Based on these results and given the absence of morbidity, we believe that prophylactic cholecystectomy is suitable during open gastric bypass.

No abstract

CO laser vaporization is a simple, safe, and successful outpatient treatment that can be performed without anesthesia.

RESUMENAntecedentes: La tuberculosis genital y la endometritis tuberculosa es una forma de tuberculosis que continúa siendo frecuente en los países en desarrollo y habitualmente es secundaria a un foco primario pulmonar. Puede cursar de forma asintomática, o bien, producir síntomas como infertilidad primaria o secundaria, alteraciones menstruales o dolor pélvico crónico, entre otros. Caso clínico: Se presenta el caso de una paciente de 47 años en estudio por ginecología y urología por dolor pélvico crónico y sintomatología urinaria inespecífica de aproximadamente 6 meses de evolución. La ecografía transvaginal muestra contenido intracavitario escaso sugerente de piometra e imágenes trabeculares compatibles con sinequias uterinas. Mediante aspirado endometrial se extrae pus y muestra endometrial que se remite para estudio anatomopatológico. Tras el informe anatomopatológico que diagnostica inflamación crónica granulomatosa necrotizante, se solicita estudio por PCR y cultivo para micobacteriumm tuberculosis, siendo ambos positivos para el microorganismo. De este modo, se diagnosticó como endometritis tuberculosa sin existir afectación de otros órganos tras el estudio completo. Se realizó tratamiento con etambutol hidrocloruro, isoniacida, pirazinamida y rifampicina durante 2 meses y pirazinamida e isonicida durante 7 meses adicionales. Al final del tratamiento, la paciente mostraba clara mejoría de los síntomas y a la ecografía desaparición de la colección intracavitaria uterina. PALABRAS CLAVE: Tuberculosis, endometritis tuberculosa, tuberculosis genital femenina SUMMARYBackground: Genital tuberculosis and endometritis tuberculosa is a form of tuberculosis which remains prevalent in developing countries and is usually secondary to a pulmonary primary focus. It may be asymptomatic, or may produce symptoms such as primary or secondary infertility, menstrual disorders or chronic pelvic pain, among others. Clinical case: We present the case of a patient of 47-year who was studied by ginecology and urology for chronic pelvic pain and unspecific urinary symptoms since about 6 months. In transvaginal ultrasound pyometra and trabecular images compatible with uterine synechiae were observed. Endometrial samples were obtaining and sent for histopathologic examination which was informed of chronic necrotizing granulomatous inflammation. We asked for PCR and culture for tuberculosis micobacteriumm, both being positive for the microorganism. Thus, she was diagnosed of endometritis tuberculosa without involvement of other organs after complete study. She performed a treatment with ethambutol hydrochloride, isoniazid, rifampicin and pyrazinamide for 2 months and pyrazinamide and isoniazid for 7 months. At the end of treatment, the patient showed clear improvement of symptoms and disappearance of uterine intracavitary collection in the ultrasonographic study.

Objective: To determine the predictors of absence of lesion on cone biopsy (white cone). We evaluated several factors including parity, cytology, human papillomavirus (HPV) typing, biopsy, colposcopy, smoking habit, use of oral contraceptive or condom, and immunosuppression as predictors for absence of dysplasia. Methods: Of 510 patients with CIN (cervical intraepithelial neoplasia) treated by loop electrosurgical excision (LEEP) in the Fundación Jimenez Diaz hospital between 2012 and 2016, 51 (10%) patients had a white cone and were defined as the study group. The control group was established from two randomly selected controls for each case (n = 102). Results: The study group had a higher prevalence of low-grade cytology (p < 0.001), minor changes (p < 0.01), and CIN 2 (<0.001) than the control group. The study group had a lower rate of oral contraceptive use (p = 0.005), as demonstrated by the multivariate analysis (except for low-grade cytology). Conclusions: In conclusion, this study indicates that the incidence of white cone in our institution is 10% of all the cone biopsy and women with low-risk cytology, minor changes in colposcopy, CIN 2, and no use of oral contraceptive have a high probability of having no lesions in the conization specimen.