[Cancers in systemic sclerosis : risk factors, impact on survival and literature review]. / Survenue de cancers au cours de la sclérodermie systémique : facteurs de risque, impact sur la survie et revue de la littérature.

INTRODUCTION: Patients with systemic sclerosis (SSc) have an increased risk of malignancy. In this study, we aimed to analyze the prevalence of cancer, the risk factors and the impact on overall survival. PATIENTS AND METHODS: We analyzed clinical (history of cancer, toxic exposition, organ involvement), immunological and treatment data in a monocentric cohort of SSc patients followed between January 2004 and December 2017. RESULTS: Two hundred and ten patients with SSc were included. During the follow-up, twenty-one patients (10 %) were diagnosed with malignancies. The underlying malignancies were breast adenocarcinoma (n=6, 28%), lung cancer (n=6, 28%), colorectal (colic adenocarcinoma, carcinoid tumor of the appendix), ovarian and cervix uteri, melanoma, kidney and papillary thyroid carcinoma (one of each). The median time between the first visit and the diagnosis of cancer was 4 [2-10] years. The overall survival in SSc patients with cancer was not significantly different from patients without cancer, with median survival during the first quartile (75%) at 12 years for patients with cancer and 11.6 years for those without cancer (P=0.9). The history of renal scleroderma crisis (HR 10.99, IC95% [1.95-62.07]; P=0.006) and the presence of anti-topoisomerase I antibodies (HR 5.5, IC95% [1.40-21.67]; P=0.01) were associated with an increased risk of cancer, whereas the presence of gastroesophageal reflux was inversely associated with the cancer occurrence (HR 0.22, IC95% [0.056-0.867]; P=0.03). CONCLUSION: The history of renal scleroderma crisis and the positivity of anti-topoisomerase I antibodies were associated with an increased risk of cancer in SSc patients in this monocentric study.

Prevalence of metabolic syndrome and its association with lower urinary tract symptoms and sexual function. / Prevalencia del síndrome metabólico y su asociación con síntomas del tracto urinario inferior y función sexual.

OBJECTIVES: To estimate the frequency of metabolic syndrome (MetS) in a daily urology practice and to determine its association with lower urinary tract symptoms (LUTS) and erectile dysfunction (ED). MATERIAL AND METHODS: A retrospective study was conducted. Data from all male patients aged ≥40 years who attended our outpatient urology clinic from 2010 to 2011 was collected. Prevalence of MetS was determined, and LUTS and ED were assessed. A logistic model was used to determine possible associations, controlling for confounders and interaction factors. RESULTS: A total of 616 patients were included. MetS was observed in 43.8% (95% CI 39.6-48.3). The bivariate model showed an association between MetS and LUTS (p<0.01), but not between MetS and ED. The logistic model showed an association between MetS and the International Prostate Symptom Score (IPSS), while controlling for other variables. Patients exhibiting moderate LUTS had a greater risk for MetS than patients with mild LUTS (OR 1.83, 95% CI 1.14-2.94). After analyzing for individual components of MetS, positive associations were found between diabetes and severe LUTS (OR 1.3, 95% CI 1.24-7.1), and between diabetes and ED (OR 2.57, 95% CI 1.12-5.8). CONCLUSION: This study was able to confirm an association between MetS and LUTS, but not for ED. Specific components such as diabetes were associated to both. Geographical differences previously reported in the literature might account for these findings. Given that MetS is frequent among urological patients, it is advisable that urologists actively screen for it.

Extended pelvic lymphadenectomy in patients with clinically localised prostate cancer: A prospective observational study. / Linfadenectomía pélvica extendida en pacientes con cáncer de próstata clínicamente localizado: estudio observacional prospectivo.

OBJECTIVE: To determine the frequency of lymph node involvement in patients with clinically localised prostate adenocarcinoma who had radical prostatectomy and extended pelvic lymphadenectomy. MATERIAL AND METHODS: A prospective observational study was conducted on 137 patients with clinically localised prostate cancer of low, intermediate or high risk according to the D'Amico classification. All participants underwent radical prostatectomy plus extended pelvic lymphadenectomy in 3 reference centres in Bogota, Colombia, between 2013 and 2014. The following variables were assessed: age, prostate specific antigen levels, Gleason score of the biopsy, probability of lymph node involvement calculated with Partin tables and the histopathology result of the surgical specimen, with the definitive Gleason pattern and the total number of resected and involved lymph nodes per tumour, according to the territory of the dissection. RESULTS: A total of 2,876 lymph nodes were extracted (an average of 20.99 lymph nodes per patient). There was lymph node involvement in 14 (10.22%) patients. The high-risk and intermediate-risk group presented lymph node metastases in 28.57% and 5.25%, respectively. There was no lymph node involvement in the low-risk group. Of the patients at risk of lymph node involvement (≥2% according to the Partin tables), 19.40% had lymph node metastases. CONCLUSION: Lymph node involvement in our population is similar to that reported in the worldwide literature. Extended pelvic lymphadenectomy increased the probability of detecting lymph node metastases in our community.

Prevalence of in vitro susceptibility to carbapenems among clinical isolates of the Bacteroides fragilis group from a Colombian tertiary hospital.

Clinical isolates of the Bacteroides fragilis group (n=29) were collected from patients attending a tertiary care hospital in Medellin, Colombia, during 2012 and were tested for susceptibility to four carbapenems using the Clinical and Laboratory Standards Institute (CLSI) Etest method. Overall rates of percent susceptibility were as follows: meropenem, 93.1%; imipenem, 100%; ertapenem, 96.6%; and doripenem, 93.1%. This is the first study to show rates of resistance of Bacteroides spp. to carbapenems in Colombia among a species formerly thought to be fully susceptible to this type of antimicrobial.

Bacterial contamination of clothes and environmental items in a third-level hospital in Colombia.

Objective. This study evaluates the bacterial contamination rate of items in the hospital setting that are in frequent contact with patients and/or physicians. By determining the bacterial species and the associated antibiotic resistance that patients are exposed to. Methods. Hospital-based cross-sectional surveillance study of potential bacterial reservoirs. Cultures from 30 computer keyboards, 32 curtains, 40 cell phones, 35 white coats, and 22 ties were obtained. Setting. The study was conducted an urban academic 650-bed teaching hospital providing tertiary care to the city of Medellin, Colombia. Results. In total, 235 bacterial isolates were obtained from 159 surfaces sampled. 98.7% of the surfaces grew positive bacterial cultures with some interesting resistance profiles. Conclusion. There are significant opportunities to reduce patient exposure to frequently pathogenic bacteria in the hospital setting; patients are likely exposed to many bacteria through direct contact with white coats, curtains, and ties. They may be exposed to additional bacterial reservoirs indirectly through the hands of clinicians, using computer keyboards and cell phones.

Priapismo de alto flujo: Manejo endovascular: Presentación de una caso / Endovascular manegement of hight flow priapism

El priapismo de alto flujo es secundario a un trauma perineal cerrado, la aparición de la erección generalmente es tardía con relación al evento del trauma. El rápido y exacto diagnóstico son importantes en la selección del tratamiento de elección. Se presenta un caso con los hallazgos clínicos e imagenológicos y su manejo endovascular, y se realiza una breve revisión de la literatura