Etiología y tratamiento de las vulvovaginitis en un grupo de pacientes prepúberes

ResumenObjetivodescribir la etiología microbiológica de la vulvovaginitis en pacientes prepúberes atendidas en la consulta de pediatría general del hospital infantil de México “Federico Gómez”.Material y métodosestudio descriptivo y longitudinal. Desde junio de 2007 hasta julio de 2009 se incorporaron al estudio 36 niñas con sintomatología y signos clínicos de vulvovaginitis, quienes además de cumplir con criterio de edad debían ser prepúberes. A las pacientes con datos clínicos compatibles con vulvovagintis se les realizaron cultivos vaginales para bacterias, examen directo en busca de formas micóti cas y cultivo para hongos, examen general de orina, coproparasitoscópico, coprocultivo y prueba de Graham.Resultadosla sintomatología más frecuente fue descarga transvaginal en 86% y prurito vaginal en 83%. Dentro de la exploración física encontramos como datos más consistentes eritema vaginal en 94% y descarga vaginal en 89%. Cultivos positivos para Escherichia coli, 88%. La vulvovaginitis de etiología inespecífica fue la más frecuente.Conclusionesno fue posible identificar en la literatura guías de tratamiento locales ni mundiales para un padecimiento pediátrico tan común, lo cual se refleja en un inadecuado tratamiento, la recurrencia del padecimiento y el uso inapropiado de antibióticos.SummaryObjectivedescribe the microbiological etiology of vulvovaginitis in prepubertal patients attended in the General Pediatrics consultation at the Mexico Children’s Hospital “Federico Gomez”.Material and methodsdescriptive and longitudinal study. There were incorporated, from June 2007 until July 2009, into the study 36 girls with symptoms and clinical signs of vulvovaginitis, who in addition to meet the criteria of age had to be pre-pubescent. To those patients with vulvovaginitis supported clinical data had to carry out vaginal cultures for bacteria, direct examination in search of culture for fungi and fungal forms, general examination of urine, stool culture and Graham test.Resultsthe most frequent symptomatology was transvaginal discharge 86% and vaginal itching 83%. Within physical examination there were as more consistent data vaginal erythema in 94% and vaginal discharge in 89%. The Positive cultures for Escherichia coli were 88%. The most frequent was vulvovagnitis of nonspecific etiology.Conclusionsit was not possible to identify in the local or global literature treatment guides for such common pediatric condition. This is reflected in an inappropriate treatment, the recurrence of the condition, and the misuse of antibiotics

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

The burden of influenza A and B in Mexico from the year 2010 to 2013: An observational, retrospective, database study, on records from the Directorate General of Epidemiology database

Despite vaccination programs, influenza still represents a significant disease burden in Mexico. We conducted an observational, retrospective analysis to better understand the epidemiological situation of the influenza virus in Mexico. Analysis of the seasonal patterns of influenza A and B were based on the Directorate General of Epidemiology dataset of influenza-like illness(ILI), and severe acute respiratory infection(SARI) that were recorded between January 2010 and December 2013. Our objectives were 1) to describe influenza A and B activity, by age group, and subtype and, 2) to analyze the number of laboratory-confirmed cases presenting with ILI by influenza type, the regional distribution of influenza, and its clinical features. Three periods of influenza activity were captured: August 2010–January 2011, December 2011–March 2012, and October 2012–March 2013. Cases were reported throughout Mexico, with 50.3% (n = 10,320) of cases found in 18–49 year olds. Over the entire capture period, a total of 76,085 ILI/SARI episodes had swab samples analyzed for influenza, 27% were positive. During the same period, influenza A cases were higher in the 18–49 years old, and influenza B cases in both 5–17 and 18–49 age groups. Peak activity occurred in January 2012 (n = 4,159) and December 2012 (n = 348) for influenza A and B respectively. This analysis confirms that influenza is an important respiratory pathogen for children and adults in Mexico despite vaccination recommendations. School-age children and adolescents were more prone to influenza B infection; while younger adults were susceptible to both influenza A and B viruses. Over the seasons, influenza A and B co-circulated

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease