Comparative analysis of short - term functional outcomes and quality of life in a prospective series of brachytherapy and Da Vinci robotic prostatectomy

ABSTRACT Introduction There is a growing interest in achieving higher survival rates with the lowest morbidity in localized prostate cancer (PC) treatment. Consequently, minimally invasive techniques such as low-dose rate brachytherapy (BT) and robotic-assisted prostatectomy (RALP) have been developed and improved. Comparative analysis of functional outcomes and quality of life in a prospective series of 51BT and 42Da Vinci prostatectomies DV Materials and Methods Comparative analysis of functional outcomes and quality of life in a prospective series of 93 patients with low-risk localized PC diagnosed in 2011. 51patients underwent low-dose rate BT and the other 42 patients RALP. IIEF to assess erectile function, ICIQ to evaluate continence and SF36 test to quality of life wee employed. Results ICIQ at the first revision shows significant differences which favour the BT group, 79% present with continence or mild incontinence, whereas in the DV group 45% show these positive results. Differences disappear after 6 months, with 45 patients (89%) presenting with continence or mild incontinence in the BT group vs. 30 (71%) in the DV group. 65% of patients are potent in the first revision following BT and 39% following DV. Such differences are not significant and cannot be observed after 6 months. No significant differences were found in the comparative analysis of quality of life. Conclusions ICIQ after surgery shows significant differences in favour of BT, which disappear after 6 months. Both procedures have a serious impact on erectile function, being even greater in the DV group. Differences between groups disappear after 6 months.

Auditoría transfusional retrospectiva en el Centro Nacional de la Transfusión Sanguínea / Retrospective transfusional audit at the Centro Nacional de la Transfusión Sanguínea

Background. Prior to a blood transfusion, we should consider the risk benefit ratio. The literature shows that 18 to 57% of red blood cells, up to 96% of fresh frozen plasma and 26% of platelet concentrates are unnecessarily transfused. The goal of the present work is to know the appropriateness of transfusion at public and private health institutions supported by the Centro Nacional de la Transfusión Sanguínea . Material and methods. An observational, retrospective, transverse and descriptive study was carried out by analyzing the requirements of blood products considering the patient's diagnosis, requested blood components, complete blood count, prothrombin and activated partial thromboplastin time. The therapeutic indication was considered either adequate or inadequate according to the guidelines for the transfusion therapy of blood products. Descriptive statistics for the analysis of the data were used. Results. We analyzed 1,573 request forms received in year 2001. In 849 cases (55%) the indication was adequate, whereas in 724 (45%) the indication of the blood products was inadequate. Conclusions. Our results show that overtransfusion is a common practice. We propose to follow the guidelines already established for the transfusion of blood components in order to avoid iatrogenia due to overtransfusion.

Introducción. Para indicar un componente sanguíneo debe valorarse el riesgo-beneficio, pues la literatura demuestra que de 18 a 57% de las transfusiones de concentrados eritrocitarios, hasta 96% del plasma fresco congelado y 26% de los concentrados plaquetarios llegan a ser innecesarios. El objetivo del presente trabajo es conocer el apego de la transfusión a las recomendaciones, en instituciones de salud pública y privadas que son apoyadas por el Centro Nacional de la Transfusión SanguíneaMaterial y mètodos.Se realizó un estudio observacional, retrospectivo, transversal y descriptivo en el Departamento de Fraccionamiento de la Sangre del Centro Nacional de la Transfusión Sanguínea analizando las solicitudes enviadas por las instituciones de salud. Los parámetros valorados fueron: diagnóstico clínico, componentes sanguíneos solicitados, hemoglobina, hematócrito, cuenta plaquetaria, tiempos de protrombina y tromboplastina parcial activado. La indicación terapèutica se consideró adecuada o inadecuada según las recomendaciones para la terapia transfusional de sangre y sus componentes. Se utilizó estadística descriptiva para el análisis de los datos.Resultados.Se analizó una muestra de 1,573 solicitudes del 2001. En 849 (55%) fue adecuada la indicación, mientras que en 724 (45%) la indicación de los productos sanguíneos fue inadecuada.Conclusión.Los resultados obtenidos en este trabajo muestran una tendencia importante a la sobretransfusión. Se propone seguir los lineamientos establecidos para la transfusión de componentes sanguíneos y así evitar la iatrogenia asociada.