Surgical outcomes in women diagnosed with deep endometriosis involving urological structures.

INTRODUCTION: The prevalence of endometriosis is estimated to be about 10% among women of reproductive age. In about 5-10% of these patients, involvement of urological structures will be developed due to deep endometriosis. Urologists should be familiar with the management of these patients, who will require multidisciplinary care with medical and surgical treatment. MATERIAL AND METHODS: Retrospective study of patients diagnosed with deep endometriosis involving urological structures who underwent surgery performed jointly with gynecology and colorectal surgery departments from June 2012 until June 2021 (60 cases). Urologic symptoms were grouped into 3 groupers for subsequent analysis (storage symptoms, voiding symptoms, and low back pain). RESULTS: Storage symptoms (frequency and urgency) are the most frequent urologic symptoms. Patients with storage symptoms and low back pain showed improvement after surgery. In contrast, patients with voiding symptoms did not improve with surgical treatment. CONCLUSIONS: The prevalence of endometriosis and the likelihood of involving urologic structures require the urologic community to be aware of the pathology. Patients with storage symptoms will improve following excision of the endometriotic nodules. The need for Partial cystectomies with ureteral reimplantation can be safely performed by laparoscopic or robotic approach, even in previously operated patients, without compromising long-term function.

Clinically used selective oestrogen receptor modulators increase LDL receptor activity in primary human lymphocytes.

BACKGROUND AND PURPOSE: Treatment with selective oestrogen receptor modulators (SERMs) reduces low-density lipoprotein (LDL) cholesterol levels. We assessed the effect of tamoxifen, raloxifene and toremifene and their combinations with lovastatin on LDL receptor activity in lymphocytes from normolipidaemic and familial hypercholesterolaemic (FH) subjects, and human HepG2 hepatocytes and MOLT-4 lymphoblasts. EXPERIMENTAL APPROACH: Lymphocytes were isolated from peripheral blood, treated with different compounds, and 1,1'-dioctadecyl-3,3,3,3'-tetramethylindocarbocyanine perchlorate (DiI)-labelled LDL uptake was analysed by flow cytometry. KEY RESULTS: Tamoxifen, toremifene and raloxifene, in this order, stimulated DiI-LDL uptake by lymphocytes by inhibiting LDL-derived cholesterol trafficking and subsequent down-regulation of LDL receptor expression. Differently to what occurred in HepG2 and MOLT-4 cells, only tamoxifen consistently displayed a potentiating effect with lovastatin in primary lymphocytes. The SERM-mediated increase in LDL receptor activity was not altered by the anti-oestrogen ICI 182,780 nor was it reproduced by 17ß-oestradiol. However, the tamoxifen-active metabolite endoxifen was equally effective as tamoxifen. The SERMs produced similar effects on LDL receptor activity in heterozygous FH lymphocytes as in normal lymphocytes, although none of them had a potentiating effect with lovastatin in heterozygous FH lymphocytes. The SERMs had no effect in homozygous FH lymphocytes. CONCLUSIONS AND IMPLICATIONS: Clinically used SERMs up-regulate LDL receptors in primary human lymphocytes. There is a mild enhancement between SERMs and lovastatin of lymphocyte LDLR activity, the potentiation being greater in HepG2 and MOLT-4 cells. The effect of SERMs is independent of oestrogen receptors but is preserved in the tamoxifen-active metabolite endoxifen. This mechanism may contribute to the cholesterol-lowering action of SERMs.

[Bacteremia due to Campylobacter fetus isolated by conventional methods from an immunocompromised patient]. / Bacteriemia por Campylobacter fetus aislado mediante métodos convencionales de una paciente inmunocomprometida.

The genus Campylobacter includes gram-negative, motile, curved rods that can evidence characteristic morphologies. These microorganisms require low oxygen tension and an increased level of CO2 for growing. A case of bacteremia due to Campylobacter fetus in a patient with a previous diagnosis of breast cancer with metastases in dorso-lumbar column and acute promyelocytic leukemia (FAB-M3 variant) is presented. The patient was admitted to our institution due to loss of consciousness and a 2 day--history of bloody diarrhea. She received successive blood transfusions on account of her pancytopenia. Thirteen days later she developed high-grade fever. Samples were taken for blood and urine cultures and antibiotic treatment with clindamycin and ciprofloxacin was instituted. Blood culture bottles were subcultivated at 48 hours in chocolate agar. After 24 hours of incubation at 35 degrees C in a 5% CO2 atmosphere (candle jars), tiny colonies developed. Gram stain showed spiral-shaped gram-negative rods in both samples. The strain was identified as Campylobacter fetus by conventional biochemical tests. The antibiotic therapy was switched to clindamycin and gentamicin. The patient evolved favorably with negative blood cultures after a 5 day- treatment.

Bacteriemia por Campylobacter fetus aislado mediante métodos convencionales de una paciente inmunocomprometida / Bacteremia due to Campylobacter fetus isolated by conventional methods from an immunocompromised patient

Las bacterias del género Campylobacter son bacilos gram-negativos móviles, helicoidales, que presentan morfologías características. Estos microorganismos requieren una baja tensión de oxígeno y un nivel aumentado de CO2 para su desarrollo. Se presenta un caso de bacteriemia por Campylobacter fetus en una paciente con diagnóstico previo de cáncer de mama, metástasis en columna dorso-lumbar y leucemia promielocítica aguda M3 variante de la clasificación FAB. La paciente ingresó al Hospital Italiano de Córdoba por pérdida de conocimiento y proctorragia de 48 h de evolución. Debido a su pancitopenia severa se le realizaron sucesivas transfusiones de sangre. A los 13 días de internación presentó fiebre permanente. Se tomaron muestras para hemocultivo y urocultivo y se comenzó el tratamiento antibiótico con clindamicina y ciprofloxacina. Los hemocultivos se subcultivaron a las 48 h en agar chocolate. A las 24 h de incubación a 35 °C en atmósfera con 5% de CO2 desarrollaron colonias diminutas. La coloración de Gram reveló en ambas muestras bacilos gram-negativos espirilados, posteriormente identificados como Campylobacter fetus por medio de pruebas bioquímicas convencionales. El esquema antibiótico fue rotado a gentamicina más clindamicina. La paciente evolucionó favorablemente y los hemocultivos resultaron negativos luego de 5 días de tratamiento.

The genus Campylobacter includes gram-negative, motile, curved rods that can evidence characteristic morphologies. These microorganisms require low oxygen tension and an increased level of CO2 for growing. A case of bacteremia due to Campylobacter fetus in a patient with a previous diagnosis of breast cancer with metastases in dorso-lumbar column and acute promyelocytic leukemia (FAB-M3 variant) is presented. The patient was admitted to our institution due to loss of consciousness and a 2 day - history of bloody diarrhea. She received successive blood transfusions on account of her pancytopenia.Thirteen days later she developed high-grade fever. Samples were taken for blood and urine cultures and antibiotic treatment with clindamycin and ciprofloxacin was instituted. Blood culture bottles were subcultivated at 48 hours in chocolate agar. After 24 hours of incubation at 35 °C in a 5% CO2 atmosphere (candle jars), tiny colonies developed. Gram stain showed spiral-shaped gram-negative rods in both samples. The strain was identified as Campylobacter fetus by conventional biochemical tests. The antibiotic therapy was switched to clindamycin and gentamicin. The patient evolved favorably with negative blood cultures after a 5 day- treatment.

Effect of age of feed restriction and microelement supplementation to control ascites on production and carcass characteristics of broilers.

Three experiments were conducted, from January until September 2001, to estimate the optimized age to apply feed restriction to control mortality from ascites, with no negative effects on production and carcass characteristics of broilers. For each experiment, 1,200 1-d-old mixed Ross x Peterson chicks were reared in floor pens (50 chicks in each) and fed commercial feed. Feed restriction was applied for 8 h/d for 14 d at 21 or 28 d of age in experiment 1, 14 or 21 d in experiment 2, and 7 or 14 d in experiment 3. In experiments 2 and 3, a microelement supplement (without or with) was tested; the control groups received feed ad libitum and no supplement. Body weight gain, feed conversion, total mortality, and mortality from ascites, leg problems, and carcass characteristics were considered at the end of each experiment. The data were analyzed as a completely randomized design, or as a 2 x 2 factorial to estimate main and interaction effects (experiments 2 and 3). Additional analyses, including the control, were done; means comparisons were by orthogonal contrasts. The production and carcass characteristics of the restricted groups were lower than the control but were not statistically different in experiments 2 and 3, although the optimized age for feed restriction was at 7 d. Total mortality and mortality from ascites decreased by restriction, but leg problems increased without supplement. The results indicated that quantitative feed restriction and microelement supplementation at 7 d of age reduced mortality from ascites and leg problems and permitted compensatory growth sufficient to equal the production characteristics of the control group at 49 d of age. However, it is necessary to determine the specific microelements to be supplemented and to estimate the effects of season and genetic line.

[Antimicrobial resistance of Shigella spp. in Córdoba, Argentina, during the period 1990-1997]. / Resistencia de Shigella spp. a los antimicrobianos en Córdoba, Argentina, durante el período 1990-1997.

This study analyzed the evolution of antimicrobial resistance in 771 isolates of Shigella spp. obtained from a total of 9,195 feces cultures done between 1990 and 1997 in a children's hospital in Córdoba, Argentina. S. flexneri, which was responsible for 73% of the Shigella infections, was the species with the greatest resistance. The frequency of S. flexneri resistance to the three antibiotics most used (ampicillin, trimethoprim-sulfamethoxazole, and chloramphenicol) increased from 10% in 1990 to 58% in 1997 (P < 0.001). Considering each of the drugs individually, the resistance to ampicillin increased from 60% to 100% (P < 0.001), the resistance to chloramphenicol from 13% to 71% (P < 0.001), and the resistance to trimethoprim-sulfamethoxazole from 79% to 84% (P = 0.22). For S. sonnei, the increase in resistance to ampicillin (from 36% in 1990 to 54% in 1997) was not statistically significant (P = 0.20), nor was the reduction in resistance to trimethoprim-sulfamethoxazole, which went from 82% in 1990 to 55% in 1997 (P = 0.08). Only two S. sonnei isolates were found that were resistant to chloramphenicol, one in 1995 and another in 1997; two S. sonnei isolates were found with resistance to all three antibiotics. We consider it essential to carry out susceptibility tests of each Shigella clinical isolate, to detect changes in the resistance profile and thus modify empiric treatment.

[Brachmann-de-Lange syndrome in our population: clinical and epidemiological characteristics]. / Síndrome de Brachmann de Lange en nuestro medio: características clínicas y epidemiológicas.

INTRODUCTION: We present the study of the clinical and epidemiological characteristics of Brachmann-de Lange syndrome in our population. PATIENTS AND METHODS: In this study we present the analysis of 13 cases of Brachmann-de Lange syndrome identified among 24,696 infants with congenital defects registered by the Spanish Collaborative Study of Congenital Malformations (ECEMC) between April 1976 and June 1996. RESULTS: The minimum estimation of the prevalence in our population is 0.97 per 100,000 live births. We have epidemiologically confirmed the presence of intrauterine growth retardation and have observed that parental ages tend to be relatively young. We have observed a wide range of clinical expression of this syndrome. One hundred percent of our cases have limb reduction defects, followed in frequency by craniofacial alterations (84.62%), abnormal hair distribution (76.92%) and genital defects (69.23%). Upper limbs are predominantly affected and one case of diaphragmatic hernia is worth mentioning. We underline the importance of the differential diagnosis with Fryns'syndrome. CONCLUSIONS: The cases studied correspond to the most severe form of the syndrome, reason for which the prevalence is a minimal estimate. However, the mild forms of the syndrome are more frequent and it is important to consider that the face, especially the form of the eyebrow, could be a good guide for the diagnosis of mild forms of the syndrome.

Effect of strain and age of the broiler breeder female on incubation time and chick weight.

Two experiments were conducted to evaluate effects of strain [five in Experiment (Exp.) 1 and six in Exp. 2)] and age (29, 47, and 57 wk in Exp. 1 and 29, 41, and 52 wk in Exp. 2) of commercial broiler breeders on incubation time and chick weight. Highly significant differences in egg weight were found among strains in both Exp. After adjusting for effects of egg weight, significant effects of strain, age, and their interactions were found on incubation time, egg weight at transfer, and chick weight at hatch in Exp. 1, but not in Exp. 2. Mean incubation times varied among strains from 496.6 to 498.8 h in Exp. 1 and from 499.3 to 501.9 h in the second experiment. In Exp. 1, incubation time decreased from 498.6 h when breeders were 29 wk to 494.8 at 47 wk, whereas in Exp. 2, it decreased from 510.5 h at 29 wk to 495.1 h at 41 wk. This decrease also resulted in a negative correlation between egg weight and incubation time. Differences due to strain and age were found for yolk and albumen percentage and yolk: albumen ratio. Percentage yolk was 27.2 and 32.7% and percentage albumen was 60.1 and 55.9% in eggs from 29 to 52 wk breeders, respectively. Shell percentage was significantly affected by strain. Strain by age interactions were found for each response in Exp. 1 but only for set and chick weight in Exp. 2. Differences among incubators were found only for incubation time; interactions of incubation time and strain and age were also detected. Results indicate that genotype, age of the female breeder, and incubator should be considered along with their interactions to obtain optimum hatching performance.

Low temperature effects on embryonic development and hatch time.

A series of experiments was conducted to estimate phenotypic correlations between incubation characteristics, and to evaluate the effects of cold stress and genotype during incubation on chick weight, egg weight loss, hatching time, and embryonic mortality. Eggs were cooled at 18 or 24 C, for 12, 24, 36, 48, or 72 h beginning on Day 8, 12, 14, 16, or 18 of incubation. Other eggs were cooled intermittently for 6 h every 48 h or 12 h every 96 h. A control group in each experiment was not cold stressed. Results indicated a low and negative correlation between hatching time and chick weight, and a low and positive correlation between hatching time and weight loss from transfer to hatching when variability due to egg weight was removed. Chick weights at hatching were lower in chicks from cooled eggs than those of chicks from eggs incubated under normal temperature. The chicks from cooled eggs were more susceptible to dehydration during holding in the hatcher. Incubation times were delayed approximately as long as the times of embryonic cooling. Embryonic mortality was significantly increased under continuous (single period) cold stress, but not under intermittent cooling (6 h every 48 h). Significant genotype by environment interactions were found in the response of embryos of various strains to cold stress. Exposure for 36 h or longer had detrimental effects on chick weight and embryo viability, but these effects were modified by interactions among the factors involved. The results indicated that embryos from cooled eggs lose more weight during incubation and that the neonatal chicks are more susceptible to dehydration during holding time, and have a longer incubation period, and a greater embryonic mortality.

[Etiology of suppurative otitis media in pediatrics]. / Etiología de la otitis media supurada en pediatría.

A study on the etiology of bacterial infectious processes of the middle ear in children was carried out in 50 patients with ages between 3 months and 12 years at two of the children's hospitals depending from the Federal District Department. Male infants were found to be preferably affected. In 46% of cases, Staphylococcus aureus was found; also, gram-negative germs appeared in 26%. Comments are made on the possible causes of the variants this report presents in relation with the literature on the etiology of otitis media in pediatrics. Stress is placed on the necessity to support antimicrobial treatment with cultures to determine the etiology of the process.