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Objective: To show the prolonged efficacy of thiazides in the prophylaxis and treatment of recurrences in patients with calcium oxalate and phosphate lithiasis., Methods: A randomised prospective study is conducted, with a three-year follow-up, in 150 patients diagnosed with recurrent calcium lithiasis. The patients are divided into three groups: A) 50 cases subject to observation with no treatment, B) 50 cases treated with 50 mg/day of hydrochlorothiazide, and C) 50 cases treated with 50 mg of hydrochlorothiazide and 20 mlEq of potassium citrate/day. Each group is subject to a renal study with imaging techniques and a urinary metabolic study at baseline, 12, 24 and 36 months., Results: The patients treated with thiazides (Groups B and C) obtain a significant reduction in lithiasis recurrence compared with the control group (Group A). The most common abnormality found in the metabolic study was hypercalciuria, 52% of cases; 16% present a mixed lithogenic pattern. The number of recurrences and need for new sessions of extracorporeal lithotripsy in patients with hypercalciuria treated with thiazides is significantly smaller than in Group A (p=0.003)., Conclusions: We observe a significant relation between lithogenic pattern and lithiasis recurrence. Thiazides help us to control lithogenic factors and recurrences in patients with calcium lithiasis. This effect is prolonged and significant in patients with hypercalciuria.

Abdominal stab wounds represent approximately 7% of abdominal injuries in our environment. However, renal involvement in these cases is relatively uncommon (2% of visceral lesions). We present a case of a stab wound in the anterior abdominal wall. In addition to intestinal lesions, the injury produced a lesion in a horseshoe kidney, a relatively uncommon malformation of the urinary system (1/400 individuals). Despite the rarity of this occurrence, when dealing with an emergency affecting a malformed kidney, knowledge of the inherent peculiarities of these defects is essential for the appropriate management of these patients.

A malignant fibrous histiocytoma (MFH) of the spermatic cord is presented and a review of the literature has been performed. The patient here presented survived for eight years and is probably cured of his tumour. In general, MFHs of the spermatic cord have a good prognosis, even when they attain a big size. They have a worse evolution when satellite nodules are present. Although more experience is needed. It is our feeling, that a spermatic MFH smaller than 8 cm, without any satellite nodule and less than 25% nuclei positive to MIB-1 (cell proliferation marker), may have a conservative therapy, including only tumorectomy.

Contribution of a new case of bladder leiomyosarcoma due to the rarity of its presentation. There are barely one hundred cases reported in the medical literature. Clinico-pathological, therapeutic and prognostic assessment of this type of bladder sarcoma and discussion on the convenience of complementary therapy after surgery.

Objective: To establish the attitude of health staff at Health Centres to new Mental Health care plan., Design: Crossover study, for which a simple random sample of 207 people was extracted. SITE. Seville's Primary Care network., Participants: Doctors and nurses from Health Centres in Sevilla., Main Measurements and Results: A questionnaire of 22 items, grouped into the 5 thematic areas of the new plan, was designed to measure attitudes. The statistical treatment analysed the variables of: age, sex, profession, type of Health Centre, participation in health programmes and the relationship to the District Mental Health Team (DMHT), 55% of health workers scored positively overall in the questionnaire. Those belonging to urban Health Centres were more favorable than those in rural centres to the incorporation of mental health into Primary Care. Those under 35 were also more favorable. Looking at thematic areas, the least preferred was "Organisation", whereas all the other areas scored positively., Conclusions: Strategies for the introduction and organisation of the new mental health plan will have to be designed before it can be implemented in Health Centres.