal intratorácica durante el estudio de posible masa pulmonar. Métodos: Se realiza una revisión bibliográfica de la incidencia, origen, clínica y diagnóstico de este tipo de ectopia renal. Resultados: En la radiografía de tórax se aprecia una masa en mediastino posterior izquierdo. Es practicada una fibrobroncoscopia apreciando signos de compresión extrínseca con ausencia de células neoplásicas. El TAC revela un riñón ectópico intratorácico con hernia diafragmática izquierda. Conclusiones: La ectopia renal intratorácica es un hallazgo muy infrecuente, habitualmente asintomático, diagnosticado con frecuencia de manera incidental y que no suele requerir tratamiento (AU)
Objective: We report the case of a 61-year-old male with the incidental diagnosis of intrathoracic renal ectopia during the workup study for a possible lung mass. Methods: We performed a bibliographic review on the incidence, origin, clinical presentation and diagnosis of this type of renal ectopia. Results: Chest x-ray showed a left posterior mediastinum mass. Bronchoscopy was performed showing signs of extrinsic compression with absence of neoplastic cells. CT scan revealed a left intrathoracic ectopic kidney with diaphragmatic hernia. Conclusions: Intrathoracic renal ectopia is a very unfrequent finding, often asymptomatic, frequently an incidental diagnosis that does not require treatment (AU)
Subject(s)
Humans , Male , Middle Aged , Hernia, Diaphragmatic/complications , Hernia, Diaphragmatic/diagnosis , Hernia, Diaphragmatic/surgery , Radiography, Thoracic/methods , Mitral Valve Stenosis/complications , Atrial Fibrillation/complications , Hernia, Diaphragmatic/pathology , Hernia, Diaphragmatic , Pulmonary Disease, Chronic Obstructive/complications , Kidney/pathology , Kidney/surgery , KidneyABSTRACT
OBJECTIVE: We report the clinical case of a 21-year-old male presenting with a 36 hour history of low flow priapism, its diagnosis and treatment. METHODS: We performed a bibliography review on the etiology, physiopathology, diagnosis and treatment options. RESULTS: The patient underwent unsuccessful punction-aspiration of intracavernous blood with phenylephrine injection and cavernous irrigation with saline solution. A covernous-spongiosum shunt was performed subsequently, firstly using the Winter technique and followed by the AlGorab technique with a final positive response. CONCLUSIONS: The performance of a sapheno-cavernous shunt is an effective treatment for the low flow priapism resistant to usual medical-surgical treatment.
Subject(s)
Priapism/surgery , Saphenous Vein/surgery , Adult , Humans , Male , Priapism/physiopathology , Regional Blood Flow , Vascular Surgical ProceduresABSTRACT
OBJECTIVE: To report a rare case of testicular metastasis secondary to an infiltrative transitional cell carcinoma years after radical surgery. CASE REPORT: 71-year-old male patient with history of infiltrative bladder tumor, status post radical cystoprostatectomy with urethrectomy. Seven years after surgery he presents with pain and swelling in the right testicle. Inguinal orchyectomy was carried out with the pathologic diagnosis of testicular metastasis of a high-grade transitional cell carcinoma. We perform a bibliographic review. RESULTS: The patient is disease-free twelve months after orchyectomy. CONCLUSIONS: Apart from leukemia and lymphoma, testicular metastases are extremely rare. The existence of testicular metastases means a metastatic dissemination to other organs, therefore chemotherapy could improve prognosis.
Subject(s)
Carcinoma, Transitional Cell/diagnosis , Carcinoma, Transitional Cell/surgery , Neoplasms, Second Primary/diagnosis , Testicular Neoplasms/diagnosis , Urinary Bladder Neoplasms/surgery , Aged , Humans , Male , Neoplasm Invasiveness , Urinary Bladder Neoplasms/pathologyABSTRACT
Objetivo: Se presenta el caso clínico de un varón de 21 años con priapismo de bajo flujo de 36 horas de evolución, su diagnóstico y su posterior tratamiento. Métodos: Se realiza una revisión bibliográfica de la etiología, fisiopatología, diagnóstico y diferentes tratamientos posibles. Resultados: El paciente es sometido a la punción-aspiración de sangre intracavernosa con inyección de fenilefrina y lavados con suero fisiológico sin éxito. Posteriormente se realiza una derivación cavernoesponjosa, primero según la técnica de Winter seguida de la de Al Ghorab, respondiendo finalmente a la realización de un shunt safeno-cavernoso. Conclusiones: La realización de un shunt safeno-cavernoso es un tratamiento eficaz para la resolución de un priapismo de bajo flujo rebelde al tratamiento médico-quirúrgico habitual (AU)
Objective: We report the clinical case of a 21-year-old male presenting with a 36 hour history of low flow priapism, its diagnosis and treatment. Methods: We performed a bibliography review on the etiology, physiopathology, diagnosis and treatment options. Results: The patient underwent unsuccessful punction-aspiration of intracavernous blood with phenylephrine injection and cavernous irrigation with saline solution. A cavernous-spongiosum shunt was performed subsequently, firstly using the Winter technique and followed by the AlGorab technique with a final positive response. Conclusions: The performance of a sapheno-cavernous shunt is an effective treatment for the low flow priapism resistant to usual medical-surgical treatment (AU)
Subject(s)
Male , Adult , Humans , Priapism/complications , Priapism/diagnosis , Priapism/surgery , Saphenous Vein/pathology , Saphenous Vein/surgery , Erectile Dysfunction/diagnosis , Erectile Dysfunction/surgery , Echocardiography, Doppler/methods , Echocardiography, Doppler , Biopsy, Needle/methods , Erectile Dysfunction/complications , Risk Factors , Erectile Dysfunction/epidemiology , Erectile Dysfunction/etiology , Phenylephrine/therapeutic use , Priapism/etiology , Priapism/physiopathologyABSTRACT
OBJETIVOS: Presentar un caso raro de metástasis testicular secundaria a carcinoma urotelial infiltrante años después de practicada cirugía radical. METODOS: Exposición del caso clínico: paciente de 71 años sometido a cistoprostatectomía radical con uretrectomía por tumor vesical infiltrante. A los siete años debuta con dolor y aumento del tamaño testicular derecho. Se le practicó orquiectomía por vía inguinal siendo diagnosticado de metástasis testicular de carcinoma vesical de alto grado. y revisión de la literatura publicada al respecto. RESULTADOS: Supervivencia libre de enfermedad a los 12 meses de la orquiectomía. CONCLUSIONES: El tumor testicular metastático excluyendo leucemias y linfomas es extremadamente raro. La presencia de metástasis testiculares supone una diseminación metastásica a otros niveles y por ello la Quimioterapia podría mejorar el pronóstico (AU)
OBJECTIVE: To report a rare case of testicular metastasis secondary to an infiltrative transitional cell carcinoma years after radical surgery. METHODS: Case Report: 71-year-old male patient with history of infiltrative bladder tumor, status post radical cystoprostatectomy with urethrectomy. Seven years after surgery he presents with pain and swelling in the right testicle. Inguinal orchyectomy was carried out with the pathologic diagnosis of testicular metastasis of a high-grade transitional cell carcinoma. We perform a bibliographic review. RESULTS: The patient is disease-free twelve months after orchyectomy. CONCLUSIONS: Apart from leukemia and lymphoma, testicular metastases are extremely rare. The existence of testicular metastases means a metastatic dissemination to other organs, therefore chemotherapy could improve prognosis
Subject(s)
Male , Aged , Humans , Carcinoma, Transitional Cell/diagnosis , Carcinoma, Transitional Cell/surgery , Neoplasms, Second Primary/diagnosis , Testicular Neoplasms/diagnosis , Urinary Bladder Neoplasms/surgery , Neoplasm Invasiveness , Urinary Bladder Neoplasms/pathologyABSTRACT
OBJECTIVES: We evaluate the indication and results in the treatment of complex urethral stenosis by the Barbagli's technique. METHODS: We retrospectively review 8 patients undergoing dorsal onlay urethroplasty with foreskin mucosa free graft. We analyze their preoperative characteristics. Mean stenosis length was 6.25 cm and the site was bulbar urethra in seven cases and penile in one. Mean preoperative flow was 8.78 ml/sec. We describe the technique and present our results. RESULTS: There are 87.5% of goods results (cure of the stenosis) with 22 months of mean follow-up. Only one patient required a second operation (end to end anastomosis) with good outcome. CONCLUSIONS: The dorsal onlay urethroplasty with foreskin mucosa free graft is an effective technique in long and complex urethral stenosis, and we consider it the technique of first choice in view of our results.
Subject(s)
Foreskin/transplantation , Urethra/surgery , Urethral Stricture/surgery , Humans , Male , Mucous Membrane/transplantation , Retrospective Studies , Urologic Surgical Procedures, Male/methodsABSTRACT
OBJECTIVES: We report two exceptional cases of metachronous adrenal metastasis of renal cell carcinomas and perform a bibliographic review. After the evaluation of various features such as frequency, etiopathogenesis, diagnosis and follow-up of these patients we conclude that these metastases are rare, and they usually appear late in the evolution of patients with low stage renal cell carcinoma. RESULTS/CONCLUSIONS: Once reviewed the treatment and checked the absence of guidelines for the therapeutic management of these patients we propose surgery for the adrenal metastasis as well as adjuvant treatment with immunotherapy.
Subject(s)
Adrenal Gland Neoplasms/secondary , Carcinoma, Renal Cell/secondary , Carcinoma, Renal Cell/surgery , Kidney Neoplasms/pathology , Kidney Neoplasms/surgery , Nephrectomy , Aged , Female , Humans , Male , Middle AgedABSTRACT
OBJETIVO: Valoramos la indicación y nuestros resultados en el tratamiento de la estenosis de uretra compleja mediante la Técnica de Barbagli.MÉTODO: Realizamos una revisión retrospectiva de 8 pacientes a los que se indica la uretroplastia dorsal con injerto de mucosa libre prepucial. Analizamos las característicaspreoperatorias de los pacientes. La longitud media de la estenosis fue de 6,25 cm, la localización bulbar en 7 casos y peneana en uno. El flujo medio obtenido en la flujometría preoperatoria fue de 8,78 ml/seg. Describimos la técnica y presentamos los resultadosobtenidos con la misma. RESULTADOS: Con un tiempo medio de seguimiento de 22 meses tenemos un 87,5% de buenos resultados, entendiendo estos como la resolución definitiva de la estenosis. Sólo 1 paciente ha precisado un nuevo tratamientoquirúrgico (anastomosis término terminal), con buen resultado evolutivo.CONCLUSIONES: Concluimos que la uretroplastia dorsalcon injerto libre de mucosa prepucial es una técnica efectiva en estenosis de uretra larga y compleja y que por los resultados obtenidos, la consideramos técnica de primera elección en este tipo de estenosis uretrales
OBJECTIVES: We evaluate the indication and results in the treatment of complex urethral stenosis by the Barbagli`s technique.METHODS: We retrospectively review 8 patients undergoingdorsal onlay urethroplasty with foreskin mucosa free graft. We analyze their preoperative characteristics. Mean stenosis length was 6.25 cm and the site was bulbar urethra in seven cases and penile in one. Mean preoperative flow was 8.78 ml/sec. We describe the technique and present our results.RESULTS: There are 87.5% of goods results (cure of the stenosis) with 22 months of mean follow-up. Only one patient required a second operation (end to endanastomosis) with good outcome.CONCLUSIONS: The dorsal onlay urethroplasty with foreskin mucosa free graft is an effective technique in long and complex urethral stenosis, and we consider it the technique of first choice in view of our results
Subject(s)
Male , Humans , Urethral Stricture/surgery , Tissue Transplantation/methods , Urologic Surgical Procedures, Male/methods , Retrospective Studies , Surgical Flaps , Plastic Surgery Procedures/methodsABSTRACT
OBJETIVOS/MÉTODOS: Presentamos dos casos excepcionales de metástasis suprarrenales metacrónicas de carcinoma de células renales y revisamos la literatura existente. Valorados distintos aspectos como la frecuencia, etiopatogenia, diagnóstico y seguimiento de estos pacientes concluimos que estas metástasis son poco frecuentes y suelen presentarse tardías en su evolución en pacientes con CCR con bajo estadios anatomopatológicos. RESULTADOS/CONCLUSIONES: Revisado el trata- miento y constatando que no hay directrices en cuanto al manejo terapéutico de estos pacientes con metástasis proponemos la cirugía de la metástasis suprarrenal así como el tratamiento adyuvante con inmunoterapia (AU)
OBJECTIVES: We report two exceptional cases of metachronous adrenal metastasis of renal cell carcinomas and perform a bibliographic review. After the evaluation of various features such as frequency, etiopathogenesis, diagnosis and follow-up of these patients we conclude that these metastases are rare, and they usually appear late in the evolution of patients with low stage renal cell carcinoma. RESULTS/CONCLUSIONS: Once reviewed the treatment and checked the absence of guidelines for the therapeutic management of these patients we propose surgery for the adrenal metastasis as well as adjuvant treatment with immunotherapy (AU)
