[Abdominal-pelvic actinomycosis with urinary tract involvement, secondary to gynecologic infection caused by intrauterine device]. / Actinomicosis abdominopélvica con afectación del aparato urinario, secundaria a infección ginecológica por dispositivo intrauterino.

Abdomino-pelvic actinomycosis is a condition caused by Actinomyces israelii, a Gram-positive opportunistic bacteria that triggers and develops the infection only in previously injured tissues, and then slowly progresses and spreads until it extrinsically affects the urinary tract. Use of an intrauterine device is a known risk factor to suffer from this disease. Relative risk in IUD users is two- to four-fold higher compared to IUD non-users. Risk increased with prolonged IUD use. Treatment is by removal of the causative agent, surgical resection of necrotic tissues and administration of intravenous Penicillin G, 4 million units every 4 hours for 30 days, followed by Amoxicillin 500 mg every 8 hours for 12 months. This paper contributes two cases of abdomino-pelvic actinomycosis with urinary tract involvement in IUD users. Standard treatment was employed with good evolution.

Actinomicosis abdominopélvica con afectación del aparato urinario, secundaria a infección ginecológica por dispositivo intrauterino / Abdomino-pelvic actinomycosis involving the urinary tract, secondary to iud-related gynaecological infection

La actinomicosis abdominopélvica es una enfermedad causada por el Actinomyces israelii, bacteria oportunista Gran positiva, que comienza y desarrolla la infección sólo en tejidos previamente lesionados, que progresa y se extiende lentamente hasta afectar extrínsecamente al aparato urinario. El dispositivo intrauterino es un factor de riesgo de padecer la enfermedad. Las mujeres con dispositivo intrauterino, tienen un riesgo de 2 a 4 veces mayor respecto a las que no lo usan y el riesgo aumenta con el tiempo de uso del mismo. El tratamiento consiste en eliminar la causa, resecar quirúrgicamente los tejidos necróticos y administrar Penicilina G intravenosa, 4 millones de unidades cada 4 horas, durante 30 días, seguida de 500 mg de Amoxicilina oral cada 8 horas durante 12 meses. Presentamos dos casos de actinomicosis abdominopélvica con afectación del aparato urinario, en mujeres portadoras de dispositivos intrauterinos. El tratamiento fue el estándar, con buena evolución (AU)

[Prevention of superficial bladder cancer with mitomycin C or interferon: final results of a prospective study]. / Profilaxis del cáncer superficial de vejiga con Mitomicina C o Interferón: resultados definitivos de un estudio prospectivo.

OBJECTIVES: Herein we present the final results of a prospective randomized study comparing two prophylactic treatment modalities for superficial bladder tumors: chemotherapy with mitomycin C and immunotherapy with interferon. METHODS: The study comprised 65 patients. Mitomycin C was utilized in 34 and interferon in 31 patients. RESULTS: The mitomycin C-treated patients had 41% recurrence, 1.7 recurrence/100 patients-month, 17 months mean time to recurrence and 8.8% tumor progression. The patients receiving interferon had 45% recurrence, 2.4 recurrence/100 patients-month, 12 months mean time to recurrence and 22.2% tumor progression rate. No significant differences were observed between the two groups of patients. Treatment was well-tolerated by both groups and the cost:efficacy ratio was higher for the interferon-treated patients. CONCLUSIONS: Immunoprophylaxis with interferon is as effective, but costs more than chemoprophylaxis with mitomycin C. Both agents have a moderate effect relative to control of recurrence, time to recurrence and tumor progression.