Surface-Enhanced Raman Scattering (SERS) Substrates Based on Ag-Nanoparticles and Ag-Nanoparticles/Poly (methyl methacrylate) Composites.

SERS substrates formed by spherical silver nanoparticles (Ag-NPs) with a 15 nm average diameter adsorbed on Si substrate at three different concentrations and Ag/PMMA composites formed by an opal of PMMA microspheres of 298 nm average diameter were synthesized. The Ag-NPs were varied at three different concentrations. We have observed from SEM micrographs, in the Ag/PMMA composites, the periodicity of the PMMA opals is slightly altered as the Ag-NP concentration is increased; as a consequence of this effect, the PBGs maxima shift toward longer wavelengths, decrease in intensity, and broaden as the Ag-NP concentration is increased in the composites. The performance of single Ag-NP and Ag/PMMA composites as SERS substrates was determined using methylene blue (MB) as a probe molecule with concentrations in the range of 0.5 µM to 2.5 µM. We found that in both single Ag-NP and Ag/PMMA composites as SERS substrates, the enhancement factor (EF) increases as the Ag-NP concentration is increased. We highlight that the SERS substrate with the highest concentration of Ag-NPs has the highest EF due to the formation of metallic clusters on the surface, which generates more "hot spots". The comparison of the EFs of the single Ag-NP with those of Ag/PMMA composite SERS substrates shows that the EFs of the former are nearly 10-fold higher than those of Ag/PMMA composites. This result is obtained probably due to the porosity of the PMMA microspheres that decreases the local electric field strength. Furthermore, PMMA exerts a shielding effect that affects the optical efficiency of Ag-NPs. Moreover, the metal-dielectric surface interaction contributes to the decrease in the EF. Other aspect to consider in our results is in relation to the difference in the EF of the Ag/PMMA composite and Ag-NP SERS substrates and is due to the existing mismatch between the frequency range of the PMMA opal stop band and the LSPR frequency range of the Ag metal nanoparticles adsorbed on the PMMA opal host matrix.

Leukocyte Nuclear Morphology Alterations in Dilated Cardiomyopathy Caused by a Lamin AC Truncating Mutation (LMNA/Ser431*) Are Modified by the Presence of a LAP2 Missense Polymorphism (TMPO/Arg690Cys).

The clinical phenotype of LMNA-associated dilated cardiomyopathy (DCM) varies even among individuals who share the same mutation. LMNA encodes lamin AC, which interacts with the lamin-associated protein 2 alpha (LAP2α) encoded by the TMPO gene. The LAP2α/Arg690Cys polymorphism is frequent in Latin America and was previously found to disrupt LAP2α-Lamin AC interactions in vitro. We identified a DCM patient heterozygous for both a lamin AC truncating mutation (Ser431*) and the LAP2α/Arg690Cys polymorphism. We performed protein modeling and docking experiments, and used confocal microscopy to compare leukocyte nuclear morphology among family members with different genotype combinations (wild type, LAP2α Arg690Cys heterozygous, lamin AC/Ser431* heterozygous, and LAP2α Arg690Cys/lamin AC Ser431* double heterozygous). Protein modeling predicted that 690Cys destabilizes the LAP2α homodimer and impairs lamin AC-LAP2α docking. Lamin AC-deficient nuclei (Ser431* heterozygous) showed characteristic blebs and invaginations, significantly decreased nuclear area, and increased elongation, while LAP2α/Arg690Cys heterozygous nuclei showed a lower perimeter and higher circularity than wild-type nuclei. LAP2α Arg690Cys apparently attenuated the effect of LMNA Ser431* on the nuclear area and fully compensated for its effect on nuclear circularity. Altogether, the data suggest that LAP2α/Arg690Cys may be one of the many factors contributing to phenotype variation of LMNA-associated DCM.

Descripción de las características de los incidentes clínicos reportados en el año 2020 al sistema de reporte voluntario de un hospital pediátrico de Costa Rica / Description of the characteristics of the clinical incidents reported in 2020 to the voluntary reporting system of a pediatric hospital in Costa Rica

El objetivo del presente manuscrito fue describir los incidentes clínicos que fueron enviados al sistema de reporte voluntario durante el año 2020, que funciona en el Hospital Nacional de Niños de Costa Rica, perteneciente a la Caja Costarricense de Seguro Social. Se realizó un estudio observacional descriptivo de los datos consolidados que se enviaron durante los meses de enero a diciembre del año 2020. Durante el año 2020 el 1,6% de los pacientes atendidos en el hospital experimentó algún tipo de incidente clínico. El total de egresos disminuyó un 38,4% en comparación con los egresos del año 2019, sin embargo, los incidentes clínicos reportados aumentaron en el año 2020 un 37,6%, especialmente a partir del mes de agosto. No se reportaron eventos centinela en este año. Los servicios que realizaron mayor cantidad de reportes fueron Cuidados Intensivos (14,3%), Cirugía General (12%), Neonatología (9,8%) e Infectología (9%). El día en el cual se reportaron más incidentes fue el miércoles (27,8%), en el primer turno hospitalario se reportaron la mayoría de los casos (48,1%) y estos incidentes ocurrieron predominantemente a individuos masculinos (66%). Respecto de la edad de los pacientes, la mayoría estuvo en el rango de edad de 1 año a menos de 5 años (36,1%), seguido por el rango de edad de mayores de 29 días a menores de 1 año (24,1%). La mayor parte de los casos estuvieron relacionados con el cuidado que se brindaba al paciente (63,9%). El 41,4% de los incidentes requirieron medidas clínicas pero las secuelas fueron transitorias. El 51,1% de los casos ameritó algún tipo de cuidado médico adicional a su esquema terapéutico al ingreso. El 96% de los incidentes clínicos fueron reportados por personal de enfermería. La mayoría de los incidentes clínicos (35,3 %) en este período fueron errores relacionados con notas en el expediente digital.

The objective of this manuscript was to describe the clinical incidents that were sent to the voluntary reporting system during 2020 at the National Children's Hospital of Costa Rica, belonging to the Costa Rican Social Security Fund.A descriptive observational study of the consolidated data that was sent during the months of January to December of the year 2020 was carried out.During 2020, 1.6% of the patients treated in the hospital experienced some type of clinical incident. The total discharges decreased by 38.4% compared to the discharges of the year 2019, however, the reported clinical incidents increased in the year 2020 by 37.6%, especially from the month of August. Sentinel events were not reported this year. The services that made the highest number of reports were Intensive Care (14.3%), General Surgery (12%), Neonatology (9.8%) and Infectiology (9%). The day on which the most incidents were reported was Wednesday (27.8%), in the first hospital shift most of the cases were reported (48.1%) and these incidents occurred predominantly to male individuals (66%). Regarding the age of the patients, the majority were in the age range from 1 year to less than 5 years (36.1%), followed by the age range from over 29 days to under 1 year (24, 1%). Most of the cases were related to the care provided to the patient (63.9%). 41.4% of the incidents required clinical measures but the sequelae were transitory. 51.1% of the cases merited some type of additional medical care to their therapeutic scheme upon admission. 96% of clinical incidents were reported by nursing staff. Most of the clinical incidents (35.3%) in this period were errors related to notes in the digital file.

Synthesis and Study of the Optical Properties of PMMA Microspheres and Opals.

Polymethylmethacrylate (PMMA) microspheres were synthesized by surfactant-free emulsion polymerization. These microspheres were used to obtain opals by the self-assembly method. Monomer and initiator quantities were varied systematically to monitor the size of PMMA microspheres. From SEM and DLS measurements, a trend was observed showing as the monomer and initiator amounts increased the average diameter of PMMA microspheres increased except when a minimum monomer amount was reached, for which the size of the microspheres remained practically constant. Diffuse reflectance spectra were processed by the Kubelka-Munk treatment to estimate the energy band gap (Eg) of the PMMA microspheres. It was found that PMMA microspheres present an indirect transition. From SEM micrographs, it is seen that PMMA opals photonic crystals are formed by microspheres in a uniform periodic face-centered cubic (fcc) array. Variable-angle specular reflectance spectra show that the opals possess a pseudo photonic band gap (PBG) in the visible and near-IR regions. Furthermore, it was found that PBGs shift towards larger wavelengths as the average diameter of the PMMA microspheres increases.

Homozygous Fukutin Missense Mutation in Two Mexican Siblings with Dilated Cardiomyopathy

ABSTRACT Background: Fukuyama congenital muscular dystrophy (FCMD) is the most common form of a group of autosomal recessive disorders characterized by altered α-dystroglycan glycosylation and caused by FKTN gene mutations. However, mutations of this gene may cause a broad range of phenotypes, including Walker-Warburg syndrome, muscle-brain-eye disease, FCMD, limb-girdle muscular dystrophy without mental retardation, and cardiomyopathy with no or minimal skeletal muscle weakness. Objective: Our purpose was to describe two siblings who died at a young age with dilated cardiomyopathy (DCM), no muscle weakness, or atrophy, and were homozygous for a FKTN missense mutation. Methods: Site-directed next-generation sequencing (NGS) was performed. Pathogenicity of variants of interest was established according to the American College of Medical Genetics (ACMG) criteria, and all available first-degree relatives were screened for mutations by Sanger sequencing. Results: NGS revealed a homozygous FKTN variant in the index case (p.Gly424Ser, rs752358445), classified as likely pathogenic by ACMG criteria. Both parents and an unaffected brother were heterozygous carriers. Since the siblings had no apparent skeletal muscle weakness or central nervous system involvement, FKTN mutations were not initially suspected. Conclusions: This is the first report demonstrating that heterozygous individuals for the FKTN p.Gly424Ser mutation were healthy, while two homozygous brothers suffered severe DCM, strongly suggesting that this FKTN mutation is a rare cause of autosomal recessive DCM.

Effectiveness and Safety of Extracorporeal Shockwave Myocardial Revascularization in Patients With Refractory Angina Pectoris and Heart Failure.

Extracorporeal shockwave myocardial revascularization (ESMR) is a therapy for refractory angina pectoris. Our aim was to assess the efficacy and safety of ESMR in the management of patients with stable coronary artery disease (CAD) and heart failure as well as its effects on inflammation and angiogenesis. In this single-arm prospective trial, we included 48 patients with CAD, myocardial ischemia assessed by radionuclide imaging, echocardiographic evidence of left ventricular systolic dysfunction and without revascularization options. Changes in angina grading score, myocardial perfusion, left ventricular ejection fraction, and six-minute walk test after ESMR therapy were used for efficacy assessment. Changes of inflammation and angiogenesis biomarkers were also evaluated. ESMR therapy was performed using a commercially available cardiac shockwave generator system (Cardiospec; Medispec). After 9 weeks of ESMR therapy, a significant improvement was found regarding the initial angina class, severity of ischemia, left ventricular ejection fraction, and six-minute walk test in most patients. No deleterious side effects after treatment were detected. Regarding biomarkers, endothelial progenitor cells and angiopoietin-3 were significantly increased whereas IL-18 and TGF-ß were significantly decreased after ESMR in the total group. Notably, VEGF, IL-1ß, and lipoxin A4 levels were significantly increased only in patients with myocardial ischemia improvement. In conclusion, ESMR therapy is safe and effective in most but not all patients with CAD and heart failure. ESMR is associated with increased markers of angiogenesis and decreased markers of inflammation. Myocardial ischemia improvement after ESMR is associated with increased markers of angiogenesis and pro-resolving mediators.

Homozygous Fukutin Missense Mutation in Two Mexican Siblings with Dilated Cardiomyopathy.

BACKGROUND: Fukuyama congenital muscular dystrophy (FCMD) is the most common form of a group of autosomal recessive disorders characterized by altered α-dystroglycan glycosylation and caused by FKTN gene mutations. However, mutations of this gene may cause a broad range of phenotypes, including Walker-Warburg syndrome, muscle-brain-eye disease, FCMD, limbgirdle muscular dystrophy without mental retardation, and cardiomyopathy with no or minimal skeletal muscle weakness. OBJECTIVE: Our purpose was to describe two siblings who died at a young age with dilated cardiomyopathy (DCM), no muscle weakness, or atrophy, and were homozygous for a FKTN missense mutation. METHODS: Site-directed next-generation sequencing (NGS) was performed. Pathogenicity of variants of interest was established according to the American College of Medical Genetics (ACMG) criteria, and all available first-degree relatives were screened for mutations by Sanger sequencing. RESULTS: NGS revealed a homozygous FKTN variant in the index case (p.Gly424Ser, rs752358445), classified as likely pathogenic by ACMG criteria. Both parents and an unaffected brother were heterozygous carriers. Since the siblings had no apparent skeletal muscle weakness or central nervous system involvement, FKTN mutations were not initially suspected. CONCLUSIONS: This is the first report demonstrating that heterozygous individuals for the FKTN p.Gly424Ser mutation were healthy, while two homozygous brothers suffered severe DCM, strongly suggesting that this FKTN mutation is a rare cause of autosomal recessive DCM.

Genomic study of dilated cardiomyopathy in a group of Mexican patients using site-directed next generation sequencing.

BACKGROUND: Dilated cardiomyopathy (DCM) is a major cause of nonischemic heart failure and death in young adults. Next generation sequencing (NGS) has become part of the diagnostic workup in idiopathic and familial DCM. More than 50 DCM genes have been identified, revealing great molecular heterogeneity and variable diagnostic yield. Interpretation of variant pathogenicity is challenging particularly in underrepresented populations, as pathogenic variant databases include studies mainly from European/Caucasian populations. To date, no studies on genomic diagnosis of DCM have been conducted in Mexico. METHODS: We recruited 55 unrelated DCM patients, 22 familial (F-DCM), and 33 idiopathic (I-DCM), and performed site-directed NGS seeking causal mutations. Diagnostic yield was defined as the proportion of individuals with at least one pathogenic (P) or likely pathogenic (LP) variant in DCM genes. RESULTS: Overall diagnostic yield was 47.3%, and higher in F-DCM (63.6%) than in I-DCM (36.4%, p = 0.047). Overall, NGS disclosed 41 variants of clinical interest (61.0% novel), 27 were classified as P/LP and 14 of unknown clinical significance. Of P/LP variants, 10 were A-band region TTN truncating variants, five were found in DSP (18.5%), five in MYH7 (18.5%), two in LMNA (7.4%), and one in RBM20, ABCC9, FKTN, ACTA1, and TNNT2. NGS findings suggested autosomal recessive inheritance in three families, two with DSP loss of function mutations in affected individuals. The increasing number of mutation reports in DCM, increasing knowledge on the functional consequences of mutations, mutational hotspots and functional domains of DCM-related proteins, the recent refinement ACMG/ClinGen Guidelines, and co-segregation analysis in DCM families helped increase the diagnostic yield. CONCLUSION: This is the first NGS study performed in a group of Mexican DCM patients, contributing to understand the mutational spectrum and complexity of DCM molecular diagnosis.

Recomendaciones sanitarias a los centros de salud para la seguridad del paciente en la pandemia por COVid-19: herramienta educativa subvalorada / Sanitary recommendations in health centers for patient safety in the COVID-19 pandemic: undervalued educational tool

Se presentan medidas preventivas (recomendaciones) basadas en la educación sanitaria que influirían en un mejor manejo de la seguridad de los pacientes en la pandemia de COVID-19. En este artículo se hace hincapié en la revalorización de la educación sanitaria con el fin de fortalecer la concientización en los profesionales de la salud y la población.

Preventive measures (recommendations) based on health education that would influence a better management of patient safety in the COVID-19 pandemic are presented. In this paper, emphasis is placed on the revaluation of health education in order to strengthen awareness among health professionals and the population.

Decavanadate Salts of Cytosine and Metformin: A Combined Experimental-Theoretical Study of Potential Metallodrugs Against Diabetes and Cancer.

Cytosine, a DNA and RNA building-block, and Metformin, the most widely prescribed drug for the treatment of Type 2 Diabetes mellitus were made to react separately with ammonium or sodium metavanadates in acidic aqueous solutions to obtain two polyoxovanadate salts with a 6:1 ratio of cation-anion. Thus, compounds [HCyt]6[V10O28]·4H2O, 1 and [HMetf]6[V10O28]·6H2O, 2 (where HCyt = Cytosinium cation, [C4H6N3O]+ and HMetf = Metforminium cation, [C4H12N5]+) were obtained and characterized by elemental analysis, single crystal X-ray diffraction, vibrational spectroscopy (IR and Raman), solution 51V-NMR, thermogravimetric analysis (TGA-DTGA), as well as, theoretical methods. Both compounds crystallized in P 1 ¯   space group with Z' = 1/2, where the anionic charge of the centrosymmetric ion [V10O28]6- is balanced by six Cytosinium and six Metforminium counterions, respectively. Compound 1 is stabilized by π-π stacking interactions coming from the aromatic rings of HCyt cations, as denoted by close contacts of 3.63 Å. On the other hand, guanidinium moieties from the non-planar HMetf in Compound 2 interact with decavanadate µ2-O atoms via N-H···O hydrogen bonds. The vibrational spectroscopic data of both IR and Raman spectra show that the dominant bands in the 1000-450 cm-1 range are due to the symmetric and asymmetric ν(V-O) vibrational modes. In solution, 51V-NMR experiments of both compounds show that polyoxovanadate species are progressively transformed into the monomeric, dimeric and tetrameric oxovanadates. The thermal stability behavior suggests a similar molecular mechanism regarding the loss of water molecules and the decomposition of the organic counterions. Yet, no changes were observed in the TGA range of 540-580°C due to the stability of the [V10O28]6- fragment. Dispersion-corrected density functional theory (DFT-D) calculations were carried out to model the compounds in aqueous phase using a polarized continuum model calculation. Optimized structures were obtained and the main non-covalent interactions were characterized. Biological activities of these compounds are also under investigation. The combination of two therapeutic agents opens up a window toward the generation of potential metalopharmaceuticals with new and exciting pharmacological properties.

Cross-cultural validation of the Prosthesis Evaluation Questionnaire in vascular amputees fitted with prostheses in Spain.

BACKGROUND: The lack of specific prosthetic-related outcome instruments for Spanish amputees must be addressed. OBJECTIVE: To elaborate a culturally equivalent version of the Prosthesis Evaluation Questionnaire in the Spanish language. STUDY DESIGN: Cross-cultural questionnaire validation. METHODS: Two-step process for cultural adaptation: forward and backward translations of English original and Spanish translated versions; assessment of both construct and criterion validity and reliability in a group of vascular amputees. RESULTS: A total of 61 patients were recruited, 44 men (72.1%) and 17 women (27.9%), with a median age of 71.1 years (standard deviation: 7.7 years; range: 51-87 years). In the Prosthesis Evaluation Questionnaire-Spanish, the lowest scores were for gait and frustration, and the highest scores were for noise and stump health. Internal consistency of the questionnaire was acceptable (>0.70) for four of the scales used in the Prosthesis Evaluation Questionnaire but poor (<0.50) for the scales relating to appearance and stump health. Correlations with the quality-of-life levels as measured by the Short Form-36 were positive and mostly significant. CONCLUSION: Prosthesis Evaluation Questionnaire-Spanish could assess the quality of life in patients who have undergone vascular amputations and then been fitted with a prosthetic limb. The questionnaire shows adequate criteria validity when compared with other instruments for measuring quality of life. CLINICAL RELEVANCE: The Prosthesis Evaluation Questionnaire-Spanish could be a valid and reliable instrument for assessing adaptation to prostheses in vascular amputees. The questionnaire adds information relevant to the patient and the physician and may identify cases with poor expected adaptation to the prosthesis.

Fe effect on the optical properties of TiO2:Fe2O3 nanostructured composites supported on SiO2 microsphere assemblies.

The effect of Fe ion concentration on the morphological, structural, and optical properties of TiO2 films supported on silica (SiO2) opals has been studied. TiO2:Fe2O3 films were prepared by the sol-gel method in combination with a vertical dip coating procedure; precursor solutions of Ti and Fe were deposited on a monolayer of SiO2 opals previously deposited on a glass substrate by the same procedure. After the dip coating process has been carried out, the samples were thermally treated to obtain the TiO2:Fe2O3/SiO2 composites at the Fe ion concentrations of 1, 3, and 5 wt%. Scanning electron microscopy (SEM) micrographs show the formation of colloidal silica microspheres of about 50 nm diameter autoensembled in a hexagonal close-packed fashion. Although the X-ray diffractograms show no significant effect of Fe ion concentration on the crystal structure of TiO2, the µ-Raman and reflectance spectra do show that the intensity of a phonon vibration mode and the energy bandgap of TiO2 decrease as the Fe(+3) ion concentration increases.

Intravesical migration and spontaneous expulsion of a Hem-o-lok polymer ligating clip after laparoscopic radical prostatectomy.

We present a rare postoperative complication occurring after a laparoscopic radical prostatectomy with nerve-sparing procedure carried out with the placement of 3 Weck Hem-o-lok-L clips in the right neurovascular bundle, in a patient with clinically localized prostate cancer. The procedure was completed without any complications and the urethral catheter was removal at 15 days. We report a case of intravesical migration and subsequent calculus formation with spontaneous expulsion of Hem-o-lok clip. To date, this is the only reported case of intravesical migration and subsequent calculus formation with a spontaneous expulsion.

[Perioperative morbidity of radical prostatectomy in patients over 70 years of age]. / Morbilidad perioperatoria de la prostatectomía radical en pacientes mayores de 70 años.

INTRODUCTION: Increased life expectancy has made possible radical treatment of localized prostate cancer in patients over 70 years of age. Perioperative morbidity of radical prostatectomy in elderly patients depending on surgical procedure has not been adequately analyzed. OBJECTIVES: To comparatively analyze the incidence, severity, and management of perioperative complications of retropubic versus laparoscopic radical prostatectomy in patients older than 70 years. MATERIAL AND METHODS: A retrospective review was made of 68 patients over 70 years of age (of whom 42 underwent retropubic and 26 laparoscopic radical prostatectomy) taken from a series of 500 patients. The modified Clavien classification was used to study complications from both surgical procedures. RESULTS: The overall complication rate was 59.5% for the retropubic and 23% for the laparoscopic procedure (P=.003). Three grade I, 2 grade Id, 19 grade II, and 1 grade IId complications were seen with retropubic surgery, as compared to 2 grade I and 5 grade Id complications with the laparoscopic procedure. The most common complications included intraoperative bleeding (38%) and urinaryi fistula (15%) respectively. CONCLUSIONS: Radical prostatectomy is a procedure that is not free from complications in patients older than 70 years, though these are usually mild. The advantages usually attributed to laparoscopy also apply to elderly patients, and should therefore be considered as the procedure of choice.

Morbilidad perioperatoria de la prostatectomía radical en pacientes mayores de 70 años / Perioperative morbidity of radical prostatectomy in patients over 70 years of age

Introducción: Debido al incremento en la esperanza de vida, es posible el tratamiento radical del cáncer de próstata en pacientes mayores de 70 años. Se ha analizado poco la morbilidad perioperatoria de la prostatectomía radical en pacientes de edad avanzada en función de la técnica quirúrgica. Objetivos: Analizar la incidencia, la severidad y el manejo de las complicaciones perioperatorias de la prostatectomía radical en mayores de 70 años en función de la técnica quirúrgica, retropúbica o laparoscópica. Material y métodos: De una serie de 500 pacientes se revisa, retrospectivamente, a 68 mayores de 70 años (42 retropúbica frente a 26 laparoscópica). Empleamos la clasificación de Clavien modificada para estudiar las complicaciones de ambas técnicas quirúrgicas. Resultados: La tasa de complicaciones globales en la retropúbica fue del 59,5% y en la laparoscópica de 23% (p = 0,003). En la retropúbica se observaron 3 complicaciones de grado I, 2de grado Id, 19 de grado II y 1 de grado II d, mientras que en la laparoscópica se observaron2 de grado I y 5 de grado Id. Las complicaciones más frecuentes fueron el sangrado intraoperatorio (38%) y la fuga urinaria (15%), respectivamente. Conclusiones: La prostatectomía radical es una técnica no exenta de complicaciones, casi siempre leves, en pacientes mayores de 70 años. Las ventajas generalmente atribuidas a la laparoscopia se mantienen en los pacientes de edad avanzada, por lo que la consideramos la técnica de elección (AU)

Introduction: Increased life expectancy has made possible radical treatment of localized prostate cancer in patients over 70 years of age. Perioperative morbidity of radical prostatectomy in elderly patients depending on surgical procedure has not been adequately analyzed. Objectives: To comparatively analyze the incidence, severity, and management of perioperative complications of retropubic versus laparoscopic radical prostatectomy inpatients older than 70 years. Material and methods: A retrospective review was made of 68 patients over 70 years of age (of whom 42 underwent retropubic and 26 laparoscopic radical prostatectomy) taken from a series of 500 patients. The modified Clavien classification was used to study complications from both surgical procedures. Results: The overall complication rate was 59.5% for the retropubic and 23% for the laparoscopic procedure (P=0.003). Three grade I, 2 grade Id, 19 grade II, and 1 grade IId complications were seen with retropubic surgery, as compared to 2 grade I and 5 grade Id complications with the laparoscopic procedure. The most common complications included intraoperative bleeding (38%) and urinary fistula (15%) respectively. Conclusions: Radical prostatectomy is a procedure that is not free from complications in patients older than 70 years, though these are usually mild. The advantages usually attributed to laparoscopy also apply to elderly patients, and should therefore be considered as the procedure of choice (AU)

[The impact of statins use in clinically localized prostate cancer treated with radical prostatectomy]. / Influencia del empleo de estatinas en el cáncer de próstata clínicamente localizado tratado con prostatectomía radical.

INTRODUCTION: Use of statins has been associated with reduced risk, progression and mortality of some tumors, including prostate cancer (CaP). According to recent Studies, long-term treatment with statins significantly reduces the risk of PC and also confers a protective effect against advanced or aggressive CaP. However, there is no conclusive data regarding the potential effect on patients diagnosed with clinically localized CaP undergoing radical treatment. MATERIALS AND METHODS: A retrospective study was performed in a cohort of 250 patients that did not undergo screening and diagnosis in clinical practice of localized CaP (T1c-T2cNxM0). All patients were treated with radical prostatectomy between 2001 and 2008. Data about clinical and pathological findings, and also the existence of dyslipemia as well as treatment with statins for at least 5 years was collected and analyzed. A logistic regression analysis was performed to determine the independent predictive variables related with a more favorable pathology. RESULTS: In our study, we found a relationship, using a univariate analysis, between treatment with statins and the presence of insignificant carcinoma in the group with low or intermediate risk of recurrence. However, this relationship is not independent when we applied a multivariate analysis. DISCUSSION: Hypothesis about the potential effect of the statins preventing or inhibiting the development of high risk CaP needs to be proven applying specific clinical trials designed for this purpose. There isn't conclusive data that demonstrate that statins lower the risk of development of potentially lethal high grade CaP.