Utilidad diagnóstica del estudio citológico del tampón de transporte en biopsias por punción prostática transrectal / Diagnostic Usefulness of the Cytological Study of the Transport Buffer in Transrectal Prostate Core Biopsies

Antecedentes: Evaluar la utilidad diagnóstica del estudio citológico del tampón de transporte en el diagnóstico de adenocarcinoma de próstata en biopsias por punción transrectal. Métodos: Un total de 256 pacientes biopsiados consecutivamente se han incluido en el análisis, 100 de ellos diagnosticados de adenocarcinoma de próstata. El procedimiento incluyó el análisis citológico del tampón de transporte y la histología convencional. Se realizó evaluación citológica de una manera ciega por el mismo patólogo. Resultados: La sensibilidad, especificidad y valores predictivos positivos y negativos globales para la detección de malignidad en los portaobjectos citológicos fueron 54, 98, 94 y 76%, respectivamente. Cuando se restringió el análisis a los casos con una puntuación de Gleason superior a 8 la sensibilidad y el valor predictivo negativo aumentaron a 85 y 97%, respectivamente. Del mismo modo, cuando el análisis se centró exclusivamente en los casos con más de 5 mm de cáncer en la biopsia la sensibilidad y el valor predictivo positivo aumentaron a 66 y 96%, respectivamente. Conclusiones: Este estudio muestra que mientras que la especificidad se mantuvo en el 98% la sensibilidad y los valores predictivos positivos y negativos mejoraron significativamente en los adenocarcinomas de alto grado y de alto volumen. Nuestros hallazgos confirman que el estudio citológico del tampón de transporte puede complementar la histología en el diagnóstico de adenocarcinoma de próstata

Background: To evaluate the diagnostic usefulness of the cytological study of the transport buffer in the diagnosis of prostate adenocarcinoma in transrectal core biopsies. Methods A total of 256 consecutively biopsied patients have been included in the analysis, 100 of them diagnosed of prostate adenocarcinoma. The procedure included the cytological analysis of the transport buffer and conventional histology. Cytological evaluation was performed in a blind way by the same pathologist. Results: Overall sensitivity, specificity, and positive and negative predictive values to detect malignancy in the cytological slides were 54%, 98%, 94% and 76%, respectively. When restricted the analysis to cases with Gleason score higher than 8, sensitivity and negative predictive value increased to 85% and 97%, respectively. Similarly, when the analysis focused exclusively to cases with more than 5 mm of cancer in the biopsy, sensitivity and positive predictive value increased to 66% and 96%, respectively. Conclusions: This study shows that whilst specificity was maintained in 98%, sensitivity, and positive and negative predictive values significantly improved in high grade and high volume adenocarcinomas. Our findings confirm that the cytological study of the transport buffer may complement the histology in the diagnosis of prostate adenocarcinoma

Diagnostic usefulness of the cytological study of the transport buffer in transrectal prostate core biopsies.

BACKGROUND: To evaluate the diagnostic usefulness of the cytological study of the transport buffer in the diagnosis of prostate adenocarcinoma in transrectal core biopsies. METHODS: A total of 256 consecutively biopsied patients have been included in the analysis, 100 of them diagnosed of prostate adenocarcinoma. The procedure included the cytological analysis of the transport buffer and conventional histology. Cytological evaluation was performed in a blind way by the same pathologist. RESULTS: Overall sensitivity, specificity, and positive and negative predictive values to detect malignancy in the cytological slides were 54%, 98%, 94% and 76%, respectively. When restricted the analysis to cases with Gleason score higher than 8, sensitivity and negative predictive value increased to 85% and 97%, respectively. Similarly, when the analysis focused exclusively to cases with more than 5mm of cancer in the biopsy, sensitivity and positive predictive value increased to 66% and 96%, respectively. CONCLUSIONS: This study shows that whilst specificity was maintained in 98%, sensitivity, and positive and negative predictive values significantly improved in high grade and high volume adenocarcinomas. Our findings confirm that the cytological study of the transport buffer may complement the histology in the diagnosis of prostate adenocarcinoma.

Primary actinomycosis of the urinary bladder.

Actinomycosis is caused by bacilli of the Actinomyces sp. They are Gram-positive, anaerobic or microaerophilic non-spore-forming bacilli. Actinomyces israelii is the most common aetiological agent. A case is reported of primary actinomycosis in the urinary bladder successfully treated with ceftriaxone.

Effect of venlafaxine hydrochloride in different preparations of isolated guinea-pig and rat organ tissues.

A study was undertaken to know better the effects of venlafaxine hydrochloride on the responses of isolated rat vas deferens to noradrenaline and dopamine, those of isolated rat uterus to serotonin and histamine, and those of isolated guinea-pig ileum to acetylcholine and histamine. Venlafaxine hydrochloride increased the response of rat vas deferens to noradrenaline but not to dopamine. Venlafaxine did not alter the response of rat isolated uterus to serotonin. In rat uterus, venlafaxine did not modify the response to histamine but was able to increase it in guinea-pig ileum. An anticholinergic effect was observed with the lowest concentration tested. Although venlafaxine is a selective serotonine reuptake inhibitor in the central nervous system, serotonin uptake was not seen in the rat uterus. The anticholinergic effects observed in the present study might be consistent with some of the side-effects associated with venlafaxine.

[Genital brucellosis]. / Brucelosis genital.

Since this is a systemic disease, it is not uncommon to find brucella organisms in urine during acute infection however, it frequently presents with orchi-epididymitis (2-20%) and, rarely, with granulomas in the urinary tract. We report on two cases of acute epididymitis. The pathogenesis, diagnosis and treatment of this disease entity are briefly viewed highlighting the urological problem.

[Scrotal and perineal pain following coitus interruptus]. / Dolor escroto-perineal tras coitus interruptus.

A case of perineal-scrotal and hypogastric pain following coitus interruptus in a young male patient is described. The physiopathological mechanisms involved in this condition in normal subjects or those with neuropathic disorders are discussed.

PIP: A 27-year old male was treated in a hospital emergency room in Vizcaya, Spain, for perineal-scrotal and hypogastric pain following coitus interruptus. There were no other systemic alterations and the genital examination was normal. The patient was treated with analgesics and the physiopathologic mechanism was explained to him. THe complex mechanism of nervous and muscular coordination leading to ejaculation is sometimes disturbed by anomalous external stimuli, e.g., during masturbation or coitus interruptus, producing a constant pain in the entire genital and hypogastric area, even after ejaculation. Some authors suggest the possibility of an underlying psychopathology. It is possible that a delayed ejaculation factor also exists in these patients. Similar pains described in diabetes with neuropathy or in lesions of the sympathetic system are attributed to functional incompetence of the internal sphincter. It is recommended that men who frequently encounter this problem seek psychotherapy. Possible medical treatments include administration of analgesics and antispasmodic or muscle relaxants and tranquilizers.

[TUR of the prostate. Low irrigation pressure. Prevention of the absorption syndrome and of virus infection (AIDS)]. / RTU de próstata. Baja presión de irrigación. Prevención del síndrome de absorción y de la infección por virus (SIDA).

Based on their experience with 2,000 procedures, the authors report on the advantages afforded by low pressure irrigation and the utilization of a trocar in TUR of the prostate. A new, efficient, automatically-controlled high-frequency surgical unit and a new trocar for suprapubic puncture are described.

[Usefulness of CAT in retroperitoneal fibrosis]. / Valor del TAC en la fibrosis retroperitoneal.

We report on six patients with with retroperitoneal fibrosis (RPF) who were evaluated preoperatively by CT. Patient scans disclosed a retroperitoneal fibrous layer localized between L4-S2, S3 in four of the six cases (65%). Similarly, varying degrees of uni-or bilateral utero-hydronephrosis were observed in five patients, and venous involvement with collateral abdominal circulation was observed in two. The surgical findings coincided with those of the CT scans, and disclosed that in the two patients with no evidence of a fibrous layer on the scan, this was due to the its being localized to an area in one or both sides of the pelvic cavity. The diagnosis was histologically confirmed as idiopathic retroperitoneal fibrosis in all six cases. We consider CT to be the preoperative method of choice in the diagnosis of RPF because it not only provides information on the status of the urinary system, the involvement of other retroperitoneal structures and the extent of the fibrous layer, it also provides orientation as to the possible etiology of the retroperitoneal fibrosis.