Renocolic fistula as a complication of radiofrequency in the treatment of renal cell carcinoma.

Method: Beyond postoperative suspicion, retrograde pyelogram was performed, the images of which are displayed, and demonstrated the fistula.

Results: Treatment has been definitive nephrectomy after failed attempt to seal the fistula with suture and TachoSil.

Conclusions: Although radiofrequency ablation can be a valid technique for treating small renal tumors in patients with high morbidity, it is not without significant complications as described in this case, despite the precautions taken.

[Photodynamic therapy for actinic cheilitis].

Actinic cheilitis is a subtype of actinic keratosis that mainly affects the lower lip and has a higher risk of malignant transformation. Its location on the labial mucosa influences the therapeutic approach. Vermilionectomy requires local or general anesthetic and is associated with a risk of an unsightly scar, and the treatment with 5-fluorouracil or imiquimod lasts for several weeks and the inflammatory reaction can be very intense.

[Communication of needs in laryngectomized patients: Pictorrino].

Objective: To design, create and validate a pictogram, called Pictorrino, as a tool to obtain direct and simple communication with laryngectomized patients.

Patients And Methods: In a prospective sample of 10 laryngectomized patients within the first postoperative week, their principal needs and demands were evaluated, and were confirmed in a retrospective second sample of 10 laryngectomized patients who attended reviews in the outpatient clinic. Thereafter, pictograms were created to state such needs in as clear a fashion as possible.

[Surgical management of salivary gland tumours].

Introduction And Objectives: Salivary gland tumours account for 3% of head and neck tumours. The aim of this study is to analyze our series of tumours of the salivary glands requiring surgical treatment at our centre from 2004 to 2007.

Material And Methods: This study is a retrospective review of 49 patients diagnosed as having tumours of the major and minor salivary glands or ectopic salivary tumours, and surgically treated at our hospital between 2004 and 2007.

Surgical treatment of familial dacryocystocele and lacrimal puncta agenesis.

Bilateral agenesis of the lacrimal puncta and enlargement of the nasolacrimal canal are rare anatomic variants. The authors present 2 familial cases: a 39-year-old woman with bilateral dacryocystocele and lacrimal puncta agenesis and her 46-year-old brother, who had a long history of epiphora and recurrent dacryocystitis, and also had bilateral lacrimal puncta agenesis and a left dacryocystocoele. The authors report the endoscopic, CT, and MRI findings, and describe the surgical treatments, by endoscopic dacryocystorhinostomy in the first case, and conjunctivodacryocystorhinostomy with Jones tube in the second case.

[Enlarged vestibular aqueduct syndrome. Report on four cases].

Although enlarged vestibular aqueduct syndrome (EVAS) has been reported to be one of the most common anomalies associated with sensorineural hearing loss, the mechanism of such loss is unclear, and there are no established criteria for diagnosis. We report 4 patients with sensorineural hearing loss that were diagnosed during the last year in our department of EVAS. We review the diagnostic criteria of this syndrome.

[Increased expression and activity of MMP-9 in chronic rhinosinusitis with nasal polyposis].

Introduction: Matrix metalloproteinases (MMP) are a family of endopeptidases involved in extracellular matrix degradation and which could potentially explain specific histological changes in nasal polyposis. The aim of this study is to determine whether MMP-2 and 9 are involved in chronic rhinosinusitis with polyposis.

Material And Method: Specimens were collected from 15 patients affected by nasal polyposis and 15 control patients (with turbinoplasty performed).

[Not Available].

A good way to promote breastfeeding is to implement the Ten Steps to Successful Breastfeeding of UNICEF. However, this is not an easy task and there are many difficulties prior to success. Based on our experience on the subject, supported by our recent accreditation as a Baby-friendly hospital, we have analyzed various doubts and problems that we think are important in order to enhance breastfeeding in a hospital setting: how to begin, how to train the health personnel and keep them updated, when and how to supplement breastfeeding, how to promote the activity of support groups, how to improve the support to the mother after discharge, how much time may be necessary, etc.

[Electrolyte and acid-base balance disorders in advanced chronic kidney disease].

1. The kidneys are the key organs to maintain the balance of the different electrolytes in the body and the acid-base balance. Progressive loss of kidney function results in a number of adaptive and compensatory renal and extrarenal changes that allow homeostasis to be maintained with glomerular filtration rates in the range of 10-25 ml/min.

[Advanced chronic kidney disease].

Chronic kidney disease (CKD), like other chronic diseases, is a serious public health problem because of both its high incidence and prevalence and its significant morbidity and mortality and socioeconomic cost. Advanced chronic kidney disease (ACKD) includes stages 4 and 5 of the CKD classification. It is defined as chronic kidney disease in which there is a severe reduction in glomerular filtration rate (GFR < 30 ml/min).

[Is chronic kidney disease (CKD) a problem of great epidemiological relevance?].

In this article some of the novelties published in 2007 on epidemiological aspects of chronic kidney disease are reviewed. Specifically, some studies on the suitability of current methods for measurement of glomerular filtration rate, the estimated current prevalence of chronic kidney disease and the influence of age and NSAIDs on progression of this disease are discussed. Finally, various recent publications on the role of chronic kidney disease as a cardiovascular risk factor are summarized.

[Validity study of the current risk assessment scale for pressure ulcers in intensive care (EVARUCI)].

Unlabelled: Pressure ulcers (PU) are the most frequent injuries in critical patients whose management is the responsibility of the nurses. The first step for its prevention is to determine the patients at risk; however the usual risk assessment scales (Norton, Braden, etc.) do not have adequate specificity to do this.

[Monitoring of pain. Recommendations of the Analgesia and Sedation Work Group of SEMICYUC].

In critically ill patients, pain is frequently underestimated and so insufficiently managed. Psychological, haemodynamic and neuroendocrine responses, secondary to untreated pain, could produce morbidity and even increases in patient mortality. All members of the intensive care team must have abilities to assess and to manage pain.

[Immune response during laparoscopic and open living donor nephrectomy. An experimental pig model].

Introduction: It's been demonstrated laparoscopic access determines a lower surgical stress, by measurement of several markers as different interleuquines (IL) or C-reactive protein (CRP). Endothelin 1 (ET-1) is a powerful vasoconstrictor produced in renal endothelium scarcely studied in laparoscopy. The objective of this study is to analyze immune response during laparoscopic and open donor nephrectomy, in a porcine experimental model by means of measuring IL-2, 10, tumoral necrosis factor alpha (TNFalpha), CRP and ET-1.

[Usefulness and difficulties for the elaboration of the nursing discharge report, according to Hospital de Fuenlabrada (Spain) nursing group].

Objective: To evaluate the utility and difficulty of writing the nursing discharge report perceived by nurses working in the hospitalization unit of the Fuenlabrada Hospital in Spain.

Method: We performed a cross-sectional, descriptive study in all nurses working in hospitalization units in the Fuenlabrada Hospital (Madrid) in the last trimester of 2006. A questionnaire was used to collect sociodemographic variables, variables related to perceived utility of the report in general and variables measuring the difficulty of completing the report.

[Comparative analysis of renal graft function after open vs. laparoscopic nephrectomy: experimental model].

Introduction: Living donor renal transplant reports a higher patient and graft survival in comparison to cadaver donor and represents a good alternative facing the current lack of organs for transplant.

Goals: To analyze comparatively in an experimental model (pig) the influence of ischemia-reperfusion and functional outcome of renal graft retrieved by open Vs laparoscopic nephrectomy.

Material And Methods: 30 lab pigs were nephrectomized (left kidney): 15 by laparoscopy and 15 by open surgery, as living donors, in a model of renal autotransplant.

[Experimental models for research and training in renal transplant].

An update on aspects and use of different experimental models applied in kidney transplant research is presented . This paper includes qualities, as long as similarities between most frequently used animal models and human clinical standards. Contributions of those models based on microsurgical or laparoscopic techniques are revised.

[Usefulness of cytokines as surgical aggression markers in the ischemia-reperfusion syndrome and post transplant renal function in an experimental model of laparoscopic vs. open renal autotransplantation].

Objectives: To analyze the modifications induced by laparoscopic and open nephrectomies in living donor transplantation on cytokines, to evaluate operative trauma of different surgical techniques and the influence on ischemia/reperfusion syndrome and renal function.

Methods: Thirty pigs underwent left nephrectomy, 15 by laparoscopy and 15 by open approach in an experimental autotransplantation model.

Results: Serum level of IL-2, IL-6, IL-10 and tumor necrosis factor (TNF) were lower during laparoscopic than open nephrectomy: 6.

[Nasosinusal endoscopic surgery as major out-patient surgery].

Introduction: Functional endoscopic sinus surgery (FESS) is a useful and widespread technique that allows the treatment of a large number of nasal pathologies. Nevertheless, although many ENT operations are carried out on an out-patient basis, FESS procedures commonly require at least 1 day of hospital admission in many centres.

Objectives: To evaluate our experience in FESS as day-case, to study causes of unexpected overnight admission, and to identify any risk factors for failing to comply with early discharge.