[Results following an action protocol in patients with severe pelvic inflammatory disease]. / Resultados tras un protocolo de actuación en pacientes con diagnóstico de enfermedad inflamatoria pélvica grave.

BACKGROUND: Pelvic inflammatory disease is manifested by a broad spectrum of genital tract infections that include: endometritis, salpingitis, tubo-ovarian abscess, and pelvic peritonitis. This disease is associated with evidence of inflammation of the lower genital tract. OBJECTIVE: To evaluate the subgroup of patients with a diagnosis of acute pelvic inflammatory disease requiring hospitalization after implementation of the protocol for action in the patient with suspected pelvic inflammatory disease. MATERIAL AND METHODS: Retrospective analysis conducted between January and December 2011 in a cohort of patients diagnosed with severe pelvic inflammatory disease after implementation of a hospital protocol for suspected patients with this condition. Patients who met the diagnostic criteria of Centers for Disease Control and Prevention (CDC) and required hospitalization were considered with severe pelvic inflammatory disease. In all cases the same complementary tests were conducted and the same antibiotic protocol was prescribed. RESULTS: We included 38 patients and found a statistically significant relationship between the IUD and mixed gram-negative flora etiologic agent (p < 0.05). There was a negative correlation (Pearson correlation coefficient -0.334) between elevated leukocyte at the time of admission and the need for surgery. CONCLUSIONS: In cases of severe pelvic inflammatory disease IUD is associated with gram-negative mixed flora infection. The normal or moderately elevated concentrations of leukocytes were correlated with failure of medical treatment.

One-Step Nucleic Acid Amplification (OSNA) of Sentinel Lymph Node in Early-Stage Endometrial Cancer: Spanish Multicenter Study (ENDO-OSNA).

The objective of this study was to evaluate the efficacy of one-step nucleic acid amplification (OSNA) for the detection of sentinel lymph node (SLN) metastasis compared to standard pathological ultrastaging in patients with early-stage endometrial cancer (EC). A total of 526 SLNs from 191 patients with EC were included in the study, and 379 SLNs (147 patients) were evaluated by both methods, OSNA and standard pathological ultrastaging. The central 1 mm portion of each lymph node was subjected to semi-serial sectioning at 200 µm intervals and examined by hematoxylin-eosin and immunohistochemistry with CK19; the remaining tissue was analyzed by OSNA for CK19 mRNA. The OSNA assay detected metastases in 19.7% of patients (14.9% micrometastasis and 4.8% macrometastasis), whereas pathological ultrastaging detected metastasis in 8.8% of patients (3.4% micrometastasis and 5.4% macrometastasis). Using the established cut-off value for detecting SLN metastasis by OSNA in EC (250 copies/µL), the sensitivity of the OSNA assay was 92%, specificity was 82%, diagnostic accuracy was 83%, and the negative predictive value was 99%. Discordant results between both methods were recorded in 20 patients (13.6%). OSNA resulted in an upstaging in 12 patients (8.2%). OSNA could aid in the identification of patients requiring adjuvant treatment at the time of diagnosis.

Ascitis quilosa secundaria a carcinomatosis peritoneal en paciente con cáncer de mama diseminado, un hallazgo inesperado / Chylous ascites secondary to peritoneal carcinomatosis in a patient with metastasic breast cancer: an unexpected finding

No disponible