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Objective: The primary objective was to estimate the incidence of granulomatous prostatitis (GP) in Son Espases University Hospital, a tertiary care hospital, in Palma de Mallorca (Spain). As secondary objectives, presence of concomitant PCa in the biopsy was analyzed, as well as the history of previous BCG instillations, biopsy origin, urinary symptoms, and cardiovascular risk (CV) factors., Methods: A descriptive retrospective study of GP and the aforedescribed variables were carried out from 2010 to 2017., Results: A total of 3651 histopathological prostate specimens were analyzed, 39 of which were diagnosed with GP (incidence of 1.06%). Lower urinary tract symptoms (LUTS) were present in a 48.7% and previous history of bladder tumor resection (TURBT) was present in 35.9% of the cases. Also, urinary tract infections were equally present. All cases with prior TURBT had intravesical instillations with BCG, although 5 (12.8%) and 4 (10.3%) cases had abnormal rectal examination and elevated PSA levels after instillations, respectively. Finally, in 14 cases (35.9%) there was also a diagnosis of concomitant PCa. The most common CV risk factor in these patients was smoking (79.5%) followed by hypertension (64.8%)., Conclusions: The estimated incidence of GP in our center (1.06%)g is close to that described by other authors. About 14 cases were diagnosed with PCa (35.9%), a higher value than previously described in the literature, and most of these were found incidentally, especially in cystoprostatectomies. This high percentage of concomitant GP and PCa could be due to a rise in Transrectal Prostate biopsies (TRPB), as in recent years there has been a tendency to increase the use of PSA in routine clinical practice.

Objectives: The purpose of this study is to analyse the effect of a community participation programme based on the ecosystem model on the incidence of dengue in urban communities., Methods: A randomized controlled field trial was conducted in the state of Colima, Mexico. The intervention consisted of a community participation programme focused on the ecosystem; simultaneously, the control groups were communities that only received the usual official prevention programs. The incidence of dengue was estimated in people of both groups due to the appearance of de novo IgM antibodies during the follow-up period., Results: The incidence of dengue in the intervened group was 2.58%/month (n = 818) and in control group 2.26%/month (n = 994), with a risk ratio of 1.14 (95% CI 0.89-1.45) and a PAF of 0.06 (95% CI - 0.056 to 0.16). The A. aegypti larval density (Breteau Index) was reduced in the treated group., Conclusions: The implementation of a community participation programme in the cities of Colima, Mexico, showed a slightly counterproductive effect on the incidence of dengue. This happened even with a reduction in the A. aegypti index.

To review the presentation, diagnosis and treatment of the renal artery aneurysms. Also, to report a non-described complication like the presence of an ureteroarterial fistula, its diagnosis, treatment and complications., Methods: We report the case of a patient with a renal artery aneurysm that presents a ureteroarterial microfistula on a CT scan, his presenting symptoms, the diagnosis, treatment and management of the subsequent complications., Results: Ureteroarterial fistula is an unusual complication of renal artery aneurysms. Currently, by the application of minimally invasive techniques and the use of new biodegradable materials we can treat a wide range of diseases endovascularly, although we often don´t know the complications that can result., Conclusions: Renal artery aneurysms are not a prevalent disease and sometimes not described complications like ureteroarterial fistula may occur. There is no clear consensus on the management and treatment, but minimally invasive endovascular techniques could represent the gold standard nowadays.

Dengue fever is considered to be one of the most important arboviral diseases globally. Unsuccessful vector-control strategies might be due to the lack of sustainable community participation. The state of Colima, located in the Western region of Mexico, is a dengue-endemic area despite vector-control activities implemented, which may be due to an insufficient health economic analysis of these interventions. A randomized controlled community trial took place in five urban municipalities where 24 clusters were included. The study groups ( n = 4) included an intervention to improve the community participation in vector control (A), ultra-low volume (ULV) spraying (B), both interventions (AB), and a control group. The main outcomes investigated were dengue cumulative incidence, disability-adjusted life years (DALYs), and the direct costs per intervention. The cumulative incidence of dengue was 17.4%, A; 14.3%, B; 14.4%, AB; and 30.2% in the control group. The highest efficiency and effectiveness were observed in group B (0.526 and 6.97, respectively) and intervention A was more likely to be cost-effective ($3952.84 per DALY avoided) followed by intervention B ($4472.09 per DALY avoided). Our findings suggest that efforts to improve community participation in vector control and ULV-spraying alone are cost-effective and may be useful to reduce the vector density and dengue incidence., Competing Interests: The authors declare no conflict of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Introduction: The present study was conducted to estimate the incidence of seropositivity to anti-Trypanosoma cruzi antibodies and analyze potential risk factors in Colima, on the western coast of Mexico., Methodology: Longitudinal studies of 209 subjects with negative serology in 1999 for anti-Trypanosoma cruzi antibodies by hemagglutination inhibition test were tested again in 2005. At the same time, 716 children under six years of age were surveyed serologically (total n = 925); the history of Trypanosoma cruzi infection was determined by the same hemagglutination inhibition test. The variables analyzed were age, sex, living in triatomine-infested places, type of community, quality of housing, presence of pets, and number of inhabitants per house., Results: Trypanosoma cruzi seropositivity in the period of six years was 22/925 cases, with a point prevalence of 2.73% and an adjusted rate of 7.3/1,000 person-years. The variable living in triatomine-infested areas showed association with seropositivity anti-Trypanosoma cruzi antibodies (RR: 5.5; 95% CI: 1.28-23.5). The remaining variables showed no significant association., Conclusions: This study confirms the active transmission of Chagas disease in Mexico´s western-central region, which merits greater epidemiological surveillance and vector control, particularly in localities infested with triatomines.

Tick paralysis is a rare entity in which it is necessary to identify the cause and remove the arthropod to have a rapid remission of symptoms. In the absence of an early diagnosis, the outcome can be fatal, as toxins are released from the tick's saliva as it feeds. To the best of the authors' knowledge, this is the first clinical report of the disease in Mexico and Latin America. A 22-year-old man from a rural area, who was in contact with cattle, developed ascending flaccid paralysis secondary to Amblyomma maculatum tick toxin. He presented flaccid paraplegia and arreflexia that progressed until causing dyspnea. The clinical symptoms subsided 48 h after the ticks spontaneously detached. The ticks were discovered by nursing personnel while the patient was being transferred to a regional hospital with the diagnosis of Guillain-Barré syndrome. The patient was asymptomatic on discharge from hospital and showed no further motor deterioration at a 1-month follow-up.

Objective: A case of intestinal obstruction following transurethral resection (TUR) of a locally advanced transitional cell carcinoma of the bladder is presented., Methods/results: The unique features of the present case are described. Laparotomy was performed and peritoneal carcinomatosis was found. Renal function became impaired and the abdominal condition persisted. The patient died five days postoperatively., Conclusions: Intestinal obstruction following TUR of transitional cell carcinoma of the bladder is an uncommon complication that is mainly due to peritoneal seeding following iatrogenic perforation of the tumor or the bladder wall during resection. Still, TUR is undeniably useful in the diagnosis, staging and treatment of bladder neoplasm.

Objective: To present a cae of giant renal angiomyolipoma that required surgical treatment owing to its size and concomitant intratumoral hemorrhage., Methods: The characteristics of the case are presented and discussed., Results/conclusions: Giant renal angiomyolipoma is one of the most frequent causes of Wünderlich syndrome and is diagnosed by ultrasound and CT. The decision to operate is based on the size of the lesion and/or symptomatology, as in the case described herein, which required a simple nephrectomy.

Objective: To describe two cases of recurrent fibrotic stricture of the uretero-vesical junction treated with a metallic self-expanding endoprosthesis which has successfully achieved patency of the stenotic area in the medium-term., Methods: Two cases of difficult ureteral stricture are described. Both cases presented obstruction of the terminal ureter by abundant fibrotic tissue in the bladder wall following radical prostatectomy in one case and TUR in the other for non-infiltrating bladder carcinoma. Several attempts to recover patency by endoscopic resection and placement of a double-J stent in these patients had previously failed. The patients were therefore submitted to resection of the fibrotic area and insertion of a self-expanding endoprosthesis (Wallstent), which was eventually enclosed by fibrous tissue at its vesical portion. Both cases underwent resection again and another endoprosthesis (Memotherm) was inserted to extend the previous prosthesis 1 cm within the bladder lumen., Results/conclusions: When the endoprosthesis is placed in the uretero-vesical junction with its tip flush with the bladder wall, it is eventually enclosed by fibrous tissue, which invariably leads to recurrent obstruction. We have found that extending the prosthesis 1 cm within the bladder lumen can overcome the foregoing complication, although the long-term results have as yet to be established.