Bariatric surgery related proximal myopathy: A partially reversible complication.

Deficiency neuropathies and rhabdomyolysis have previously been reported after bariatric surgery (BS) but never myopathies. We report cases of five patients with morbid obesity who developed within 2 to 4 months of a BS, proximal myopathy following significant and rapid weight loss worsened by postoperative gastrointestinal complications. Muscle weakness concerned lower limbs in particular in quadriceps and less frequently in upper limbs and diaphragm, sometimes mimicked a Guillain-Barré syndrome. Muscle biopsy performed in 1 patient, revealed selective atrophy of type 2 fibers. Weakness slowly decreased with refeeding with vitamins supplementation. We enlarge here the clinical pattern of post-BS complications.

Microbiological surveillance of endoscopes and implications for current reprocessing procedures adopted by an Italian teaching hospital.

BACKGROUND: Hospital acquired infections have been associated with the contamination of flexible endoscopes caused by a failure of the reprocessing procedure. Microbiological surveillance of endoscope reprocessing is valuable for assessing contamination by pathogens. The aim of this study is to evaluate microbiological contamination of endoscopes after reprocessing, and the involvement of reprocessing procedures adopted in endoscopy units of an Italian teaching-hospital. METHODS: The study was carried out, on several dates in 2014, in 11 endoscopic operation units equipped with 100 endoscopes (18 bronchoscopes, 41 gastroduodenoscopes, 29 colonoscopes, 12 laryngoscopes) and 9 Automated Endoscope Reprocessors. Presence/absence of common pathogens and indicator micro-organisms (including multi-drug resistant bacteria) and Total Microbiological Count (TMC) were obtained from the biopsy channels of endoscopes after reprocessing, from final rinse water of automated endoscope reprocessors and from tap water applying standard microbiological culture methods. Following the European Guidelines for quality assurance in reprocessing, the post-reprocessing criteria were "absence of indicator micro-organisms and absence of TMC in samples obtained from endoscopes' channels". RESULTS: A total of 180 samples were collected (143 endoscopes, 25 Automated Endoscope Reprocessors and 12 water supply). Compliance to the European Guidelines was achieved for 112 out of the 180 (62.2%) samples analyzed. Presence of indicator micro-organisms (mainly Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa and other Gram-negative non-fermenting bacteria) was found in 51 out of 143 endoscopes (35.7%). Multi-drug resistant bacteria were also found. Presence of pathogen micro-organisms was statistically associated with the increase of TMC level, but not with time after reprocessing. CONCLUSION: The study provides information about the microbiological quality of endoscope reprocessing procedures adopted by different endoscopic operation units. The high prevalence of contaminated endoscopes provides evidence of the need to improve the quality of reprocessing.

Mesotelioma maligno de túnica vaginal de testículo: caso clínico y revisión de la bibliografía / Malignant mesothelioma of tunica vaginalis testis; a case report

El mesotelioma maligno de túnica vaginal testicular es un tumor muy raro. Se publicaron menos de 90 casos. El tratamiento indicado inicialmente es la orquituniculectomía inguinal; no hay tra-tamientos estandarizados para la recurrencia local ni para la diseminación a distancia del tumor. Los resultados con quimioterapia y radioterapia son pobres. Presentamos un caso de mesotelioma maligno de la túnica vaginal testicular en un hombre de 37 años, con tumor localizado, que fue sometido a orquifuniculectomía inguinal como único tratamiento; luego de 18 meses de segui-miento se encuentra asintomático y sin signos de recurrencia local ni diseminación a distancia. Realizamos una revisión de la literatura.

Cáncer de vejiga: tabaco como factor de riesgo / Bladder cancer: tobacco like risk factors

Entre setiembre de 1997 y marzo de 1998 se diagnosticaron y trataron en nuestro servicio 45 pacientes con cáncer de vejiga, de los cuales 41 casos fueron carcinomas superficiales, 3 infiltrantes y el restante carcinoma "in situ". El objetiv o del presente trabajo fue observar cuáles eran los factores de riesgo para el desarrollo de esta neoplasia. Se detectó que en el 85 por ciento de estos pacientes el hábito de fumar se encontraba presente (p<0,01), determinándose además la relación entre la cantidad de cigarrillos consumidos por día y el grado de diferenciación celular. Se registró también que los pacientes que fumaban tabaco negro desarrollaron tumores de mayor estadio de infiltración. En los restantes pacientes los factores de riesgo fueron labvorales (4 por ciento); hereditarios (2 por ciento); o dfesconocidos (9 por ciento)

[Calcified periarthritis. Disappearance of periarticular calcification after laser therapy]. / Periartrite calcifica. Scomparsa di calcificazioni periarticolari dopo laserterapia.

The authors report their results in the laser therapy of 30 calcific shoulder joint periarthritis. In two out of the ten radiographed cases, at the end of therapy, the complete disappearance of calcifications has been shown and in one case a decrease in calcification volume has been demonstrated. In the follow up after 6 months, 80% of clinically checked patients had no painful relapse.