Sobrevida após exenteração pélvica em câncer de colo de útero recidivado: uma série de cinco casos / Survival after pelvic exenteration in recurrent cervical cancer: a series of five cases

A exenteração pélvica pode curar pacientes com câncer de colo do útero com recorrência central após radioterapia e quimioterapia. A avaliação pré-operatória é essencial para excluir doença metastática e evitar cirurgias desnecessárias nesse cenário. O objetivo do presente estudo é avaliar a sobrevida de uma série de casos de pacientes submetidas à exenteração pélvica em clínica privada de Teresina. Este é o resultado parcial de um estudo observacional, retrospectivo, transversal e descritivo, realizado em uma clínica privada especializada no tratamento do câncer em Teresina, PI, Brasil, de junho de 2002 a fevereiro de 2020. Cinco pacientes foram incluídas no estudo, com idades entre 29 e 62 anos. No presente estudo, a sobrevida mediana foi de 44,8 meses. Duas pacientes estão vivas e sem doença com seguimento de 201 e 5 meses, respectivamente.(AU)

Pelvic exenteration can heal patients with cervical cancer with central recurrence after radiotherapy and / or chemotherapy. Preoperative evaluation is essential to exclude metastatic disease and to avoid unnecessary surgery in this scenario. The objective of the present study is to evaluate the survival of a series of cases of patients submitted to pelvic exenteration in a private clinic in Teresina. This is the partial result of an observational, retrospective, cross-sectional and descriptive study, conducted at a private clinic specialized in cancer treatment in Teresina, Brazil, from June 2002 to February 2020. Five patients were included in the study, aged between 29 and 62 years. In the present study, the median survival was 44,8 months. Two patients are alive and without disease with a follow-up of 201 and 5 months, respectively.(AU)

Experiencia COVID-19 en un sanatorio privado de Buenos Aires durante el primer mes de la pandemia: 26 casos / COVID-19 experience in a private institution in Buenos Aires during the first month of the pandemic: 26 cases

El primer caso de infección por coronavirus (COVID-19) en Argentina se informó en Buenos Aires el 3 de marzo de 2020, en un paciente proveniente de Milán. El objetivo de este trabajo es describir las características clínicas y curso de la enfermedad de una serie de pacientes infectados con COVID-19 en un sanatorio privado durante el mes de marzo del 2020. Durante marzo 2020 se internaron 63 pacientes sospechosos de infección por COVID-19. Fueron diagnosticados 26 positivos para COVID-19 por hisopado nasofaríngeo, con el método RT-PCR para SARS Cov2. Se recopilaron datos sobre las características epidemiológicas, signos y síntomas, así como comorbilidades, laboratorio e imágenes. La edad promedio fue 40 años (SD ± 15 años); hubo un igual número de varones; solo 1 caso no venía del exter ior. El síntoma más frecuente fue la fiebre (24/26 casos) y la linfopenia (8/26). En un grupo (n = 17) la fiebre se limitó dentro de las primeras 72 h y en otro, la fiebre duró 6 o más días (7 casos). Hubo un fallecido entre los 26 casos. La población de nuestro estudio era joven y la mayoría de los casos fueron importados, en concordancia con el estadio de la epidemia en el momento en que el estudio fue realizado. Observamos que hubo 2 patrones en la curva térmica pero la persistencia de la fiebre no implicó un peor pronóstico. Se necesitan estudios poblacionales más grandes para confirmar estos hallazgos clínicos.

The first case of coronavirus (COVID-19) infection in Argentina was reported in Buenos Aires on March 3rd, 2020, in a patient who arrived from Milan. The aim of this study is to describe the clinical characteristics and course of illness of patients infected with Covid-19 that were hospitalized in a private clinical setting during March 2020. Sixty three patients suspected of COVID-19 infection, were admitted to our hospital during March 2020. Twenty six of these subjects were diagnosed positive by the RT-PCR for SARS Cov-2 in a nasopharyngeal swab specimen. We recorded data about epidemiological characteristics, clinical signs and symptoms, in addition to comorbidities, laboratory and radiological studies were done. The median age was 40 years (SD±15 years); there was an equal number of men and women; all the patients but one were coming from abroad; the most common symptom was fever (24/26 cases) and lymphopenia (n = 8). We found that there were patients in whom fever disappeared within the first 72h (n = 17) and another group in which the fever lasted six or more days (n = 7). One patient out of 26 died. The population of our study was young and almost all were imported cases, in alinement with the stage of the epidemic at the time when the study was conducted. We observed that there were two patterns in the fever curve but the persistence of it did not lead to a worse prognosis. Larger population studies are required in order to confirm these clinical findings.

Tratamiento laparoscópico de la hernia inguinal por técnica transabdominal preperitoneal. Análisis retrospectivo de una serie de casos / Laparoscopic treatment of inguinal hernia by preperitoneal transabdominal technique. Retrospective analysis of a series of cases

El objetivo del presente trabajo es reportar y analizar nuestra experiencia con la técnica endoscópica transabdominal preperitoneal (TAPP) en el tratamiento de la hernia inguinal. Métodos: Estudio retrospectivo mediante la revisión de nuestra base de datos electrónica y las historias clínicas en físico de la Clínica Santa Sofía, de los pacientes con diagnóstico de hernia inguinal tratados por los autores en los últimos 8 años. Se incluyeron para el análisis los casos con abordaje laparoscópico, recolectándose sexo, edad, diagnóstico pre e intraoperatorio, procedimientos adicionales, tiempo quirúrgico, complicaciones perioperatorias, tiempo de hospitalización, y morbilidad. Resultados: Se recolectaron 158 intervenciones de hernias inguinales en 102 pacientes, 89 hombres y 13 mujeres, de las cuales 135 (85,4%) fueron por abordaje laparoscópico tipo TAPP. Mediante la laparoscopia se modificó el diagnóstico preoperatorio en 17 pacientes (16.6%). El tiempo quirúrgico promedio fue de 50,5±11,6 minutos, y se presentaron 3 complicaciones perioperatorias y 4 tardías, para una morbilidad total de 5,1%. La estancia hospitalaria fue de 1±0,08 días y el tiempo de seguimiento promedio fue de 7,5±15,4 meses, detectándose 3 recidivas (2,2%) en ese período. Cinco pacientes presentaron dolor crónico posoperatorio, ninguno debilitante, que cedió gradualmente en todos los casos utilizando analgésicos comunes. Conclusiones: La técnica TAPP es una alternativa válida en el tratamiento de la hernia inguinal. Sus principales ventajas son las de optimizar el diagnóstico, permitiendo la reparación en un solo tiempo de hernias no diagnosticadas clínicamente, y su baja incidencia de dolor posoperatorio crónico(AU)

Currently the Lichtenstein technique is the most used worldwide for inguinal hernia repair, however, the laparoscopic approach has been gaining ground in recent years. The objective of the present work is to present and analyze our experience with the transabdominal preperitoneal (TAPP) technique for the treatment of this pathology.Methods: A retrospective study by the revision of our electronic database and the Santa Sofía clinic physical medical records, of the patients with groin hernia diagnosis treated by the authors in the last 8 years. The cases with the laparoscopic approach were included, collecting sex, age, pre and intraoperative diagnosis, additional procedures, surgical time, perioperative complications, hospital stay, and morbidity.Results : A 158 inguinal hernia repairs were collected in 102 patients, 87 males, and 13 females, of which 135 (85.4%) were through laparoscopic approach TAPP type. By means of laparoscopy, the preoperative diagnosis was modified in 17 patients (16.6%). Mean surgical time was 50.5±11.6 minutes, and 3 perioperative complications and 4 late complications were observed, for total morbidity of 5.1%. Hospital stay was 1±0.08 days, and mean follow-up was 7.5±15.4 months, detecting 3 recurrences (2.2%) at that time. Five patients presented chronic postoperative pain, none debilitating, which gradually yielded in all cases by common pain relievers.Conclusions : The TAPP technique is a valid alternative for the treatment of an inguinal hernia. Its main advantages are to optimize the diagnosis, allowing the repair of clinically undiagnosed hernias in one surgical time, and its low incidence of chronic postoperative pain(AU)