Search

Many natural processes rely on optimizing the success ratio of a search process. We use an experimental setup consisting of a simple online game in which players have to find a target hidden on a board, to investigate how the rounds are influenced by the detection of cues. We focus on the search duration and the statistics of the trajectories traced on the board. The experimental data are explained by a family of random-walk-based models and probabilistic analytical approximations. If no initial information is given to the players, the search is optimized for cues that cover an intermediate spatial scale. In addition, initial information about the extension of the cues results, in general, in faster searches. Finally, strategies used by informed players turn into non-stationary processes in which the length of e ach displacement evolves to show a well-defined characteristic scale that is not found in non-informed searches.

Studies of social microbes often focus on one fitness component (reproductive success within the social complex), with little information about or attention to other stages of the life cycle or the ecological context. This can lead to paradoxical results. The life cycle of the social amoeba Dictyostelium discoideum includes a multicellular stage in which not necessarily clonal amoebae aggregate upon starvation to form a possibly chimeric (genetically heterogeneous) fruiting body made of dead stalk cells and spores. The lab-measured reproductive skew in the spores of chimeras indicates strong social antagonism that should result in low genotypic diversity, which is inconsistent with observations from nature. Two studies have suggested that this inconsistency stems from the one-dimensional assessment of fitness (spore production) and that the solution lies in tradeoffs between multiple life-history traits, e.g.: spore size versus viability; and spore-formation (via aggregation) versus staying vegetative (as non-aggregated cells). We develop an ecologically-grounded, socially-neutral model (i.e. no social interactions between genotypes) for the life cycle of social amoebae in which we theoretically explore multiple non-social life-history traits, tradeoffs and tradeoff-implementing mechanisms. We find that spore production comes at the expense of time to complete aggregation, and, depending on the experimental setup, spore size and viability. Furthermore, experimental results regarding apparent social interactions within chimeric mixes can be qualitatively recapitulated under this neutral hypothesis, without needing to invoke social interactions. This allows for simple potential resolutions to the previously paradoxical results. We conclude that the complexities of life histories, including social behavior and multicellularity, can only be understood in the appropriate multidimensional ecological context, when considering all stages of the life cycle., Competing Interests: The authors have declared that no competing interests exist.

Objective: To prospectively determine the usefulness of contrast-enhanced ultrasound (CEUS) in the diagnostic assessment of acute gangrenous cholecystitis, using histopathology as the reference method., Material & Methods: The local institutional review board approved the study protocol, and all patients at enrollment provided a written informed consent. From December 2011 to July 2014, all patients with a clinical-sonographic diagnosis of acute cholecystitis underwent a CEUS examination. We included only patients who underwent cholecystectomies within 24-h of CEUS. Radiologists in the course of routine clinical care interpreted the US and CEUS images at the end of the examination, filling out a questionnaire. Two radiologists, blinded to the final diagnosis, independently reviewed the video CEUS sequences for the presence of defects of the gallbladder wall enhancement. Associations between the sonographic findings and histological gangrenous cholecystitis were evaluated by using univariate and multivariate logistic regression analysis., Results: A total of 150 patients were analyzed. The histological diagnoses were 41 (27%) nongangrenous cholecystitis and 109 acute gangrenous cholecystitis (73%). Multivariate analysis of the predictive parameters at univariate analysis revealed that only leukocytosis, diabetes mellitus, lithiasis and defects of wall enhancement on CEUS were independent variables related to gangrenous cholecystitis. The presence of enhancement defects on CEUS enabled the diagnosis of the gangrenous form with sensitivity between 85 and 91% and specificity of 67.5-84.8%. Interobserver agreement for CEUS interpretation was good (median k value: 0.664; range, 0.655-0.680)., Conclusion: Local or widespread absence of gallbladder wall enhancement on CEUS is associated with the presence of gangrenous acute cholecystitis., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Clinical microbiologists should ensure, to the maximum level allowed by the scientific and technical development, the reliability of the results. This implies that, in addition to meeting the technical criteria to ensure their validity, they must be performed with a number of conditions that allows comparable results to be obtained, regardless of the laboratory that performs the test. In this sense, the use of recognized and accepted reference methodsis the most effective tool for these guarantees. The activities related to verification and validation of analytical methods has become very important, as there is continuous development, as well as updating techniques and increasingly complex analytical equipment, and an interest of professionals to ensure quality processes and results. The definitions of validation and verification are described, along with the different types of validation/verification, and the types of methods, and the level of validation necessary depending on the degree of standardization. The situations in which validation/verification is mandatory and/or recommended is discussed, including those particularly related to validation in Microbiology. It stresses the importance of promoting the use of reference strains as controls in Microbiology and the use of standard controls, as well as the importance of participation in External Quality Assessment programs to demonstrate technical competence. The emphasis is on how to calculate some of the parameters required for validation/verification, such as the accuracy and precision. The development of these concepts can be found in the microbiological process SEIMC number 48: «Validation and verification of microbiological methods» www.seimc.org/protocols/microbiology., (Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)

We study the spatial patterns formed by a system of interacting particles where the mobility of any individual is determined by the population crowding at two different spatial scales. In this way we model the behavior of some biological organisms (like mussels) that tend to cluster at short ranges as a defensive strategy, and strongly disperse if there is a high population pressure at large ranges for optimizing foraging. We perform stochastic simulations of a particle-level model of the system, and derive and analyze a continuous density description (a nonlinear diffusion equation). In both cases we show that this interplay of scale-dependent-behaviors gives rise to a rich formation of spatial patterns ranging from labyrinths to periodic cluster arrangements. In most cases these clusters have the very peculiar appearance of ring-like structures, i.e., organisms arranging in the perimeter of the clusters, which we discuss in detail.

We introduce a model of interacting random walkers on a finite one-dimensional chain with absorbing boundaries or targets at the ends. Walkers are of two types: informed particles that move ballistically towards a given target and diffusing uninformed particles that are biased towards close informed individuals. This model mimics the dynamics of hierarchical groups of animals, where an informed individual tries to persuade and lead the movement of its conspecifics. We characterize the success of this persuasion by the first-passage probability of the uninformed particle to the target, and we interpret the speed of the informed particle as a strategic parameter that the particle can tune to maximize its success. We find that the success probability is nonmonotonic, reaching its maximum at an intermediate speed whose value increases with the diffusing rate of the uninformed particle. When two different groups of informed leaders traveling in opposite directions compete, usually the largest group is the most successful. However, the minority can reverse this situation and become the most probable winner by following two different strategies: increasing its attraction strength or adjusting its speed to an optimal value relative to the majority's speed.

The minimal ecological requirements for the fomation of regular vegetation patterns in semiarid systems have been recently questioned. Against the general belief that a combination of facilitative and competitive interactions is necessary, recent theoretical studies suggest that, under broad conditions, non-local competition among plants alone may induce patterns. In this paper, we review results along this line, presenting a series of models that yield spatial patterns when finite-range competition is the only driving force. A preliminary derivation of this type of model from a more detailed one that considers water-biomass dynamics is also presented., (© 2014 The Author(s) Published by the Royal Society. All rights reserved.)

Unlabelled: The process of atherosclerosis begins at early ages and is closely related to plasma lipid levels, specifically, an increase in low density lipoprotein (LDL), very low density lipoprotein (VLDL), and a decrease in high density lipoprotein (HDL)., Objective: To determine if high birth weight, or macrosomia, is of predictive value for dyslipidemia in school children., Methods: A descriptive study with a case control design was conducted on two groups of children; one group of 140 children with a history of macrosomia, and another group of 100 children with normal weight at birth, born between January 1992 and December 1995. The aim was the early identification of atherosclerotic risk factors in school children with high weight at birth. Anthropometric variables and lipid profile were studied (cholesterol, HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol, and triglycerides)., Results: There were significant differences between the mean weights of the two groups. There were no significant statistical differences between the two groups in the cholesterol levels (93.57% normal and 6.43% abnormal in the study group, and 90.00% normal and 10.00% abnormal in the control group), or in the values of HDL cholesterol. LDL cholesterol was abnormal in more children in the control group, and abnormal values of triglycerides were observed in 14.00% of cases in the study group 0.00% in the control group., Conclusion: High birth weight is not a predictive factor for hypercholesterolemia or HDL and LDL-cholesterol esters, but is positive for triglycerides in our study., (Copyright © 2014 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.)

We investigated the relationships between search efficiency, movement strategy, and nonlocal communication in the biological context of animal foraging. We considered situations where the members of a population of foragers perform either Gaussian jumps or Lévy flights, and show that the search time is minimized when communication among individuals occurs at intermediate ranges, independently of the type of movement. Additionally, while Brownian strategies are more strongly influenced by the communication mechanism, Lévy flights still result in shorter overall search durations.

Waxy maize starch was subjected to α-amylase (Bacillus licheniformis) hydrolysis in buffered medium to determine the evolution of reaction in quantitative terms and also in terms of the morphology and crystallinity of the partially hydrolyzed starch granules. Gathered data allowed studying the pattern of action of this α-amylase over waxy maize starch granules, with particular focus on a preferential hydrolysis of the amorphous regions of starch. Results showed that waxy maize starch hydrolysis followed a two-stage kinetic profile with an initial stage characterized by high reaction rate, followed by a slower second stage. The change of hydrolysis rate occurred at approximately 6h of reaction, a time for which X-ray diffraction data quantitatively analyzed by three different techniques showed a maximum of crystallinity in partially hydrolyzed granules. Scanning electron microscopy images illustrated the action of α-amylases which implied the exoerosion of the granules surface, the entry of α-amylases into the granules through radial channels, their endoerosion towards the granule exterior, and their fragmentation. Fragmentation of waxy maize starch granules revealed internal layered structures of starch which were interpreted as hydrolyzed/non-hydrolyzed growth rings. Under the conditions chosen, kinetic, electron microscopy and X-ray data all gave evidence of a preferential action of α-amylase from Bacillus licheniformis towards the less ordered regions of waxy maize starch. Results showed that, provided the proper hydrolysis time is chosen, starch granules with increased crystallinity can be obtained by a pure enzymatic treatment., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

We propose a model equation for the dynamics of tree density in mesic savannas which considers long-range competition among trees and the effect of fire indirectly acting as a local facilitation mechanism. Despite the fact that we take short-range facilitation to the local-range limit, the standard full spectrum of spatial structures already obtained in self-organization models of vegetation is recovered. Nonlocal competition, in the limit of infinitesimally short facilitation, promotes the clustering of trees. The long time coexistence between trees and grass, and how fires affect the survival of trees as well as the maintenance of the patterns is studied. The influence of demographic noise is analyzed. The stochastic system, under the parameter constraints typical of mesic savannas, shows non-homogeneous patterns characteristic of realistic situations. The coexistence of trees and grass still remains at reasonable noise intensities., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background: there has been recent evidence of an alteration in irritable bowel syndrome (IBS) immune regulation, as well as variations in cytokine polymorphisms., Aims: to determine the frequency of the IL-10 (-1082G/A) and TNF-alpha (-308G/A) polymorphisms in subjects with IBS in Mexico., Methods: volunteers answered the Rome II Questionnaire and were classified as IBS (n = 45) and controls (n = 92). The IBS subjects were then categorized as IBS-D: 22.2%, IBS-C: 28.9%, and IBS-A/M: 48.9%. The polymorphism frequency among groups was compared., Results: there were no differences between IBS vs. controls in the frequency of the high (8.9 vs. 18.5%), intermediate (60.0 vs. 57.6%), or low (23.9 vs. 38.9%) producer IL-10 genotypes, p = 0.315. Neither were there differences in the high (0 vs. 1.1%), intermediate (55.4 vs. 43.2%), or low (43.5 vs. 56.8%) producer TNF-alpha genotypes, p = 0.296. However the low producer of IL-10 was more frequent in IBS-D vs. IBS-C vs. IBS-A/M (63.6 vs. 7.1 vs. 33,3%) p = 0.023., Conclusions: in this group of volunteers in Mexico, the frequency of the IL-10 (-1082G/A) and TNF-alpha (-308G/A) genotypes was similar in IBS and controls. However, there was a greater frequency of the low producer of IL-10 in those subjects with IBS-D, suggesting a genetic predisposition to abnormal immune regulation due to a lower anti-inflammatory component in this subgroup.

We investigate the relationship between communication and search efficiency in a biological context by proposing a model of Brownian searchers with long-range pairwise interactions. After a general study of the properties of the model, we show an application to the particular case of acoustic communication among Mongolian gazelles, for which data are available, searching for good habitat areas. Using Monte Carlo simulations and density equations, our results point out that the search is optimal (i.e., the mean first hitting time among searchers is minimum) at intermediate scales of communication, showing that both an excess and a lack of information may worsen it.

The effect of temporal disorder on systems with up-down Z_{2} symmetry is studied. In particular, we analyze two well-known families of phase transitions-the Ising and the generalized voter universality classes-and scrutinize the consequences of placing them under fluctuating global conditions. We observe that variability of the control parameter induces in both classes "temporal Griffiths phases" (TGPs). These recently uncovered phases are analogous to standard Griffiths phases appearing in systems with quenched spatial disorder, but where the roles of space and time are exchanged. TGPs are characterized by broad regions in parameter space in which (i) mean first-passage times scale algebraically with system size, and (ii) the system response (e.g., susceptibility) diverges. Our results confirm that TGPs are quite robust and ubiquitous in the presence of temporal disorder. Possible applications of our results to examples in ecology are discussed.

This study was aimed to investigate in a sample of Spanish elderly whether measures of physical activity are related to health-related quality of life (HRQoL) and symptoms of depression in community dwelling and institutionalized elderly. The sample was a cohort of 436 elderly (234 women and 202 men, aged 60-98 years) from the North of Spain. 58% were community-dwellers and 42% were institutionalized in senior residences. Participants completed measures of physical activity (Yale Physical Activity Survey, YPAS), HRQoL (Medical Outcomes Study 36-item Short Form Health Survey, SF-36) and symptoms of depression (Geriatric Depression Scale, GDS). All SF-36 domains, except role-emotional, were significantly correlated with the YPAS activity dimension summary index. Physical function, role-physical, general health and vitality correlated with total time activity, and correlations were observed between weekly energy expenditure and physical function, role physical, vitality and mental health. Depressive symptom scores correlated significantly with the YPAS activity dimension summary index and the weekly energy expenditure. Scores for various domains of the SF-36 and for depressive symptoms significantly differed among less and more active individuals of the same sex and institutionalization category. Differences generally reached a higher extent in institutionalized subjects in comparison to community dwellers. In conclusion, physical activity was related to different domains of both the physical and mental components of HRQoL and to decreased depressive symptoms. Results emphasize the positive effects of physical activity in both community-dwelling and institutionalized older adults., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

Objective: To ascertain the prevalence of enuresis among primary school children in Spain., Materials and Methods: A multicenter, observational, cross-sectional, epidemiologic, regional study. After sample size calculation, a total of 1687 questionnaires were sent to schools. Nocturnal enuresis was defined as <>., Results: The prevalence of enuresis found in primary school children aged 6-11 years was 7.8%, decrease with age, and was significantly greater in boys (70%). Children without enuresis were taller and had a greater weight than those with enuresis, but the differences were not statistically significant. No differences were found in the family or educational setting between children with and without enuresis. Seventy-three percent of children with enuresis had a family history of the condition. The disorder also occurred in some sibling of 21% of children with enuresis who had siblings. Fifty-five percent of the bedwetting population had primary enuresis. Thirty-one percent of children with enuresis reported losses every night, 38% at least once a week, and 31% at least once a month. Eighty-seven percent of this population was under treatment for this condition. As regards subjective symptoms, 96.9% said they felt fine, but there were more bedwetting children who reported feeling a little bit uncomfortable (76.7% vs 23.1%; P=.004)., Conclusions: Enuresis is a common disorder which is significantly more frequent in boys as compared to girls and whose prevalence decreases with age. It has a significant hereditary component. Most enuresis sufferers take measures against urine losses., (Copyright 2008 AEU. Published by Elsevier España, S.L. All rights reserved.)

POEMS syndrome is a rare multisystemic disorder characterized by polyneuropathy (P), organomegaly (O), endocrinopathy (E), blood dyscrasia with M-protein band (M), and skin changes (S). The pathogenesis of POEMS syndrome is not completely understood. This paraneoplastic syndrome may be associated to bone lesions that are characteristically sclerotic or lytic with sclerotic halo and negative at bone scintigraphy. We report a case of a 37-year-old man with several manifestations of POEMS syndrome who presented bone lesions characteristic of osteosclerotic myeloma confirmed by bone biopsy.

Background: A dose-finding study was performed as the first step in the clinical development of the new drug, cizolirtine citrate., Objective: To assess the efficacy and safety of cizolirtine citrate in overactive bladder with urinary incontinence., Design, Setting, and Participants: Seventy-nine outpatients with clinical overactive bladder and/or urodynamic diagnosis of detrusor overactivity were randomized in a multicentre, 12-wk, double-blind, pilot trial., Interventions: Patients received cizolirtine citrate 400 mg bid (C400), cizolirtine citrate 200 mg bid (C200), or placebo., Measurements: Patients recorded efficacy variables in 7- and 14-d bladder diaries: urinary incontinence episodes, voluntary micturitions, and urgency episodes. The primary efficacy endpoints were changes from baseline to week 12 in average 24-h frequencies of the efficacy variables., Results and Limitations: Average 24-h frequency of urinary incontinence episodes decreased by a median of 1.14 in C400 versus 0.21 in placebo (p=0.08). Urgency episodes decreased by a median of 3.00 in C400, by 1.29 in C200 and by 0.43 in placebo (p=0.004; C400 vs placebo). Cizolirtine showed a clear improvement regarding the percentage of patients free from urinary incontinence episodes at the end of the study, being 68.75% in C400, 45% in C200, and 30% in placebo (p=0.04; C400 vs placebo). The global efficacy assessment reported by patients showed a clearly favourable opinion ("excellent" or "good") given by 80% of the patients in C400 and 60% in C200 versus 39% in placebo. Patients reporting adverse events (AEs) were 37% in placebo, 68% in C200, and 81% in C400. The majority of AEs had mild to moderate severity and none was serious., Conclusions: The therapeutic potential of cizolirtine citrate 400mg bid in overactive bladder has been evidenced.

Aim: To assess the usefulness of FibroTest to forecast scores by constructing decision trees in patients with chronic hepatitis C., Methods: We used the C4.5 classification algorithm to construct decision trees with data from 261 patients with chronic hepatitis C without a liver biopsy. The FibroTest attributes of age, gender, bilirubin, apolipoprotein, haptoglobin, alpha2 macroglobulin, and gamma-glutamyl transpeptidase were used as predictors, and the FibroTest score as the target. For testing, a 10-fold cross validation was used., Results: The overall classification error was 14.9% (accuracy 85.1%). FibroTest's cases with true scores of F0 and F4 were classified with very high accuracy (18/20 for F0, 9/9 for F0-1 and 92/96 for F4) and the largest confusion centered on F3. The algorithm produced a set of compound rules out of the ten classification trees and was used to classify the 261 patients. The rules for the classification of patients in F0 and F4 were effective in more than 75% of the cases in which they were tested., Conclusion: The recognition of clinical subgroups should help to enhance our ability to assess differences in fibrosis scores in clinical studies and improve our understanding of fibrosis progression.

The aim of the research was to investigate in a sample of Spanish elderly whether measures of physical activity and physical function are related to feelings of well being, and whether level of dependence is a moderator in the relation of well being, physical activity and physical function. The sample was a cohort of 151 elderly people (89 women and 62 men, aged 60-98 years) from the North of Spain. Participants completed surveys including demographic characteristics, and measures of physical activity (Yale Physical Activity Survey, YPAS), instrumental activities of daily living (Barthel Index, BI) and well being (Psychological Well Being Scale, from Spanish: Escala de Bienestar Psicológico=EBP). Components of the physical function were measured by the Senior Fitness Test (SFT). Upper and lower body strength, dynamic balance, aerobic endurance, self-reported weekly energy expenditure and physical activity total time were significantly correlated with both Material and Subjective well being. All components of physical function were significantly impaired in dependent subjects when compared to independent individuals of the same sex and physical activity category. Significant differences were also observed in Subjective well being among less active dependent or independent individuals. In conclusion, physical function and physical activity are related to feelings of well being, and results emphasize the positive functional and psychological effects of physical activity in dependent subjects.

Tuberculosis (TB) is a common disease in Spain, whose incidence has increased due to AIDS, immunotherapy and immigration. Intestinal disease is rare and can be difficult to diagnose because its symptoms and laboratory results are nonspecific. In addition, endoscopic lesions resemble those of other diseases such as Crohns disease (CD). Differentiating between intestinal TB and CD is very important since steroid treatment con be life saving in CD and lethal in intestinal TB. Colonoscopy plays an important role in establishing a suspected diagnosis. The endoscopic findings most characteristic of intestinal TB are circular ulcers, small diverticula (3-5 mm), and sessile firm polyps. The suspected diagnosis must be confirmed by the presence of caseating granulomas and/or acid fast bacilli. Polymerase chain reaction is currently recommended for assessing the presence of tubercle bacilli in tissue specimens obtained by endoscopic biopsy. We report a case of intestinal TB in a female renal transplant recipient that demonstrates the difficulty of making this diagnosis.

Objective: To assess the clinical efficacy of sildenafil as treatment for erectile dysfunction (ED) the factors associated with treatment failure were investigated., Methods: Open, prospective study including 244 patients suffering from ED who were evaluated by anamnesis, physical exploration, blood test, dynamic penile color duplex ultrasonography and Sexual Health Inventory for Male (SHIM). The efficacy of sildenafil was assessed by repeating the SHIM 2 months after therapy, independent of the final dose used. Side effects were also recorded. Factors influencing treatment outcome were evaluated by univariate and multivariate statistical analysis., Results: Overall, sildenafil was effective in 56.8% of 213 eligible patients. When the etiologic diagnosis was not included in the multivariate analysis, antecedents of diabetes mellitus, non-nerve-sparing radical prostatectomy and SHIM basal score were selected as predictors of a poor response. In a second analysis including etiologic diagnosis, only SHIM basal score and etiological diagnosis proved to be of prognostic value. Side effects were noticed by 24.4% of patients, none of them being severe., Conclusions: Sildenafil is a rather effective and well-tolerated treatment for ED. The basal severity of ED and etiological diagnosis are the prognostic factors most significantly associated with treatment outcome.

A 28-year-old woman with systemic lupus erythematosus and a history of aseptic meningitis, digestive bleeding due to thrombopenia and deep venous thrombosis underwent elective cesarean for transverse presentation at 35 weeks. Preoperative blood work-up showed an antinuclear antibody titre that was slightly positive and steroid treatment was started. Surgery operation was performed with general anesthesia. The outcome was satisfactory even though serious complications can develop during the management of anesthesia in such patients. Systemic lupus erythematosus is a chronic, multisystemic disease that mainly affects women of childbearing age. Antibodies and immunocomplexes play a fundamental role. Given the multiorgan involvement in this disease, preoperative study of the lupus patient should assess all such involvement, including maternal-fetal risk, as well as consider the drug and anesthetic management to be applied. Among the clinical signs that can affect management of anesthesia are the following: aseptic meningitis, high blood pressure, pericarditis, pneumonitis and recurrent venous thrombosis. Anemia, thrombopenia and significantly altered coagulation events are common.

Management of the cervical spine in orotracheal intubation for general anesthesia is an important aspect of daily practice in anesthesiology. Also important are the requirements, techniques and consequences of patient position during surgery. We report a case of tetraplegia during the early postoperative period after stapedectomy for otosclerosis. After surgery, the spontaneously breathing patient was transferred to the recovery room, where a clinical picture of anesthesia and paralysis of all four limbs was evident. We ordered an emergency magnetic resonance image of the cervical spine, which revealed a massive acutely herniated disk at C6-C7 with signs of ischemia or necrosis of the medulla at the same level. After eight months, the patient was still paraplegic and lacked sensation in the lower limbs. Sensation and motor function in the upper limbs was nearly normal. We review the etiopathogenetic mechanisms that might be responsible for this clinical profile.

Presentation of one case of cystic lymphangioma of the suprarenal gland in a 34-year-old female patient with a background of lower urinary tract infections, presenting with continuous and aggravating pain in left lumbar area and with no other associated symptomatology, diagnosed with ultrasound, IVU and CAT. A review of the literature is made. The present study pretends to give an overall view of a rare and benign disease, commenting upon the difficulties found in its diagnosis and the different therapeutical options.

A 62-year-old female patient consulted for a suppurative-hemorrhagic nasal condition 18 months evolution. Exploration found granulomatous rhinitis which was producing septal perforation and histology compatible with necrotizing granulomatous vasculitis, fulfilling the diagnostic criteria for focal Wegener's granulomatosis, in view of the absence of lung and renal damage. Treatment with trimethoprim-sulfamethoxazole alone described in the medical literature as an option for this process, yielded excellent results with remission of symptoms and normalization of the exploration.

One gm ceftriaxone was administered i.m. to 266 patients 1 h before urologic surgery. The antimicrobial spectrum and long half life of this beta-lactam make it potentially useful for prophylaxis. Its efficacy was determined by the incidence of infections and antibiotics required postoperatively. Postoperative bacteriuria was determined by two urine cultures: one at discharge from hospital or after catheter removal and another 4 weeks postoperatively. The overall postoperative infection rate was 9.7% and bacteriuria was 11.2%; most of these were asymptomatic. Antibiotics were administered postoperatively in 13.9% of the patients. The foregoing results corroborate the efficacy of this agent given in a single dose for prophylaxis against infection in urologic surgery.

A case of leiomyoma of the urachus is reported herein. A review of the literature revealed only 6 cases have been reported. Its incidence is suspected to be higher, but this tumor type is only detected when it is large enough or when complications arise such as bleeding, infection, etc. There is no other data of interest except for its rarity.

The recent introduction of new methods to identify different lymphocytic subsets has made it possible to recognise a rare variant of the classic hairy cell leukaemia, showing intermediate features between prolymphocytic leukaemia and hairy cell leukaemia. A 37-year-old patient is reported who followed a mildly aggressive clinical course and had massive splenomegaly without lymph node enlargement. Moderate leucopenia with lymphocytosis was present, with frequent hairy cells carrying one prominent nucleole. The cytochemical pattern include tartrate-sensitive acid phosphatase positivity, and the immunophenotype of such cells was CD22++, CD11++, CD24-, CD25-, CD2-, CD5-, CD19++. No lamellar ribosomal complex was seen in the ultrastructural study of the hairy cells. The patient was diagnosed as having variant hairy cell leukaemia and achieved partial response after splenectomy. The clinical, diagnostic and therapeutic aspects of this rare variant are discussed.

We report on two cases of renal liposarcoma. The clinical features of this tumor type are described and diagnostic and therapeutic considerations are put forward. The usefulness of CT in the diagnosis of this disease entity is underscored. This permits us to evaluate the response to treatment and furthermore, it permits early detection of recurrence.

We present a case of primitive renal pelvis and calix adenocarcinoma. The clinical evaluation was carried out by means of UIV, echography and TC. Although the tumoral type diagnosis is histologic, the clinical manifestations of chronic renal infection-inflammation, whether associated with obstruction and/or lithiasis or not, are suggestive of this possibility.

Cavernosometry and cavernosography in conjunction with artificial erection have been included in the protocol for the evaluation of sexual dysfunction in the male. The device is comprised of a volumetric infusion pump with a digital flow indicator, and the technique employed is bilateral puncture of the corpora cavernosa. Pressures are recorded by one needle while saline and contrast medium are introduced through the other. Eight males with no organic disorder were assessed for erection flow (EF) and maintenance flow (MF) to determine the normal and pathologic values for this method of evaluation. These values have a normal distribution. Calculation using formulas with a 99% reliability gave the following as pathological values: EF greater than 181 ml/min. or MF greater than 99 ml/min.

Fourteen cases of angiomyolipoma have been diagnosed and treated at our center since it opened 19 years ago. The diagnostic methods and therapeutic approach have changed since then. Noninvasive imaging techniques like CT and ultrasound have significantly enhanced the accuracy of diagnosis. The mode of presentation, number, size and the differential diagnosis may decide between conservative or surgical management of these tumors. A small tumor mass only requires observation. For larger ones, the treatment of choice is preferably by conservative surgery or highly selective embolization if permitted by the severity of the disease. Surgery is warranted when doubt exists on CT and ultrasonography.