Cystic lesion of pectoralis minor muscle: learning from mistakes.

Hydatidosis is a frequent infestation in large endemic areas, caused by helminths. Primary localization within the muscle or bone tissues is rare. We report the case of a 52-year-old woman with a cystic lesion located in the right pectoralis minor muscle, who was initially diagnosed with cystic lymphangioma by imaging examination. She was submitted for surgical treatment; in block resection of the tumor along with the involved muscle was performed. The histopathological diagnosis was of hydatid cyst. The contribution of the ancillary lab tests is analyzed for a precise preoperative diagnostic approach. This case well illustrates that the most likely is not always what it appears to be. Facing of a cystic lesion in the lungs, liver or muscle, clinicians should always think on hydatid disease, particularly in endemic areas.

Cystic lesion of pectoralis minor muscle: learning from mistakes

Hydatidosis is a frequent infestation in large endemic areas, caused by helminths. Primary localization within the muscle or bone tissues is rare. We report the case of a 52-year-old woman with a cystic lesion located in the right pectoralis minor muscle, who was initially diagnosed with cystic lymphangioma by imaging examination. She was submitted for surgical treatment; in block resection of the tumor along with the involved muscle was performed. The histopathological diagnosis was of hydatid cyst. The contribution of the ancillary lab tests is analyzed for a precise preoperative diagnostic approach. This case well illustrates that the most likely is not always what it appears to be. Facing of a cystic lesion in the lungs, liver or muscle, clinicians should always think on hydatid disease, particularly in endemic areas.

Reingreso no planificado tras cirugía de resección pulmonar: revisión sistemática / Unplanned readmission after lung resection surgery: A systematic review

Los reingresos urgentes suponen un impacto importante sobre los resultados en la salud de los pacientes y los costes sanitarios. Los factores de riesgo asociados a reingreso tras cirugía de resección pulmonar han sido poco estudiados. El principal objetivo del presente trabajo es la identificación de factores pre- y perioperatorios determinantes de reingreso; secundariamente, determinación de tasa de reingresos, identificación de diagnósticos de reingreso, e impacto de los reingresos sobre las tasas de supervivencia en los estudios que lo analizaban. La revisión se realizó mediante búsqueda sistemática en las principales bases de datos bibliográficas. Finalmente, 19 trabajos cumplieron los criterios de selección. Los principales factores de riesgo fueron: variables sociodemográficas de los pacientes; comorbilidades; tipo de resección; complicaciones postoperatorias; estancia prolongada. A pesar de la gran variabilidad en los estudios publicados, todos destacan la importancia de reducir los índices de reingreso por su significativo impacto sobre pacientes y sistema sanitario

Urgent readmissions have a major impact on outcomes in patient health and healthcare costs. The associated risk factors have generally been infrequently studied. The main objective of the present work is to identify pre- and perioperative determinants of readmission; the secondary aim was to determine readmission rate, identification of readmission diagnoses, and impact of readmissions on survival rates in related analytical studies. The review was performed through a systematic search in the main bibliographic databases. In the end, 19 papers met the selection criteria. The main risk factors were: sociodemographic patient variables; comorbidities; type of resection; postoperative complications; long stay. Despite the great variability in the published studies, all highlight the importance of reducing readmission rates because of the significant impact on patients and the healthcare system

Unplanned readmission after lung resection surgery: A systematic review. / Reingreso no planificado tras cirugía de resección pulmonar: revisión sistemática.

Urgent readmissions have a major impact on outcomes in patient health and healthcare costs. The associated risk factors have generally been infrequently studied. The main objective of the present work is to identify pre- and perioperative determinants of readmission; the secondary aim was to determine readmission rate, identification of readmission diagnoses, and impact of readmissions on survival rates in related analytical studies. The review was performed through a systematic search in the main bibliographic databases. In the end, 19 papers met the selection criteria. The main risk factors were: sociodemographic patient variables; comorbidities; type of resection; postoperative complications; long stay. Despite the great variability in the published studies, all highlight the importance of reducing readmission rates because of the significant impact on patients and the healthcare system.

Quilotórax espontáneo bilateral desencadenado por estornudo: una entidad peculiar de buen pronóstico / Spontaneous bilateral chylothorax caused by a sneeze: an unusual entity with good prognosis

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Giant primary mediastinal liposarcoma: A rare cause of atrial flutter.

We report the case of a 68-year-old man who presented with atrial flutter and was observed radiologically to have a large mass in the posterior mediastinum. During surgical removal, spontaneous recovery of sinus rhythm occurred. There was no late recurrence of arrhythmia. The diagnosis was mediastinal liposarcoma of mixed type (extremely rare). Supraventricular arrhythmia associated with mediastinal tumors is exceptional. Surgery appears to be the only potentially curative treatment for these tumors. In cases like ours presenting with arrhythmia, surgery is considered essential for control of the arrhythmia.

Efecto de los flavonoides en la prevención del cáncer de pulmón: revisión sistemática / Effect of flavonoids in the prevention of lung cancer: systematic review

Desde hace años, el cáncer de pulmón es el tumor que origina un mayor número de muertes en los países industrializados y emergentes. Un cuidado meticuloso de los aspectos nutricionales, insistiendo en altos niveles de consumo de frutas y verduras, puede suponer un importante elemento de prevención primaria. Investigando el efecto de sustancias con poder antioxidante, numerosos estudios epidemiológicos han centrado su atención en los flavonoides. El objetivo de esta revisión es analizar la evidencia científica disponible en la literatura médica respecto al papel de los flavonoides en el cáncer de pulmón. Tras una revisión bibliográfica sistemática, se identificaron un metaanálisis, una revisión sistemática, 11 estudios prospectivos de cohortes y 5 estudios de casos y controles.Tras analizar la evidencia científica establecida por estos trabajos, se observó un pequeño efecto protector del consumo de flavonoides (especialmente a altas dosis) frente al desarrollo de cáncer de pulmón, aunque no todos los estudios lo confirman. En este sentido, parecen no existir diferencias entre la ingesta selectiva de distintos tipos de flavonoides y el consumo de flavonoides totales, pero sí se observan diferencias entre las distintas poblaciones estudiadas (AU)

For years, lung cancer has been the tumor causing more deaths in industrialized and emerging countries. A meticulous care of the nutritional aspects, with emphasis on high consumption of fruits and vegetables, can be an important element of primary prevention.Taking into account research on the effect of substances with antioxidant power, many epidemiological studies have focused on flavonoids. The objective of this review is to analyze the available scientific evidence in the literature regarding the role of flavonoids in lung cancer.After a systematic literature review, we identified a meta-analysis, a systematic review, 11 prospective cohort studies and 5 case-control studies. After reviewing the scientific evidence provided by these works, there was a small protective effect of flavonoid consumption (especially at high doses) against the development of lung cancer, although not all studies confirmed it. There seems to be no differences between selective intake of different types of flavonoids and consumption of total flavonoids, but there are differences between the different populations studied (AU)

Efecto de los flavonoides en la prevención del cáncer de pulmón: revisión sistemática / Effect of flavonoids in the prevention of lung cancer: systematic review

Desde hace años, el cáncer de pulmón es el tumor que origina un mayor número de muertes en los países industrializados y emergentes. Un cuidado meticuloso de los aspectos nutricionales, insistiendo en altos niveles de consumo de frutas y verduras, puede suponer un importante elemento de prevención primaria. Investigando el efecto de sustancias con poder antioxidante, numerosos estudios epidemiológicos han centrado su atención en los flavonoides. El objetivo de esta revisión es analizar la evidencia científica disponible en la literatura médica respecto al papel de los flavonoides en el cáncer de pulmón. Tras una revisión bibliográfica sistemática, se identificaron un metaanálisis, una revisión sistemática, 11 estudios prospectivos de cohortes y 5 estudios de casos y controles. Tras analizar la evidencia científica establecida por estos trabajos, se observó un pequeño efecto protector del consumo de flavonoides (especialmente a altas dosis) frente al desarrollo de cáncer de pulmón, aunque no todos los estudios lo confirman. En este sentido, parecen no existir diferencias entre la ingesta selectiva de distintos tipos de flavonoides y el consumo de flavonoides totales, pero sí se observan diferencias entre las distintas poblaciones estudiadas (AU)

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[Effect of flavonoids in the prevention of lung cancer: systematic review]. / Efecto de los flavonoides en la prevención del cáncer de pulmón: revisión sistemática.

For years, lung cancer has been the tumor causing more deaths in industrialized and emerging countries. A meticulous care of the nutritional aspects, with emphasis on high consumption of fruits and vegetables, can be an important element of primary prevention. Taking into account research on the effect of substances with antioxidant power, many epidemiological studies have focused on flavonoids. The objective of this review is to analyze the available scientific evidence in the literature regarding the role of flavonoids in lung cancer. After a systematic literature review, we identified a meta-analysis, a systematic review, 11 prospective cohort studies and 5 case-control studies. After reviewing the scientific evidence provided by these works, there was a small protective effect of flavonoid consumption (especially at high doses) against the development of lung cancer, although not all studies confirmed it. There seems to be no differences between selective intake of different types of flavonoids and consumption of total flavonoids, but there are differences between the different populations studied.

Técnica de cierre de la toracotomía y su relación con el dolor postoracotomía: revisión sistemática / Suture Techniques of the Intercostal Space in Thoracotomy and Their Relationship with Post-Thoracotomy Pain: A Systematic Review

El dolor postoracotomía es un síntoma de alta incidencia entre los pacientes sometidos a toracotomía, que actúa como factor de riesgo importante en la patogénesis de diversas complicaciones posquirúrgicas. Su cronificación postoracotomía alcanza una alta prevalencia. Desde los primeros estudios se observó su relación con la lesión de los nervios intercostales y la conveniencia de evitar su lesión durante la toracotomía. Esta revisión pretende establecer el procedimiento quirúrgico más adecuado para el cierre de la toracotomía, mediante una revisión sistemática de la literatura médica y el análisis de los niveles de evidencia que proporcionan los estudios hallados.Tras una búsqueda bibliográfica exhaustiva en MEDLINE, EMBASE, IME, IBECS y Biblioteca Cochrane Plus, se hallaron escasos estudios. Cada uno de ellos se orienta a distintos aspectos de técnica quirúrgica en toracotomía, con el denominador común del enfoque hacia la preservación de los nervios intercostales, y conclusiones con distintos niveles de evidencia(AU)

Post-thoracotomy pain is a symptom of high incidence among patients who have undergone thoracotomy and is a major risk factor in the pathogenesis of several postoperative complications. Chronic pain after thoracotomy reaches a high prevalence. Since the earliest studies, this pain has been seen to be related with intercostal nerve injury, thus the need to avoid these lesions during thoracotomy has been recommended. This review aims to establish the appropriate surgical procedure for closure of the thoracotomy through a systematic review of the literature and analysis of levels of evidence provided by the studies found.After an exhaustive search in MEDLINE, EMBASE, IME, IBECS and Cochrane Library, few studies were found. Each focuses on different aspects of thoracotomy surgical techniques, with a common denominator focused on the preservation of the intercostal nerves, and conclusions with different levels of evidence(AU)

Suture techniques of the intercostal space in thoracotomy and their relationship with post-thoracotomy pain: a systematic review.

Post-thoracotomy pain is a symptom of high incidence among patients who have undergone thoracotomy and is a major risk factor in the pathogenesis of several postoperative complications. Chronic pain after thoracotomy reaches a high prevalence. Since the earliest studies, this pain has been seen to be related with intercostal nerve injury, thus the need to avoid these lesions during thoracotomy has been recommended. This review aims to establish the appropriate surgical procedure for closure of the thoracotomy through a systematic review of the literature and analysis of levels of evidence provided by the studies found. After an exhaustive search in MEDLINE, EMBASE, IME, IBECS and Cochrane Library, few studies were found. Each focuses on different aspects of thoracotomy surgical techniques, with a common denominator focused on the preservation of the intercostal nerves, and conclusions with different levels of evidence.

Clinical value of p53, c-erbB-2, CEA and CA125 regarding relapse, metastasis and death in resectable non-small cell lung cancer.

The prognostic value of p53 and c-erbB-2 immunostaining and preoperative serum levels of CEA and CA125 was investigated in a prospective multicentric study including 465 consecutive non-small cell lung cancer (NSCLC) patients with resectable tumors. Four end-points were used: lung cancer death, first relapse (either locoregional or metastasis), loco-regional recurrence and metastasis development. Standard statistical survival methods (Kaplan-Meier and Cox regression) were used. The specificity of the prognostic effect across different types of tumors was also explored, as had been planned in advance. Our results showed, once again, that pathological T and N classifications continue to be the strongest predictors regarding either relapse or mortality. Three of the studied markers seemed to add further useful information, however, but in a more specific context. For example, increased CEA concentration defined a higher risk population among adenocarcinomas but not among people with squamous tumors; and p53 overexpression implied a worse prognosis mainly in patients with well differentiated tumors. The analysis of type of relapse proved to be very informative. Thus, CA125 level was associated with a worse prognosis mainly related with metastasis development. Another interesting result was the influence of smoking, which showed a clear dose-response relationship with the probability of metastasis. For future studies, we recommend the inclusion of different endpoints, namely considering the relationship of markers with the type of relapse involved in lung-cancer recurrence. They can add useful information regarding the complex nature of prognosis.