ABSTRACT
OBJECTIVES: Renal Artery Aneurysms (RAA) affect approximately 0.01%-0.97% of the population. Early diagnosis, thorough 3D-preoperative planning, and timely surgical treatment may offer effective and safe management. METHODS: We report the open reparation of a segmental renal artery saccular aneurysm close to the bifurcation with detailed preoperative planning based on 3D printing, and with successful postoperative results. RESULTS: We report the case of a 36-year-old man with a 3.5 × 5 cm segmental renal artery saccular aneurysm close to the bifurcation, for which endovascular management was ruled out and open management was chosen with detailed preoperative planning based on 3D printing and with successful postoperative results. CONCLUSIONS: When an open approach is chosen in the RAA treatment, a detailed study of the anatomical configuration of the RAAs is mandatory, and life-size 3D printing is a valuable tool that could contribute to the operative technique, reduce surgical times associated with renal ischemia and provide minute details that would make a clear anatomical difference during in situ repair.
ABSTRACT
INTRODUCTION: There is currently no universal and uniform pattern of peripheral arterial disease (PAD) in the lower limbs; however, it is influenced by various cardiovascular factors of the individual. The objective of this study was to identify the arteriographic patterns of PAD in the lower limbs according to cardiovascular factors in a Peruvian cohort of patients. METHODS: This is an analytical, observational, and retrospective study. The arteriographic patterns of PAD in the aortoiliac segment were analyzed with the TransAtlantic InterSociety Consensus (TASC-II) score and the Global Anatomic Staging System (GLASS) for the femoropopliteal (FP), infraopopliteal (IP), and pedial (P) segments in a Peruvian cohort from January 2018 to May 2021. RESULTS: 595 patients (833 extremities) were analyzed with a mean age of 67.54 ± 16.39 years, and the main cardiovascular factor was diabetes (65.04%). The patients older than 65 years with GLASS FP 4 (p = 0.042), IP 0 (p = 0.004), and P2 (p = 0.047) presented significant findings: in men and women with GLASS IP 4 (p = 0.031) and P 2 (p = 0.045); diabetes with TASC-II A (p = 0.031), GLASS FP 4 (p = 0.038), IP 4 (p = 0.009), and P2 (p = 0.003); dyslipidemia with TASC-II D (p = 0.027), GLASS FP 4 (p = 0.038), IP 0 (p = 0.009), and P0 (p = 0.003); smoking with TASC-II D (p = 0.001), GLASS FP 4 (p = 0.049) and IP 0 (p = 0.008); chronic coronary disease with GLASS IP 4 (p = 0.049) and P2 (p = 0.037); chronic kidney disease with GLASS FP 4 (p=0.047), IP 4 (p = 0.004), and P2 (p = 0.016); and previous amputation history with GLASS IP 4 (p = 0.015) and P2 (p = 0.039). The most frequent arteriographic pattern of PAD in the lower limbs of our cohort was TASC-II A, GLASS FP 0 and 4, IP 0, and P2 (p = 0.047). CONCLUSION: Our work will allow the limb salvage teams to understand the behavior of PAD affectation in the population of our environment, allowing a timely control of cardiovascular risk factors, adequate revascularization planning, and a significant reduction in the risk of loss of limb.
Subject(s)
Peripheral Arterial Disease , Popliteal Artery , Male , Humans , Female , Middle Aged , Aged , Aged, 80 and over , Popliteal Artery/diagnostic imaging , Popliteal Artery/surgery , Retrospective Studies , Peru/epidemiology , Risk Factors , Peripheral Arterial Disease/therapy , Peripheral Arterial Disease/surgery , Lower Extremity/blood supply , Treatment Outcome , Limb Salvage , Ischemia/surgeryABSTRACT
Resection and reconstruction of the chest wall for the radical surgical treatment of malignant soft tissue tumors are currently considered a substantial challenge for thoracic surgeons. We present an unusual case of infantile fibrosarcoma with tropomyosin 3-neurotrophic receptor tyrosine kinase 1 fusion in a 13-year-old patient. The surgical treatment consisted of radical resection of the right posterior chest wall and reconstruction with the use of the STRATOS (Strasbourg Thoracic Osteosynthesis System) titanium rib bridge system. The patient had a favorable postoperative course and received respiratory-ventilatory rehabilitation, adjuvant therapy with chemotherapeutic agents, immunotherapy, and radiotherapy.
ABSTRACT
Objetivo: Determinar la prevalencia de portadores asintomáticos y sensibilidad antimicrobiana de Staphylococcus aureus en trabajadores del Hospital Regional de Ica. Material y métodos: Estudio de tipo descriptivo transversal realizado en noviembre del 2011. Según muestreo aleatorio simple sin reposición, la muestra fue de 131 trabajadores. Se obtuvieron los datos con la aplicación de una ficha y la extracción de las muestras mediante hisopado, obteniendo 262 cepas de manos y fosas nasales. El aislamiento, identificación y pruebas de sensibilidad se efectuaron según los criterios del Clinical and Laboratory Standars Institute (CLSI). Los datos se procesaron en el programa SPSS, realizando análisis univariado y pruebas de significación estadística. Resultados: La prevalencia de portadores asintomáticos fue de 12,98% en total, 10,7% en manos y 5,3% en fosas nasales. Todos los gérmenes fueron sensibles a: meticilina, cefaclor, ceftazidima, vancomicina y rifampicina. Sólo fueron resistentes algunas cepas de fosas nasales (7,1%) a: oxacilina, dicloxacilina, claritromicina y cloranfenicol. Conclusiones: La prevalencia de portadores asintomáticos de Staphylococcus aureus fue baja. Se observó menor frecuencia de portadores cuando se utilizaban algunas medidas de protección. La resistencia antimicrobiana también fue baja. Se debe realizar un estudio caso-control para identificar los factores de protección.
Objective: To determinate the prevalence of asymptomatic carriers and antimicrobial susceptibility of Staphylococcus aureus in workers at Ica Regional Hospital. Material and Methods: A descriptive-transversal study realized in November 2011. A simple aleatory sampling without repositioning, a total of 131 workers participated in the study. Dates were collected using a file and the samples by cottons sawbs, obtaining 262 nasal and hand strains. The isolation, identification and susceptibility testing were made using the criteria of Clinical and Laboratory Standars Institute (CLSI). Data were processed in the SPSS version 18, doing univariate analysis and statistical significance tests. Results: The prevalence of asymptomatic carriers was 12.98%, in which 5.3% is the rate of nasal carriage and 10.7% in hands. All isolates were susceptible to: methicillin, cefaclor, ceftazidime, vancomycin and rifampin. Only a few nasal isolates were resistant (7.1%) to: oxacillin, dicloxacilin, clarithromycin and chloramphenicol. Conclusion: The prevalence of asymptomatic carriers was low. It was showed a lower carrier frequency when workers used protective measures (p>0.05).The antimicrobial resistance was low, too. There must be a case-control study to identify protective factors.
