Obstrucción de sonda nasogástrica por molde de nutrición enteral / Nasogastric tube obstruction due to enteral feeding bezoar

Introducción: la administración de nutrición enteral por sonda nasogástrica puede presentar complicaciones potencialmente graves. Presentamos un caso de obstrucción esofágica por un bezoar de nutrición enteral. Caso clínico: el paciente de 77 años ingresó en nuestro centro en la unidad de cuidados intensivos por neumonía COVID. El paciente recibía nutrición enteral por sonda nasogástrica (SNG) presentando al mes del seguimiento dificultad para el paso de la misma. Tras retirada de la sonda y unida a ella se extrajo un molde esofágico de nutrición enteral. Posteriormente se administra a través de una nueva SNG una solución disolvente y se modifica la fórmula por una hidrolizada. Discusión: los bezoar de nutrición enteral son una complicación rara pero potencialmente mortal. (AU)

Introduction: the administration of enteral nutrition through a nasogastric tube can cause potentially serious complications. We present a case of esophageal obstruction due to an enteral nutrition bezoar. Case report: the 77-year-old patient was admitted to our center in the intensive care unit for COVID pneumonia. The patient received enteral nutrition through a nasogastric tube (NGT), presenting difficulty passing it after a month of follow-up. After removal of the tube and attached to it, an esophageal mold for enteral nutrition was extracted. Later, a solvent solution is administered through a new SNG and the formula is modified for a hydrolyzed one. Discussion: enteral nutrition bezoars are a rare but can be a life-threatening complication (AU)

[Nasogastric tube obstruction due to enteral feeding bezoar]. / Obstrucción de sonda nasogástrica por molde de nutrición enteral.

Introduction: Introduction: the administration of enteral nutrition through a nasogastric tube can cause potentially serious complications. We present a case of esophageal obstruction due to an enteral nutrition bezoar. Case report: the 77-year-old patient was admitted to our center in the intensive care unit for COVID pneumonia. The patient received enteral nutrition through a nasogastric tube (NGT), presenting difficulty passing it after a month of follow-up. After removal of the tube and attached to it, an esophageal mold for enteral nutrition was extracted. Later, a solvent solution is administered through a new SNG and the formula is modified for a hydrolyzed one. Discussion: enteral nutrition bezoars are a rare but can be a life-threatening complication.

Introducción: Introducción: la administración de nutrición enteral por sonda nasogástrica puede presentar complicaciones potencialmente graves. Presentamos un caso de obstrucción esofágica por un bezoar de nutrición enteral. Caso clínico: el paciente de 77 años ingresó en nuestro centro en la unidad de cuidados intensivos por neumonía COVID. El paciente recibía nutrición enteral por sonda nasogástrica (SNG) presentando al mes del seguimiento dificultad para el paso de la misma. Tras retirada de la sonda y unida a ella se extrajo un molde esofágico de nutrición enteral. Posteriormente se administra a través de una nueva SNG una solución disolvente y se modifica la fórmula por una hidrolizada. Discusión: los bezoar de nutrición enteral son una complicación rara pero potencialmente mortal.

Research priorities in multiple sclerosis in Latin America: A multi-stakeholder call to action to improve patients care: Research priorities in MS in LATAM.

As human and economic resources are limited, especially in Latin America (LATAM), it is important to identify research priorities to improve multiple sclerosis (MS) patients care in the region. The objective was to generate a multidisciplinary consensus on research priorities in MS for patients care in LATAM by involving healthcare professionals and MS patient associations. METHODS: consensus was reached through a four-step modified Delphi method designed to identify and rate research priorities in MS in LATAM. The process consisted of two qualitative assessments, a general ranking phase and a consensus meeting followed by a more detailed ranking phase RESULTS: a total of 62 participants (35 neurologists, 4 nurses, 12 kinesiologists, 7 neuropsychologists and 4 patient association members) developed the process. At the final ranking stage following the consensus meeting, each participant provided their final rankings, and the top priority research questions were outlined. 11 research priorities were identified focusing on healthcare access, costs of the disease, physical and cognitive evaluation and rehabilitation, quality of life, symptoms management, prognostic factors, the need of MS care units and patient's management in emergencies like COVID-19. CONCLUSION: this work establishes MS research priorities in LATAM from multiple perspectives. To pursue the actions suggested could launch the drive to obtain information that will help us to better understand the disease in our region and, especially, to better care for affected patients.

Sarcomas of the sellar region: a systematic review.

PURPOSE AND METHODS: Sarcomas of the sellar region are uncommon and unexpected tumors. Here, we review the cases reported in literature via a systematic search. RESULTS: Ninety-four patients, 58.5% male with mean age of 39.2 ± 17.2 years were included. Fifty-seven (62%) had soft tissue sarcomas (STS) and 35 (38%) bone sarcomas (BS). Sarcoma was a primary tumor in 66%, developed after radiotherapy in 31.9% and 7.4% were metastatic. Median time between radiotherapy and sarcoma development was 10.5 (11) years. Main presentation symptoms were visual disorders (87.9%), headache (61.5%) and III cranial nerve palsy (24.1%). After surgery, sarcoma persisted or recurred in 82.3% and overall mortality reported was 44.6% with 6.5 (14) months of median survival. Tumor appeared earlier in BS compared to STS (34.4 ± 15.1 vs. 42.6 ± 17.6 years), p = 0.034 and complete tumor resection was achieved more often (41.3% vs. 4.4%), p = < 0.001. Condrosarcoma and rhabdomyosarcoma were more frequent subtypes among primary tumors while fibrosarcoma was among post-radiation sarcomas. Tumor size was larger in radiation associated sarcomas (mean maximum diameter 46.3 ± 9.3 vs. 29.1 ± 8.0 mm, p = 0.004) and persistency/recurrence was similar in both groups (70.1 vs. 73.3%, p = 0.259). CONCLUSION: Sarcomas appear as mass effect symptoms in the middle aged population, mainly as primary tumors, but one third is associated with radiotherapy. Surgery is commonly not curative, mortality rate is high and death ensues shortly after diagnosis.

Instruction Modes for Motor Control Skills Acquisition: A Randomized Controlled Trial.

The objective was to compare two different instruction modes used to teach patients with nonspecific chronic low back pain (CLBP) to perform a lumbar motor control task. The three intervention instruction modes used were: common verbal explanation of a motor task based on a motor control therapeutic exercise (MCTE-control group), MTCE instructed using motor imagery (MI) and MCTE instructed using tactile feedback (TF). The main outcome measure was lumbar motor control of the neutral position test. Forty-eight patients with CLBP were randomly allocated into three groups of 16 patients per group. The MI strategy was the most effective mode for developing the motor control task in an accurate and controlled manner, obtaining better outcomes than TF or verbal instruction.

Tratamiento del carcinoma de mama en tejido mamario ectópico axilar / Management of breast carcinoma in ectopic axillary breast tissue

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