Incidence and management of inguinodynia after inguinal plasty

Background: Hernia is defined as a defect of fascial and muscle-aponeurotic structures, allowing the protrusion of elements. The most frequent is inguinal region, prevailing in men 3:1 vs female. The most frequent complications are persistent chronic pain.Methods: A descriptive, prospective and cross-sectional study was performed in postoperative inguinal plasty patients, using a laparoscopic approach and open approach, the presence or absence of inguinodynia was studied using the visual analogue pain scale (VAS) and the Semmes-Weinstein monofilament, in addition to a systematic investigation in the following PubMed, Medline, Clinical Key and Index Medicus databases, with articles from July 2019 to April 2020.Results: Inguinodynia was present in laparoscopic surgery and open approach, 58 patients had inguinodynia at two weeks associated with the inflammatory response of the tissues and the presence of a foreign body (mesh), 77% of the patients with persistence of pain at 3 months reported mild pain (VAS 1-4), 21% moderate pain that did not limit their daily activities (VAS 5-8) and 2% of the patients reported severe pain which limited physical activity and effort   (VAS 9-10).Conclusions: Inguinodynia has an impact on hospital costs and quality life, we consider it is essential to domain the anatomical variants of the region. We propose an extensive follow-up of this group of patients, to make a comparison of diagnostic methods, as well as conservative management vs. modern techniques for pain control.

Miocardiopatía arritmogénica del ventrículo derecho: Breve revisión de la literatura a propósito de un caso / Arrhythmogenic right ventricular cardiomyopathy: Case report and a brief literature review

Hombre de 51 años admitido en el hospital por presentar palpitaciones y mareos de 2 h de evolución. El electrocardiograma demostró taquicardia regular de QRS ancho y frecuencia cardíaca de 250 lpm, con eje superior y morfología de bloqueo completo de rama izquierda sin descompensación hemodinámica. Se administraron dosis de carga y mantenimiento con amiodarona, revirtiendo a ritmo sinusal. El estudio electrofisiológico demostró el origen ventricular de la taquicardia y su inducibilidad. En la angiografía coronaria no se observaron lesiones significativas en los vasos epicárdicos. Se realizó un ecocardiograma Doppler que presentó cavidades con diámetros y función sistólica y diastólica dentro de los parámetros normales. Ante la sospecha de enfermedad estructural miocárdica se llevó a cabo una resonancia magnética cardíaca contrastada con realce tardío que demostró alteración estructural del ventrículo derecho con incremento de la trabeculación e infiltración fibrograsa parietal y deterioro moderado de su función sistólica, y deterioro leve de la función sistólica del ventrículo izquierdo, lo cual permitió realizar el diagnóstico de miocardiopatía arritmogénica del ventrículo derecho por presentar 2 criterios mayores. Se decidió implantar un cardiodesfibrilador automático, para prevenir la muerte súbita. El paciente evolucionó de manera favorable y fue dado de alta.

A 51-year-old man was admitted to this hospital because of palpitations and a feeling of dizziness for a period of 2h. The electrocardiogram revealed a regular wide-QRS complex tachycardia at a rate of 250 beats per minute, with superior axis and left bundle branch block morphology without hemodynamically decompensation, the patient was cardioverted to sinus rhythm after the administration of a loading and maintenance dose of amiodarone. The elechtrophysiological study showed the ventricular origin of the arrhythmia. In order to diagnose the etiology of the ventricular tachycardia we performed a coronary arteriography that showed normal epicardial vessels, thus ruling out coronary disease. Doppler echocardiography revea- led systolic and diastolic functions of both left and right ventricles within normal parameters, and normal diameters as well. A cardiac magnetic resonance with late enhancement was done, showing structural abnormalities of the right ventricle wall with moderate impairment of the ejection fraction, and a mild dysfunction of the left ventricle. The diagnosis of arrhythmogenic right ventricular cardiomyopathy was performed as 2 major Task Force criteria were met. We implanted an automatic cardioverter defibrillator as a prophylactic measure. The patient was discharged without complications.

Endocarditis de válvula protésica por Salmonella no tifoidea / Prosthetic Valve Endocarditis due to Non-Typhoid Salmonella

Existen varios factores predisponentes para el desarrollo de endocarditis infecciosa; entre ellos se destacan el antecedente de haber padecido endocarditis infecciosa y el recambio valvular con válvula protésica. La endocarditis infecciosa de válvula protésica producida por Salmonella es una entidad de muy baja incidencia. En esta presentación se describe el caso de una paciente con antecedente de doble recambio valvular, mitral y aórtico, que ingresó con un cuadro de sepsis grave. Se llegó al diagnóstico etiológico de endocarditis infecciosa por Salmonella enteritidis a través de hemocultivos. La paciente tuvo una evolución fulminante y falleció antes de las 24 horas.

There are several predisposing factors for the development of infectious endocarditis, among them, the history of infectious endocarditis and prosthetic valve replacement. Infectious endocarditis in prosthetic valve caused by Salmonella is an unusual entity. We report the case of a female patient with a history of double-valve mitral and aortic replacement, who was admitted due to severe sepsis. The etiological diagnosis of infectious endocarditis by Salmonella enteritidis was reached through blood cultures. The clinical course was fulminant and she died within the first 24 hours.

Actividad proteolítica de extractos enzimáticos obtenidos de plantas de la familia Bromeliaceae / Proteolytic activity of enzymatic extracts from plants of the Bromeliaceae family

Las enzimas proteolíticas aisladas de plantas de la familia Bromeliaceae se utilizan ampliamente en la industria médica, biotecnológica y alimenticia. Los estudios realizados en los últimos años sobre la actividad contra metástasis y tumores de las cisteíno-proteasas hacen que se incremente el interés por explorar nuevas fuentes naturales de obtención de fitoproteasas. En el presente trabajo se evaluó la actividad proteolítica de extractos enzimáticos obtenidos a partir de diferentes órganos de plantas de la familia Bromeliaceae. Se colectaron y clasificaron cinco grupos. Las plantas que se colectaron pertenecen a 3 géneros de la mencionada familia: 3 grupos son del género Tillandsia, 1 es del género Guzmania y otro del género Hohenbergia. Los mayores índices de actividad específica (3,3 U/mg de proteínas) se obtuvieron en los preparados obtenidos a partir de diferentes órganos de Hohenbergia penduliflora Mez, de cuyos extractos obtenidos se evaluó la influencia del pH de extracción y la actividad específica fue superior al realizarla a pH 3 a partir de sus tallos.

The proteolytic enzymes isolated from the Bromeliaceae family are widely used in the medical, biotechnological, and food industries. The studies conducted in recent years on the activity against metastasis and cysteine-proteases, increase the interest in screening new natural sources of obtention of phytoproteases. In the present paper, the authors assessed the proteolytic activity of enzymatic extracts obtained from different organs of the Bromeliaceae family plants. Five groups were collected and classified. Plants obtained belong to three genuses of the above mentioned family: 3 groups are of genus Tillandsia , one of genus Guzmania , and the other of genus Hohenbergia . The highest rates of specific activity (3.3 U/mg of proteins) were attained in preparations obtained from different organs of Hohenbergia penduliflora Mez. from whose extracts the influence of extraction pH was assessed. The specific activity was greater on carrying it out at pH3, starting from their stalks.