ABSTRACT
INTRODUCCIÓN: El trauma en México es un problema mayor de salud pública, siendo una de las principales causas de mortalidad en personas jóvenes. La incidencia reportada de trauma cardiaco varía. El sitio primario de lesión miocárdica es la pared libre del ventrículo derecho. CASOS CLÍNICOS: Se reportan dos casos de pacientes lesionados con un instrumento punzocortante en el tórax, sufriendo lesión miocárdica que requirió tratamiento quirúrgico de urgencia. DISCUSIÓN: Existen diversas incisiones del tórax. La elección dependerá de la situación a tratar, el estado hemodinámico y el número de lesiones. Ante una lesión cardiaca, el abordaje de Spangaro es una prudente elección. INTRODUCTION: Trauma in Mexico is a major public health problem, being one of the main causes of mortality in young people. The reported incidence of cardiac trauma complications. The primary site of myocardial injury is the free wall of the right ventricle. CLINICAL CASES: Two cases of injured patients with a throbbing instrument in the chest are reported, suffering from myocardial injury that required emergency surgical treatment. DISCUSSION: There are various chest incisions. The choice will depend on the entity to be treated, the hemodynamic state, number of injuries. Faced with a heart injury, Spangaro's approach is a prudent choice.
Subject(s)
Hemodynamics , Adolescent , Humans , Incidence , Mexico/epidemiologyABSTRACT
INTRODUCTION: Recent studies have identified both the prognostic and predictive utility of determining the number of circulating tumour cells (CTC) in patients with solid cancers. MATERIAL AND METHODS: In the present pilot study we evaluated the ability of two different methods to isolate CTC in combination with two strategies to enumerate CTC from patients with stages II and III surgically treated colorectal cancer (CRC). First, we used two systems for tumour cell enrichment (differential centrifugation and immunomagnetic beads), combined with two methods to enumerate CTC (real-time PCR and fl ow cytometry), to determine the most efficient combination. These experiments were performed in a model system using serial dilutions of HT29 tumour cell lines with lymphocytes. Then, CTC analysis using the technical approach selected before was performed in 109 blood samples from 16 stage II and III CRC patients during chemotherapy treatment and follow-up. RESULTS: Immunomagnetic beads followed by flow cytometry was the most efficient combination (ED=60.53; p=0.5). Two cases out of 16 patients analysed had clinical tumour relapse. In both, we detected a significant increase of CTC five and six months, respectively, before the relapse was clinically evidenced. An increase of CTC was also observed in another case without clinical evidence of relapse. The remaining cases (13) had very few or no detectable CTC and no clinical evidence of relapse (p=0.029). CONCLUSIONS: Changes in CTC numbers during follow-up might predict tumour relapse. Further evaluation of CTC prognostic and predictive value in patients with early CRC is warranted.