ABSTRACT Objective The aim was to describe the clinical features of patients with ectopic Cushing syndrome (ECS) from Colombia and compare these findings with other series to provide the best management for these patients. Materials and methods Records of patients with ECS from 1986 to 2017 were retrospectively reviewed; patients with a diagnosis of adrenal or pituitary Cushing syndrome (CS) were excluded. Results Fourteen patients with ECS were analyzed in this study. The mean age was 54.4 (SD 17.1) years, and the female to male ratio was 1.33:1. Regarding the etiology of ECS, four patients had lung carcinoids (28.6%), three had small-cell lung carcinoma (21.4%), three had pancreatic neuroendocrine tumors (21.4%), one had medullary thyroid cancer (7.1%), one had non-metastatic pheochromocytoma (7.1%), one had metastatic thymoma (7.1%) and one patient had an occult source of ACTH (7.1%). The most common clinical features at presentation were moon-face, muscle weakness, diabetes mellitus and hypertension. Hyperpigmentation was present in 36% of patients, and 12 patients had hypokalemia with a mean value of 2.3 mEq/L (SD 0.71). The median basal cortisol, 24-hour urinary free cortisol (UFC) and ACTH were 30.5 ug/dL (IQR 21-59 ug/dL), 2,600 ug/24 h (IQR 253-6,487 ug/24 h) and 91 pg/mL (IQR 31.9-141.9), respectively. Thirteen patients (92.8%) had the site of the primary lesion identified. Six patients had undergone a surgical intervention to address the primary tumor. Resection was curative in 28.5% of patients. Death occurred in 57.1% of patients, and the median overall survival was 27 months. Intrathoracic tumors had the most aggressive behavior. Conclusions ECS is a rare disease; however, it is associated with high morbidity and mortality. A rapid intervention supported by an interdisciplinary group is required to improve overall survival and quality of life

Se presenta la metaheurística de Optimización de Enjambre de Partículas (PSO) para la solución del Problema de Ruteo de Vehículos con Entrega y Recolección Simultáneas (VRPSPD). Se aplica una representación de la solución y un método de decodificación para implementar el PSO al VRPSPD. El método de decodificación inicia transformando una partícula en una lista de prioridades de clientes para entrar a las rutas y en una matriz de prioridades de vehículos para servir cada cliente. Las rutas de los vehículos son construidas con base en la lista de prioridad de clientes y en la matriz de prioridad de vehículos. El algoritmo es validado usando 18 instancias disponibles en la literatura para problemas de 100, 200 y 400 clientes.

In this paper, the Particle Swarm Optimization (PSO) algorithm for solving the Vehicle Routing Problem with Simultaneous Pickup and Delivery (VRPSPD) is presented. A solution representation is applied with random elements and a decoding method for implementing PSO for VRPSPD. The decoding method begins by transforming a particle into a customer's priority list to enter the routes and the vehicles priority matrix to serve each customer. Vehicle routes are constructed based on the customer's priority list and the vehicles priority matrix. The algorithm is tested using 18 instances available from the literature. Computational results show that the proposed method gives good solutions for 100, 200 and 400 customers problems.