Revista Colombiana de Obstetricia y Ginecologia最新文献

{"title":"Tumor response to neoadjuvant chemotherapy in molecular breast cancer subtypes in Medellin, Colombia. Retrospective cohort study","authors":"Manuela Restrepo-Mejía,&nbsp;Ana Maria Guarín-García,&nbsp;Óscar Alejandro Bonilla-Sepúlveda,&nbsp;Melissa Rincón-Medina,&nbsp;Lina Marcela Barrera-Arenas","doi":"10.18597/rcog.3925","DOIUrl":"https://doi.org/10.18597/rcog.3925","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the frequency of clinical and pathological response in different molecular subtypes of breast cancer, in patients receiving prior neoadjuvant chemotherapy.</p><p><strong>Materials and methods: </strong>Descriptive retrospective cohort. The study population consisted of women 18 years of age and older with a histological diagnosis of invasive breast cancer stages IIA, IIB, IIIA, IIIB and IIIC, with a classification by molecular subtypes, who had received prior neoadjuvant chemotherapy, seen at a high complexity clinic in Medellin (Colombia), between July 1, 2017, and July 30, 2019. We measured age clinical stage, histological characteristics, molecular classification, and complete clinical and pathological responses by molecular subtype. A descriptive analysis was conducted.</p><p><strong>Results: </strong>Overall, 255 patients met the inclusion criteria. Mean age was 55.2 years; the clinical stages with the highest prevalence were IIIB (28.6 %) and IIB (26.3 %), and the most frequent by histologic grading were grades 3 (48.2 %) and 2 (37.3 %). Frequency by molecular types was as follows: luminal A (10.2 %), HER2-negative luminal B (39.6 %), triple-negative (23.1%), HER2-positive luminal B (13.7 %), and pure HER2 (13.3 %). Complete clinical response following chemotherapy, by molecular type, was as follows: luminal A (26.9 %), HER2-negative luminal B (37.6 %), HER2-positive luminal B (48.6 %), pure HER2 (41.2 %), triple-negative (45.8 %). Complete pathological response by molecular subtype was achieved in the luminal A (19.2 %), HER2-negative luminal B (32.7 %), HER2-positive luminal B (54.3 %), pure HER2 (50 %) and triple-negative (42.4 %) subtypes.</p><p><strong>Conclusions: </strong>In clinical practice, breast cancer classification by molecular subtypes is a means to approach the assess the to neoadjuvant chemotherapy. Prospective studies are needed in the region in order to determine the ability to predict overall and disease-free survival based on the complete pathologic response.</p>","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b7/20/2463-0225-rcog-74-02-3925.PMC10419873.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10095332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of postpartum hemorrhage in a patient with bicornuate uterus using the B-Lynch suture. Case report and review of the literature","authors":"Amanecer Rueda-Monsalbe,&nbsp;Jhon Edison Sanabria-Castelblanco,&nbsp;Miguel Ángel Montañez-Aldana","doi":"10.18597/rcog.3989","DOIUrl":"https://doi.org/10.18597/rcog.3989","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the use of the B-Lynch suture in a case of postpartum hemorrhage of a\u0000woman with bicornuate uterus, and to carry out a review of the literature on PPH control strategies in patients with müllerian anomalies, maternal outcomes in terms of hemorrhage control, as well as early and late complications.</p><p><strong>Material and methods: </strong>Case report of a patient with bicornuate uterus who presented to a regional referral hospital with postpartum hemorrhage following a cesarean section, which was successfully controlled using the B-Lynch suture. A search was conducted in the PubMed, Embase, Medline, Google Scholar and LILACS databases. The MeSh terms used were: “Uterine Atony,” “Postpartum Hemorrhage,” “Immediate Postpartum Hemorrhage,” “Bicornuate Uterus,” “Müllerian Anomalies,” “Müllerian Duct Abnormalities”. Case reports and case series of patients with müllerian malformations and PPH not responding to initial pharmacological management in whom conservative surgical procedures were used to control bleeding were included. A narrative analysis of the findings was carried out based on study characteristics, techniques used and complications.</p><p><strong>Results: </strong>Five studies were selected, 4 case reports and 1 case series which included 12 women with uterine malformations who developed PPH and in whom surgical management (uterine compression sutures) or devices (intrauterine balloon) were used for hemorrhage control. Bleeding was successfully controlled in 11 cases, with hysterectomy required only in one case (8.3 %). No long-term complications were reported.</p><p><strong>Conclusions: </strong>The literature on PPH management in women with müllerian uterine malformations is limited to case reports in which either compression sutures or medical devices such as intrauterine balloons were used. The B-Lynch-type compression suture appears to be a good option for controlling PPH in these women in order to preserve fertility, with a low rate of complications. Further documentation of these types of cases is needed in order to build the evidence regarding the usefulness of this technique for controlling postpartum uterine bleeding in this population.</p>","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6c/8f/2463-0225-rcog-74-02-3989.PMC10419877.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10095334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of ectopic pregnancy implanted on cesarea scar: cohort study 2018-2022, Lima, Peru","authors":"Oswaldo Tipiani-Rodríguez,&nbsp;José Carlos Elías-Estrada,&nbsp;Yuliana Libet Bocanegra-Becerra,&nbsp;Miguel Angel Ponciano-Biaggi","doi":"10.18597/rcog.3958","DOIUrl":"https://doi.org/10.18597/rcog.3958","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the clinical characteristics and treatment of ectopic pregnancy arising in the cesarean section scar, as well as its complications and obstetric prognosis.</p><p><strong>Material and methods: </strong>Retrospective cohort study of pregnant women with the diagnosis of a scar pregnancy in accordance with Maternal-Fetal Medicine Society criteria, seen between January 2018 and March 2022 in two high complexity institutions of the social security system, located in Lima, Peru. Consecutive sampling was used. Baseline sociodemographic and clinical variables were measured, including diagnosis, type of treatment, complications and obstetric prognosis. A descriptive analysis was performed.</p><p><strong>Results: </strong>Out of 29,919 deliveries, 17 patients were included. Of these, 41.2 % received medical management and the rest were treated surgically. Successful management with intra-gestational sac methotrexate was performed in two patients with ectopic pregnancy type 2. Four patients required total hysterectomy. Six patients became pregnant after the treatment and 4 completed their pregnancy with healthy mother and neonate pairs.</p><p><strong>Conclusions: </strong>Ectopic pregnancy implanted in a cesarean section scar is an infrequent occurrence for which medical and surgical management options are available with apparently good outcomes. Further studies of better methodological quality and random assignment are needed in order to help characterize the safety and effectiveness of the various therapeutic options for women with suspected scar pregnancy.</p>","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6d/87/2463-0225-rcog-74-02-3958.PMC10237182.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10034011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoughts about the teaching role in health education","authors":"Cristhiam David Sánchez-Corredor,&nbsp;Jorge Andrés Rubio-Romero","doi":"10.18597/rcog.4086","DOIUrl":"10.18597/rcog.4086","url":null,"abstract":"<p><p></p>","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/35/14/2463-0225-rcog-74-02-4086.PMC10419871.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10095333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors associated with the need for insulin in patients with gestational diabetes in a reference hospital in Buenos Aires, Argentina: retrospective cohort study","authors":"Melina Saban,&nbsp;Gabriela Rovira,&nbsp;Marina Inés Curriá","doi":"10.18597/rcog.3883","DOIUrl":"https://doi.org/10.18597/rcog.3883","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the clinical and sociodemographic characteristics of pregnant women diagnosed with gestational diabetes mellitus (GDM) and to assess factors potentially associated with out-of-target glycemic control and the need for insulin.</p><p><strong>Materials and methods: </strong>Retrospective descriptive cohort. Women with GDM delivered at a reference hospital between January 2018 and September 2020 were included; women delivered in a different institution were excluded. Measured variables were age, body mass index (BMI) at the start of pregnancy, family history of diabetes, gestational age at the time of diagnosis, blood glucose levels at baseline and following oral glucose tolerance test, fructosamine, Hba1c, and insulin therapy use. A descriptive exploratory analysis of factors associated with poor glycemic control was conducted using uni and multivariate analyses.</p><p><strong>Results: </strong>Of the patients with GDM, 44 % were out of target for blood glucose with lifestyle and dietary measures. The exploratory analyses revealed a potential increase in the risk of poor glycemic control associated with initial blood glucose level on OGTT (raw OR: 3.57; 95 % CI: 2.1 - 6.1), BMI > 25 kg/m2 (OR: 1.97, 95 % CI: 1.15 - 3.34), and more advanced gestational age at the time of diagnosis as a protective factor against the need for insulin therapy (OR: 0.45, 95 % CI: 0.27- 0.75). However, these associations were not confirmed in the multivariate analysis.</p><p><strong>Conclusions: </strong>A baseline blood glucose value greater than 95 mg/dl and BMI of more than 25 kg/m2 could be associated with poor glycemic control in women with GDM. Studies that assess these variables and control for confounding factors are needed in order to identify the factors associated with insulin requirement in pregnant women.</p>","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e3/57/2463-0225-rcog-74-02-3883.PMC10419874.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10038496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pyramids in medical education: Their conceptualization and utility summarized","authors":"Luis Carlos Domínguez-Torres,&nbsp;Neil Valentín Vega-Peña","doi":"10.18597/rcog.3994","DOIUrl":"https://doi.org/10.18597/rcog.3994","url":null,"abstract":"RESUMEN Objetivos: Examinar los aspectos conceptuales que sustentan las pirámides educativas, sus limitaciones, las modificaciones que se han propuesto en algunas de ellas y hacer una descripción de su utilidad. Materiales y métodos: A partir de la selección de las pirámides con base en que el diseño gráfico hubiera sido parte de su conceptualización original, y de la descripción conceptual, se hace una reflexión de las críticas que han sido objeto y las modificaciones resultado de estas observaciones y del uso que se ha dado a las pirámides más comúnmente utilizadas en la educación médica. Resultados: Se incluyeron cinco pirámides: George Miller, Edgar Dale, Donald Kirkpatrick, Benjamín Bloom, y Abraham Maslow. Las pirámides describen diferentes aspectos de la evaluación en la educación médica, ya sea en los individuos o en los programas, tales como: competencias, identidad, confiabilidad, aprendizaje, comportamiento, resultado, complejidad cognitiva y realización personal. Conclusiones: Las pirámides revisadas han contribuido, como referentes teóricos, para el soporte de procesos educativos en las profesiones de la salud. Su utilidad práctica es extensiva a diferentes especialidades y niveles de educación por cuanto pueden asistir a los profesores para optimizar los procesos de diseño curricular, instruccional y de evaluación. Es importante evaluar, en el medio local, los efectos en los programas de ciencias de la salud que se han basado en estos referentes teóricos.","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1c/a6/2463-0225-rcog-74-02-3994.PMC10419883.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10394476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary breast B-cell non-Hodgkin’s lymphoma of the breast. Case Report and review of the literature","authors":"Leopoldo Santiago-Sanabria,&nbsp;Julieta Garza-Arrieta,&nbsp;Gina Daniela Porras-Ibarra,&nbsp;Montserrat Malfavón-Farias","doi":"10.18597/rcog.3844","DOIUrl":"https://doi.org/10.18597/rcog.3844","url":null,"abstract":"<p><strong>Objectives: </strong>To report a case of primary breast B-cell non-Hodgkin’s lymphoma (PBL) and to conduct a literature review of its diagnosis and treatment.</p><p><strong>Materials and methods: </strong>Case report of an 80-year-old female patient who presented to a private referral institution in Mexico, with PBL. She was also diagnosed with primary liver melanoma by means of targeted biopsy and pathology testing. The patient received treatment with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone), quadrantectomy, lymph node dissection and radiotherapy. The PBL showed good response but, because of progression of the second primary tumor, the patient went on to receive palliative care. A review of the literature was conducted in Medline via PubMed, LILACS and Google Scholar. Cohort studies, case reports and case series in patients with PBL that discussed diagnosis, treatment and prognosis of this disease, published in English and Spanish between 2000 and 2022, were included.</p><p><strong>Results: </strong>Overall, 23 titles were identified, of which 17 consisting of case reports and case series met the inclusion criteria. The majority of patients received R-CHOP as chemotherapy regimen, with irradiation as adjunct therapy. Close to 80 % went into complete remission. The most frequent site of recurrence was the central nervous system. Five-year survival was 83.6 % in the included studies.</p><p><strong>Conclusions: </strong>At present, the CHOP regimen, with or without rituximab and usually accompanied by radiotherapy, is the most widely used and the only one that has shown a positive impact on survival. Additional randomized clinical trials are needed in order to gain a clearer insight into the effectiveness and safety of these treatments.</p>","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/37/09/2463-0225-rcog-74-01-3844.PMC10174716.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9504602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on the article, “Primary ADN-VPH screening in women under 30 years of age: health technology assessment”","authors":"Hugo Franco Campos-Ponce,&nbsp;Samantha Castro-Mamani,&nbsp;Yolvi Ocaña-Fernández","doi":"10.18597/rcog.3970","DOIUrl":"https://doi.org/10.18597/rcog.3970","url":null,"abstract":"","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/04/1c/2463-0225-rcog-74-01-3970.PMC10171332.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9505064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: “Comments on the article entitled “Primary ADN-VPH screening in women under 30 years of age: health technology assessment”","authors":"Carmen Doris Garzón-Olivares,&nbsp;Carlos Fernando Grillo-Ardila,&nbsp;Jairo Amaya-Guio","doi":"10.18597/rcog.4015","DOIUrl":"https://doi.org/10.18597/rcog.4015","url":null,"abstract":"","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/0a/2463-0225-rcog-74-01-4015.PMC10168191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The editorial process in medical journals: reconciling different perspectives","authors":"Hernando Gaitán-Duarte","doi":"10.18597/rcog.4033","DOIUrl":"https://doi.org/10.18597/rcog.4033","url":null,"abstract":"","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e5/78/2463-0225-rcog-74-01-4033.PMC10168188.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9445179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}