BackgroundMultiple observational studies suggest an increased risk of colon cancer in patients with diabetes mellitus (DM). This can theoretically be the result of an influence of the diabetic environment on carcinogenesis or the tumor biologic behavior.AimTo gain insight into the influence of a diabetic environment on colon cancer characteristics and outcomes.Material and methodsRetrospective analysis of clinical records in an academic tertiary care hospital with detailed analysis of 81 diabetic patients diagnosed of colon cancer matched with 79 non-diabetic colon cancer patients. The impact of streptozotocin-induced diabetes on the growth of colon cancer xenografts was studied in mice.ResultsThe incidence of DM in 1,137 patients with colorectal cancer was 16%. The diabetic colon cancer cases and non-diabetic colon cancer controls were well matched for demographic and clinical variables. The ECOG Scale Performance Status was higher (worse) in diabetics (ECOG ≥1, 29.1% of controls vs 46.9% of diabetics, p = 0.02), but no significant differences were observed in tumor grade, adjuvant therapy, tumor site, lymphovascular invasion, stage, recurrence, death or cancer-related death. Moreover, no differences in tumor variables were observed between patients treated or not with metformin. In the xenograft model, tumor growth and histopathological characteristics did not differ between diabetic and nondiabetic animals.ConclusionOur findings point towards a mild or negligible effect of the diabetes environment on colon cancer behavior, once cancer has already developed.

This is a retrospective study about the prevalence of ESBL-producing Escherichia coli (EEC) in urinary specimens from patients from the Comunitat Valenciana from January 2007 to December 2008. Data were retrieved from RedMIVA, and Bayesian generalized linear mixed models were considered to study the prevalence of EEC with regard to demographical and microbiological factors.The total number of infections considered was 164,502, the amount of urinary isolates was 70,827 belonging to 49,304 different patients, and 5,161 (7.3%) of the urinary isolates were EEC. Three out of four E. coli were isolated in women (76.8%), men showed higher rates of EEC (9.7% in men vs. 6.5% in women). EEC patients were, in average, 10.8 years older, and hospitalization was more frequent (9.9% vs. 6.9%).Resistance to non-β-lactams antimicrobials was higher in EEC. The rates of ciprofloxacin and co-trimoxazol resistance in EEC were 75.5% and 52.0%, respectively, whereas it ranged between 1.4-12.4% for the rest of antimicrobials.Prior EEC infection and hospitalization were the most relevant risk factors and increased the expected EEC probability approximately 400% and 50% respectively. Other infections played an important and positive role too, Enterobacteriaceae, P. aeruginosa and other bacteria being the most relevant elements. Female gender was a protective factor and reduced the risk by approximately 25% while age was an additive risk factor.Finally, an open-access web-based software was constructed to compute the probability that an E. coli in a urinary infection be an EEC from a specific combination of risk factors. This pharmacovigilance tool should prove useful to monitor and control antimicrobial resistance spread.

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The resistance to antimicrobials is an alarming topic and little known outside of the scientific community. Therefore, this study was undertaken with the objectives of analyzing the use of antimicrobials for veterinary doctors in canines that consult in veterinary clinics, which are part of a veterinary association in Asuncion and Greater Asuncion, to determine the percentage of antimicrobials that are most utilized according to the affected systems, the prescribed therapy for them and the quantity of veterinary doctors that request the culture and antibiogram. Thirty-one veterinary clinics were surveyed, it was confirmed that for the respiratory system the beta-lactam antimicrobials are the most utilized in 71% (22/31), for the gastrointestinal system the potentiated sulfonamides in 29% (9/31), for the urogenital system the enrofloxacin in 55% (17/31) and for the integumentary system the cephalexin in 81% (25/31). About the posology a total of 120 responses were obtained, where 53% administers a dose within the range suggested by it, 36% (44/120) underdoses and 11% (14/120) overdoses. Likewise, analyzingthe frequency and duration of the prescription 33% (40/120) do it properly, 56% (67/120) do it inadequately and 11% (13/120) did not specified complete data. Referring to the use of culture and antibiogram, it was observed that the majority of respondents do not use it, reaching a maximum percentage of 42% with affirmative answers in the urogenital system, while, in other systems, the percentage did not surpass 26% of affirmative answers.