Giant bladder lithiasis: case report and bibliographic review.

OBJECTIVE: Urinary lithiasis is a very frequent urological disease but bladder lithiasis is very uncommon.Patients usually refer voiding symptoms and hematuria. The diagnosis is made after imaging tests. We report a clinical case describing a giant bladder stone and perform a bibliographic review. METHODS: A 43 year old man with the diagnosis of giant bladder stone (more than 10 cm diameter). We searched Medline using the terms: giant bladder stone, giant bladder lithiasis, bladder lithiasis, giant bladder lithiasis. RESULTS: We made the diagnosis of giant bladder stone after a simple kidney, ureter and bladder (KUB) X Ray. The treatment for this patient was a cystolithotomy. We found more than 230 reports at Medline and chose the most referred ones and the last 10 years reports. CONCLUSIONS: Giant bladder lithiasis is a very rare pathology. The gold standard for diagnosis is cystoscopy but sometimes with a KUB Xray or an ultrasound is enough. Because of its size, cistolitotomy is the correct treatment for giant bladder stone.

Litiasis vesical gigante. Presentación de un caso y revisión de la literatura / No disponible

OBJETIVO: La litiasis es una de las patologías más prevalentes en urología. Sin embargo son poco frecuentes a nivel vesical.Las litiasis vesicales producen, generalmente, síndrome miccional y hematuria y se llega al diagnóstico después de pruebas de imagen.Presentamos un caso clínico en el que se describe la litiasis vesical primaria de mayor tamaño recopilada y hacemos una revisión de la literatura existente. MÉTODOS: Presentamos un caso clínico de un hombre de 43 años de edad diagnosticado de litiasis vesical de más de 10 cm de diámetro.Realizamos una búsqueda en Medline utilizando los siguientes términos: giant bladder stone, giant bladder lithiasis, blader lithiasis, giant bladder litiasis.RESULTADO: Nuestro paciente fue diagnosticado de litiasis vesical tras realización de Rx simple de aparato urinario y sometido a cistolitotomía. Actualmente se encuentra asintomático y libre en enfermedad.Encontramos más de 232 artículos referentes a este tema en Medline de los que seleccionamos los de mayor citación y los de los últimos 10 años.CONCLUSIONES: La litiasis vesical gigante es una enfermedad muy rara que requiere diagnósticos por imagen, la prueba patrón oro para su filiación es la cistoscopia diagnóstica aunque en ocasiones, mediante una Rx simple de abdomen o ECO urológica es suficiente.Debido a su tamaño, la cistolitotomía es todavía el tratamiento de elección para esta enfermedad(AU)

OBJECTIVE: Urinary lithiasis is a very frequent urological disease but bladder lithiasis is very uncommon.Patients usually refer voiding symptoms and hematuria. The diagnosis is made after imaging tests.We report a clinical case describing a giant bladder stone and perform a bibliographic review.METHODS: A 43 year old man with the diagnosis of giant bladder stone (more than 10 cm diameter).We searched Medline using the terms: giant bladder stone, giant bladder lithiasis, bladder lithiasis, giant bladder lithiasis.RESULTS: We made the diagnosis of giant bladder stone after a simple kidney, ureter and bladder (KUB) X Ray. The treatment for this patient was a cystolithotomy.We found more than 230 reports at Medline and chose the most referred ones and the last 10 years reports.CONCLUSIONS: Giant bladder lithiasis is a very rare pathology. The gold standard for diagnosis is cystoscopy but sometimes with a KUB Xray or an ultrasound is enough.Because of its size, cistolitotomy is the correct treatment for giant bladder stone(AU)

Isoflavones versus hormone therapy for reduction of vertebral fracture risk: indirect comparison.

OBJECTIVE: The aim of this study was to conduct an indirect comparison of the results from meta-analyses that evaluated the incidence of osteoporotic vertebral fracture in postmenopausal women exposed to hormone therapy (HT) or isoflavones. METHODS: Systematic review and meta-analysis of HT and isoflavones related to the reduction of vertebral fracture risk in osteoporotic women versus the same control (placebo) were undertaken. Then, the combination of the overall results obtained from these two meta-analysis (indirect comparison) was adjusted to the common control (placebo). RESULTS: The indirect odds ratio (OR), obtained from the combination of both individual meta-analyses, was calculated by using the following equation: OR(indirect) = OR(HT)/OR(isoflav), with a total indirect variance equivalent to the following equation: var(total) = var(HT) + var(isoflav). These calculations yielded a point estimate of 1.56 (95% CI, 0.39-6.19) for the indirect OR. CONCLUSIONS: According to this indirect comparison, there is no statistically significant difference between HT or isoflavones in the reduction of vertebral fracture risk due to osteoporosis, and both interventions seem to be similar for this outcome.

Soy isoflavones versus placebo in the treatment of climacteric vasomotor symptoms: systematic review and meta-analysis.

OBJECTIVE: The incidence of vasomotor crises during the climacterium varies in women across different populations, and phytoestrogen consumption seems to play an important role in this problem. The aim of this study was to determine whether intervention with soy (dietary, extract, or concentrate), as compared with placebo, reduces the incidence of hot flashes in climacteric women. METHODS: Only published, randomized, placebo-controlled clinical trials were selected, with a 12-week duration of intervention, having selected postmenopausal women affected with hot flashes attributed to the climacterium (without cancer background). The intervention to be evaluated was soy, as "soy dietary supplement," "soy extract," or "isoflavone concentrate" (genistein or daidzein). The results were expressed as the number of hot flashes, average score of vasomotor symptoms, or average percent reduction in hot flashes within a time unit (day, week, or month). RESULTS: Nineteen studies were analyzed. The minimum heterogeneity was observed in the "isoflavone concentrate" group. In the "extract" and "dietary supplement" groups, heterogeneity reached an intermediate level, I(2) = 42% and 59.73%, respectively. The overall result showed a standardized mean difference of -0.39 (95% CI, -0.53 to -0.25) in favor of soy as well as -0.45 (95% CI, -0.64 to -0.25), -0.51 (95% CI, -0.79 to -0.22), and -0.20 (95% CI, -0.46 to -0.06) for the "concentrate," "extract," and "dietary supplement" subgroups, respectively. CONCLUSIONS: Although the overall combined results and the results by subgroups (according to the type of supplement used) showed a significant tendency in favor of soy, it is still difficult to establish conclusive results given the high heterogeneity found in the studies.

Espondilitis cervical subaguda por Brucella abortus / Subacute cervical Espondilitis by Brucella abortus

Se presenta el caso de un paciente de 79 años con un tiempo de dos meses, por presentar en forma insidiosa: poliartralgias, astenia y cervicalgía e incapacidad para la movilización del hombro izquierdo por dolor. Sin antecedentes importantes. La radiografía de columna cervical presentó una perdida de la lordosis en C5 y una disminución de altura de C-6 la gamagrafía ósea presentó un patrón hipercaptador en articulación de miembros de tipo inflamatorio crónico, con deterioro a nivel de las vértebras cervicales bajas. Un estudio con EMC informó una polineuropatía motora mixta. La RMN mostró un patrón inflamatorio a nivel del C5, C6 y C7, con destrucción ósea, desaparición del disco vertebral entre C5 y C6, además de retrolistesis. El estudio serológico fue positivo para Brucella abortus. Un control de RMN luego de un mes no reveló cambios significativos con relación al primer estudio. El paciente recibió un régimen de Doxiciclina-Rifampicina-Ciprofloxacino durante seis semanas y, posteriormente, tratamiento de rehabilitación presentando una mejoría clínica. Se presenta el caso luego de revisar la literatura debido a la infrecuencia de presentación de Brucella abortus como complicación articular a nivel cervical con compromiso neurológico.