Radiology volunteers to support a breast cancer screening program in Peru: Description of the project, preliminary results, and impressions.

Breast cancer is the second most common cancer in Peruvian women. Due to limitations in national breast cancer screening programs, especially in rural areas, more than 50% of cases of breast cancer in Peru are diagnosed in advanced stages. In collaboration with a local clinic registered as a nongovernmental organization (CerviCusco), RAD-AID International aims to create a sustainable diagnostic structure to improve breast cancer screening in Cuzco. With the support of local, national, and international partners that have collaborated in analyzing radiological resources, raising awareness in the population, acquiring equipment, training clinical staff, and building referral networks, our teams of radiologists, included in the RAD-AID team, have participated in training CerviCusco staff in breast ultrasound, thus enabling additional training for radiology residents through a regulated international collaboration.

Radiology volunteers to support a breast cancer screening program in Peru: description of the project, preliminary results, and impressions. / Voluntariado radiológico para apoyar un programa de detección precoz del cáncer de mama en Perú: descripción del proyecto, presentación de los primeros resultados e impresiones.

Breast cancer is the second most common cancer in Peruvian women. Due to limitations in national breast cancer screening programs, especially in rural areas, more than 50% of cases of breast cancer in Peru are diagnosed in advanced stages. In collaboration with a local clinic registered as a nongovernmental organization (CerviCusco), RAD-AID International aims to create a sustainable diagnostic structure to improve breast cancer screening in Cuzco. With the support of local, national, and international partners that have collaborated in analyzing radiological resources, raising awareness in the population, acquiring equipment, training clinical staff, and building referral networks, our teams of radiologists, included in the RAD-AID team, have participated in training CerviCusco staff in breast ultrasound, thus enabling additional training for radiology residents through a regulated international collaboration.

Queratoacantoma de vulva: presentación de un caso / Vulvar keratoacanthoma: presentation of a case

El queratoacantoma de vulva es una entidad rara que podría presentar confusión en su diagnóstico con el carcinoma bien diferenciado de células escamosas. Presentamos un caso de una paciente con diagnóstico de queratoacantoma de vulva tratada con resección quirúrgica de la lesión y su seguimiento posterior.

Vulvar keratoacanthoma is a rare disease that may present confusion in diagnosis with well differentiated squamous cell carcinoma. We report one patient with vulvar keratoacanthoma, treated by resection surgery of the lesion and her outcome.

Tumores virilizantes del ovario: presentación de dos casos manejados mediante cirugía por monopuerto / Virilizing tumors of the ovary: presentation of two cases managed by single-port surgery

Los tumores virilizantes, corresponden al 1% de todos los tumores funcionales del ovario. Estos tipos de tumores virilizantes se originan de las células pluri-potenciales del estroma ovárico, tienen la capacidad de secretar 17-hidroxiprogesterona, testosterona y androstenediona, desencadenando hiperandrogenismo clínico. Son catalogados como de bajo potencial maligno, con un patrón de crecimiento lento, bien diferenciados, diagnosticados en su mayoría en estadío I y II, de buen pronóstico y típicos de mujeres en edad reproductiva. El objetivo de esta comunicación es presentar dos casos clínicos con diagnóstico de tumor virilizante de ovario, tratadas con cirugía laparoscópica por mono puerto.

Virilizing tumors, corresponding to 1% of all functional ovarian tumors. Those type of virilizing tumors originate from pluripotential ovarian stromal cells and have the capacity to secrete 17-hydroxyprogesterone, testosterone and androstenedione, triggering clinical hyperandrogenism. They are classified as low malignant potential, well differentiated, with a pattern of slow growth, mostly diagnosed in stage I and II, with good prognosis and typical of women of reproductive age. The aim of this paper is to present two cases of virilizing ovarian tumor treated by mono port laparoscopic surgery.

Priapismo de bajo flujo convertido en priapismo de alto flujo por fístula arterio-lacunar secundaria a la técnica de Winter / Low-flow priapism developing to high-flow priapism by arterial-lacunar fistula secondary to the winter procedure

El priapismo es una afección patológica que consiste en una erección peneana persistente más allá de la estimulación sexual. Presentamos el caso de un paciente de 80 años, diagnosticado inicialmente, por la historia clínica, valores gasométricos de los cuerpos cavernosos y ultrasonografía doppler color peneana, de priapismo de bajo flujo que durante la realización de la técnica de Winter se produce iatrogénicamente la laceración bilateral de las arterias dorsales, originando una fístula arteriolacunar y en consecuencia un priapismo de alto flujo. Se realizó arteriografía selectiva de la pudenda, al no ser la eco-doppler color concluyente, que puso de manifiesto dicha fístula y permitió la embolización supraselectiva con microcoils...

Priapism is a pathology consisting of prolonged penile erection unrelated to sexual stimulation. We present an 80-year-old patient with relevant clinical history; corpora cavernosa blood gas analysis and penile Doppler ultrasound examination confirmed low-flow priapism. The Winter procedure was performed, which provoked iatrogenic laceration of the dorsal artery, leading to an arterio-lacunar fistula and high-flow priapism. A second Doppler ultrasound was inconclusive, and so a selective angiography was performed to observe the pudendal artery, following which selective embolization with microcoils was carried out...

Abdominal radical trachelectomy for invasive cervical cancer: a case series and literature review.

OBJECTIVE: The objective of this study was to review our experience with abdominal radical trachelectomy in patients with early-stage cervical cancer. METHODS: We performed a retrospective review of all patients who underwent an abdominal radical trachelectomy at the Instituto de Cancerologia--Clinica las Americas in Medellin, Colombia, between April 2002 and January 2008. Data collected included age, stage, histopathologic subtype, tumor size, evidence of lymph-vascular space invasion, estimated blood loss, number of perioperative blood transfusions, number and disease status of lymph nodes removed, disease status of surgical specimen, length of hospital stay, intraoperative and postoperative complications, follow-up time, and fertility outcomes. RESULTS: Fifteen patients underwent an abdominal radical trachelectomy during the study period. The median patient age was 30 years (range, 25-38). Three patients had stage IA2 and 12 had stage IB1 cervical cancer. Eleven patients had squamous cell carcinoma and 4 had adenocarcinoma. Thirteen patients were diagnosed by cervical conization and 2 by colposcopically directed biopsy. All patients had tumors smaller than 2 cm. The median estimated blood loss was 400 ml (range, 200-1000). The median surgical time was 265 min (range, 210-330). The median number of units of packed red blood cells transfused per patient was 2. The median number of lymph nodes removed was 26 (range, 11-48). The median length of hospitalization was 3 days (range, 2-7). The median follow-up time was 32 months (range, 5-32). There was 1 intraoperative complication and 6 postoperative complications in 4 patients. No patient has had a recurrence. Three patients were able to conceive spontaneously; 1 delivered at 31 weeks' gestation, and 2 delivered at term. CONCLUSION: Abdominal radical trachelectomy is feasible and can be performed safely in a developing country in well-selected patients with early cervical cancer who wish to preserve their fertility.

Repercusión económica de la infección del tracto urinario durante la gestación en el presupuesto del hospital III Alberto Sabogal Sologuren / Economical impact in the budget of the Hospital Alberto Sabogal Sologuren due to infection of urinary tract during pregnancy

El presente estudio fue motivado por las altas tasas de morbilidad materno infantil existentes, especialmente en la gestación, por tal motivo, se hace uso de protocolos de diagnóstico y tratamiento aunados a los árboles de decisiones, los cuales se manejan mediante probabilidades. Las operaciones de mayor significancia se aplican al programa de costos unitarios por daño programático para obtener luego la repercusión económica dentro del presupuesto del Hospital "Alberto Sabogal Sologuren", siendo el ahorro distribuído en capacitación, adquisición de tecnología de avanzada y aplicación de programas de salud eficientes.