Isquemia Mesentérica secundaria a Trombosis Arterial Abdominal Múltiple, Reporte de un Caso

Masculino de 61 años, que acude con cuadro de dolor abdominal generalizado, asociado a distensión y defensa. Refiere que el dolor empezó aproximadamente 6 horas previo a la consulta. Entre los antecedentes clínicos relevantes hay historia de hipertensión arterial y fibrilación auricular. Al llegar a cuarto de urgencias, entre los hallazgos relevantes de laboratorio se identifica un valor de creatinina de 2.31 mg/dL y elevación de los valores de lactato. A pesar del manejo, y sin otros hallazgos relevantes al examen físico, el paciente persistía con dolor abdominal severo. Debido a la sospecha clínica de isquemia mesentérica, se le realizó una angio-tomografía abdominal donde se evidenció trombosis arterial múltiple que comprometía la arteria mesentérica superior, inferior y otras estructuras vasculares. El paciente fue trasladado a un hospital de tercer nivel y llevado al salón de operaciones, pero debido al gran compromiso vascular que presentaba, falleció en el procedimiento. (provisto por Infomedic International)

A 61-year-old male, who presented with generalized abdominal pain, associated with distention and defense. He reports that the pain started approximately 6 hours prior to the consultation. Relevant medical history includes a history of arterial hypertension and atrial fibrillation. Upon arrival to the emergency room, relevant laboratory findings included a creatinine value of 2.31 mg/dL and elevated lactate values. Despite management, and without other relevant findings on physical examination, the patient persisted with severe abdominal pain. Due to clinical suspicion of mesenteric ischemia, an abdominal angio-tomography was performed, showing multiple arterial thrombosis involving the superior and inferior mesenteric artery and other vascular structures. The patient was transferred to a tertiary hospital and taken to the operating room, but due to the great vascular compromise he died during the procedure. (provided by Infomedic International)

Transoral approach in facial penetrating trauma - importance of multidisciplinary management and nutritional support a case report.

The high incidence and prevalence of facial trauma makes it important to consider related injuries and possible complications that may arise as a result. Penetrating trauma to the face, although not common, requires a surgeon with knowledge of the anatomy and physiology of the injured area and injury patterns. We present a case of penetrating trauma to the face that was caused by a blunt object (stake) resulting from the felling of a palm tree. We describe the transoral management that was performed and the multidisciplinary support that allowed optimal management of the injury without complications, including functional or aesthetic sequelae.

Intra-abdominal cystic lymphangioma of the mesocolon sigmoids: a rare entity in adult patient woman.

The lymphangioma is a benign neoplasm, mostly connate, it occurs more often in children. It is more frequently located in the head-neck region, as well as in the armpit, and less frequently in the abdomen. The diagnosis, as well as their appearance is variant, they can be asymptomatic depending on the size. The signs on the physical exam are usually nonspecific and can look like an acute abdomen. Imaging tests used are the ultrasound and tomography, which determine the therapeutic behavior. The differential diagnosis should be made with other intra-abdominal injuries, such as cavernous hemangioma, mesotheliomas, pancreatic and ovarian tumors and even peritoneal hydatid cyst. The definitive treatment is surgical in most cases, with complete excision of the mass. The definitive diagnosis is obtained with the histopathological study of the surgical piece.

Intraocular Pressure Responses to Maximal Cycling Sprints Against Different Resistances: The Influence of Fitness Level.

PURPOSE: This study investigated the acute effect of maximal cycling sprint against difference resistances on intraocular pressure (IOP) depending on participants' fitness level. METHODS: In total, 26 physically active collegiate men performed 5 maximal cycling sprints against different resistances in a randomized order, and IOP was measured immediately before and after each sprint. Participants were divided in 2 subgroups (low fit and high fit) according to their maximum power output relative to body weight to assess the influence of fitness level. Two identical testing sessions were performed to assess the repeatability of IOP values. RESULTS: We found that IOP decreases with the lightest resistance (P<0.01), whereas IOP increases with heavier resistances (P<0.01), and it showed a positive linear tendency (r=0.99). Our results suggest that participants' fitness level seems to influence IOP responses, with a more stable response in the high-fit group. A strong intersession repeatability of IOP values was observed (intraclass correlation coefficient range, 0.82 to 0.98; coefficients of variations range, 1.76% to 6.23%). CONCLUSIONS: We conclude that (1) IOP is sensitive to cycling resistance in all-out sprints, with a lowering effect on the lightest resistance and an increasing effect with medium and heavy resistances, (2) high fitness level is beneficial to avoid IOP fluctuations during sprints, and (3) these changes are comparable when measured on 2 different days under the same experimental conditions. A progressive involvement in physical activity may be desirable to avoid IOP peaks during highly demanding physical effort. Future studies are needed to clarify the consequences of exercise in glaucoma patients.

Características cardiotocográficas del producto de madres con hipertensión inducida por el embarazo / Cardiotocographic features of fetus from mothers with pregnancy induced hypertension

Objetivo: Comparar los trazados cardiotocográficos de los productos de madres con y sin Hipertensión Inducida por el Embarazo (HIE) y contrastarlo con el estado del recién nacido. Material y Métodos: Estudio de cohortes de 6 meses en el Instituto Materno Perinatal, revisando un total de 287 registros cardiotocográficos, de los cuales se descartaron 116. Noventa y seis trazados correspondieron a madres con HIE y 75 a madres sin HIE. Se evaluó los siguientes parámetros: Línea de base (LB), Variabilidad, Aceleraciones, Desaceleraciones, Movimientos Fetales, Reactividad al estímulo Vibroacústico. Resultados: La LB se encontró dentro de los valores normales en el 95,83 por ciento de las hipertensas y en el 100 por ciento de las gestantes control. EI RR de presentar Variabilidad < 5 latidos/min en hipertensas fue 1,43 (IC 95 por ciento). Se encontró riesgo elevado de hacer < 5 aceleraciones en 30 min en productos de madres con HIE. No se evidenció desaceleraciones tipo II en productos de madres sin HIE. Conclusiones: Las características cardiotocográficas de productos de madres con HIE son: LB entre 120-160 latidos/min, variabilidad < 5 latidos/min, menos de 5 aceleraciones en 30 min e hipoactividad.