Assuntos
Humanos , Masculino , Feminino , Carcinoma in Situ , Biologia Celular , Infecções por Papillomavirus , Ácido TricloroacéticoRESUMO
Objetivo: Se presenta un caso de rotura esplénica atraumática. Caso Clínico: Mujer joven que estando ingresada y con reposo relativo por colección intraabdominal cercana a la colostomía presenta rotura de bazo. Se realiza esplenectomía urgente evidenciando gran hemoperitoneo y rotura esplénica. Discusión y conclusiones: El diagnóstico de rotura esplénica atraumática debe tenerse en cuenta en los pacientes con dolor abdominal de aparición súbita ya que un retraso en el diagnóstico puede conducir a un aumento de la tasa de mortalidad.
Objective: A case of idiopathic atraumatic splenic rupture is presented. Clinical case: A young woman was admitted to hospital with relative rest due to an intra-abdominal collection near the colostomy and presented with a ruptured spleen. An urgent splenectomy was performed, revealing large haemoperitoneum and splenic rupture. Discussion and conclusions: the diagnosis of atraumatic splenic rupture should be taken into account in patients with sudden onset abdominal pain, as a delay in diagnosis may lead to an increased mortality rate.
RESUMO
Objetivo: El objetivo principal consistió en determinar si en nuestra población existía una diferencia en la tasa de diagnóstico de cáncer de colon derecho para los pacientes mayores de 45 años en los 36 meses siguientes, tras apendicitis aguda en comparación con un grupo control. Pacientes y Métodos: Estudio de cohortes retrospectivo con un grupo expuesto de 300 pacientes con diagnóstico histológico de apendicitis aguda y un grupo control de 300 pacientes intervenidos de patología benigna entre enero de 2014 y agosto 2017. Se han realizado referencias cruzadas entre las historias clínicas electrónicas y la base de datos del Registro de Cáncer de Granada. Resultados: Se presentaron 2/300 pacientes (0,7%) mientras que en el grupo control, se presentaron 4/300 (1,3%). Antes estos hallazgos, no existe un mayor riesgo de desarrollar un carcinoma colon en los pacientes con apendicitis (p > 0,05). Discusión: La apendicitis aguda puede tratarse de la primera manifestación de carcinoma de colon derecho, sin embargo, en nuestra revisión no encontramos dicha asociación en nuestra población.
Aim: The main objective was to determine whether in our population there was a difference in the rate of right colon cancer diagnosis for patients over 45 years of age in the 36 months following acute appendicitis compared to a control group. Patients and Methods: Retrospective cohort study with an exposed group of 300 patients with histological diagnosis of acute appendicitis and a control group of 300 patients operated on for benign pathology between January 2014 and August 2017. Electronic medical records and the Granada Cancer Registry database were cross-referenced. Results: 2/300 patients (0.7%) presented while 4/300 (1.3%) presented in the control group. Given these findings, there is no increased risk of developing colon carcinoma in patients with appendicitis (p > 0.05). Discussion: Acute appendicitis may be the first manifestation of right colon carcinoma, however, in our review we found no such association in our population.
RESUMO
Amyloidosis with gastrointestinal involvement is a rare cause of chronic diarrhoea, and should be considered especially in adult patients with intestinal malabsorption and extra GI manifestations. We present the case of a male patient who, after an oncological gastrectomy, presented with chronic diarrhea that did not respond to treatment and, after study, the cause of the diarrhea was finally found. Primary systemic light chain amyloidosis (AL) initially presents as chronic diarrhea and weight loss after gastrectomy. Immunohistochemistry was completely negative for amyloid A, which virtually rules out AA amyloidosis. With regard to the immunoglobulin chains, an amyloid signal was observed for both light chains, with a predominance of lambda light chain but not entirely conclusive. This situation is not uncommon since amyloid, whatever its chemical nature, can annex serum proteins, including immunoglobulin chains. In the case of chronic diarrhea, the possibility of amyloidosis should be kept in mind, especially in the case of weight loss.
Assuntos
Amiloidose , Adulto , Humanos , Masculino , Amiloidose/complicações , Amiloidose/cirurgia , Diarreia/etiologia , Subunidades de Imunoglobulinas , Gastrectomia/efeitos adversos , Redução de PesoAssuntos
Humanos , Masculino , Idoso , Gastrectomia/efeitos adversos , Amiloidose/complicações , Diarreia/etiologia , Doença CrônicaRESUMO
Las reacciones a la vacuna contra el virus causante de la actual pandemia del covid-19 están todavía en estudio. Presentamos el caso de una mujer de edad avanzada que, tras la administración de dicha vacuna en el brazo izquierdo, desarrolla 24 horas después una mastitis en la mama ipsilateral. Ningún caso previo ha sido descrito en la literatura. (AU)
Reactions to the vaccine against the virus causing the current pandemic are still under investigation. We present the case of an elderly woman who, after administration of the vaccine in the left arm, developed mastitis in the ipsilateral breast 24 h later. No previous case has been described in the literature. (AU)
Assuntos
Humanos , Feminino , Mastite/diagnóstico por imagem , Mastite/diagnóstico , Mastite/prevenção & controle , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/prevenção & controle , Vacinação em Massa , Infecções por Coronavirus/epidemiologia , Coronavírus Relacionado à Síndrome Respiratória Aguda GraveAssuntos
Humanos , Masculino , Adulto , Fígado/anormalidades , Fígado/diagnóstico por imagem , Fígado , Obstrução Intestinal , Vômito , Dilatação Gástrica , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Pacientes Internados , Gastroenterologia , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: Surgical wound infection is the most frequent postoperative complication in abdominal surgery, especially at the colorectal level. The aim of this study is analysing the results of mechanical colon preparation combined with oral antibiotic versus mechanical colon preparation without antibiotic therapy in patients with colorectal cancer undergoing elective surgery. METHODS: This retrospective cohort study had been developed from November 2017 to February 2020. We have included a total of 281 consecutive patients undergoing elective colon and rectal oncological surgeries by the same surgical group using laparoscopic and open approaches. Transanal minimally invasive surgery (TAMIS) and transanal total mesorectal excision (TaTME) approaches were excluded. Exposed patients undergoing colon and rectal cancer surgery received mechanical bowel preparation and oral antibiotics with three doses of neomycin 1 g and erythromycin 500 mg the day before surgery. RESULTS: The primary outcome was reduction in surgical wound infection rates before and after starting the oral antibiotic therapy from 17 to 6% (p < 0.05). As a secondary analysis, we evaluated the anastomotic dehiscence rate, corresponding with a decrease from 12 to 3% (p < 0.05). CONCLUSION: Mechanical bowel preparation combined with oral antibiotic therapy is still not unanimously carried out in all the medical hospitals. In this report, we show that mechanical bowel preparation in combination with oral antibiotic reduces the risk of surgical wound infection and anastomotic leakage in patients undergoing colon and rectal cancer surgery.
Assuntos
Neoplasias Retais , Infecção da Ferida Cirúrgica , Administração Oral , Antibacterianos/uso terapêutico , Antibioticoprofilaxia , Catárticos , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Humanos , Cuidados Pré-Operatórios , Neoplasias Retais/tratamento farmacológico , Estudos Retrospectivos , Infecção da Ferida Cirúrgica/tratamento farmacológico , Infecção da Ferida Cirúrgica/etiologiaRESUMO
A current challenge in breast cancer (BC) patients is how to reduce the side effects of cancer and cancer treatments and prevent a decrease in quality of life (QoL). Neurotoxic side effects, especially from chemotherapy, are present in up to 75% of women with BC, which implies a large impact on QoL. There is a special interest in the preventive possibilities of therapeutic exercise (TE) for these neurological sequelae, and the benefits of TE could be improved when it is combined with vagal activation techniques (VATs). This superiority randomized controlled trial aims to examine the feasibility and efficacy of an 8-week multimodal intervention (ATENTO) based on moderate-vigorous intensity and individualized TE (aerobic and strength exercises) and VAT (myofascial and breathing exercises), on neurotoxicity prevention in women with BC before starting adjuvant chemotherapy (ATENTO-B) versus throughout adjuvant chemotherapy (ATENTO-T). A sample of 56 women newly diagnosed with BC, as calculated with a power of 85%, will be randomly allocated into these two groups. This study could provide an impetus for the introduction of early multimodal intervention methods to prevent neurotoxicity and consequently avoid the QoL deterioration that BC patients presently suffer throughout their treatments.
Assuntos
Neoplasias da Mama , Quimioterapia Adjuvante/efeitos adversos , Terapia por Exercício , Doenças do Sistema Nervoso Periférico/prevenção & controle , Qualidade de Vida/psicologia , Adulto , Idoso , Neoplasias da Mama/complicações , Neoplasias da Mama/tratamento farmacológico , Feminino , Humanos , Pessoa de Meia-IdadeAssuntos
Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Coronavirus/complicações , Infecções por Coronavirus/tratamento farmacológico , Coronavírus Relacionado à Síndrome Respiratória Aguda Grave/efeitos dos fármacos , Colite Isquêmica/diagnóstico , Colite Isquêmica/tratamento farmacológico , Colite Isquêmica/etiologia , Anticorpos Monoclonais Humanizados/efeitos adversos , Anticorpos Monoclonais Humanizados/uso terapêutico , Gastroenterologia , Gastroenteropatias , Resultado do Tratamento , Pacientes Internados , Exame Físico , Avaliação de Sintomas , PandemiasAssuntos
Dor Abdominal/etiologia , Febre/etiologia , Fístula Gástrica/etiologia , Pancreatite Necrosante Aguda/complicações , Esplenopatias/etiologia , Adulto , Diagnóstico Diferencial , Fístula Gástrica/diagnóstico por imagem , Fístula Gástrica/terapia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pancreatite Necrosante Aguda/diagnóstico por imagem , Pancreatite Necrosante Aguda/terapia , Valor Preditivo dos Testes , Prognóstico , Esplenopatias/diagnóstico por imagem , Esplenopatias/terapia , Tomografia Computadorizada por Raios XRESUMO
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