¿Ha influido la pandemia por COVID-19 en el diagnóstico del cáncer de mama? / Has the COVID-19 pandemic influenced the diagnosis of breast cancer?

Introducción: con la situación creada por la pandemia de COVID-19, los hospitales asumieron protocolos que podrían concluir en una demora en el proceso oncológico, sumando a ello, el miedo de las pacientes a acudir a consultas médicas ante determinadas molestias. Métodos: estudio retrospectivo, observacional y analítico realizado en pacientes diagnosticadas de cáncer mamario. Se determinaron 2 cohortes según el periodo pandémico, una previa al auge de la COVID-19, entre enero de 2019 y febrero de 2020, y otra expuesta a la situación de urgencia, entre marzo de 2020 y diciembre de 2021. El objetivo principal fue determinar el estadio tumoral durante la pandemia para comprobar si era más elevado que antes de ello. Resultados: la muestra de estudio contenía 193 casos, con una media de edad de 65,5 años. En la cohorte no expuesta habían 71 casos (36,6%) y en la cohorte expuesta 122 casos (63,4%). Entre ellos un 46,1% presentaban un estadio avanzado de la enfermedad. Un total de 53 casos fueron diagnosticados desde el cribado poblacional, de los cuales 35 fueron estadio precoz. No se encontró relación estadísticamente significativa entre el periodo expuesto a la pandemia y estadio tumoral avanzado. Conclusiones: las medidas implantadas durante la COVID-19 no han llevado a un diagnóstico más tardío de la enfernedad en nuestro hospital. (AU)

Introduction: With the situation created by COVID-19 pandemic, hospitals assumed protocols that could lead to a delay in the oncological process, adding to this, the fear of patients to go to medical consultations due to certain discomforts. Methods: Retrospective, observational and analytical study carried out in patients diagnosed with breast cancer. Two cohorts were determined according to the pandemic period, one prior to the rise of COVID-19, between January 2019 and February 2020, and another exposed to the emergency situation, between March 2020 and December 2021. The main objective was to determine the tumor stage during the pandemic to verify that it was higher than before. Results: The study sample contained 193 cases, with a mean age of 65.5 years. In the unexposed cohort there were 71 cases (36.6%) and in the exposed cohort 122 cases (63.4%). Among them, 46.1% had an advanced stage of the disease. 53 cases were diadnosed from the population screening, of which 35 were early stage. No statistically significant relationship was found between the period exposed to the pandemic and advanced tumor stage. Conclusions: The measures implemented during COVID-19 have not led to a later diagnosis of the disease in our hospital. (AU)

[Fournier gangrene: presentation of 6 cases with no mortality]. / Gangrena de Fournier: presentación de 6 casos sin mortalidad.

INTRODUCTION: Fournier's gangrene is a serious and potentially lethal rare infection of perineal and external genital that must be treated as a medical and surgical emergency. The aim of this study is to share our experience over the last 10 years in the management of this disease. PATIENTS AND METHOD: We carried out a descriptive and retrospective chart review of patients diagnosed and treated for this pathology in our Hospital over the last 10 years. The patient age, sex, risk factors, urgent laboratory investigations, presenting symptoms, duration of hospital stay, microbiological findings, and number of debridements were recorded. RESULTS: Six patients had this pathology, all males, with a mean age of 58.5 years. Half of them (50%) showed predisposing factors, but none of them showed a clear aetiology. The initial symptomatology was perineal or perianal phlegmon-abscess with a torpid evolution and gangrene. The treatment was intravenous antibiotics and debridement, which was repeated in 4 patients. The most commonly isolated microorganism was Escherichia coli followed by Acinetobacter and Bacteroides. The mean hospital stay was 32 days. There were no deaths recorded in this study. CONCLUSIONS: Fournier's gangrene is a serious disease that occurs in patients with risk factors. Early surgical treatment and broad-spectrum antibiotics are important.

Gangrena de fournier: presentación de 6 casos sin mortalidad / Fournier gangrene: presentation of 6 cases with no mortality

Introducción. La gangrena de Fournier es una infección poco frecuente del periné y los genitales externos grave y potencialmente mortal que debe ser tratada médica y quirúrgicamente de forma precoz. Nuestro objetivo es realizar una revisión de nuestra casuística de los últimos 10 años y de la enfermedad y su tratamiento. Pacientes y método. Realizamos un estudio descriptivo retrospectivo de los pacientes diagnosticados y tratados por esta enfermedad en nuestro hospital durante los últimos 10 años. De ellos recogemos edad, sexo, antecedentes patológicos, analítica de urgencias, cuadro clínico de presentación, estancia hospitalaria, cultivo microbiológico y número de intervenciones quirúrgicas. Resultados. Seis pacientes han presentado esta enfermedad, todos ellos varones, con una media de edad de 58,5 años. El 50% tenía factores de riesgo, pero en ninguno se encontró una etiología clara. La clínica de inicio varía entre flemón-absceso perineal o perianal de evolución tórpida y gangrena. El tratamiento fue antibioterapia intravenosa y desbridamientos, que se repitió en 4 pacientes. El germen aislado más frecuentemente fue Escherichia coli, seguido de Acinetobacter y Bacteroides. La estancia media fue 32 días. No hubo fallecimientos en nuestra serie. Conclusiones. La gangrena de Fournier es una enfermedad infecciosa grave que se presenta generalmente en pacientes con factores de riesgo, por lo que son importantes el tratamiento quirúrgico precoz y la antibioterapia de amplio espectro (AU)

Introduction. Fournier’s gangrene is a serious and potentially lethal rare infection of perineal and external genital that must be treated as a medical and surgical emergency. The aim of this study is to share our experience over the last 10 years in the management of this disease. Patients and method. We carried out a descriptive and retrospective chart review of patients diagnosed and treated for this pathology in our Hospital over the last 10 years. The patient age, sex, risk factors, urgent laboratory investigations, presenting symptoms, duration of hospital stay, microbiological findings, and number of debridements were recorded. Results. Six patients had this pathology, all males, with a mean age of 58.5 years. Half of them (50%) showed predisposing factors, but none of them showed a clear aetiology. The initial symptomatology was perineal or perianal phlegmon-abscess with a torpid evolution and gangrene. The treatment was intravenous antibiotics and debridement, which was repeated in 4 patients. The most commonly isolated microorganism was Escherichia coli followed by Acinetobacter and Bacteroides. The mean hospital stay was 32 days. There were no deaths recorded in this study. Conclusions. Fournier’s gangrene is a serious disease that occurs in patients with risk factors. Early surgical treatment and broad-spectrum antibiotics are important (AU)

El toro: el gran peligro de las fiestas de verano / The bull: the great danger of summer festivals

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