Introducción: El carcinoma epidermoide de pene se considera una enfermedad rara en países desarrollados, representando el 0.4-0.6% de las neoplasias malignas en los hombres, sin embargo, en los países en vías de desarrollo representa el 10-20% de las neoplasias malignas. El 95% de los casos corresponde a carcinoma epidermoide, los factores de riesgo que destacan son fimosis, tabaquismo e infección por virus del papiloma humano. Objetivo: Describir las características clínicas y patológicas de pacientes con diagnóstico de cáncer de pene. Material y métodos: Se realizó un estudio retrospectivo, retrolectivo y descriptivo de expedientes clínicos físicos y electrónicos de los pacientes atendidos en servicio de Urología y Oncología del Hospital General de México en un periodo de 5 años de enero 2015 a enero 2020. Resultados: Se incluyeron datos de 93 pacientes con edad promedio de 57.87 años (23-86), tabaquismo en el 55.9%. Comorbilidades en el 50%. El grado de escolaridad primaria, secundaria o analfabeta en el 65.6%, 20.4 y 7.5%, respectivamente. Se identificó fimosis en el 74.2%. Los sitios más frecuentes de localización del cáncer fueron Glande, glande-prepucio o cuerpo en el 40.9%, 33.5% y 23.7%, respectivamente. Coilocitosis en el 17.2%. Identificamos invasión linfovascular en el 18.3%, perineural en el 19.4%. Conclusiones: En nuestro hospital contamos con casos de cáncer de pene frecuentemente, está incluido en los 20 principales diagnósticos anuales, en su mayoría de tipo escamoso, moderadamente diferenciado, de presentación ulceroso, estadio T3, estadio clínico N0.
Introducción: La infección de tracto urinario asociada a catéter (ITUCV) es la causa más frecuente de infección asociada a los cuidados de la salud. Existen diversas estrategias para prevenir dichas infecciones. Se deben considerar nuevas estrategias como los catéteres vesicales BIP (catéteres con recubrimiento de plata, oro, paladio), como una alternativa para reducir las mismas. Objetivos: Comparar la incidencia de las ITUCV en pacientes con catéter vesical Foley BIP versus Foley convencional. Metodología: Se realizó un ensayo clínico con aleatorización simple, siguiendo el sistema de doble ciego. Se estableció un nivel de confianza del 95%, un error no mayor del 5%. Obteniendo un total de 140 casos, alcanzando así una muestra representativa. Resultados: 140 casos con una inclusión de 125 casos y una exclusión de 15 casos (11%). La media de edad fue 50 años ± 18, con un 52 % hombres y 48% mujeres. El tiempo observado promedio fue de 10 días ± 7. Se presentó una tasa de incidencia global de 25 ITUCV x 1000 días. Discusión: El uso del catéter urinario Foley es una práctica cotidiana. El uso de catéteres Foley BIP disminuyó la tasa de incidencia de infección de vías urinarias asociada a catéter. Conclusiones: Las ITUCV son la infección más frecuente asociado a cuidados de la salud. Las infecciones nosocomiales representan un indicador de calidad de atención de los pacientes, repercuten en la morbimortalidad y economía de los pacientes. Los catéteres con recubrimiento fueron una medida eficaz, disminuyendo de manera considerable la incidencia de ITUCV.
On March 11, 2020, coronavirus disease 2019 (COVID-19) was declared a pandemic and has created an impact like no other on health systems worldwide. A restructuring in the priority of patient care has currently taken place that is based on the patient’s underlying pathology. Urology services are no exception, postponing all the elective surgeries that can be delayed without putting the patient at risk. A surgical protocol has been adopted during the pandemic that attempts to reduce the amount of time the operating room is in use, as well as the risk for postoperative complications, so that hospital stay can be reduced. In such a setting, minimally invasive surgery, such as laparoscopic and robotic-assisted surgery, can play a beneficial role in treating oncologic pathologies that cannot be deferred. Based on the best evidence that has currently been published and the guidelines of international associations, this paper summarizes the recommendations regarding urologic laparoscopic and robotic-assisted surgery in times of COVID-19.
Background: Pediatric urolithiasis is a rare condition around the world. Its presence and incidence are augmenting in developing countries, remarking the importance for urologists to keep updated to latest trends about its management. Objective: The aim of this study was to describe the clinical features and therapeutic surgical options and results for urinary tract stone disease in pediatric patients. Materials and Methods: This study included all pediatric patients who undergo surgical procedures to manage pediatric urolithiasis between 2017 and 2020 who had complete medical records and adequate follow-up in the General Hospital of México "Dr. Eduardo Liceaga." Results: Twenty-one pediatric patients undergo surgical treatment for urinary lithiasis between 2017 and 2020. Males were more affected than female with a relation of 3:1. The mean age at the procedure time was between 1 and 5 years old. The majority of the patients had and adequate body mass index (BMI) according to percentile by age. The upper urinary tract was mostly affected by lithiasis, only 9% of cases were located in the lower urinary tract. The majority of cases were treated with minimal invasive techniques with 14% of complications, and success rate of 90.47%. Conclusions: Urinary lithiasis is more common in male, usually locates at the upper urinary tract, frequently in the group of 1-5 years old, most cases had an adequate BMI, and the most frequently used techniques are minimal invasive, with a lower rate of complications and great success.
Background: Emphysematous pyelonephritis (EPN) is a necrotizing infection of the kidney and the surrounding tissues associated with considerable mortality. We aimed to formulate a score that classifies the risk of mortality in patients with EPN at hospital admission. Materials and methods: Patients diagnosed with EPN between 2013 and 2020 were retrospectively included. Data from 15 centers (70%) were used to develop the scoring system, and data from 7 centers (30%) were used to validate it. Univariable and multivariable logistic regression analyses were performed to identify independent factors related to mortality. Receiver operating characteristic curve analysis was performed to construct the scoring system and calculate the risk of mortality. A standardized regression coefficient was used to quantify the discriminating power of each factor to convert the individual coefficients into points. The area under the curve was used to quantify the scoring system performance. An 8-point scoring system for the mortality risk was created (range, 0-7). Results: In total, 570 patients were included (400 in the test group and 170 in the validation group). Independent predictors of mortality in the multivariable logistic regression were included in the scoring system: quick Sepsis-related Organ Failure Assessment score ≥2 (2 points), anemia, paranephric gas extension, leukocyte count >22,000/μL, thrombocytopenia, and hyperglycemia (1 point each). The mortality rate was <5% for scores ≤3, 83.3% for scores 6, and 100% for scores 7. The area under the curve was 0.90 (95% confidence interval, 0.84-0.95) for test and 0.91 (95% confidence interval, 0.84-0.97) for the validation group. Conclusions: Our score predicts the risk of mortality in patients with EPN at presentation and may help clinicians identify patients at a higher risk of death.
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