Prediction and Potential Spatially Explicit Spread of COVID-19 in Mexico's Megacity North Periphery.

The novel COVID-19, detected in Wuhan, China, has reached almost every city across the globe, and researchers from many countries have used several epidemiologic models to describe the epidemic trends. In this context, it is also important to know the geographic extent of the infected population. Following this approach, a Gumpertz model was adapted with official data from the state of Hidalgo, Mexico, in order to estimate the people infected during this COVID-19 pandemic. We found, based on the adjusted data, the highest value in infected people according to official and theoretical data. Furthermore, using a geographical analysis based on geostatistical measures related to density of demographic and economic data, traffic level and geolocation, raster files were generated to estimate probability of coronavirus cases occurrence using the areas where the contagion may occur. We also distributed the maximum contagion obtained by the epidemic model, using these raster files, and a regression model to weight factors according their importance. Based on this estimated distribution, we found that most of the infected people were located in the southern border, a trend related to the economic strip in the southern part of Hidalgo State, associated with its vicinity to the Megacity of Mexico.

Forequarter Amputation and Immediate Reconstruction with a Free Extended Humeral-Radial Forearm Flap.

A forequarter amputation is a radical ablative surgical procedure that includes the entire upper extremity with its shoulder girdle. We present a 53-year-old woman with a solid slow growing tumor in her right shoulder of 15 x 20 cm in diameter. Resection and immediate reconstruction with a free radial forearm flap extended from the distal third of the arm to the midpalmar region, taking the humeral artery and the cephalic vein as a main peddicle. The final outcome is shown at six weeks after the surgery.

[Clinical characteristics of the thyroid follicular carcinoma]. / Características clínicas del carcinoma folicular de tiroides.

BACKGROUND: the prevalence of thyroid follicular carcinoma (TFC) is 39 % in patients with an undetermined histological diagnosis. The aim was to know the prevalence of TFC in a hospital with high population concentration. METHODS: surgical reports with a final diagnosis of TFC were reviewed. The size of the tumor, age, gender, pre- and post-surgical diagnosis and comorbidities were retrieved. RESULTS: a total of 35 reports with a diagnosis of TFC were found: 30 (85 %) were females with a mean age 44 ± 16.9 years. The mean age was 57 ± 6.6 in males. The diagnoses before surgery were follicular carcinoma 14 (40 %), thyroid cancer 6 (17.1 %), thyroid adenoma 4 (11.4 %), goiter 3 (8.5 %), thyroid nodule 3 (8.5 %), one papillary carcinoma (2.8 %), one thyroid neoplasm (2.8 %), one poorly differentiated adenocarcinoma (2.8 %), one well differentiated follicular adenocarcinoma (2.8 %), and one medullary thyroid cancer (2.8 %). The comorbidities found were Hashimoto disease 2 (5.6 %) and papillary contralateral carcinoma 2 patients (5.6 %). CONCLUSIONS: follicular carcinomas of the thyroid of our population differ in clinical presentation compared with previous reports.

Introducción: se ha identificado carcinoma folicular en 39 % de los pacientes con nódulos tiroideos cuya citología prequirúrgica ha indicado resultados indeterminados. El propósito de esta investigación fue conocer la prevalencia de esta entidad en un hospital de concentración. Métodos: se buscaron los reportes quirúrgicos con diagnóstico de carcinoma folicular. Se registró tamaño del tumor, sexo y edad del paciente, diagnósticos pre y posquirúrgico y patologías asociadas. Resultados: se diagnosticó carcinoma folicular en 35 pacientes: 30 mujeres (85 %) y cinco hombres (15 %). La edad en los hombres fue de 57 ± 6.6 y de 44 ± 16.9 en las mujeres. Los diagnósticos preoperatorios fueron carcinoma folicular en 14 (40 %), cáncer tiroideo en seis (17.1 %), adenoma folicular en cuatro (11.4 %), bocio en tres (8.5 %), nódulo tiroideo en tres (8.5 %); carcinoma papilar, tumor de tiroides, carcinoma poco diferenciado de tiroides, adenocarcinoma folicular bien diferenciado, cáncer medular en un paciente (2.8 %) cada uno. Las patologías asociadas fueron tiroiditis de Hashimoto y carcinoma papilar contralateral, con dos pacientes cada uno (5.6 %). Conclusiones: la edad de los pacientes y la presentación clínica del carcinoma folicular difirieron de las informadas en otras investigaciones.