Hernioplastia inguinal con cono protésico de polipropileno en pacientes no subsidiarios de cirugía mayor ambulatoria: estudio multivariante de factores relacionados con las complicaciones postoperatorias y la estancia hospitalaria

[Resumen] PLANTEAMIENTO Y OBJETIVOS Se estudia el método de hernioplastia con cono de polipropileno en régimen de Corta Estancia Quirúrgica con el objetivo de describir las características de este grupo de pacientes, identificar las variables relacionadas con las complicaciones postoperatorias y la prolongación de la estancia. MATERIAL Y MÉTODOS Estudio prospectivos de las hernioplastias realizadas en 1997-1999 en los pacientes rechazados para hernioplastia ambulatoria en el área A Coruña. Se practicó hernioplastia bajo raquianestesia, anestesia general o local, con cono protésico de polipropileno. En las hernias indirectas se colocó un cono en el orificio inguinal profundo y una lámina plana de refuerzo de la pared posterior. En las hernias directas se colocó cono protésico en el defecto cubriendo toda la pared posterior del conducto inguinal y suturada a sus límites. Se realizó profilaxis antibótica y antitrombótica. La intervención se realiza en régimen de Corta Estancia Quirúrgica y se realiza seguimiento clínico programado. Las variables registradas en base de datos informáticas son analizadas estadísticamente utilizando el test Ji-cuadrado y el test exacto de Fischer para la comparación de proporciones entre variables culitativas y la prueba t-student para las cualitativas. Se realiza un análisis de regresión múltiple para detectar variables relacionadas con las complicaciones postoperatorias y con la prolongación de la estancia. Se realiza un análisis de las recidivas precoces aplicando el método de Kaplan-Meier. RESULTADOS Se analizan 240 hernioplastias en 196 pacientes con edades entre los 30 y los 85 años. La causa más frecuente de rechazo para cirugía ambulatoria fue el elevado riesgo anestésico. Un 64% de los pacientes presentaron patología asociada. Un 53,7% de los pacientes seguían algún tratamiento farmacológico. Se empleó anestesia intradural en el 90% de los casos y solo en el 3,3

Sequential Colocalization of ERa, PR, and AR Hormone Receptors Using Confocal Microscopy Enables New Insights into Normal Breast and Prostate Tissue and Cancers

Multiplex immunohistochemistry (mIHC) use markers staining different cell populations applying widefield optical microscopy. Resolution is low not resolving subcellular co-localization. We sought to colocalize markers at subcellular level with antibodies validated for clinical diagnosis, including the single secondary antibody (combination of anti-rabbit/mouse-antibodies) used for diagnostic IHC with any primary antibody, and confocal microscopy. We explore colocalization in the nucleus (ColNu) of nuclear hormone receptors (ERa, PR, and AR) along with the baseline marker p63 in paired samples of breast and prostate tissues. We established ColNu mIHCF as a reliable technique easily implemented in a hospital setting. In ERa+ breast cancer, we identified different colocalization patterns (nuclear or cytoplasmatic) with PR and AR on the luminal epithelium. A triple-negative breast-cancer case expressed membrane-only ERa. A PR-only case was double positive PR/p63. In normal prostate, we identified an ERa+/p63+/AR-negative distinct population. All prostate cancer cases characteristically expressed ERa on the apical membrane of the AR+ epithelium. We confirmed this using ERa IHC and needle-core biopsies. ColNu mIHCF is feasible and already revealed a new marker for prostate cancer and identified sub-patterns in breast cancer. It could be useful for pathology as well as for functional studies in normal prostate and breast tissues

Should we suspect primary aldosteronism in patients with hypokalaemic rhabdomyolysis? A systematic review

Severe hypokalaemia causing rhabdomyolysis (RML) in primary aldosteronism (PA) is a rare entity, and only a few cases have been reported over the last four decades. This systematic review and case report aims to gather all published data regarding a hypokalaemic RML as presentation of PA in order to contribute to the early diagnosis of this extremely rare presentation. With the use of PubMed Central, EMBASE, and Google Scholar, a thorough internet-based search of the literature was conducted to identify articles and cases with RML secondary to hypokalaemia due to PA between June 1976 and July 2023. The case study concerns a 68-year-old male patient with hypokalaemic RML at presentation of PA. In the systematic review of the literature, 37 cases of RML secondary to hypokalaemia due to PA have been reported to date. In summary, the median age was 47.5 years, the male/female ratio was 17/21, all patients presented symptoms (weakness and/or myalgia), all the patients were hypertensive, and only four patients had complications with acute kidney injury (AKI). Although PA rarely presents with RML, it should be suspected when marked hypokalaemia and hypertension are also present. Early detection and management are essential to reduce the frequency of manifestations such as AKI