Linfoma no Hodgkin primario de mama: reporte de un caso / Primary non-Hodgkin lymphoma of the breast: a case report

El linfoma no Hodgkin primario de la mama es una patología poco frecuente, constituye menos del 0,5 por ciento de todos los tumores mamarios malignos, debido a que carecen de características propias, tanto clínicas, mamográficas como ultrasonográficas. Es difícil el diagnóstico preoperatorio, la citología mediante BAAF tiene mejor rendimiento que el estudio con material congelado ya que este último tiende a confundirse con el carcinoma. En la actualidad se prefiere el tratamiento con quimioterapia tanto para el tratamiento local como para el regional. Presentamos el caso de un linfoma no Hodgkin primario de la mama en una paciente de 72 años. (AU)

Primary non-Hodgkin lymphoma of the breast is a rare entity. It represents less than 0.5 percent of all breast cancer malignancies. No features at clinical presentation distinguish patients with lymphoma from those with carcinoma of the breast. There are both mammographic and sonographic difficulties to establish the preoperative diagnosis. Contemporary frozen sections can be mistaken with breast carcinoma. In this article we present a case of a primary non-Hodgkin lymphoma of the breast in 72 years old women.(AU)

Infecciones del tracto urinario bajo en adultos y embarazadas: consenso para el manejo empírico / Lower Urinary Tract Infections in Adults and Pregnant Women: A Consensus for Empirical Treatment

Introducción: La infección no complicada del tracto urinario bajo y la bacteriuria asintomática son causas frecuentes de consulta médica ambulatoria y en el servicio de urgencias en Colombia y el mundo. La falta de pautas y consenso para el manejo, así como la emergencia de resistencia a las múltiples opciones terapéuticas disponibles en los uropatógenos provenientes de la comunidad, hacen necesario elaborar unas recomendaciones que orienten al clínico sobre el abordaje óptimo de estas entidades. Objetivo: Definir un consenso sobre el manejo empírico de la bacteriuria asintomática y la infección del tracto urinario (ITU) bajo en adultos y mujeres embarazadas en Colombia. Metodología: Se lleva a cabo una metodología de consenso con expertos en urología, infectología, medicina interna, ginecología y microbiología basada en la revisión de las referencias bibliográficas disponibles en los términos de búsqueda relacionados, haciendo énfasis en estudios locales. Resultados: Se elaboró un algoritmo de manejo para el tratamiento empírico de la ITU baja no complicada en adultos con antisépticos urinarios como nitrofurantoína y fosfomicina trometamol como primera línea, con recomendaciones terapéuticas específicas para el tratamiento de la bacteriuria asintomática en mujeres embarazadas. Adicionalmente, se formuló un algoritmo de decisión para el procesamiento de cultivos de orina. La recurrencia o recaída frecuente justifica remisión a urología e infectología. Conclusiones: Se generan recomendaciones prácticas de fácil implementación en el diagnóstico y manejo de la ITU bajo en adultos y embarazadas, y de los casos donde es necesario tratar la bacteriuria asintomática, con opciones terapéuticas efectivas y de espectro reducido.

Background: Uncomplicated infection of the lower urinary tract and asymptomatic bacteriuria are frequent causes of visits to outpatient clinics and emergency departments in Colombia and worldwide. The lack of guidelines and a consensus for their management, and the emergence of resistance of community-based uropathogens to the available therapeutic options, make it necessary to develop recommendations to guide clinicians on the optimal approach to these entities. Objective: Define a consensus for the empiric management of asymptomatic bacteriuria and Urinary Tract Infection (UTI) in adults and pregnant women in Colombia. Methods: We carried out a consensus methodology with experts in urology, infectious diseases, internal medicine, gynecology and clinical microbiology; based on reviewing the available literature on the related terms, and emphasizing local studies. Results: We developed a management algorithm for the empirical treatment of uncomplicated lower UTI in adults with urinary antiseptics such as nitrofurantoin and fosfomycin trometamol as first line, with specific therapeutic recommendations for the treatment of asymptomatic bacteriuria in pregnant women. Additionally, we created a decision algorithm for processing urine cultures. Frequent recurrence or relapse justifies referral to urology and infectious disease professionals. Conclusions: We generated straightforward and easy-to-implement recommendations for the diagnosis and management of UTI in adults and pregnant women, and in cases where it is necessary to treat asymptomatic bacteriuria, with effective therapeutic and narrow spectrum options.

Etiología y factores de riesgo en una muestra de 200 pacientes consecutivos con insuficiencia cardiaca / Etiology and risk factors in a serie of 200 consecutive patients with heart failure

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[Colchicine treatment for recurrent pericarditis]. / Tratamiento con colchicina de la pericarditis recidivante.

The treatment of the recurrent pericarditis is difficult habitually. The colchicine, antiinflammatory drug used in gouty arthritis, is effective in preventing the recurrences of acute pericarditis. We review the literature about the efficacy of colchicine in the prevention of recurrent pericarditis.

[Primary cardiac tumors: a review of 29 cases]. / Tumores cardíacos primários: revisión de 29 casos.

A series of 29 cardiac tumors were operated in Asturias Central Hospital between 1974 and 1994. There were 23 benign and 6 malignant tumors. Among the benign neoplasms, 22 were myxomas and 1 lipoma; there were 6 remalignant tumors, one pulmonary artery sarcoma, two rhabdomyosarcoma, one mesothelioma and two lymphomas. We review the clinical findings of these patients. Long-term results were excellent in patients with benign lesions, and only one recurrence was found. In patients with malignant tumors, surgical procedures were only palliative and aimed at prolonging life; hence, prognosis remained unchanged.

[Reversible dilated cardiomyopathy and hyperthyroidism]. / Miocardiopatía dilatada reversible e hipertiroidismo.

Thyrotoxicosis may precipitate atrial fibrillation, myocardial ischemia or heart failure if underlying heart disease is present. However, reversible dilated cardiomyopathy is rare. We report a case of a 51-year-old man with thyrotoxicosis and dilated cardiomyopathy that was reversed with antithyroid treatment.

[Primary pulmonary hypertension]. / Hipertensión pulmonar primaria.

Primary pulmonary hypertension is defined as pulmonary arterial hypertension of unknown cause. It's a diagnosis made by exclusion; all recognizable causes of pulmonary hypertension must be ruled out before the diagnosis of primary pulmonary hypertension can be made. The prognosis is poor for medical management. Recently, with the advent first of heart-lung transplantation and then of single-lung transplantation the therapeutic options have increased considerably. We discuss the characteristics of this disease and we review the literature.