ABSTRACT
Background: Currently, there are few studies that have analyzed the benefits of using lung ultrasound in the field of primary care, including in homes and nursing homes, for patients with suspected COVID-19 pneumonia and subsequent follow-ups. The aim of this study was to demonstrate that lung ultrasound is a useful technique for triaging these patients. Methods: An observational and retrospective study of individuals who presented with clinical suspicion of SARS-CoV-2 pneumonia was carried out during the months of March to June 2020 in Health Center number 2 of Ciudad Real and in homes of patients and nursing homes belonging to the Health Service of Castilla-La Mancha (Spain). Results: A total of 209 patients, of whom 86 (41.1%) were male, were included in the study. The most frequent ultrasound findings were bilateral B-lines, with a right predominance, specifically in the posterobasal region. Additionally, there was a statistical significance (p < 0.05) correlation between pathological positivity on lung ultrasound and PCR and chest X-ray positivity. When calculating the sensitivity and specificity of ultrasound and X-ray, ultrasound had a sensitivity of 93%, and X-ray had a sensitivity of 75%. Conclusion: Due to its high sensitivity and negative predictive value, lung ultrasound is very useful as a triage tool for patients with suspected SARS-CoV-2 pneumonia.
ABSTRACT
El himen imperforado es un trastorno congénito en el desarrollo del aparato genital femenino. Pese a ser la más frecuente, su incidencia es alrededor del 0,1 % de las recién nacidas. La anamnesis y exploración física son útiles para el diagnóstico, aunque a menudo se requieren técnicas de imagen. La plastia o apertura del himen es el tratamiento de primera línea. A continuación, exponemos un caso de una paciente de 12 años que consultó por anuria
Imperforate hymen is a congenital disorder of the female genital tract. Despite being the most frequent, its incidence is about 0.1% in female newborns. Medical history and physical examination are useful for diagnosis, although imaging studies are often required. The hymen plasty or opening is the first-line treatment. Below, we present the case of a 12-year-old patient who consulted because of anuria
Subject(s)
Humans , Female , Child , Anuria/etiology , Hymen/abnormalities , Urogenital Abnormalities/complications , Plastic Surgery Procedures/methods , Urinary Retention/etiology , Hematocolpos/etiology , Diagnosis, Differential , Abdominal Neoplasms/diagnosis , Hymen/surgeryABSTRACT
BACKGROUND: Herlyn-Werner-Wunderlich syndrome is a congenital urogenital malformation that is associated with a uterus didelphys and a longitudinal vaginal septum, resulting in a blind hemivagina and ipsilateral renal agenesis. Clinical presentation is highly variable, delaying diagnosis and leading to important complications. CLINICAL CASE: We present the case of a 13-year-old female who was diagnosed with Herlyn-Werner-Wunderlich syndrome following an acute abdomen due to a right tubo-ovarian abscess. She had a vaginal septum giving rise to a right blind hemivagina. It was microperforated, causing intermittent genital bleeding. This hematocolpos was colonized by microorganisms that ascended to the pelvic cavity, causing right tuboovarian abscess. Nuclear magnetic resonance imaging provided theWernermost diagnostic information. We performed a vaginal septum resection, and both hemiuteros communicated with a single vagina, resulting in an asymptomatic patient. CONCLUSION: Herlyn-Werner-Wunderlich syndrome is a little known entity and can be presented atypically, resulting in diagnostic difficulty and treatment delay. It is important to be aware of this syndrome in order to avoid irreversible complications.
ANTECEDENTES: el síndrome de Herlyn-Werner-Wunderlich es una malformación urogenital congénita que asocia un útero didelfo con un tabique vaginal longitudinal que forma una hemivagina ciega y agenesia renal ipsilateral a ésta. La presentación clínica es muy variable, lo que retrasa el diagnóstico y provoca algunas complicaciones que pueden ser graves. Caso clínico: paciente femenina de 13 años de edad, con diagnóstico de síndrome de Herlyn-Werner-Wunderlich a raíz de un cuadro de abdomen agudo por un absceso tuboovárico derecho. El tabique vaginal formaba una hemivagina ciega derecha microperforada que provocaba sangrados genitales intermitentes. Este hematocolpos se colonizó con microorganismos y el ascenso de estos a la cavidad pélvica causó el absceso tuboovárico derecho. La resonancia magnética nuclear aportó mayor información para el diagnóstico. La resección del tabique vaginal comunicó los dos hemiúteros con una sola vagina y los síntomas desaparecieron. CONCLUSIÓN: el síndrome de Herlyn-Werner-Wunderlich es poco conocido y puede manifestarse de forma atípica, lo que dificulta el diagnóstico y retrasa el tratamiento. Para evitar complicaciones irreversibles es importante mantener una alta sospecha clínica.
