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BACKGROUND AND AIMS: Oxaliplatin (OX) has been described as a potential etiologic agent for porto-sinusoidal vascular disorder (PSVD). Our aim was to describe the natural history of PSVD due to OX in colon cancer (CRC) and identify risk factors for its development. METHODS: We made a multicenter retrospective case-control (ratio 1:3) study with patients diagnosed of PSVD-OX. Baseline data, end of treatment, years of follow-up and diagnosis of PSVD were collected and compared to controls (without PSVD). Besides, 16 different SNPs were selected from bibliography and analyzed by genotyping in the case group to identify potential genetic risk factors. RESULTS: 41 cases were identified, with a median time to PSVD diagnosis after the end of OX of 34 months. Spleen diameter was the strongest predictor of PSVD during treatment (OR 43.94 (14.48-133.336); p < 0.0001). Additionally, thrombocytopenia (<150 × 10^9) at one year was a significant disease risk marker (OR 9.35; 95% CI: 3.71-23.58; p = 0.001). We could not establish any significant association between the selected SNPs and PSVD diagnosis. CONCLUSION: The increase of spleen diameter is the strongest predictor of PSVD in patients treated with OX for CRC. These patients could be candidates for a specific follow-up of portal hypertension-related complications.
RESUMEN
INTRODUCCIÓN. La fotografía digital, la formación continuada a distancia y la universalización de internet son campos de gran proyección en la práctica habitual del médico de familia. OBJETIVO. Creación de una página web de acceso gratuito que ofrezca imágenes médicas de calidad en formato digital. MÉTODO. Se seleccionaron todas aquellas imágenes de la consulta susceptibles de ser de interés docente para el médico de familia. Se diseñó un circuito para la realización de fotografías digitales en dos Áreas Básicas de Salud y un hospital de referencia. Una vez obtenida una casuística importante de imágenes en formato JPEG, se diseñó la forma de la página, la política de privacidad, se buscó un servidor, se registró un dominio, y finalmente se colgó la página en red. RESULTADOS. Se ha creado una página con 1.200 imágenes médicas. Se han recibido más de 600.000 peticiones al servidor en un año, con visitas procedentes de España y varios países de habla hispana. Ha habido una transferencia media diaria de 17,15 megabytes. La mayor afluencia se realiza de martes a viernes (63% del total de visitas), siendo de 10 a 13 y de 15 a 19 las horas de más entradas. CONCLUSIONES. Se ha conseguido crear una página dinámica e interactiva que ofrece libremente múltiples imágenes de interés docente para el médico de familia
INTRODUCTION. Digital photography, correspondence continuous education and universalization of Internet are fields having great projection in the usual practice of the family doctor. OBJECTIVE. Creation of a free access web page that offers medical images of quality in digital format. METHOD. All those images of medical consultation that may have teaching interest for the family doctor were selected. A circuit to perform digital photographs in two basic health areas and a reference hospital were selected. Once an important casuistry of the images in JPEG format was obtained, the page form and privacy policy were designed, a server sought, a domain was registered and finally the page was up-loaded in the net. RESULTS. A page with 1200 medical images has been created. More than 600,000 requests have been received by the server in one year, with visits from Spain and several Spanish speaking countries. There has been a mean daily transference of 17.15 megabytes. The greatest number of visits is from Tuesday to Friday (63% of all the visits), 10 a.m. and 1 p.m. and 3 p.m. to 7 p.m. having the most visits. CONCLUSIONS. It has been possible to create a dynamic and interactive page that freely offers multiple images of teaching interest for the family doctor
