Case report: Endovascular stent-graft repair of aortic penetrating trauma, literature review, and case report.

Penetrating aortic injuries are infrequent. Its incidence is unknown because most patients die of hemorrhage even before they receive adequate treatment. Aortic wounds generally require conventional thoracotomy/laparotomy repair and are related to high mortality rates. Recently with the advent of endovascular techniques, most authors prefer endovascular management when feasible due to better (still poor) outcomes. The short- and mid-term results of immediate endovascular repair of traumatic aortic injuries are promising, especially when compared with open surgical treatment, indicating that endovascular therapy is preferable in patients with multi-trauma and traumatic ruptures of the thoracic aorta. Here we present the diagnosis and treatment of a 30 years-old male patient with multiple traumatic stab wounds, including anterior aortic laceration with a grade II aortic lesion successfully managed with an endovascular stent graft.

Automatic base-model selection for white blood cell image classification using meta-learning.

Healthcare has benefited from the implementation of deep-learning models to solve medical image classification tasks. For example, White Blood Cell (WBC) image analysis is used to diagnose different pathologies like leukemia. However, medical datasets are mostly imbalanced, inconsistent, and costly to collect. Hence, it is difficult to select an adequate model to overcome the mentioned drawbacks. Therefore, we propose a novel methodology to automatically select models to solve WBC classification tasks. These tasks contain images collected using different staining methods, microscopes, and cameras. The proposed methodology includes meta- and base-level learnings. At the meta-level, we implemented meta-models based on prior-models to acquire meta-knowledge by solving meta-tasks using the shades of gray color constancy method. To determine the best models to solve new WBC tasks we developed an algorithm that uses the meta-knowledge and the Centered Kernel Alignment metric. Next, a learning rate finder method is employed to adapt the selected models. The adapted models (base-models) are used in an ensemble learning approach achieving accuracy and balanced accuracy scores of 98.29 and 97.69 in the Raabin dataset; 100 in the BCCD dataset; 99.57 and 99.51 in the UACH dataset, respectively. The results in all datasets outperform most of the state-of-the-art models, which demonstrates our methodology's advantage of automatically selecting the best model to solve WBC tasks. The findings also indicate that our methodology can be extended to other medical image classification tasks where is difficult to select an adequate deep-learning model to solve new tasks with imbalanced, limited, and out-of-distribution data.

Percutaneous closure of subclavian iatrogenic injuries after central venous catheterization: a Latin American experience.

Introduction: Arterial injuries following central venous catheterization (CVC) range between 0.1%-2.7%. The open surgical approach could be related to increased rates of morbidity and mortality. Vascular closure devices (VCD) are often used for the management of these patients with a success rate of up to 80%. Objectives: Describe our experience in managing arterial vascular injuries following central venous catheterization with Perclose ProGlide (Abbott Vascular IncSanta Clara, CA, USA). Methods: A retrospective review of all patients over 18 years old who underwent percutaneous closure of arterial injuries following central venous catheterization in our center between January 2018 and May 2023 was included and reported with a 90-day follow-up. Results: 3 Patients were included, in all cases, access to the CVC were right with a subclavian artery injury. Ultrasound and fluoroscopy guide was used in all cases. For the 3 cases, a percutaneous technique using Perclose ProGlide (Abbott Vascular IncSanta Clara, CA, USA) was performed. With a 100% success rate, and no complications evidenced after 90 days of follow-up. Conclusion: Inadvertent arterial catheterization it's a non-negligible complication after CVC placement. VCD could be considered a safe and feasible approach for the management of these traumatic injuries.

Sin ciencia no hay futuro / Without Science there is not Future

La medicina ha desempeñado un papel pionero en el desarrollo científico de nuestro país y, sin duda, seguirá haciéndolo en el siglo XXI. En ese contexto es pertinente mencionar que desde comienzos de los años setenta, con la fundación de Colciencias como fondo adscrito al Ministerio de Educación, el Estado colombiano empezó a dar un espacio a la ciencia y a la tecnología. Sin embargo, el tema no ha sido una ver-dadera prioridad para ninguno de los gobiernos de los últimos treinta años.

Medicine has played a pioneering role in the scientific development of our country and will undoubtedly continue to do so in the 21st century. In this context, it is pertinent to mention that since the early 1970s, with the founding of Colciencias as a fund attached to the Ministry of Education, the Colombian State began to give a space to science and technology. However, the subject has not been a real priority for any of the governments of the last thirty years.

Galactosemia

Se presenta un informe de dos hermanas con galoctosemia hereditaria, siendo éstos los primeros casos que se publican en Cuba.......(AU)

Organización y normas de funcionamiento de una sala de terapéutica intensiva

Gran número de afecciones capaces de producir notables alteraciones de distintos aparatos o sistemas tienen un alto índice de mortalidad, a menos que se instuya una terapéutica racional mediante un equipo de trabajo dedicado a estos fines que se concentran en una pequeña sala de un hospital para el cuidado intensivo y continuado de pacientes agudamente enfermos......(AU)

Enfermedad de inclusión citomegálica

Se presenta una casuística de 7 casos de enfermedad de inclusión citomegálica diagnosticados durante los años 1962 a 1968 en el Hospital Infantil Docente "William Soler" y representan el 0,24 por ciento del total de necropsias realizadas en ese período......(AU)