Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introducción: El suicidio en adolescentes es una grave problemática de salud pública a nivel mundial. El objetivo de la presente investigación es caracterizar el suicidio en adolescentes residentes en el departamento de Cauca entre los años 1998 y 2017.Métodos: Se realizó un estudio descriptivo de corte transversal. La información de los decesos se obtuvo de los certificados de defunción que procesa el Departamento Administrativo Nacional de Estadística –DANE- de Colombia. Las tasas de mortalidad se calcularon utilizando las estimaciones y proyecciones poblacionales que realizó el DANE. Se calcularon medidas de frecuencia absoluta y relativa en las variables de persona, tiempo, lugar que fueron analizadas.Resultados: En los veinte años estudiados se registraron 496 suicidios en adolescentes residentes del departamento de Cauca. 51,0 % fueron cometidos por hombres. 17,3 % tenían algún tipo de unión marital. 33,1 % residían en la cabecera municipal. 42,7 % murió en su residencia. La tasa de suicidios se ubicó en 9,5 por cada cien mil adolescentes (9,4 en hombres y 9,5 en mujeres). El quinquenio 2003-2007 registró la más alta tasa con 12,7 suicidios por cada cien mil adolescentes. Por provincias, la zona Oriental registró el riesgo más alto con una tasa de 12,8 suicidios por cada cien mil.Conclusiones: Se concluye que el suicidio en adolescentes de Cauca presenta tasas altas, razón por la cual es importante que las autoridades de salud implementen programas de detección temprana.

This paper aims to provide elements that enrich the debate on the usefulness of the temporary cut in International Relations established in the Peace of Westphalia. To this end, a historical overview of diplomacy from the ancient world to 1648 is made, which shows that diplomatic tools such as those used to reach the peace treaties of Osnabrück and Münster were developed from antiquity in the four civilizational foci of Eurasia. Then, this knowledge was synthesized in Constantinople and returned to Europe through Venice. The relevance of this work is linked to its inclusion in the debate on the periodicity of the object of study in International Relations and the history of this discipline.

Objective: To present our case series of idiopathic urethral stricture in adolescents, analyzing the treatments applied and the results obtained. Methods: A retrospective study of 7 patients with idiopathic urethral stricture treated at our center between 2000 and 2021 was performed. Results: The average age at the moment of surgery was 14.7 years. In 85% of cases the main symptom was voiding difficulty. The diagnosis was by voiding cystourethrography (VCUG) in five patients and by cystoscopy in two, locating the stricture in the anterior urethra in all cases. Six patients were treated with endoscopic urethrotomy and one with balloon dilation. Two patients recurred. The subsequent treatment in both cases was a second endoscopic urethrotomy and one of them required a posterior urethroplasty. Currently 6 out of 7 patients are asymptomatic and the patient who underwent urethroplasty is undergoing regular dilations. Limitations: The number of patients is limited due to the shortage of this pathology in childhood. Value: The available literature is quite limited. It is usually secondary to trauma or surgical interventions such as hypospadias repair. Idiopathic etiology represents less than a third of urethral strictures in adolescents and it causes the greatest controversy regarding its management. Conclusions: We should suspect idiopathic urethral stricture in childhood when symptoms appear, such as voiding difficulty in patients without previous pathologies. VCUG can help diagnosis, but a cystoscopy allows diagnosis and treatment at the same time. Endoscopic urethrotomy should be the treatment of choice for idiopathic strictures smaller than 1 cm, since the success rate is greater than 85%.

Twenty-five percent of patients with renal cancer initiate with metastatic disease at diagnosis and thirty percent of patients with localized disease present recurrence after nephrectomy. Metastatic activity to the bladder is extremely rare, representing only 1% of bladder tumors. We report a rare case of clear cell renal carcinoma metastasis to the bladder 7 years after initial management with radical nephrectomy. Management of the metastatic lesion was by transurethral resection. The available evidence suggests that surgical treatment offers good results, whether through transurethral resection, partial or radical cystectomy. The prognosis will be determined by some prognostic factors such as the time interval between initial management and recurrence, number and volume of metastatic lesions.  

Objective: To describe the patients operated on for hypospadias at the Baca Ortiz Pediatric Hospital in the last 8 years. Method: It is a descriptive study of 376 cases between January 2012 and January 2020. The demographic data were age, karyotype, personal history, type of hypospadias, type of surgery, and post-surgical complications. We performed descriptive statistical analysis and comparisons between types of hypospadias (SPSSv19), Chi square, cross tables, Wilcoxon. Results: 61 patients met the inclusion criteria, 14.3% of them underwent a karyotype. The age at surgery presents a mean of 4.7 years, with no family history. In distal hypospadias, the surgical technique varied, with 7.6% of Claiven and Dindo type complications. In proximal hypospadias, which correlates with two-stage surgery (Snodgrass technique) (the type of intervention performed in our institution and which corresponds to 52.4%), there were 37.2% complications, 4.5% of these patients underwent reoperation (cripple). The average number of days of hospitalization was 7.9% and there is no statistically significant difference (p=0.6). Of the patients, 98% reported in the 6 items of the penile perception scale a score that indicates satisfaction with the appearance of the penis. 10% underwent uroflowmetry with a normal pattern of Qmax 15ml/s and a bladder echo without residue. Conclusions: Our series shows that hypospadias, depending on its level, is a pathology that frequently causes complications, despite the technique used.

  Case description: A 68-year-old man with a constitutional syndrome secondary to an abscess in the psoas, which was incidentally diagnosed in the CT scan of a possible neoplastic lesion. Cystoscopy identifies a polypoid neoformation that is completely removed by transurethral resection, being diagnosed as a granular cell tumor of the bladder.   Relevance: The granular cell tumor is a rare neoplasm, in bladder there are only 27 cases published. These lesions are mostly benign, although cases of a malignant nature have been described. Due to their asymptomatic presentation, there is an underdiagnosis of these lesions, which translates into a lack of clinical and therapeutic information, without the existence of guidelines for their management.   Clinical implications: It is important to know the clinical and histological characteristics of this pathology because its symptoms mimic some neoplasms of the bladder. It is also important to know the entity to perform a correct treatment, considering its characteristic recurrence tendency.   Conclusion: Despite being infrequent lesions, due to the recurrence tendency and their possible malignant nature, it is important to consider them as a possible differential diagnosis in bladder lesions.

Case report: 73-year-old male who is diagnosed with a right renal tumor undergoes a laparoscopic partial nephrectomy which, due to complication controlling the vascular pedicle, turns into an open surgery. After 48 hours, the patient develops a left gluteal compartment syndrome (pain, paresis and edema in lower limb) and rhabdomyolysis (CK 50000Ul/l) . The diagnosis was mainly clinical. Abdominal-pelvic CT showed volume increase and edema at the gluteal muscle level. Due to high clinical suspicion, urgent decompressive fasciotomy in the area is required (48h post-nephrectomy). 48 and 96 hours after this urgent surgery, the fasciotomy wound was reviewed in the operating room, debriding and cleaning the affected tissues exhaustively. Finally, vacuum assisted closure is applied to enhance the healing of the tissues. Relevance and clinical implications: The aim of our study is to present a case of compartment syndrome after a laparoscopic partial nephrectomy that converted to open surgery, a complication thathas not been previously described in medical literature.   Conclusions: Compartment syndrome is a very infrequent post-surgical complication but potentially life-threatening, can also occurs after nephrectomies in patients placed in lateral decubitus. Clinical suspicion is fundamental in patients with risk factors and compatible symptoms, and should be treated early to reduce the sequelae and the high morbidity associated with it.  

Introduction: Lymphadenectomy is the method of choice in lymphatic evaluation in patients diagnosed with prostate cancer. The first challenge is to know the probability of involvement with nomograms, Partin, being the most used. According to these nomograms, those patients with node involvement higher than 2% have an indication for lymphadenectomy during prostatectomy for therapeutic and prognostic purposes. Biochemical recurrence is defined as a serum prostate-specific antigen level greater than 0.2 ng / ml confirmed at least 4 weeks after prostatectomy. Material and methods: We performed an observational retrospective study where the records of 150 consecutive radical prostatectomy cases performed between 2007-2019 were reviewed. A total of 109 patients were included. The probability of lymph node involvement was calculated by Partin nomogram, and all those with more than 2% were selected. They were divided into two groups: with pelvic lymph node dissection (PLND group) or without pelvic lymph node dissection (non-PLND). A Shapiro-Wilks analysis was carried out to check the normality of the data. The p <0.01 in both cases, therefore a Wilcoxon test was carried out, using the Statistical 8.0 program Results: Using a Spearman correlation and with a p> 0.01, it was found that there was no relationship between the calculation of more than 2% of lymph node involvement by Partin and early biochemical recurrence. We found no significant differences. Conclusion: In our study, lymphadenectomy did not showed difference in the risk of biochemical progression. Sparing pelvic lymphadenectomy during prostatectomy with a percentage greater than or equal to 2% per Partin nomogram does not have a direct relationship with biochemical recurrence. The use of other nomograms adjusted to our population can make a difference in these results.

Objective: Compare the different definitions for bladder outlet obstruction (BOO) in women with dysfunctional voiding (DV) and find which one is most specific and sensitive to achieve a more accurate diagnosis. Materials and methods: a cross-sectional study of urodynamic investigation studies from women diagnosed with DV in a period from 2017-2020 were classified with obstruction or not, based on 6 urodynamic definitions. The control group were women who had been categorized with obstruction in at least 3 definitions of BOO. Likelihood positive ratio, sensitivity and specificity were calculated. Statistical analysis was carried out by IBM SPSS Statistics for Windows, Version 23.0 (IBM Corp., Armonk, N.Y., USA). A p <0.5 was considered statistically significant. Results: A total of 146 urodynamic studies were analyzed, Solomon-Greenwell nomogram has shown to be the more specific and sensitive, obtaining the highest likelihood positive ratio >100. The comparison between our the control group and every definition of BOO has shown statistically significant difference. Conclusions: The diagnosis of BOO requires expertise and individualization, it is made through physical examination and complete urodynamic study, Solomon-Greenwell has shown to be specific and sensitive for diagnosis in the group of study.