Subject(s)
Humans , Female , Aged , Breast Neoplasms/surgery , Breast Neoplasms/therapy , Minimally Invasive Surgical ProceduresABSTRACT
OBJETIVOS: La tendencia actual en el tratamiento de la diverticulitis aguda no complicada es el manejo ambulatorio de los pacientes con pautas cortas de antibiótico o incluso con antiinflamatorios en casos seleccionados. Presentamos una comparativa de los resultados obtenidos en nuestro hospital con distintos protocolos aplicados en 2016 y 2017. MATERIAL Y MÉTODOS: Todos los pacientes seleccionados para este estudio fueron diagnosticados de diverticulitis grado Ia de la clasificación de Hinchey, según los hallazgos radiológicos en la TC abdominal. Hemos analizado dos cohortes retrospectivas: 100 pacientes tratados en 2016 según protocolo antiguo y 104 pacientes tratados en 2017 con protocolo nuevo. En el año 2016 los pacientes candidatos a tratamiento ambulatorio permanecieron en observación durante 24 horas antes de ser dados de alta. El tratamiento consistió en 14 días de ciprofloxacino y metronidazol. En 2017 solo se observaron durante 24 horas los pacientes con sintomatología más aguda y se prescribió amoxicilina-clavulánico durante solo cinco días. RESULTADOS: La persistencia de la enfermedad en 2016 fue del 6% y en 2017 solo alcanzó el 5,77% (p = 0,944). La recidiva durante el primer año fue del 13% en el primer grupo, mientras que en el segundo fue del 5,7%, aunque esta diferencia no fue estadísticamente significativa. Asimismo, se consiguió una significativa reducción del coste sanitario. CONCLUSIONES: El tratamiento ambulatorio de la diverticulitis aguda no complicada con pauta corta de antibiótico oral parece ser una estrategia terapéutica segura y efectiva en pacientes seleccionados con escasa comorbilidad
GOALS: The current trend in the treatment of non-complicated diverticulitis is the outpatient management with antibiotic or even anti-inflammatory regimens in selected cases. We present a comparison of the results in our hospital with different protocols applied in 2016 and 2017. MATERIAL AND METHODS: All patients selected for this study were diagnosed with diverticulitis grade Ia of Hinchey's classification according to radiological findings on abdominal CT. We have analyzed two retrospective cohorts: 100 patients treated in 2016 according to the old protocol and 104 patients treated in 2017 with a new protocol. In 2016, the candidates for ambulatory treatment remained under observation for 24 hours before being discharged. The treatment consisted of 14 days of ciprofloxacin and metronidazole. In 2017, only patients with more acute symptoms were observed 24 hours and amoxicillin-clavulanic acid was prescribed for only 5 days. RESULTS: The persistence of the disease in 2016 was 6% and in 2017 was only 5.77% (p = 0.944). Recurrence during the first year was 13% in the first group, while in the second it was 5.7%, although this difference was not statistically significant. Likewise, a significant reduction in health costs was achieved. CONCLUSIONS: Outpatient treatment of acute uncomplicated diverticulitis with oral treatment seems to be a safe and effective therapeutic strategy in selected patients with low comorbidity
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Diverticulitis/drug therapy , Treatment Outcome , Ambulatory Care/methods , Cohort Studies , Retrospective Studies , Ciprofloxacin/administration & dosage , Metronidazole/administration & dosage , Amoxicillin-Potassium Clavulanate Combination/administration & dosageABSTRACT
GOALS: The current trend in the treatment of non-complicated diverticulitis is the outpatient management with antibiotic or even anti-inflammatory regimens in selected cases. We present a comparison of the results in our hospital with different protocols applied in 2016 and 2017. MATERIAL AND METHODS: All patients selected for this study were diagnosed with diverticulitis grade Ia of Hinchey's classification according to radiological findings on abdominal CT. We have analyzed two retrospective cohorts: 100 patients treated in 2016 according to the old protocol and 104 patients treated in 2017 with a new protocol. In 2016, the candidates for ambulatory treatment remained under observation for 24 hours before being discharged. The treatment consisted of 14 days of ciprofloxacin and metronidazole. In 2017, only patients with more acute symptoms were observed 24 hours and amoxicillin-clavulanic acid was prescribed for only 5 days. RESULTS: The persistence of the disease in 2016 was 6% and in 2017 was only 5.77% (p = 0.944). Recurrence during the first year was 13% in the first group, while in the second it was 5.7%, although this difference was not statistically significant. Likewise, a significant reduction in health costs was achieved. CONCLUSIONS: Outpatient treatment of acute uncomplicated diverticulitis with oral treatment seems to be a safe and effective therapeutic strategy in selected patients with low comorbidity.
Subject(s)
Diverticulitis/drug therapy , Acute Disease , Adult , Aged , Female , Humans , Male , Middle Aged , Retrospective Studies , Treatment OutcomeABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Neurilemmoma/diagnosis , Anus Neoplasms/diagnosis , Abscess/diagnosis , Diagnosis, DifferentialSubject(s)
Abscess/diagnosis , Anus Neoplasms/diagnosis , Neurilemmoma/diagnosis , Adult , Anus Neoplasms/chemistry , Anus Neoplasms/diagnostic imaging , Anus Neoplasms/pathology , Diagnosis, Differential , Humans , Male , Neoplasm Proteins/analysis , Neurilemmoma/chemistry , Neurilemmoma/diagnostic imaging , Neurilemmoma/pathology , S100 Proteins/analysis , UltrasonographyABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Fibroma/pathology , Fibroma/surgery , Fibroma , Carcinoma/complications , Carcinoma/surgery , Carcinoma , Mammography/methods , Biopsy, Large-Core Needle/instrumentation , Biopsy, Large-Core Needle/methods , Cell Proliferation/physiologyABSTRACT
La endometritis granulomatosa es una inflamación crónica que se define histológicamente por la presencia de granulomas en un endometrio con un infiltrado linfoplasmocitario. Su hallazgo en una biopsia o pieza de endometrio, debe hacer pensar en tuberculosis (TBC) genital. Esta TBC era una infección rara en la mujer, las localizaciones endometriales, tubárica y ovárica casi siempre secundaria de otra localización. Más rara en mujeres posmenopáusicas, se cree debida a la escasez de los cultivos del endometrio atrófico. El diagnóstico definitivo de TBC genital es el cultivo del bacilo de Koch. La presunción se puede hacer si aparecen granulomas en la biopsia y Mantoux positivo. Su tratamiento es médico y con buen pronóstico. Presentamos 5 casos clínicos en posmenopáusicas, diagnosticados entre junio de 2001 y abril de 2003
Granulomatous endometritis is a chronic inflammation histologically characterized by the presence of granulomas in an endometrium with lymphoplasmacytic infiltrate. A finding of granulomatous endometritis in the biopsy or endometrial specimen should lead to suspicion of genital tuberculosis. This infection used to be rare in women. Tubal, endometrial and ovarian localizations are almost always secondary to a focus in another location. This entity is less frequent in postmenopausal women, probably because the atrophic endometrium provides a poor environment for growth of the tuberculosis bacillus. The definitive diagnosis of genital tuberculosis is culture of the Koch bacillus. A presumptive diagnosis can be made on the basis of granulomas in biopsy and a positive Mantoux test. Treatment is medical and the prognosis is good. We present five cases of genital tuberculosis in postmenopausal women, diagnosed between June 2001 and April 2003
Subject(s)
Female , Middle Aged , Aged , Humans , Endometritis/pathology , Tuberculosis, Female Genital/pathology , Endometrial Neoplasms/pathology , Granuloma/pathology , PostmenopauseABSTRACT
Anderson-Fabry disease (AFd) is an X-linked metabolic disease with clinical manifestations secondary to accumulation of glycosphingolipids in various tissues. We report the first case in which a patient with renal variant of AFd and chronic renal failure developed bilateral conventional renal cell carcinoma. His metabolic disorder was diagnosed only after histopathologic study of the kidney specimen resected because of the tumoral lesion. There is no clear etiologic relation between the metabolic and neoplastic disease. As AFd is not common or well known and its clinical manifestations tend to be nonspecific, the disorder is often unrecognized, misdiagnosed, or diagnosed late in life. The pathologist should be aware of this disorder when evaluating a kidney specimen from patients with chronic renal failure of unknown cause.
