Neo-adjuvant chemotherapy as treatment for fertility preservation in patients with stage IB cervical cancer: Case presentation and review of the literature [Quimioterapia neoadyuvante como tratamiento para la preservación de la fertilidad en pacientes con cáncer de cérvix en estadio IB: Reporte de un caso y revisión de la literatura]
Vasquez-Arenas M.I.,Hospital Universitario Of San Vicente Fundacion |
Echeverri-Alvarez L.,Hospital de San Jose |
Rendon-Pereira G.,Institute Cancerologia |
Pareja-Franco R.,Institute Cancerologia
Revista Colombiana de Obstetricia y Ginecologia | Year: 2015
Objective: To present the case of a patient with stage IB1 cervical cancer larger than 2 centimetres who received neo-adjuvant chemotherapy followed by laparoscopic radical cervicectomy and pelvic lymphadenectomy for fertility preservation; and to review the literature for case reports emphasizing obstetric and oncologic outcomes. Materials and methods: Case presentation and search of the literature in Medline through PubMed of articles published in English, French and Spanish between January 2000 and August 2014 on the topic of neo-adjuvant chemotherapy and fertility preservation surgery in patients with stage IB cervical cancer. Results: Overall, 12 relevant articles were selected totalling 55 patients. Over follow-up period ranging between 14 and 69 months there were 4 relapses and only one death attributable to the disease. Obstetric outcomes included 30 pregnancies, 24 births, 3 miscarriages, 1 ectopic pregnancy, and 2 on going pregnancies. Conclusion: Neo-adjuvant chemotherapy followed by conservative, fertility preservation surgery may be an option for the management of selected patients with stage IB cervical cancer involving large tumours sizes, who wish to preserve their fertility.
Munoz-Grajales C.,Hospital Pablo Tobon Uribe |
Gonzalez F.Z.,CES University |
Arenas R.B.,Hospital Universitario Of San Vicente Fundacion |
Velasquez Franco C.J.,Hospital Pablo Tobon Uribe |
And 4 more authors.
International Journal of Clinical Rheumatology | Year: 2014
Behçet's disease, is an inflammatory disease of unknown etiology with multisystem involvement and chronic course. In addition to the triad (recurrent oral and genital ulcers, and uveitis), it may exhibit involvement of other organs, but it is a rare hematologic commitment. Behçet's disease association with myelodysplastic processes, although uncommon, has been previously described. We report the case of a patient with Behçet's disease who developed thrombocytopenia and monocytosis. Trisomy 8 was found in karyotypic analysis and findings of myelodysplastic/myeloproliferative disease in the bone marrow. We discuss the relationship between trisomy 8, myelodysplastic syndrome and Behçet's disease. © 2014 Future Medicine Ltd.
Risk factors for multidrug-resistant Pseudomonas aeruginosa infection, in a tertiary hospital in Colombia [Factores de riesgo para infección por Pseudomonas aeruginosa multi-resistente en un hospital de alta complejidad]
Ossa-Giraldo A.C.,Co-operative University of Colombia |
Echeverri-Toro L.M.,Hospital Universitario Of San Vicente Fundacion |
Santos Z.M.,Major College of Antioquia |
Garcia M.G.,Major College of Antioquia |
And 3 more authors.
Revista Chilena de Infectologia | Year: 2014
Introduction: Multi-resistant Pseudomonas aeruginosa (MR) is frequently associated with healthcare infections. Its epidemiology is complex and few studies help to understand it. A study about risk factors associated with this type of bacteria is needed. Objective: To determine risk factors associated with MR P. aeruginosa infection in hospitalized patients from the Hospital Universitario San Vicente Foundation-Medellin. Materials and Methods: case-control study to identify risk factors associated with infection by MR P. aeruginosa. Results: 140 patients were included, 70 in each group. Bivariate analysis found association with previous use of carbapenems (OR 3.12 - IC 1.21 to 8.03, p = 0.02), aminoglycosides (OR 5.09 - CI: 1.38 to 18, 77, p = 0.01) and days of stay prior to isolation of the organism (OR 1.03 - CI: 1.01-1.05, p = 0.01). In multivariate analysis MR P. aeruginosa infection was associated with hospital stay (OR 1.03 - IC 1.01 to 1.05), use of aminoglycosides (OR 1.30 to 19.28) and treatment with two or more antimicrobials in the last 30 days (OR 3.09 - CI: 1.26 to 7.58). The risk of developing infection was 3% per day of hospital stay prior to isolation of the agent. Conclusion: Developing MR P. aeruginosa infection was associated with prior use of antimicrobials and prior hospital stay. © 2014, Sociedad Chilena de Infectologia. All rights reserved.
Rodriguez E.A.,University of Antioquia |
Correa M.M.,University of Antioquia |
Ospina S.,Hospital Universitario Of San Vicente Fundacion |
Atehortua S.L.,Hospital Universitario Of San Vicente Fundacion |
Jimenez J.N.,University of Antioquia
PLoS ONE | Year: 2014
Background: Clinical significance of Staphylococcus aureus colonization has been demonstrated in hospital settings; however, studies in the community have shown contrasting results regarding the relevance of colonization in infection by community-associated MRSA (CA-MRSA). In Colombia there are few studies on S. aureus colonization. The aim of this study was to determine the molecular and epidemiological characteristics of nasal colonization by S. aureus (MSSA-MRSA) in children from a university hospital and day care centers (DCCs) of Medellin, Colombia. Methods: An observational cross-sectional study was conducted in 400 children (200 in each setting), aged 0 months to 5 years, during 2011. Samples were collected from each nostril and epidemiological information was obtained from the parents. Genotypic analysis included spa typing, PFGE, MLST, SCCmec typing, detection of genes for virulence factors and agr groups. Results: Frequency of S. aureus colonization was 39.8% (n = 159) (hospital 44.5% and DCCs 35.0%) and by MRSA, 5.3% (n = 21) (hospital 7.0% and DCCs 3.5%). Most S. aureus colonized children were older than two years (p = 0.005), the majority of them boys (59.1%), shared a bedroom with a large number of people (p = 0.028), with history of β-Lactamase inhibitors usage (p = 0.020). MSSA strains presented the greatest genotypic diversity with 15 clonal complexes (CC). MRSA isolates presented 6 CC, most of them (47.6%) belonged to CC8-SCCmec IVc and were genetically related to previously reported infectious MRSA strains. Conclusion: Differences in epidemiological and molecular characteristics between populations may be useful for the understanding of S. aureus nasal colonization dynamics and for the design of strategies to prevent S. aureus infection and dissemination. The finding of colonizing MRSA with similar molecular characteristics of those causing infection demonstrates the dissemination capacity of S. aureus and the risk of infection among the child population. © 2014 Rodriguez et al.
Agudelo M.,University of Antioquia |
Agudelo M.,Hospital Universitario Of San Vicente Fundacion |
Rodriguez C.A.,University of Antioquia |
Zuluaga A.F.,University of Antioquia |
And 2 more authors.
International Journal of Antimicrobial Agents | Year: 2015
After demonstrating with diverse intravenous antibacterials that pharmaceutical equivalence (PE) does not predict therapeutic equivalence, we tested a single generic product of piperacillin/tazobactam (TZP) in terms of PE, pharmacokinetics and in vitro/vivo pharmacodynamics against several pathogens in neutropenic mouse thigh, lung and brain infection models. A generic product was compared head-to-head against the innovator. PE was evaluated by microbiological assay. Single-dose serum pharmacokinetics were determined in infected mice, and the MIC/MBC were determined by broth microdilution. In vivo experiments were done in a blind fashion. Reproducibility was tested on different days using different infecting organisms and animal models. Neutropenic MPF mice were infected in the thighs with Staphylococcus aureus GRP-0057 or Pseudomonas aeruginosa PA01 and in the lungs or brain with Klebsiella pneumoniae ATCC 10031. Treatment started 2 h (thigh and brain) or 14 h (lung) after infection and was administered every 3 h over 24 h (thigh and lung) or 48 h (brain). Both products exhibited the same MIC/MBC against each strain, yielded overlaid curves in the microbiological assay (P > 0.21) and were bioequivalent (IC90 83-117% for AUC test/reference ratio). In vivo, the generic product and innovator were again undistinguishable in all models and against the different bacterial pathogens involved. The relevance of these neutropenic murine models of infection was established by demonstrating their accuracy to predict the biological response following simultaneous treatment with a generic product or the innovator of TZP. Therapeutic equivalence of the generic product was proved in every model and against different pathogens. © 2014 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.