Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introduction: Bilateral testicular tumors are very rare, representing between 1 % and 5 % of all testicular germ cell tumors (TGCT). The vast majority of primary bilateral TGCTs are metachronous, while synchronous tumors account for approximately 0.5 % to 1 % of all cases. Synchronous tumors mostly share the same histological pattern, predominantly seminoma, and synchronous bilateral TGCTs (SBTGCT) with discordant subtypes are extremely rare. Relevance & discussion: The atypical presentation of synchronous bilateral testicular carcinoma with metastatic histopathological discordance poses a therapeutic challenge. Historically, the pathogenesis behind the development of synchronous bilateral TGCTs has been a controversial and still undetermined topic. Apparently are result from separate oncological mechanisms and occur as the development of two independent primary tumors. Clinical case: A 19-year-old male presented with swelling in the left side of the neck. The biopsy reported an embryonal carcinoma, confirmed by ultrasound and tumor markers, revealing bilateral testicular tumors. A left radical orchiectomy was performed, resulting in a mixed germ cell tumor, followed by a right radical orchiectomy after chemotherapy, which yielded a teratoma. Conclusion: It is known that synchronous primary bilateral testicular germ cell tumors (TGCTs) typically present with similar histology; however, we discuss discordant histology presentations.

Background: Penile cancer is rare in developed countries but prevalent in developing regions. Known risk factors include phimosis, inflammation, and smoking. This study aims to determine the prevalence of these factors and explore potential novel ones in South Africa.   Methods: A case-control study was performed with 23 cases diagnosed with penile cancer from January 2008 to October 2023, and 46 age-matched controls with benign prostatic hyperplasia (BPH) or lower urinary tract symptoms (LUTS). Participants were interviewed using a standardized questionnaire. Pathological profiles and stage presentations were also documented.   Results: The most common risk factors were phimosis (OR 34.2, 95 % CI 7.9 to 244.5), inflammation (OR 14.1, 95 % CI 3.2 to 100.4), and smoking (OR 3.3, 95 % CI 1.1 to 12.9). Phimosis remained a significant risk factor even after adjusting for smoking, low income, and inflammation (OR 22.7, 95 % CI 3.9 to 210.6). Smoking and inflammation lost significance after adjusting for phimosis. The pathological profile was consistent with international data, but our patients presented with more advanced disease.   Conclusions: Phimosis was identified as the most important risk factor for penile cancer in this South African cohort, followed by smoking and preputial inflammation. The pathological profile was similar to international cohorts, though our patients presented at more advanced stages.

Description: We present two cases of bladder PEComa:1- A 43-year-old man with haematuria and urinary frequency was diagnosed with a subcentimeter, non-papillary, exophytic tuberous lesion via cystoscopy, which was completely removed by transurethral resection. 2- A 36-year-old woman was incidentally diagnosed with a bladder lesion during a gynaecological ultrasound, having had symptoms of overactive bladder previously. Cystoscopy revealed a 2 cm solid lesion near the right ureteral orifice, compatible with bladder PEComa pT2G3, with a healthy base in re-resection. Partial cystectomy was performed. Relevance: PEComa are a family of mesenchymal tumours composed of perivascular epithelioid cells that exhibit melanocytic and smooth muscle markers and can appear in almost any organ of the body. Appearance in bladder is extremely rare, with very few cases reported in the literature. Diagnosis is anatomopathological, so it is important to distinguish from other bladder tumours. Clinical implications: PEComa may be associated with Tuberous Sclerosis and, although most are benign, malignant lesions have been reported. They do not usually present specific clinical or radiological features, being the definite diagnosis histological. Conclusions: Bladder PEComa are a rare entity that should be considered in the differential diagnosis of other bladder tumours.

Clinical case description: we present the case of a 17-year-old male from Chiapas, who has a history of HIV infection and neuroinfection caused by Cryptococcus neoformans. He was treated for acute orchiepididymitis, with histopathological identification of Blastomyces spp. and Mycobacterium tuberculosis in the surgical specimen (orchiectomy and epididymectomy). Relevance: Blastomycosis is infrequent outside endemic regions, and reported cases typically involve patients with a history of travel to or residence in such areas. Genitourinary blastomycosis is rare (accounting for 10 % of total cases) and more commonly affects the prostate, epididymis, and testicles. Tuberculosis of the genitourinary tract is often diagnosed late, leading to irreversible damage and the need for radical interventions such as orchiectomy. Blastomycosis is rare outside of endemic areas; reported cases have a history of travel or residence in these areas. Genitourinary blastomycosis is rare (10 % of all cases) and most frequently involves the prostate, epididymis, and testes. Tuberculosis of the genitourinary tract is often diagnosed late, leading to irreversible damage and the need for radical interventions such as orchiectomy. Clinical implications: genitourinary blastomycosis is an underdiagnosed infectious condition due to the lack of specific symptoms, with approximately half of patients with blastomycosis remaining asymptomatic. Conclusions: it is likely that more cases of BM in Mexico are undiagnosed or unreported and are caused mainly by Blastomyces no-dermatitidis species. 

Background: urolithiasis, the formation of kidney stones, is associated with chronic conditions such as metabolic syndrome, which increases the risk of uric acid and calcium oxalate stones. Based on CT scan findings, this study aims to investigate the association between non-alcoholic fatty liver disease (NAFLD) and urolithiasis. Method: over two years, a cross-sectional comparative study was conducted at Razi Hospital in Birjand, Iran. Participants were patients aged 16 to 80 presenting with renal colic who underwent non-contrast abdominopelvic CT scans. Exclusion criteria included other liver diseases, excessive alcohol consumption, and a history of splenectomy. Data were collected using a structured checklist and analyzed for the presence of fatty liver and kidney stones. Results: the study included 911 participants, with a mean age of 47.88 years (SD = 16.48). Among the participants, 80 had fatty liver disease, and 50 of these had kidney stones. In contrast, of the 831 participants without fatty liver, 356 had kidney stones. The association between fatty liver and kidney stones was significant (p < 0.001). Gender-stratified analysis showed that males with fatty liver had a higher incidence of kidney stones compared to females (p < 0.001 for males, p = 0.631 for females). Conclusion: the study confirms a significant association between NAFLD and urolithiasis, particularly in males. The findings suggest that screening for kidney stones in patients with fatty liver disease might be beneficial. Addressing underlying metabolic disorders could help mitigate the risk of developing both conditions.

Introduction: The safety of the percutaneous approach has made it possible to improve instrumentation and progressively decrease the caliber of the instruments. The objective of this study is to present our experience in the use of the percutaneous approach for the treatment of recurrent lithiasis and recurrent pyeloureteral stenosis in children. Material and methods: A retrospective review was carried out in our center, including all the patients who underwent a percutaneous approach between the years 2007-2020. In the case of patients with recurrent pyeloureteral junction obstruction (PUJO) a high-pressure balloon is placed retrogradely at the pyeloureteral junction. Next, the kidney was percutaneously approached by ultrasound and fluoroscopic control. Percutaneous endopyelotomy or lithotripsy was accomplished using monopolar hook electrocautery or holmium laser fiber. All patients had a double J catheter for 3-4 weeks. Nephrostomy was necessary in 9 of 24 patients. Results: A total of 24 patients were included. Two groups were established: group 1 (n=15) had recurrent PUJO, and group 2 with 7 patients had kidney stones. Two more patients are added who do not belong to the groups described, a 16-year-old patient with hydrocalyx and a 13-year-old patient with renal cyst. The median age was 5 years (2-16). The most frequent complication was hematuria, followed by urinary tract infection in 3 patients. The median surgical time in group 1 was 60 minutes (35-90), in group 2 was 100 minutes (75-180). The mean time of admission in both groups was 3 days (2-7). The mean follow-up time in group 1 was 6 years (2-13), in group 2 it was 7 years (5-8). Conclusions: Percutaneous approach is a safe and very practical technique in the management of lithiasis and recurrent PUJO in children. The miniaturization of the instruments makes it possible to expand the indications and reduce morbidity in our patients.

Cancer presents as a leading cause of mortality worldwide, with its incidence exhibiting an upward trend attributable to population aging, the implementation of novel diagnostic tools, and the availability of innovative therapies. In males, prostate cancer stands out as one of the neoplasms with the highest incidence and prevalence, further associated with an elevated mortality rate, excluding skin cancer. A detailed understanding of the incidence, mortality, and particularly, the disease burden of this neoplasm is of paramount relevance, as it allows for the formulation and implementation of measures and strategies in health policies aimed at mitigating the negative impact on both public health and national economies. Globally in 2021, 432,463 deaths due to prostate cancer were recorded, whereas in Mexico the figure reached 8,860. In Mexico and worldwide, prostate cancer is a highly prevalent neoplasm and represents a substantial disease burden. Timely intervention is necessary to mitigate its impact.

Research on religion and spirituality has focused on understanding virtues, strengths, and well-being to develop interventions or programs to address various processes. The objective of this quantitative study with a non-experimental cross-sectional design was to evaluate the possible relationship between specific aspects of well-being (flourishing and life satisfaction) and the intrapersonal, interpersonal, and transpersonal dimensions of spirituality. 300 adults living in Puerto Rico between the ages of 18 and 39 completed an online questionnaire containing the variables of Personal Spirituality, Flourishing, and Life Satisfaction. Through a Pearson correlation analysis, a positive relationship was observed between spirituality and the variables associated with well-being. Also, the relevance of religion and spirituality was highlighted as a factor present in the evaluation of said variables in adults.

Academic self-efficacy, defined as the confidence in one's abilities to face and overcome academic demands, is a determining factor in student performance. This study analyzed the factorial structure and psychometric properties of the Academic Behavior Self-Efficacy Scale (EACA) in Mexican university students. A sample of 1385 undergraduate students were evaluated. A confirmatory factor analysis was applied to examine the factorial structure of the questionnaire. After evaluating models with different structures (four-factor, three-factor, and three specific models), the four-factor model with 11 items presented the best fit indices. This structure demonstrated adequate validity and reliability indicators. In conclusion, the study's results support the four-factor structure of the EACA, confirming its psychometric robustness as a tool for assessing academic self-efficacy in Mexican university students.