Search

BACKGROUND: In Sweden, all patients with urinary bladder cancer (UBC) are recorded in the Swedish National Register for Urinary Bladder Cancer (SNRUBC). The purpose of this study was to validate the registered clinical tumour categories (cT-categories) in the SNRUBC for Norrland University Hospital, Sweden, from 2009 to 2020, inclusive. METHODS: The medical records of all 295 patients who underwent radical cystectomy for the treatment of UBC were reviewed retrospectively. Possible factors impacting the cT-categories were identified. To optimise cT-classification, computed tomography urography of all patients with suspected tumour-associated hydronephrosis (TAH) or suspected tumour in bladder diverticulum (TIBD) were retrospectively reviewed by a radiologist. Discrepancy was tested with a logistic regression model. RESULTS: cT-categories differed in 87 cases (29.5%). Adjusted logistic regression analysis found TIBD and TAH as significant predictors for incorrect registration; OR = 7.71 (p < 0.001), and OR = 17.7, (p < 0.001), respectively. In total, 48 patients (68.6%) with TAH and 12 patients (52.2%) with TIBD showed discrepancy regarding the cT-category. Incorrect registration was mostly observed during the years 2009-2012. CONCLUSION: The study revealed substantial incorrect registration of cT-categories in SNRUBC. A major part of the misclassifications was related to TAH and TIBD. Registration of these variables in the SNRUBC might be considered to improve correct cT-classification.

Metabolic syndrome is considered a cluster of risk factors that include abdominal obesity, insulin resistance, elevated blood pressure, and atherogenic dyslipidemia. The origin of metabolic syndrome is due to a combination of genetic and epigenetic factors, lifestyle and environmental factors. Cardiovascular disease and type 2 diabetes mellitus are the main coexisting conditions. Diagnosis is made when three or more of the five criteria are present, including: 1) systolic blood pressure ≥130 mm/Hg and/or diastolic blood pressure ≥85 mm/Hg, 2) triglyceride levels ≥150 mg/dL, 3) HDL levels <40 mg/dL in men and <50 mg/dl in woman, 4) glucose levels ≥100 mg/dL and 5) abdominal circumference ≥ 88 cm for women and ≥ 102 cm in men. Treatment is based on both pharmacological and non-pharmacological measures. Metabolic syndrome is a condition that should always be kept in mind and should be excluded in the risk population. Anthropometric measurements are a good method of early detection to be able to start with complementary laboratory tests and thus diagnose the pathology in a timely manner and thus avoid long-term repercussions., El síndrome metabólico se considera un conjunto de factores de riesgo que incluyen obesidad abdominal, resistencia a la insulina, presión arterial elevada y dislipidemia aterogénica. El origen del síndrome metabólico se debe a la combinación de los factores genéticos y epigenéticos, estilo de vida y factores ambientales. La enfermedad cardiovascular y la diabetes mellitus tipo 2 son las principales condiciones coexistentes. El diagnóstico se realiza cuando hay presencia de tres o más de los cinco criterios que incluyen: 1) presión arterial sistólica ≥130 mm/Hg y/o presión arterial diastólica ≥85 mm/Hg, 2) niveles de triglicéridos ≥150 mg/dL, 3) niveles de HDL <40 mg/dl en hombres y <50 md/dl en mujeres, 4) niveles de glucosa ≥100 mg/dL y 5) circunferencia abdominal ≥88 cm para las mujeres y ≥ 102 cm en hombres. El tratamiento se basa en medidas tanto farmacológicas como no farmacológicas. El síndrome metabólico es una condición que siempre debe tenerse presente y que debe de ser excluida en la población de riesgo. Las medidas antropométricas constituyen un buen método de detección temprana para poder iniciar con las pruebas complementarias de laboratorio y así diagnosticar la patología de manera oportuna y así evitar las repercusiones a largo plazo.

Eosinophilic esophagitis is a chronic inflammatory disease of the esophagus that occurs due to an immunoallergic response triggered in most cases by food antigens. Clinically it is characterized by signs and symptoms related to esophageal dysfunction and histologically by tissue inflammation in which eosinophils predominate. Eosinophilic eophagitis is diagnosed when there are symptoms related to esophageal dysfunction such as dysphagia and food impaction, the presence of ≥15 eosinophils per high-power field on esophageal mucosal biopsy, and after a thorough evaluation for disorders that may cause or contribute to esophageal eosinophilia. The treatment consists of dietary modifications, pharmacological therapies and endoscopic interventions. In 2022, dupilumab became the first Food and Drug Administration -approved treatment for eosinophilic esophagitis. The importance of health personnel dealing with this disease lies in the fact that although it is a chronic disease, its early and timely diagnosis improves the evolution of the disease and the quality of life of the patient's treatment., La esofagitis eosinofílica es una enfermedad inflamatoria del esófago de carácter crónico que ocurre por una respuesta inmunoalérgica desencadenada en la mayoría de los casos por antígenos alimentarios. Clínicamente, se caracteriza por signos y síntomas relacionados con disfunción esofágica, e histológicamente por inflamación tisular en la cual predominan los eosinófilos. La esofagitis eosinofílica se diagnostica cuando hay síntomas relacionados con disfunción esofágica, como disfagia e impactación alimentaria, presencia de ≥15 eosinófilos por campo de alto poder en la biopsia de la mucosa esofágica, y después de realizar una evaluación exhaustiva de trastornos que pueden causar o contribuir potencialmente a la eosinofilia esofágica. El tratamiento consiste en modificaciones dietéticas, terapias farmacológicas e intervenciones endoscópicas. En 2022, el dupilumab se convirtió en el primer tratamiento para la esofagitis eosinofílica aprobado por la “Food and Drug Administration”. La importancia de que el personal de salud se familiarice con en el manejo de esta enfermedad radica en que, si bien es una enfermedad crónica, su diagnóstico precoz y tratamiento oportuno mejoran la evolución de la enfermedad y la calidad de vida del paciente.