ORCID Profile
0000-0001-6015-2987
Current Organisations
Universitat de Barcelona
,
IDIBAPS
,
Hospital Clinic de Barcelona Instituto Clinic de Nefrologia y Urologia
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Related Links
Publications
Prognostic value of circulating microRNAs in upper tract urinary carcinoma
Publisher: Impact Journals, LLC
Date: 30-03-2018
Differential gene expression profile between progressive and de novo muscle invasive bladder cancer and its prognostic implication
Publisher: Springer Science and Business Media LLC
Date: 17-03-2021
DOI: 10.1038/S41598-021-85137-1
Abstract: This study aimed to ascertain gene expression profile differences between progressive muscle-invasive bladder cancer (MIBC) and de novo MIBC, and to identify prognostic biomarkers to improve patients’ treatment. Retrospective multicenter study in which 212 MIBC patients who underwent radical cystectomy between 2000 and 2019 were included. Gene expression profiles were determined in 26 s les using Illumina microarrays. The expression levels of 94 genes were studied by quantitative PCR in an independent set of 186 MIBC patients. In a median follow-up of 16 months, 46.7% patients developed tumor progression after cystectomy. In our series, progressive MIBC patients show a worse tumor progression (p = 0.024) and cancer-specific survival (CSS) (p = 0.049) than the de novo group. A total of 480 genes were found to be differently expressed between both groups. Differential expression of 24 out of the 94 selected genes was found in an independent cohort. RBPMC2 and DSC3 were found as independent prognostic biomarkers of tumor progression and CALD1 and LCOR were identified as prognostic biomarkers of CSS between both groups. In conclusion, progressive and de novo MIBC patients show different clinical outcome and gene expression profiles. Gene expression patterns may contribute to predict high-risk of progression to distant metastasis or CSS.
Feasibility of Transvaginal NOTES-Assisted Laparoscopic Nephrectomy
Publisher: Elsevier BV
Date: 02-2010
DOI: 10.1016/J.EURURO.2009.09.025
Abstract: Recently, the feasibility of a transvaginal hybrid natural orifice transluminal endoscopic surgery (NOTES) nephrectomy was demonstrated in a 23-yr-old woman with a nonfunctional atrophic kidney. To evaluate the feasibility and reproducibility of transvaginal NOTES-assisted laparoscopic nephrectomy in female patients with and without renal cancer. Between March 2008 and June 2009, 14 female patients were submitted to transvaginal NOTES-assisted laparoscopic nephrectomy for T1-T3a N0M0 renal cancer (n=10), lithiasis (n=2), or renal atrophy (n=2) at the Hospital Clinic of Barcelona, Spain. Under general anaesthesia, female patients underwent laparoscopic nephrectomy by transvaginal NOTES using a deflectable camera by vaginal access and two additional 5- and 10-mm trocars in the abdomen. The renal artery and vein were dissected and taken separately between clips. The dissected kidney was removed via the vagina after enlarging the vaginal trocar incision. All data referring to patient demographics, surgery, pathology, and perioperative outcomes were recorded. The procedure was completed in all patients. The mean age of the women was 59.1 yr. The mean operative time was 132.9 min and the mean estimated blood loss was 111.2 ml. None of the patients required a blood transfusion and the use of analgesics was low. The mean hospital stay was 4 d. In one case, a major complication (a colon injury) occurred. The patient underwent surgery and a temporary colostomy was performed. The patient has already undergone reconstruction. Transvaginal NOTES-assisted laparoscopic nephrectomy is feasible and reproducible and may be an alternative technique for treatment of women with renal cancer. Proper selection of patients is warranted for success of this new approach. However, longer follow-up in an increasing number of patients is needed to establish its role in the treatment of renal cancer.
Prognostic value of microRNA expression pattern in upper tract urothelial carcinoma
Publisher: Wiley
Date: 09-04-2014
DOI: 10.1111/BJU.12551
Abstract: To examine the microRNA (miRNA) expression pattern in tumour s les from patients with progressing and non-progressing upper tract urothelial carcinoma (UTUC) in order to identify putative miRNAs that may be used as prognostic markers. We conducted a multicentre, retrospective study of formalin-fixed paraffin-embedded tissue s les from 150 patients with UTUC who had undergone radical nephroureterectomy. Global miRNA expression patterns were analysed in 18 selected s les from patients with UTUC using TaqMan arrays. The differential expression of five key miRNAs was validated by quantitative polymerase chain reaction in an independent cohort of 132 s les from patients with UTUC. Models to predict tumour progression and cancer-specific survival that included miRNA expression patterns were developed by Cox regression analysis. Twenty-six miRNAs were found to be aberrantly expressed between s les from patients with progressing and non-progressing UTUC and five of these were selected for subsequent studies. The regression analysis identified tumour stage and miR-31 and miR-149 expression as independently associated with tumour progression and tumour stage and miR-149 expression as independently associated with cancer-specific survival. The risk scores derived from these miRNA models were able to discriminate two groups with a highly significantly different probability of tumour progression (hazard ratio [HR] 4.78 P < 0.001) and death (HR 276 P = 0.004). There is a differential miRNA expression pattern between patients with progressing and non-progressing UTUC. The identification of new miRNAs associated with a high probability of tumour recurrence and cancer-specific survival in patients with UTUC and their combination in a robust, easy-to-use and reliable algorithm may help tailor treatment and surveillance strategies in these patients.
Third and Fourth Kidney Transplant: Still a Reasonable Option
Publisher: Elsevier BV
Date: 09-2010
DOI: 10.1016/J.TRANSPROCEED.2010.04.064
Abstract: At present, a second kidney transplant is considered an established therapeutic option for patients who have lost a previous graft. Second transplants show similar graft survival as first transplants. A debate exists about the benefit of submitting the patient to a third or fourth renal transplant, or to maintain dialysis. We sought to analyze graft and patient survivals as well as associated variables and surgical complications of third and fourth transplantations. From July 1985 to December 2008, we performed 74 third and 8 fourth transplantations among 2763 cases. We prospectively collected the variables of age, gender, graft origin, hyperimmunization, time on dialysis, location, bench surgery, acute rejection episodes, graft survival, and operative complications. Third and fourth trasplantations were performed in 49 men and 33 women, with an overall mean age of 40.26 years who were on dialysis for an average of 126.89 months before transplantation. Mean graft survivals of their first and second grafts were 35.6 and 50.1 months, respectively. Acute or chronic rejection was reason for renal failure in 71% and 75% of cases, respectively. Patient survivals at 1 and 5 years were 92.7% and 90.6%, for third and both 85.7% for the fourth transplantation. The third and fourth transplantations showed 1- and 5-year graft survivals of 88% and 76.4% and 71.4% and 42.9%, respectively. Sixty-eight cases underwent cadaveric donor and 14 living donor (mean age, 42.1 years) transplantations. Nine patients were hyperimmunized. In 60 cases, we used the left kidney. Orthotopic kidney transplantation was performed in 15 cases heterotopic transplant to the right iliac fossa in 40 and in the left iliac fossa in 17 cases. Arterial bench surgery was necessary in 6 cases and venous in 3. We performed 3 hepatorenal and 1 cardiorenal transplantation. The complications included 29 cases (35.4%) of postoperative acute tubular necrosis, 14 of acute rejection episodes (17.1%) 12 of perirenal hematoma (14.6%) 1 urinary fistula (1.2%) 4 lymphocele (4.9%) 2 ureteral stenosis (2.4%) variables arterial kink requiring surgery (1.2%), and 1 venous thrombosis with graft loss (1.2%). The 4 patients who died in the perioperative period succumbed to intravascular disseminated coagulation (n = 1) cardiac failure (n = 2), and septic shock (n = 1). Induction antibody therapy, hyperimmunized status, or operative complications were not independent prognostic factors for patient or graft survival. Third or fourth renal transplantations constitute a valid therapeutic option with reasonable short- and long-term patient and graft survivals. Although orthotopic kidney transplantation was used in selected patients, we preferred an iliac fossa approach for most.
Using gene expression from urine sediment to diagnose prostate cancer: development of a new multiplex mRNA urine test and validation of current biomarkers
Publisher: Springer Science and Business Media LLC
Date: 09-02-2016
Prognostic implication of TERT promoter mutation and circulating tumor cells in muscle-invasive bladder cancer
Publisher: Springer Science and Business Media LLC
Date: 17-04-2202
DOI: 10.1007/S00345-022-04061-9
Abstract: Current clinical prognostic factors are not accurate enough to identify and monitor those muscle-invasive bladder cancer (MIBC) patients at high risk of progression after radical cystectomy (RC). Here, we determined genetic alterations in the tumor and circulating tumor cell (CTC) enumeration to find biomarkers useful for the management of MIBC after RC. Thirty-nine MIBC patients undergoing RC were included. Tumoral tissue DNA was analyzed by next generation sequencing. CTCs were isolated from blood collected before RC and one, four and 12 months later. Sixteen (41%) patients progressed in a median time of 8.5 months and 11 (69%) of these patients harbored the TERT c.-124C T mutation. All progressive patients harboring the TERT c.-124C T mutation presented a significant increase in CTC number 12 months after RC compared to those without the mutation. Additionally, CTC number at 12 months was identified as an independent prognostic biomarker for tumor progression and cancer specific survival (CSS). Ten (63%) progressive patients showed an increment of CTC number with a median anticipation period of four months compared with imaging techniques. The TERT c.-124C T mutation could be considered a biomarker of aggressivity. CTC enumeration is a useful tool for identifying MIBC patients at high risk of progression and CSS after RC and for detecting tumor progression earlier than imaging techniques.
Interactions Between Hemodynamics and Pharmacology in Kidney Transplantation
Publisher: Elsevier BV
Date: 2011
DOI: 10.1016/J.TRANSPROCEED.2010.12.018
Abstract: Renal transplantation (RT) is considered the treatment of choice for patients with end-stage renal disease due to the improved short- and long-term survival benefits over dialysis treatment. The success of RT can be improved by working within a multidisciplinary team. The aim of this work was to assess the anesthetic management of RT to guarantee success. Anesthesiologists who work in RT should know the interactions between hemodynamics and pharmacology in these patients. But to be able to work as a team, there are three questions that need to be answered: What do the urologist and the anesthesiologist need to know about renal transplantation? What does the urologist need to know about anesthesia? Or, in other words, what do anesthesiologists really want the urologists to know, and what does an anesthesiologist want to know about RT? RT is a complex procedure that needs a multidisciplinary approach, especially in patients with important comorbidities. It is necessary to learn how to look through the eyes of the rest of the team. Working within a multidisciplinary team is basic to ensure the success of the RT.
Perfil de expresión génica en el cáncer de próstata: identificación de marcadores candidatos para el diagnóstico no invasivo
Publisher: Elsevier BV
Date: 04-2014
Multicenter Analysis of Postoperative Complications in Octogenarians After Radical Cystectomy and Ureterocutaneostomy: The Role of the Frailty Index
Publisher: Elsevier BV
Date: 10-2019
DOI: 10.1016/J.CLGC.2019.07.002
Abstract: The purpose of this study was to assess patient frailty as a risk factor for radical cystectomy (RC) complications. We performed an analysis of prospectively collected data of consecutive patients 80 years of age or older who underwent RC and ureterocutaneostomy in 6 primary care European urology centers. Frailty was measured using a simplified frailty index (sFI) with a 5-item score including: (1) diabetes mellitus (2) functional status (3) chronic obstructive pulmonary disease (4) congestive cardiac failure and (5) hypertension, with a maximum 5-item score meaning high level of frailty. Within 90 days surgical complications were scored according to the Clavien Classification System (CCS). sFI ≥3 was considered as poor frailty status. Clinical and pathological variables were analyzed as predictors of severe complications (CCS ≥3). One hundred seventeen patients were enrolled. Most patients reported an sFI score of 2 and 3, respectively, 31/117 (26.5%) and 45/117 patients (38.5%). CCS ≥3 occurred in 17/117 patients (14.5%). Patients with sFI ≥3 were significantly older than patients with sFI <3 (median age, 85 years [interquartile range (IQR), 82-86] versus 82 years [IQR, 80-84] P = .001). Most CCS ≥3 scores occurred in patients with sFI ≥3: 13 (11.1%) versus 4 (3.4% P = .02). No significative differences were detected in terms of length of hospital stay, pathological stage, and postoperative bowel canalization when related to sFI. sFI ≥3 was an independent risk factor of CCS ≥3 in univariate and multivariate analysis (respectively, odds ratio [OR], 3.81 [95% confidence interval (CI), 1.16-12.5 P = .02] and OR, 3.1 [95% CI, 0.7-13.7 P = .01]). Body mass index, age, American Society of Anesthesiologists score ≥3, and pathological stage were not related to CCS ≥3. RC appears feasible in elderly patients with an sFI <3. In cases of sFI ≥3, this choice should be carefully valued, discussed, and possibly avoided because of a higher risk of complications.
Adhesion molecules α, β and γ‐catenin as prognostic factors of tumour progression in upper urinary tract urothelial tumours: the role of AKT‐P/GSK‐3β/β‐catenin pathway
Publisher: Wiley
Date: 09-06-2009
Molecular characterization of upper urinary tract tumours
Publisher: Wiley
Date: 26-08-2010
Nursing Care Program for Erectile Dysfunction After Radical Prostatectomy
Publisher: Oncology Nursing Society (ONS)
Date: 28-09-2012
Audit of an Initial 100 Cases of Laparoscopic Live Donor Nephrectomy
Publisher: Elsevier BV
Date: 11-2010
DOI: 10.1016/J.TRANSPROCEED.2010.06.037
Abstract: The objective of this study was to analyze variables related to the surgical technique and postoperative evolution of kidney donors. This retrospective analysis describes 100 laparoscopic nephrectomies from living donors performed in our hospital between February 2002 and July 2007. The variables were age, family relationship, surgical time, warm ischemia time, hospital stay, oral feeding resumption, morphine use, return to work, and complications. The average age of the donors was 49.5 years and their male:female ratio was 1:2. The left kidney was extracted from 82% of patients. The warm ischemia time was 2.5 minutes (range = 1.09-5.10). There was only one case of multiple vessels. The surgical time was 149.5 minutes (range = 80-255). The mean hospital stay was 4.8 days (range = 1-18). Food intake was resumed after 24 hours, with morphine needed for 0.9 days. The time to return to work was 39 days (range = 7-120). The complications included kidney rupture (n = 1), liver tear (n = 1), hematoma (n = 6), including four requiring blood transfusions fever and leukocytosis (n = 5) and one collection. No patients died as a result of the surgery. Living-donor laparoscopic nephrectomy constitutes the gold standard among surgical options.
Postoperative adjuvant and very early salvage radiotherapy after prostatectomy in high-risk prostate cancer patients can improve specific and overall survival
Publisher: Springer Science and Business Media LLC
Date: 20-08-2018
DOI: 10.1007/S12094-018-1931-3
Abstract: Adjuvant radiotherapy (ART) for biochemical relapse (BR) after radical prostatectomy (RP) showed increased disease-free survival (DFS) in three previous randomized trials. Retrospective phase II trials evaluated if early salvage RT (ESRT) is equivalent to ART. Our study aims to compare ART and ESRT to salvage RT. We compared RP plus ART and ESRT versus SRT. Indication for RT was made by PSA determination after RP: ART when PSA ≤ 0.2 ng/ml, ESRT when PSA ≤ 0.3 after PSA rise from 0.0 to SRT PSA ≥ 0.3. The cause of death of each patients was analyzed, DFS, cause-specific survival (CSS) overall survival (OS) and metastasis-free survival (MFS) in relation to RT intention. Between 1993 and 2008, 204 patients with a median age of 65 years (44-75) were treated. The median follow-up was 160 months (28.1-273.3). At diagnosis, 89.7% had localized clinical stages and 90.2% had Gleason (G) ≤ 7. The median PSA was 10 (range 4-101). The postoperative G was ≥ 7 in 66.2% 56.4% had ≥ 2 positive margins 29.4% received ART, 20% ESRT and 59.3% SRT. The DFS for ART, ESRT and SRT was 74, 56 and 39% with significant differences between the three groups (p < 0.001). ART + ESRT were combined versus SRT for the DFS, the significant differences (p < 0.001) remained 67% versus 39%. Positive margins, pT3 and pre-RT PSA were significant factors on multivariate analysis. The CSS in the ART + ESRT group was 92 vs. 78% in the SRT group (p < 0.05). OS was 69% in ART + ESRT vs. 57% in SRT (p < 0.05). MFS was 82.7% in ART + ESRT vs. 67.4% in SRT. In this study the ART + ESRT presented benefits versus SRT in DFS, CSS, OS and MFS.
Health-Related Quality of Life in Patients With Urostomies
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2014
Urine cytology suspicious for urothelial carcinoma: Prospective follow‐up of cases using cytology and urine biomarker‐based ancillary techniques
Publisher: Wiley
Date: 21-02-2020
DOI: 10.1002/CNCY.22252
Low testosterone bioavailability is related to prostate cancer diagnose in patients submitted to prostate biopsy
Publisher: Springer Science and Business Media LLC
Date: 11-08-2011
DOI: 10.1007/S00345-011-0741-9
Abstract: Relationship between prostate cancer (PCa) and testosterone (T) is controversial. Conflicting evidence has been published about T levels and development of PCa. (1) To determine the relationship between hormone levels and the diagnosis of PCa. (2) To specifically focus on the relationship between PCa and T in men classified as biochemically hypogonadal. Prospective analysis of 1,000 transrectal ultrasound guided prostate biopsies (5 + 5 cores biopsies) between September 2007 and January 2010 in one center. Indication for prostate biopsy was suspicion of PCa on the basis of elevated prostate-specific antigen (PSA) and/or digital rectal examination (DRE). Serum testosterone and sex hormones binding globulin (SHBG) were determined in these patients. Of 557 men, the data were sufficient for further analysis. Age, body mass index (BMI), smoking/drinking habits, PSA, free PSA, PSA density, prostate volume, number of previous biopsies, DRE, and hormone levels were prospectively recorded. No relationship was found between T and PCa (449 ± 167 ng/dL in PCa versus 437 ± 169 ng/dL in non-PCa). SHBG was significantly higher in patients with PCa (51 ± 27 ng/dL in PCa vs. 44 ± 18 ng/dL in non-PCa). In hypogonadal men, T levels correlated with the PCa (235 ± 95 ng/dL in men with PCa versus 270 ± 58 ng/dL in men without PCa, P = 0.004). T levels were comparable in men with and without PCa, but SHBG levels were significantly higher in men with PCa. In men with low T, the men with PCa had a lower serum T levels and a lower prostate volume than the men without PCa.
Recent advances of natural orifice transluminal endoscopic surgery in urological surgery
Publisher: Wiley
Date: 08-01-2013
DOI: 10.1111/IJU.12066
Abstract: Natural orifice transluminal endoscopic surgery designates a surgical procedure that utilizes one or more patent natural orifices of the body with the intention to puncture a hollow viscera in order to enter the abdominal cavity. First carried out at the beginning of the 2000s in experimental models, it can be considered the natural evolution of laparoscopy towards the ideal of scarless surgery, as the avoidance of a large abdominal scar is associated with better cosmetic results and better recovery. However, the technology currently available does not allow the performance of complete pure natural orifice transluminal endoscopic surgery procedures. The surgical tools used are not specially designed for this approach, so difficulties in retracting organs, bleeding control and clashing of instruments are the main obstacle surgeons face. For this reason, the current available technique is the so-called hybrid approach, where a natural orifice approach is combined with some abdominal trocars, using the natural orifice as the exit door for the specimen removal. As not many comparative studies have been published evaluating the advantages of natural orifice transluminal endoscopic surgery in front of traditional laparoscopic surgery, a review of the history of natural orifice transluminal endoscopic surgery, and an assessment of the available evidence of this technique regarding renal and urological pelvic surgery are performed in this article.
Impact of a Nurse-Run Clinic on Prevalence of Urinary Incontinence and Everyday Life in Men Undergoing Radical Prostatectomy
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2013
Cancer-Specific Survival Stratification Derived from Tumor Expression of Tissue Inhibitor of Metalloproteinase-2 in Non-Metastatic Renal Cell Carcinoma
Publisher: Springer Science and Business Media LLC
Date: 04-11-2017
DOI: 10.1007/S12253-017-0339-7
Abstract: Degradation of the extracellular matrix is a prerequisite for the processes of cancer cell invasion and metastasis. The purpose of our study was to assess the association of matrix metalloproteinases (MMP-1, MMP-2, MMP-3, MMP-9) and their inhibitors (TIMP-1 and TIMP-2) with renal cell carcinoma (RCC) progression and cancer-specific survival (CSS), using immunohistochemical analysis of 60 formalin-fixed, paraffin-embedded sections of tumor tissue and normal tissue near the tumor from surgical T1-3bN0 M0 RCC specimens. Significant overexpression of MMP-2 in tumor and normal tissue was correlated with advanced stages, tumor size, sarcomatous differentiation and clinical symptoms. Overall survival was 31.7% (55.2% M0, 9.7% M1) and CSS 56.7% (100% M0, 16.1% M1) with a follow-up of 76 (5-230) months. Fuhrman grade [HR 2.87 (95% CI: 1.28-6.45) p = 0.01], tumor size [HR 1.13 (95% CI: 1.03-1.26) p = 0.009] and low TIMP-2 expression [HR 0.35 (95% CI: 0.16-0.78) p = 0.01] were independent predictive factors of CSS and stratified the patients into three groups with different rates of 10-year CSS [100%, 73.9% and 20.5% for the good, intermediate and poor prognosis group respectively (p = 0.000006)] . This study offers strong evidence that TIMP-2 expression in tumor tissue may play a crucial role in progression and poor prognosis in human localized and locally advanced RCC.
Experiencia pionera en España con nefrectomía LESS de donante vivo
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1016/J.ACURO.2011.04.007
Abstract: LESS surgery (Laparoendoscopic single site surgery) is a surgical technique that aims to perform intraabdominal surgery using a single site entry, allowing for reduction in the number and size of the incisions, achieving better esthetic results with at least the same functional outcomes as with the conventional laparoscopic surgery. We present the first experience of LESS living donor nephrectomy carried out by a totally European team. To perform it, a Quadport® device was placed through a 4 cm long paraumbilical incision. The nephrectomy was performed using the standards of conventional laparoscopic surgery, with the use of a precurved instrument in the left hand and straight instruments in the right. After bagging the kidney, the artery and vein were sectioned after clipping, allowing for rapid extraction of the organ through the same incision, with warm ischemia of 3.30" and 2.47," respectively. Living donor nephrectomy using the LESS technique is feasible and can be considered a good option for obtaining live donor kidney grafts in males. The application of said surgical in living kidney donor can increase the rate of donation, by reducing morbidity and improving the esthetic results with the same outcome for the donor as for the recipient.
Elderly Donor Kidney Transplant: Factors Involved in Graft Survival
Publisher: Elsevier BV
Date: 11-2005
DOI: 10.1016/J.TRANSPROCEED.2005.09.130
Abstract: To evaluate whether control of risk factors associated with worse results has improved graft survival, with respect of renal function quality and other factors influencing graft survival: recipient age, immunosuppressive therapy, cold ischemia time, acute tubular necrosis (ATN), acute rejection episodes (ARE) and 1-month creatinine levels. Retrospective review of 147 patients who underwent kidney transplant between 1995 and 2001. Inclusion criteria were donor and recipient age older than 60 years, first renal transplant, follow-up period longer than 12 months, donor creatinine clearance higher than 75 mL/min, and less than 20% glomerulosclerosis observed in donor renal biopsy. Graft survivals were 87%, 83%, 78%, and 70% at first, second, third, and fifth year after transplantation, respectively. Mean serum creatinine levels were 2.3 mg/dL and mean follow-up time, 46 months. Multivariate analysis using a Cox regression model identified donor age, ARE, and serum creatinine levels 1 month after surgery as independent variables affecting graft survival. Recipient age, immunosuppressive therapy, and serum creatinine levels at 1 month after surgery were predictive variables of recipient survival. Renal transplantation is an accepted therapeutic option in elderly patients with chronic renal insufficiency, if both donor and recipient are carefully selected.
Carcinoma urotelial de tracto urinario superior: 114 casos con largo seguimiento
Publisher: Elsevier BV
Date: 03-2010
Terapia focal en cáncer de próstata. Racionalidad, indicaciones y selección
Publisher: Elsevier BV
Date: 07-2014
DOI: 10.1016/J.ACURO.2013.12.005
Abstract: The great controversy surrounding the treatment of localized prostate cancer is related with its possibilities of radical treatment or active surveillance. The objective of this paper is to analyze the rationale selection among current focal therapy modalities regarding tumor and patient selection. Current articles about advantages and disadvantages on the treatment of localized prostate cancer as well as information about focal therapy regarding tumour selection, characteristics and indications cited in MEDLINE search were reviewed. Focal therapy standardized criteria must be: low risk tumors, PSA 15. Focal therapy is an alternative for localized prostate cancer treatment. However, some aspects of their diagnosis and selection criteria should be defined by prospective studies which should provide knowledge about the indication for focal therapy.
Evolución del trasplante renal de donante vivo: datos históricos, estadísticos, nacionales y propios
Publisher: Archivos Espanoles de Urologia
Date: 08-2005
DOI: 10.4321/S0004-06142005000600005
Abstract: Despite representing a small percentage of the transplant activity in our country, living donor kidney transplantation is a good alternative for the future because the needs exceed the offer of cadaver donor organs. We present the evolution of living donor kidney transplantation in Spain from the beginning in accordance to the ONT (Organización Nacional de trasplantes), and our current situation in comparison with other countries, as well as data obtained from the experience in our hospital which began in 1965.
Incidence of non‐benign arrhythmia in neonatal intensive care unit: 18 years experience from a single center
Publisher: Wiley
Date: 14-03-2022
DOI: 10.1002/JOA3.12694
Abstract: Non‐benign arrhythmias, which require urgent recognition and care in neonatal intensive care unit (NICU) settings, are rare but can severely impact neonates. We aimed to clarify the epidemiology and characteristics of non‐benign arrhythmias and their influence on neonates. This single‐center retrospective study included patients admitted to the NICU at Kurashiki Central Hospital between January 2001 and December 2019. Only patients with structurally normal hearts were included. The use of direct cardioversion (DC), antiarrhythmic agents, and the presence of risk factors was reviewed from medical records. Of the 8082 admissions, 2919 patients (36.1%) were low birth weight infants (LBWI) weighing less than 1500 g. There were 23 patients with arrhythmias (nine of them were LBWIs) with an incidence of 0.28%. There were 16 patients with tachyarrhythmia (eight supraventricular tachycardia [SVT] cases, three atrial flutters [AFL] cases, three ventricular tachycardia cases, two junctional ectopic tachycardia cases), and seven with bradyarrhythmia (all with complete atrioventricular [AV] block). For tachyarrhythmia cases, seven patients required DC, and eight were on antiarrhythmic agents at the time of discharge. Two patients (28.5%) with complete AV block required pacemaker implantation before discharge. The treatment strategy was dependent on the type of arrhythmia. All patients were discharged without significant morbidities. The incidence of non‐benign arrhythmias was as low as 0.28%. Arrhythmias can be managed successfully in neonates, yet risk factors related to mortality warrant further study.
Feasibility of Transvaginal Natural Orifice Transluminal Endoscopic Surgery–Assisted Living Donor Nephrectomy: Is Kidney Vaginal Delivery the Approach of the Future?
Publisher: Elsevier BV
Date: 06-2011
DOI: 10.1016/J.EURURO.2011.03.021
Abstract: Natural orifice transluminal endoscopic surgery (NOTES) uses natural orifices to access the abdominal cavity. We adapted NOTES to perform transvaginal NOTES-assisted laparoscopic nephrectomy in living donors. To assess the feasibility and reproducibility of this procedure and compare it with conventional laparoscopic living donor nephrectomy (LLDN). From July 2009 to October 2010, 20 women underwent transvaginal NOTES-assisted living donor nephrectomy (LDN) in our centre. We compared the prospectively collected clinical data of each donor with those of a contemporaneous matched pair of conventional LLDNs (40 donors). The procedure was performed using three abdominal trocars and one trocar through the vaginal wall. Variables evaluated for donors were procedure length, blood loss, warm ischaemia time (WIT), complications, hospital stay, and first-month creatinine nadir. In the transvaginal LDN group, sexual function was assessed with the Female Sexual Function Index questionnaire before and after surgery. Variables evaluated for recipients were complications, graft function, and creatinine evolution. The procedure was completed in all cases. Operative variables were similar for both groups except for WIT, which was longer in the transvaginal LDN group (p<0.001) without consequences for graft functioning. One transvaginal LDN case had postoperative bleeding requiring immediate open surgery. All transvaginal LDN donors reported unaltered sexual function after surgery and satisfaction with the results. All recipients had immediate urine output, and all had a functioning graft at last follow-up except for one recipient of the transvaginal LDN group who required transplantectomy. Despite promising results, randomised controlled studies with longer follow-up are warranted to further elucidate the potential of this novel technique. Transvaginal NOTES-assisted LDN appears to be a feasible and reproducible surgical technique. The WIT was longer in the transvaginal group, and there was no effect on graft function after the short follow-up.
Prognostic Gene Expression-Based Signature in Clear-Cell Renal Cell Carcinoma
Publisher: MDPI AG
Date: 08-2022
Abstract: The inaccuracy of the current prognostic algorithms and the potential changes in the therapeutic management of localized ccRCC demands the development of an improved prognostic model for these patients. To this end, we analyzed whole-transcriptome profiling of 26 tissue s les from progressive and non-progressive ccRCCs using Illumina Hi-seq 4000. Differentially expressed genes (DEG) were intersected with the RNA-sequencing data from the TCGA. The overlapping genes were used for further analysis. A total of 132 genes were found to be prognosis-related genes. LASSO regression enabled the development of the best prognostic six-gene panel. Cox regression analyses were performed to identify independent clinical prognostic parameters to construct a combined nomogram which includes the expression of CERCAM, MIA2, HS6ST2, ONECUT2, SOX12, TMEM132A, pT stage, tumor size and ISUP grade. A risk score generated using this model effectively stratified patients at higher risk of disease progression (HR 10.79 p 0.001) and cancer-specific death (HR 19.27 p 0.001). It correlated with the clinicopathological variables, enabling us to discriminate a subset of patients at higher risk of progression within the Stage, Size, Grade and Necrosis score (SSIGN) risk groups, pT and ISUP grade. In summary, a gene expression-based prognostic signature was successfully developed providing a more precise assessment of the in idual risk of progression.
Discrepancies in PSA values among laboratories: the case of a traveling patient
Publisher: Walter de Gruyter GmbH
Date: 06-03-2023
Results and Lessons Learned on Robotic Assisted Kidney Transplantation
Publisher: Hindawi Limited
Date: 02-09-2020
DOI: 10.1155/2020/8687907
Abstract: Introduction . Nowadays, minimally invasive surgery in kidney transplantation is a reality thanks to robotic assistance. In this paper, we describe our experience, how we developed the robotic assisted Kidney transplantation (RAKT) technique, and analyze our results. Material and Methods . This is a retrospective study of all RAKTs performed at our center between July 2015 and March 2020. We describe the donor selection, surgical technique, and analyze the surgical results and complications. A comparison between the first 20 cases and the following ones is performed. Results . During the aforementioned period, 82 living donor RAKTs were performed. The mean age was 47.4 ± 13.4 and 50 (61%) were male. Mean body mass index was 25 ± 4.7 and preemptive in 63.7% of cases. Right kidneys and multiple arteries were seen in 14.6% and 12.2%, respectively. Mean operative and rewarming time was 197 ± 42 and 47 ± 9.6 minutes, respectively. Five cases required conversion to open surgery because of abnormal kidney vascularization. Two patients required embolization for subcapsular and hypogastric artery bleeding without repercussion. Three kidneys were lost, two of them due to acute rejection and one because venous thrombosis. Late complications requiring surgery included one kidney artery stenosis, one ureteral stenosis, two lymphoceles, and three hernia repairs. We noticed a significant reduction in time between the first 20 cases and the following ones from 248.25 ± 38.1 to 189.75 ± 25.3 ( p 0.05 ). With a mean follow-up time of 1.8 years (SD 1.3), the mean creatinine was 1.52 (SD 0.7) and RAKT graft survival was 98%. Conclusions . The robotic approach is an attractive, minimally invasive method for kidney transplantation, yielding good results. Further studies are needed to consider it a standard approach.
Urinary cell microRNA-based prognostic classifier for non-muscle invasive bladder cancer
Publisher: Impact Journals, LLC
Date: 14-02-2017
Ability of a urine gene expression classifier to reduce the number of follow-up cystoscopies in bladder cancer patients
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.TRSL.2019.02.003
Abstract: This study aimed to improve our previous urine gene expression classifiers focusing on the detection of non-high-risk non-muscle-invasive bladder cancer (NMIBC), and develop a new classifier able to decrease the frequency of cystoscopies during bladder cancer (BC) patients' surveillance. A total of 597 urines from BC patients, controls and patients in follow-up for BC (PFBC) were included. The study has 3 phases. In the urinary biomarker discovery phase, 84 urines from BC and control patients were retrospectively included and analyzed by Ribonucleic Acid (RNA) sequencing. In the classifier development phase, a total of 132 selected genes from previous phase were evaluated by nCounter in 214 prospectively collected urines from PFBC (98 with tumor). A diagnostic classifier was generated by logistic regression. Finally, in the classifier validation phase, a multicentric and international cohort of 248 urines (134 BC and 114 nonrecurrent PFBC) was used to validate classifier performance. A total of 521 genes were found differentially expressed between non-high-risk NMIBC s les and all other groups (P < 0.05). An 8-gene diagnostic classifier with an area under curve (AUC) of 0.893 was developed. Validation of this classifier in a cohort of PFBC achieved an overall sensitivity (SN) and a negative predictive value (NPV) of 96% and 97%, respectively (AUC = 0.823). Notably, this accuracy was maintained in non-high-risk NMIBC group (SN = 94% NPV = 98%). In conclusion, this 8-gene expression classifier has high SN and NPV in a real clinical scenario. The use of this classifier can reduce the number of follow-up cystoscopies in PFBC, although assessing its final place in clinical setting is necessary.
The Role of Fluorescence In Situ Hybridization for Predicting Recurrence after Adjuvant bacillus Calmette-Guérin in Patients with Intermediate and High Risk Nonmuscle Invasive Bladder Cancer: A System
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2020
Urine Gene Expression Profiles in Bladder Pain Syndrome Patients Treated with Triamcinolone
Publisher: Elsevier BV
Date: 03-2020
DOI: 10.1016/J.EUF.2018.10.001
Abstract: The pathogenesis of bladder pain syndrome (BPS) remains incompletely defined, and there is no standard treatment for BPS as yet. To gain detailed insight into the disease pathobiology of BPS through comparative gene expression analysis of urine from BPS patients versus control in iduals and, furthermore, to determine the efficacy of triamcinolone treatment in BPS patients in terms of the gene expression profiles in urine. A prospective pilot study including 21 urine s les from patients with Hunner's lesions (n=6) and controls (n=9) between January and August 2017. Triamcinolone treatment of BPS patients. Urine s les from BPS patients were collected before (pretreatment group) and 2 wk after triamcinolone treatment (post-treatment group). Gene expression of urine sediment was analyzed using RNA sequencing. Pathways and biological processes in which differentially expressed genes are involved were analyzed. A total of 3745 genes were found to be differentially expressed between the three groups tested. Gene expression differences between controls and BPS s les (630 differentially expressed genes) were more pronounced than the differences between pre- and post-treatment BPS s les (197 differentially expressed genes). Gen Set Enrichment Analysis showed that differentially expressed genes in BPS patients (pretreatment), compared with controls, were enriched for some functional gene networks associated with several metabolic processes and ribosome biogenesis. The limited number of patients included may not accurately represent the BPS population. Gene expression profiles of urine sediment are able to discriminate between BPS and control patients. Moreover, we show that triamcinolone induces changes in urine gene expression profiles. In this report, we looked at gene expression profiles of urine sediment from patients with Hunner's lesions, before and after triamcinolone treatment, and control in iduals. We found that urine gene expression profiles are able to discriminate Hunner's lesions patients from controls. Furthermore, we report, for the first time, that triamcinolone treatment of patients with Hunner's lesions induces changes in bladder gene expression profiles that can be observed in urine s les.
Anuria intermitente postrasplante renal secundaria a granuloma calcificado del neomeato
Publisher: Elsevier BV
Date: 09-2010
Is Robotic Kidney Transplant the Near Future?
Publisher: Elsevier BV
Date: 08-2017
Low testosterone level predicts prostate cancer in re‐biopsy in patients with high grade prostatic intraepithelial neoplasia
Publisher: Wiley
Date: 18-01-2012
Living Donor Renal Transplantation: Prognostic Factors on Graft Survival
Publisher: Elsevier BV
Date: 11-2005
DOI: 10.1016/J.TRANSPROCEED.2005.10.071
Abstract: Living donor renal transplantation is a treatment option for patients on dialysis in view of the ever-growing transplantation waiting lists and the stagnation in the number of deceased donors. The objectives of this study were to provide retrospective review of our living donor kidney transplantation series (1978-2003) and analysis of graft survival prognostic factors. Among 121 living donor transplantations, the donor mean age was 50.9 years (SD, 1.53) and recipient mean age was 30.4 years (SD, 1.4). Eighty-eight percent of donors were women, 90% were related: siblings 21%, parents 69%, and spouses 6.6%. Kidney failure was of nephrological etiology in 65% of patients and urologic in 15.6%. Eighty-four percent were primary grafts and 16% were second ones. Also, 66.7% of kidneys were placed in the iliac fossa and the rest were left orthotopic approaches. Other analyzed variables included donor gender, acute rejection episodes (ARE), creatinine levels at 1 and 6 months, hypertension (HT), and pediatric recipients. Univariate analysis (Kaplan-Meier) showed that, in patients suffering from ARE or not, the mean graft survival was 7.5 and 15 years, respectively (P <.05). Mean graft survival among patients with nephrological problems was 8 years and in those with urologic etiology 15 years (P < .05). Multivariate analysis with Cox regression showed that etiology, ARE, and creatinine level at 6 months after transplantation were independent prognostic variables for graft failure. The overall graft survival rates were 78% at 5 years, 58% at 10 years, 42% at 15 years, and 24% at 20 years follow-up. Living donor kidney transplantation is a valid treatment choice for end-stage patients with excellent graft survival rates, especially in cases of urologic etiology. Development of new immunosupressant strategies will help improve outcomes.
Factores predictores, características patológicas y evolución de las recidivas vesicales después de nefroureterectomía
Publisher: Elsevier BV
Date: 10-2015
DOI: 10.1016/J.ACURO.2015.02.006
Abstract: To analyze the predictors for bladder recurrence (BR) after nephroureterectomy (NU) for upper urinary tract tumors (UUTT), as well as its pathological characteristics, outcomes and impact on survival. Retrospective study of 117 patients who underwent laparoscopic nephroureterectomy by UUTT between 2007-2012 at our center. The potential predictors for BR were analyzed using Cox regression Kaplan-Meier curves were employed to study survival. The s le was composed of 85 men (73%) and 32 women (27%), with a mean age of 70 years. After a mean follow-up of 26 months, 23 patients presented BR (19.6%). In the multivariate analysis, sex (p=.003 HR [female], 3.8) and the location of the UUTT in the distal ureter (p=.002 HR, 4.8) were independent predictors for BR. The median time to BR was 8 months. Fifteen patients presented a nonmuscle-invasive BR (65.2%), and 8 presented a muscle-invasive BR (34.8%). All BRs, except for 2, appeared during the first 2 years. Five cases with nonmuscle-invasive BR presented a new BR. Six patients with muscle-invasive BR died before it could be determined whether cause of death was the BR or an UUTT relapse. The onset of BR showed no repercussion on the survival of patients with UUTT. Sex (female) and the location of the UUTT (distal ureter) are predictors for BR after NU. Patients with these characteristics might benefit from adjuvant intravesical treatment and closer monitoring. The onset for RV has no impact on the survival of patients with UUTT.
Low testosterone levels are related to poor prognosis factors in men with prostate cancer prior to treatment
Publisher: Wiley
Date: 15-05-2012
Related Organisations
Hospital Clinic De Barcelona Instituto Clinic De Nefrologia Y Urologia
Location: Spain
Related Funding Activities
MiRNAs Para El Diagnóstico No Invasivo Del Carcinoma Urotelial
Start Date: 2011
End Date: 2013
Funder: Instituto de Salud Carlos III
View Funded ActivityMonitorización De La Progresión Tumoral Y La Respuesta Terapéutica En Pacientes Con Cáncer De Vejiga Músculo-invasivo Mediante Biopsia Líquida.
Start Date: 2021
End Date: 2023
Funder: Instituto de Salud Carlos III
View Funded ActivityCaracterización De Los Perfiles De Expresión Génica Del Tumor Vesical No Músculo Invasivo De Bajo Riesgo En Orinas. Desarrollo De Un Modelo Diagnóstico No Invasivo Para El Cáncer Vesical
Start Date: 2014
End Date: 2016
Funder: Instituto de Salud Carlos III
View Funded ActivityGeneration Of Isogenic Models Of Clear Cell Renal Cell Carcinoma (ccRCC) Using CRISPR-engineered Kidney Organoids, For The Identification Of Diagnostic Biomarkers
Start Date: 2017
End Date: 2020
Funder: Fundación Científica Asociación Española Contra el Cáncer
View Funded ActivityIdentificación De Biomarcadores Pronósticos Del Tumor Vesical Músculo Invasivo Y Su Inferencia En La Biopsia Líquida
Start Date: 2018
End Date: 2020
Funder: Instituto de Salud Carlos III
View Funded Activity