The existence of bilateral renal angiomyolipoma (AML) is fairly infrequent, especially when not associated with such syndromes as tuberous sclerosis or linfangioleimiomatosis. Here we present the case of a 40-year-old woman who was accidentally diagnosed at week 33rd of gestation by an ultrasound, of bilateral renal AML and that could be treated with kidney sparing conservative treatment. We have also done a review of the literature focusing on its management and its relationship with pregnancy.

No abstract

Introduction:Prostate-specific antigen (PSA) is the main tool for early detection, risk stratification and monitoring of prostate cancer (PCa). However, there are controversies about the use of PSA as a population screening test because of the high potential for overdiagnosis and overtreatment associated. The net benefit of screening is unclear and according to the available recommendations, it should be offered to well-informed men with an adequate health status and a life-expectancy of at least 10 years or to men at elevated risk of having PCa. In addition, the factors that influence test results are unclear, as is impact of false positive or negative results on patient health.Our objective is to assess the clinical and analytical factors associated with the presence of false positive and false negative results and the diagnostic/therapeutic process followed by these patients.Methods and analysis:A prospective observational cohort study will be carried out. We will include a cohort of patients with a positive PSA result (1.081 patients) and a sample of patients with negative results (572 patients); both will be followed for 2 years by reviewing medical records to assess the variables associated with these results, as well as characteristics of patient management after a positive PSA value. We will include those patients with a PSA determination from 2 hospitals in the Valencian Community. Patients who have been previously diagnosed with prostate cancer or who are being followed for previous high PSA values will be excluded.Discussion:The study will estimate the frequency of false positive and false negative PSA results in routine clinical practice, and allow us to quantify the potential harm caused.Study registration:Clinicaltrials.gov (https://clinicaltrials.gov/): NCT03978299, June 7, 2019.

The inconsistent use of hormonal contraceptive methods can result, during the first year of use, in one in twelve women still having an undesired pregnancy. This may lead to women experiencing fear of becoming pregnant (FBP). We have only found one study examining the proportion of FBP among women who used hormonal contraceptives. To gather further scientific evidence we undertook an observational, cross-sectional study involving 472 women at a Spanish university in 2005–2009. The inclusion criteria were having had vaginal intercourse with a man in the previous three months and usual use for contraception of a male condom or hormonal contraceptives, or no method of contraception. The outcome was FBP. The secondary variables were contraceptive method used (oral contraceptives; condom; none), desire to increase the frequency of sexual relations, frequency of sexual intercourse with the partner, the sexual partner not always able to ejaculate, desire to increase the partner’s time before orgasm, age and being in a stable relationship. A multivariate logistic regression model was used to determine the associated factors. Of the 472 women, 171 experienced FBP (36.2%). Factors significantly associated (p < 0.05) with this FBP were method of contraception (condom and none), desire to increase the partner’s ability to delay orgasm and higher frequency of sexual intercourse with the partner. There was a high proportion of FBP, depending on the use of efficient contraceptive methods. A possible solution to this problem may reside in educational programmes. Qualitative studies would be useful to design these programmes.

We describe the sonographic (US) and computed tomographic appearances of a large, solitary tumor in the liver produced by extramedullary hematopoiesis in an 82-year-old patient with agnogenic myeloid metaplasia. Confirmation of this diagnosis was made by US-guided fine-needle aspiration biopsy.

ResumenIntroducción: A pesar del creciente interés que despiertan en nuestro país la Incontinencia Urinaria (IU), la enuresis nocturna y la Vejiga Hiperactiva (VH), no existe ningún estudio epidemiológico que evalúe la prevalencia de estas patologías en los diferentes grupos sobre los que se asientan, de la población general de España. Material y Métodos: Estudio epidemiológico, observacional, multicéntrico y de ámbito nacional. Se recogieron datos, a través de encuestas en 5 áreas representativas de todo el ámbito nacional y en cuatro grupos de la población: 1) Mujeres, laboralmente activas (entre 25 y 64 años); 2) Varones, laboralmente activos (entre 50 y 64 años); 3) Niños en enseñanza primaria (entre 6 y 11 años); y 4) Personas mayores de 65 años institucionalizadas con nivel cognitivo conservado. La encuesta a población adulta y ancianos incluía dos partes: 1) variables socio-demográficas y antecedentes de la historia clínica; y 2) sobre síntomas de VH e IU. La encuesta a niños incluía variables socio-demográficas y sobre ingesta de líquidos y control de la orina. Resultados: El porcentaje de respuesta en los diferentes grupos del estudio osciló entre el 79,7% y el 98%. La prevalencia de VH y de IU aisladas en mujeres laboralmente activas fue de 2,69% y 4,01% respectivamente; en varones fue de 3,55% y 0,56%; en personas de más de 65 años fue de 9,14% y 15,16%. En conjunto el 9,94% (95% IC= 8,9-11,04) de las mujeres estudiadas padecían una o las dos patologías, porcentaje que fue de 5,14% (95% IC= 3,89 -6,63) para varones y de 53,71% (95% IC= 50,56-56,85) para personas de más de 65 años. La prevalencia de enuresis nocturna en niños fue de 7,82% (95% IC= 6,62-9,17). Conclusión: La prevalencia de VH y/o IU en España se acerca al 10% en mujeres entre 25 y 64 años, está alrededor del 5% en varones entre 50 y 65 años y es superior al 50% en personas de más de 65 años de ambos sexos; la prevalencia de enuresis nocturna en niños entre 6 y 11 años está alrededor del 8%.Palabras clave: Incontinencia urinaria. Vejiga Hiperactiva. Epidemiología. Prevalencia. Población general. Prevalencia de Incontinencia Urinaria y Vejiga Hiperactiva en la población española: resultados del estudio EPICC AbstractBackground: Despite the growing interest on Urinary Incontinence (UI) in our country, nocturnal enuresis and Overactive Bladder (OAB), there are no epidemiologic studies on the prevalence of these health problems in the different affected groups of the general population. Patients and methods: This is an epidemiologic, observational, multicentre and national study. Data were collected by means of personal interviews in 5 representative areas from Spain and in 4 groups of population: 1) working women (25-64 years old); 2) working men (50-64 years old); 3) children attending primary school (6-11 years old); and 4) elderly institutionalized subjects (over 65 years old) with no mental impairment. The Interview addressed to adult population included two parts: 1) socio-demographic variables and clinical history; and 2) data about OA...

No abstract

No abstract