[Epidemiological study of colorectal cancer in Zamora (Spain): a comparison between the years 1996 and 2003]. / Estudio epidemiológico del cáncer colorrectal en la provincia de Zamora: comparación entre los años 1996 y 2003.

INTRODUCTION: Colorectal cancer (CRC) is one of the most frequent tumors in Western countries. In Spain, widely different rates have been reported for distinct regions. AIM: To determine the epidemiological characteristics of CRC in the province of Zamora in 1996 and 2003 and to identify possible variations in these characteristics in each of these two years. MATERIAL AND METHODS: We performed a descriptive, retrospective study of all cases of CRC diagnosed in the Complejo Asistencial de Zamora in 1996 and 2003. RESULTS: In 1996, 146 patients were diagnosed with CRC, representing an unadjusted and adjusted incidence of 70.85 and 49.40 cases per 10(5) inhabitants. In 2003, 173 patients were diagnosed, representing an unadjusted and adjusted incidence of 86.89 and 58.12 cases per 105 inhabitants. The mean age at diagnosis was 72.08 years in 1996 and 71.15 years in 2003. The mean time to diagnosis was 3.37 months in 1996 and 4.11 in 2003. The mean time to diagnosis in 1996 was 4.35 months in rectal tumors and 2.87 months in colon tumors (p = 0.013). In 2003, the mean time to diagnosis was 4.70 months in rectal tumors and 3.84 months in colon tumors (p = 0.0749). The mean time to diagnosis was 3.56 and 3.83 months in patients living in urban areas and was 3.24 and 4.35 months in those living in rural areas in 1996 and 2003, respectively. More than 65% of the neoplasms were located in the rectum and sigmoid colon, with no differences between the two years. In 1996, 46.1% of the tumors were stage III or IV at diagnosis while in 2003, this percentage increased to 50.9%. In both years, the four basic health areas with the highest rates within the province were Aliste, Carbajales, Carballeda and Corrales. CONCLUSION: CRC is a highly frequent disease in the province of Zamora, especially in some of the western regions. The incidence of CRC was higher in 2003 than in 1996. Most of the tumors were located in the rectum and sigmoid colon. The time from symptom onset to diagnosis was prolonged. A high percentage of tumors were diagnosed in advanced stages.

Estudio epidemiológico del cáncer colorrectal en la provincia de Zamora: comparación entre los años 1996 y 2003 / Epidemiological study of colorectal cancer in Zamora (Spain): a comparison between the years 1996 and 2003

Introducción: El cáncer colorrectal (CCR) es uno de los tumores más frecuentes en los países occidentales. En España se han comunicado tasas muy diferentes en distintas regiones. El objetivo del presente estudio ha sido conocer las características del CCR en la provincia de Zamora en los años 1996 y 2003, evaluando si existen variaciones en las características epidemiológicas en estos 2 años. Material y métodos: Se ha realizado un estudio descriptivo, retrospectivo, de todos los casos diagnosticados en el Complejo Asistencial de Zamora en los años 1996 y 2003. Resultados: En el año 1996, se diagnosticó de CCR a 146 pacientes, con una tasa bruta de 70,85 casos/105 habitantes. En el año 2003, se diagnosticó a 173 enfermos, con una tasa bruta de 86,89 casos/105 habitantes. Las tasas ajustadas fueron de 49,40 casos/105 habitantes en 1996 y de 58,12 casos/105 habitantes en 2003. La edad media en el momento del diagnóstico fue de 72,08 años en 1996 y de 71,15 en 2003. En el año 1996, el tiempo medio de diagnóstico fue de 3,37 meses, que ascendió hasta 4,11 meses en 2003. El tiempo medio de diagnóstico de los tumores rectales en el año 1996 fue de 4,35 meses, y el de los tumores de colon, de 2,87 meses (p = 0,013). En 2003, las neoplasias rectales se diagnostican en 4,70 meses de media y las de colon, en 3,84 meses (p = 0,0749). En el año 1996, el tiempo medio de diagnóstico fue de 3,56 meses en pacientes que vivían en medio urbano y de 3,24 meses en los del medio rural, mientras que en 2003 fue de 3,83 meses en el primer caso y de 4,35 en el segundo. Más del 65% de las neoplasias se asentó en el recto y el sigma, situación que ocurrió por igual en ambos años estudiados. El 46,1% de los tumores se diagnosticó en estadios III y IV en el año 1996, porcentaje que amumentó en el año 2003 hasta el 50,9%. Aliste, Carbajales, Carballeda y Corrales son las 4 zonas básicas de salud con tasas más altas dentro de la provincia en ambos años. Conclusión: El CCR es muy frecuente en nuestra provincia, fundamentalmente en algunas comarcas de la franja oeste. Su incidencia aumentó en el año 2003 en comparación con 1996. La mayoría de las neoplasias se asientan en el recto y elsigma. El tiempo que transcurre desde el comienzo de los síntomas hasta su diagnóstico es muy prolongado. En un gran porcentaje de tumores, el diagnóstico se realiza en estadios avanzados

Introduction: Colorectal cancer (CRC) is one of the most frequent tumors in Western countries. In Spain, widely different rates have been reported for distinct regions. Aim: To determine the epidemiological characteristics of CRC in the province of Zamora in 1996 and 2003 and to identify possible variations in these characteristics in each of these two years. Material and methods: We performed a descriptive, retrospective study of all cases of CRC diagnosed in the Complejo Asistencial de Zamora in 1996 and 2003. Results: In 1996, 146 patients were diagnosed with CRC, representing an unadjusted and adjusted incidence of 70.85 and 49.40 cases per 105 inhabitants. In 2003, 173 patients were diagnosed, representing an unadjusted and adjusted incidence of 86.89 and 58.12 cases per 105 inhabitants. The mean age at diagnosis was 72.08 years in 1996 and 71.15 years in 2003. The mean time to diagnosis was 3.37 months in 1996 and 4.11 in 2003. The mean time to diagnosis in 1996 was 4.35 months in rectal tumors and 2.87 months in colon tumors (p = 0.013). In 2003, the mean time to diagnosis was 4.70 months in rectal tumors and 3.84 months in colon tumors (p = 0.0749). The mean time to diagnosis was 3.56 and 3.83 months in patients living in urban areas and was 3.24 and 4.35 months in those living in rural areas in 1996 and 2003, respectively. More than 65% of the neoplasms were located in the rectum and sigmoid colon, with no differences between the two years. In 1996, 46.1% of the tumors were stage III or IV at diagnosis while in 2003, this percentage increased to 50.9%. In both years, the four basic health areas with the highest rates within the province were Aliste, Carbajales, Carballeda and Corrales. Conclusion: CRC is a highly frequent disease in the province of Zamora, especially in some of the western regions. The incidence of CRC was higher in 2003 than in 1996. Most of the tumors were located in the rectum and sigmoid colon. The time from symptom onset to diagnosis was prolonged. A high percentage of tumors were diagnosed in advanced stages

Preparación colónica con polietilenglicol, hipofosfatemia y síndrome confusional agudo / Colonic preparation with polyethylene glycol, hypophosphatemia and acute confusional síndrome

No disponible

Efficacy and safety of argon plasma coagulation for the treatment of hemorrhagic radiation proctitis.

OBJECTIVE: To evaluate the efficacy, safety and medium-/long-term clinical course of patients undergoing endoscopic treatment with argon plasma coagulation for hemorrhagic radiation proctopathy. DESIGN: Descriptive, retrospective study with medium- and long-term follow-up. PATIENTS, MATERIAL AND METHODS: Ten patients were treated with argon plasma coagulation for hemorrhagic radiation proctopathy between July 1998 and February 2003. Inclusion criteria were: evidence of chronic rectal bleeding, consistent endoscopic findings, and absence of any other cause of hematochezia after a comprehensive ano-rectal examination and complete colonoscopy. The equipment used was a standard colonoscope, an argon delivery unit, an argon plasma coagulation probe 1.5 mm in internal diameter, and a high-frequency electrosurgical generator. Consecutive treatment sessions were programmed whenever it was considered necessary until all mucosal lesions had been treated. Clinical and evolutive follow-up was performed with a focus on tolerance, efficacy, and potential argon plasma coagulation-related complications. Data were updated by personal or telephonic interview. RESULTS: In all patients, chronic rectal bleeding stopped after the last treatment session. The mean number of treatment sessions to stop symptoms was 1.7. Mean follow-up was 31.1 months. All sessions were well tolerated, similarly to standard rectoscopy. In one case a recurrence of rectal bleeding was observed four months later, which required two repeat sessions. Four patients were anemic at inclusion. Three of them reported a resolved anemia at the end of the study. No delayed argon plasma coagulation-related complications such us ulcers or strictures were seen. CONCLUSIONS: Argon plasma coagulation appears to be a useful, effective and safe treatment for rectal bleeding resulting from chronic radiation proctitis when compared to standard medical and endoscopic treatments. These successful outcomes seem to persist even after long-term follow-up.

Eficacia y seguridad de la electrocoagulación con plasma de argón en el tratamiento del sangrado rectal secundario a proctitis por radioterapia / Efficacy and safety of argon plasma coagulation for the treatment of hemorrhagic radiation proctitis

Objetivo: evaluar la eficacia, seguridad y curso evolutivo a medio / largo plazo de los pacientes tratados endoscópicamente con plasma de argón en nuestra unidad por sangrado rectal asociado a proctitis por radioterapia. Diseño: estudio descriptivo y retrospectivo a medio / largo plazo. Pacientes, material y métodos: entre julio de 1998 y febrero de 2003, se trataron con plasma de argón 10 pacientes que presentaron rectorragia secundaria a proctitis por radioterapia. Se consideraron criterios de inclusión la existencia de sangrado rectal crónico, presencia de hallazgos endoscópicos compatibles y ausencia de otras lesiones justificativas de sangrado. Se emplearon colonoscopios convencionales y equipo con fuente de gas argón y unidad quirúrgica de alta frecuencia. Se programaron sesiones consecutivas hasta conseguir la total eliminación de las lesiones rectales realizándose seguimiento clínico-evolutivo y valorando tolerancia, eficacia y potenciales complicaciones derivadas de la técnica. Se actualizaron los datos por entrevista personal o encuesta telefónica. Resultados: en todos los casos se consiguió la desaparición del sangrado después de la última sesión de tratamiento. El número medio de sesiones de tratamiento por paciente fue de 1,7. En cuatro casos fue precisa una única sesión. El tiempo medio de seguimiento tras concluir el tratamiento fue de 31,1, meses. En un caso recidivó el sangrado a los 4 meses, siendo precisas dos sesiones adicionales. Cuatro pacientes presentaban inicialmente signos analíticos de anemia que persistía sólo en un caso al final del estudio. No se registraron complicaciones tardías derivadas de la técnica, como úlceras o estenosis rectales. Conclusiones: la electrocoagulación endoscópica con plasma de argón supone en nuestra experiencia, una alternativa segura, eficaz y bien tolerada en el tratamiento del sangrado rectal asociado a la proctitis por radioterapia, con respecto a los tratamientos farmacológicos y endoscópicos tradicionales. Estos resultados favorables parecen mantenerse incluso tras periodos prolongados de seguimiento (AU)

[Alendronate-induced hepatocellular lesion]. / Lesión hepatocelular inducida por alendronato.

Bisphosphonates are widely used in the treatment of metabolic bone disease. Bisphosphonate-induced hepatotoxicity is extremely infrequent. We present the case of a 76-year-old female patient with osteoporosis who was prescribed alendronate. A routine laboratory investigation carried out three months later revealed markedly elevated transaminase concentrations. Six weeks after withdrawal of treatment, laboratory parameters had returned to normal levels. We analyze this adverse reaction to alendronate as well as its possible pathogenic mechanisms.

Fallo hepático fulminante inducido por flutamida / Fulminant hepatic failure associated with flutamide

No disponible