ABSTRACT
Screening programs for prostate cancer based on the determination of serum prostate specific antigen has led to overdiagnosis, and consequently overtreatment. A percentage of men diagnosed with prostate cancer have a tumour that will not progress, or do so slowly (overdiagnosis or pseudo-disease). This overdiagnosis rate ranges from 17-50%. Mass screening is defined as the systematic examination of asymptomatic men. Early detection or opportunistic screening involves the pursuit of individual cases being initiated by the doctor or the patient. In the case of a patient who requests a prostate specific antigen from their general practitioner, a number of issues on overdiagnosis, over-treatment and possible damage from the biopsy, should be explained to him. With data from randomised studies on prostate specific antigen and prostate cancer screening, population screening is not recommended by any urological society.
Subject(s)
Mass Screening/methods , Prostate-Specific Antigen/blood , Prostatic Neoplasms/diagnosis , Biopsy/methods , Early Detection of Cancer/methods , Humans , Male , Medical Overuse , Prostatic Neoplasms/pathology , Randomized Controlled Trials as TopicABSTRACT
La infertilidad, entendiendo ésta como la que padece una pareja que, tras un año de relaciones sin tomar medidas de protección, no consigue un embarazo, afecta aproximadamente al 15% de parejas. La importancia del factor masculino como causa de infertilidad puede llegar a suponer el 50% del total de consultas. Entre las múltiples causas de infertilidad masculina se encuentran los problemas obstructivos de la vía seminal, el fallo testicular primario, el varicocele, las infecciones urogenitales o los disturbios endocrinos entre otros. Pero existe también un porcentaje de varones en los que no se encuentra una causa específica de infertilidad, estando en muchos de estos casos implicados un problema genético o inmunológico. En este trabajo revisamos las causas más frecuentes exponiendo de manera esquemática su etiología, anamnesis, exploraciones y tratamiento recomendados
Infertility, understanding this as that suffered by a couple who, after one year of relationships without using any protection measures, does not achieve pregnancy, affects approximately 15% of couples. The importance of the masculine factor as cause of infertility can reach 50% of all the consultations. Among the multiple causes of masculine infertility are the obstructive problems of the seminal duct, primary testicular failure, varicocele, urogenital infections or endocrine disorders, among others. However, there is also a percentage of men in whom no specific cause of infertility is found, a genetic or immunological problem being involved in many of these cases. In this paper, we review the most frequent causes, presenting its etiology, anamnesis, recommended examinations and treatment schematically
