A study of crystalluria: effectiveness of including hygienic-dietary recommendations in laboratory reports.

Objectives: To assess the effectiveness of incorporating hygienic-dietary recommendations in laboratory reports in reducing the incidence of renal colic (RC). A study was performed to compare the incidence of RC in two groups of patients who had suffered at least a crystalluria event associated with the risk of urolithiasis. Recommendations were only incorporated in the laboratory reports of one group. Methods: A retrospective observational study. The study sample was composed of patients who had at least an episode of crystalluria associated with a higher risk of urolithiasis. The laboratory reports of patients in Group A (n=1,115), treated in 2017, did not include any hygienic-dietary recommendations, whereas patients in Group B (n=1,692), treated in 2018, received hygienic-dietary recommendations through their laboratory reports. χ2 and Mann-Whitney U test were used to assess differences based on sex, age, and type of urinary crystals. Results: The incidence of RC was 2.02 times higher in group A (2.24%) than in group B (1.12%). No significant differences were observed in the incidence of RC based on the type of urinary crystal. The incidence of RC was substantially higher in patients who suffered at least an event of crystalluria associated with a higher risk for urolithiasis as compared to the general population during the same period (0.46%, consistently with the incidence rates reported in the literature). Conclusions: The incorporation of messages alerting on the risk of urolithiasis and the inclusion of hygienic-dietary recommendations in laboratory reports may be useful for reducing the incidence of RC.

Valor actual de la biopsia de vesículas seminales en pacientes con cáncer de próstata e influencia de la prostatecmía radical en pacientes con infiltración seminal / Current value of seminal vesicle biopsy in patients with prostate cancer and influence of radical prostatectomy in patients with seminal vesicle invasion

OBJETIVO: Comprobar si la prostatectomíaradical puede influir favorablemente en la supervivenciacáncer-específica (SCE), tiempo libre de hormonorresistenciay tiempo libre de metástasis (TLM) y calidad de vida (CV), en pacientes con adenocarcinomade próstata e invasión de vesículas seminales, así como, realizar una actualización de nuestro pensamientosobre la biopsia de vesículas seminales.MÉTODOS: Se incluyeron 114 pacientes En 46 se diagnosticó invasión de vesículas seminales tras la realizaciónde prostatectomía radical (PRVS) de intención curativa y en 68 casos, la invasión fue diagnosticada mediante la biopsia de las mismas (BxVS) no practicándosela prostatectomía radical. Se compararon la SCE, tiempo hasta la hormonorresistencia desde el inicio del tratamiento hormonal (THR), TLM y CV medida en necesidadesde atención hospitalaria en ambos grupos. La mediana del tiempo de seguimiento fue de 52,6 meses.RESULTADOS: No hubo diferencias estadísticamente signi- ficativas entre ambos grupos en SCE, THR, TLM y CV. La SCE a 3 y 5 años fue del 100% y 80.77% para el grupo PRVS y del 92.03% y 77,46% para el grupo BxVS. El THR a 3 y 5 años fue del 90.6% y 58.7% para el grupo PRVS y del 74,4% y 56,2% para el grupo BxVS. En la regresión de Cox se mostraron predictores independientes de SCE el grado primario y suma de Gleason y de THR el estadio clínico.CONCLUSIONES: La prostatectomía radical como monoterapiano influye de forma estadísticamente significativaen el tiempo de seguimiento realizado, en la SCE, THR, TLM y CV de los pacientes con cáncer de próstata e invasión de vesículas seminales asociada a otros factoresde mal pronóstico (Gleason y PSA desfavorables). El valor de la biopsia de vesículas seminales permaneceen el estudio de nuevos tratamientos multimodales, como pueden ser la quimioterapia en combinación con la cirugía, y esta pendiente de definir en la planificaciónde la radioterapia y la criocirugía

OBJECTIVES: To evaluate if radicalprostatectomy may positively influence cancer-specific survival (CSS), hormone-resistance-free time, metastasis-free time, and quality of life(QoL) of patients with prostate adenocarcinoma and seminal vesicle invasion, and also to update our thoughts about seminal vesicle biopsy.METHODS: 114 patients were included. Forty-six cases were diagnosed of seminal vesicle invasion after radical prostatectomy; 68 cases were diagnosed of seminal vesicle invasion after biopsy, not undergoing then surgery. Cancer specific survival, time to hormone resistance from the start of hormonal treatment, metastasis free time and QoL, measured as need for hospital care, were compared between groups. Median follow-up time was 52.6 mos.RESULTS: There were not statistically significant differences between groups in CSS, time to hormone resistance, metastasis free time and QoL. Three and five-year cancer specific survival were 100% and 80.77% for the radical prostatectomy group and 74.4% and 56.2% for the biopsy group. Primary grade and Gleason Score were independent predictors for CSS in the Cox regression test; clinical stage was independent predictor for time to hormone resistance.CONCLUSIONS: Radical prostatectomy as monotherapy does not show a statistically significant influence onfollow-up time, CSS, time to hormone resistance, metastasis free time or QoL in patients with prostate cancer and seminal vesicle invasion associated with other bad prognostic factors (unfavourable Gleason and PSA). The value of seminal vesicle biopsy remains for the study of new multimodal treatments, such as chemotherapy + surgery, and it is to be defined in the planning of radio and cryosurgery

Vigencia actual de los nomogramas en la estadificación del cáncer de próstata / Current validity of nomograms for prostate cancer staging

OBJETIVO: En este trabajo se presenta una revisión del concepto de “nomograma” aplicado al cáncer de próstata y específicamente como medio de estadificación.MÉTODOS/RESULTADOS: Para ello se describen los parámetros indispensables para evaluar este tipo de modelos predictivos, a saber: Calibración, Discriminacióny Utilidad Clínica. Estos requisitos son analizados sobre un caso práctico real en nuestro medio asistencial comparando las “Tablas de Partin” y el “Nomograma del Hospital Universitario Miguel Servet”, demostrando su correcta calibración, discriminación y utilidad clínica previa selección de adecuados puntos de corte.CONCLUSIÓN: La aplicación del modelo predictivo a nuestra práctica asistencial ha logrado una infraestadificaciónclínica tras prostatectomía radical del 17,3%

OBJETIVE: This paper presents a review of the concept of “nomogram” applied to prostate cancer, and specifically as a staging tool.METHODS/RESULTS: We describe the essentialparameters for the evaluation of such type of predictive models: Calibration, discrimination and clinical usefulness. Such requisites are analyzed using a real clinical case in our clinical setting, comparing the “Partin`s tables” and the “Miguel Servet University Hospital´s nomogram”. We demonstrate its correct calibration, discrimination and clinical usefulness after previous selection of proper cut points.CONCLUSION: The application of the predictivemodel to our clinical practice has achieved a clinical understaging of 17.3% after radical prostatectomy

Controversies related to epithelioid variant of renal angiomyolipoma: a review of the literature.

We performed a review of the epithelioid-type angiomas to determine their clinical course and propose an appropriate plan for follow-up. We present the case of a patient with possible adrenal carcinoma suggested by computed tomography for whom the histopathologic study revealed an epithelioid angiomyolipoma arising from the kidney. In the absence of consensus, we consider it worthwhile to register the very few cases diagnosed and record a detailed follow-up of the clinical course. We recommend surgical treatment and a follow-up regimen similar to that for renal carcinoma.