Analysis of the Direct Cost of Medical and Surgical Care for Testicular Cancer in Early and Advanced Stages in a Third Level Medical Facility of the Mexican Social Security Institute

Background: The testicular cancer prevails in the third decade of life, the care cost increases with higher staging of the disease. Objective: Compare the direct costs of medical and surgical attention for testicular cancer in early and advanced stages in a Third Level Medical Facility. Material and Methods: Process study, direct costs of medical attention are evaluated. Number of laboratory studies, imaging studies, and medical and surgical treatment were analyzed. The patients were divided into 2 groups: group 1 early stages and group 2 advanced stages. Mann Whitney U test was used for the difference between groups. Results: There were 10 patients in each group, Group 1: 8 (80%) seminomas and 2 (20%) non-seminoma, Group 2: 4 (40%) seminomas and 6 (60%) non-seminomas. The average cost of care in Group 2 is higher than in Group 1, 288,827.90 and 145,911.70 Mexican pesos respectively (p=0.00578). Conclusions: The direct cost of medical attention is higher in the advanced stages compared to the early stages (AU)

Objetivo: Comparar los costes directos de atenciónmédica y quirúrgica del cáncer testicular en etapa tempranay avanzada en un hospital de tercer nivel.Material y Métodos: Estudio de proceso, se evalúancostes directos de atención médica. Se analizaron númerode estudios de laboratorio, gabinete y tratamiento médico yquirúrgico. Los pacientes se dividieron en 2 grupos: grupo1 estadios tempranos y grupo 2 estadios avanzados. Se utilizó la prueba de U de Mann Whitney para diferencia entregrupos.Resultados: Fueron 10 pacientes en cada grupo,Grupo 1: 8 (80%) seminomas y 2 (20%) no seminomas,Grupo 2: 4 (40%) seminomas y 6 (60%) no seminomas. Elcoste promedio de atención en el Grupo 2 es mayor que enel Grupo 1, $288,827.90 y $145,911.70 pesos mexicanosrespectivamente (p=0.00578).Conclusiones: El coste directo de atención médica esmayor en los estadios avanzados comparado con los estadios tempranos. (AU)

[Ultrasonographic diagnosis of polyhydramnios and its association with congenital malformations]. / Diagnóstico ultrasonográfico de polihidramnios y su asociación con malformaciones congénitas.

We carried out a prospective study at the Hospital de Gineco-Obstetricia del Instituto Mexicano del Seguro Social, in León, Guanajuato in order to evaluate the association between polyhydramnios and fetal congenital anomalies. 200 women were included, 100 with polyhydramnios and 100 with normal amniotic fluid (control group). The diagnosis of polyhydramnios was made with ultrasound scanning using maximum vertical pocket technique and amniotic fluid index. The patients with polyhydramnios had an average maximum vertical pocket of 9.3 centimeters and amniotic fluid index of 27.0 centimeters. In patients with polyhydramnios 24 cases of congenital malformations were found, and none in patients with normal amniotic fluid (P < 0.01). The most common fetal anomalies were: esophageal atresia (25%), anencephaly (21%) and ductus arteriosus (21%). There were six perinatal deaths in the group of patients with polyhydramnios, five of them had congenital abnormalities, on the other hand in the control group there were no perinatal deaths (P < 0.01). Owing to the signifficative association between polyhydramnios and congenital anomalies, we suggest to reinforce the ultrasound evaluation in order to detect these abnormalities and to offer an early treatment and therefore a better prognosis to the fetus.