Situs inversus totalis

Situs inversus totalis (SIT) es una enfermedad rara, en la cual existe transposición de los órganos torácicos y abdominales. Se presenta el caso de una paciente de 65 años de edad, que acude a emergencias por dolor epigástrico de 20 horas de evolución que luego de unas horas migra a fosa iliaca izquierda asociado a hiporexia. En primera instancia, se sospecha del diagnóstico de diverticulitis, luego de los exámenes imagenológicos respectivos es descartada por encontrarse hallazgos correspondientes con situs inversus totalis y se plantea apendicitis del lado izquierdo. Por tal motivo, la realización de una adecuada historia clínica y examen físico apoyado en pruebas imagenológicas resultan importantes para tener en cuenta a la apendicitis como parte del diagnóstico diferencial, con el fin de evitar errores en su diagnóstico per se y tratamiento.; Situs inversus totalis (SIT) is a rare disease in which there is transposition of thoracic and abdominal organs. The symptoms of appendicitis in SIT are often confused with other intraperitoneal processes such as diverticulitis. We report the case of a 65-year-old, attended by emergency epigastric pain of 20 hours of the onset after a few hours left iliac fosse migrates associated with hyporexia. Diverticulitis is diagnosed in the first instance, and after the respective imaging tests is discarded for being relevant findings with situs inversus totalis and left poses appendicitis. Therefore, the realization of an adequate medical history and physical examination supported by imaging tests are important to keep in mind, appendicitis as part of the differential diagnosis, in order to avoid errors in diagnosis and treatment..
Authors: Navarro, Veronica; Oshiro, Harumi; Peña, Bruce; Moquillaza Pineda, Fernando
Source:Revista de Gastroenterología del Perú

URL: http://hdl.handle.net/10757/322409

A new virus A/H1N1, a new pandemic: A continuing risk to a globalized humanity

Influenza is a highly contagious disease. There are some historical descriptions of this condition by ancient Greek physicians, and the etiological agents have been known only for the last eight decades. The causative agent is the influenza virus, which has three main types: A, B, and C. Type A is capable of circulating within many different biological reservoirs, including humans, swine, and birds. It also has high genetic variability, which allows it to have minor antigenic drifts or mutations which are responsible of epidemics in humans. Sometimes changes are quite marked, leading to pandemics. In a globalized world, with more than 6 billion inhabitants, with many social inequities and evident climate changes, influenza viruses are a permanent risk for mankind. Clinical features for the different viral subtypes may vary from subtle infections to full blown and severe, life-threatening forms. Event with the great advances in diagnostics and immunization, the manufacture and distribution of new diagnostic kits may take some time, and new vaccines are not always readily available. Specific therapies against influenza are not well developed. There are two groups of drugs, the so called adamantane derivatives, such as amantadine and rimantadine, and the neuraminidase inhibitors, such as oseltamivir and zanamivir. Most vulnerable areas for the new flu pandemics include developing countries, particularly the poorest ones, so that the greatest effort must be made for helping these areas.
Authors: Osores Plenge, Fernando; Gómez Benavides, Jorge; Suárez Ognio, Luis; Cabezas Sánchez, César; Alave Rosas, Jorge; Maguiña Vargas, Ciro
Source: Acta méd. peruana

URL: http://hdl.handle.net/10757/323238

Development of a 16S rRNA PCR-RFLP Assay for Bartonella Identification: Applicability in the Identification of Species Involved in Human Infections

Abstract We designed a 16S rRNA gene PCR-RFLP scheme to identify all currently described Bartonella spp. The 16S rRNA genes of all Bartonella spp. were in-silico analyzed in order to design a RFLP technique able to discriminate among different species. The restriction enzymes selected were MaeIII, MseI, Sau96I, BsaAI, DrdI, FokI, BssHII, BstUI, AluI, TspDTI and HphI which, according to a decision-making tree, facilitated the differentiation of all the currently described species of Bartonella.The technique was experimentally tested in different species of Bartonella, including human pathogenic B. bacilliformis and B. henselae with a 100% of concordance with the in-silico predicted patterns.This novel RFLP assay could be used to identify both human and non-human pathogenic Bartonella in diagnostic, phylogenetic and epidemiologic studies.
Authors: Del Valle, Luis J.; Jaramillo, Michael L.; Talledo, Miguel; Pons, Maria J.; Flores, Lidia; Quispe, Ruth L.; Ramírez, Pablo; García de la Guarda, Ruth; Alvarado, Débora; Espinoza-Culupú, Abraham; Del Valle Mendoza, Juana;Vargas, Martha; Ruíz, Joaquim
Source: Horizon Research Publishing

URL: http://hdl.handle.net/10757/322342

Short scar lipoabdominoplasty without neoumbilicoplasty in tipe III abdomen (Matarasso)

We present an innovative surgical technique for treatment of abdominal region, in which we combine liposculpture and limited-incisions abdominoplasty without neoumbilicoplasty, in Type III Matarasso Classification patients. We conducted a retrospective study of patients undergoing surgery with this new proposal, between 2002 to 2008. The deep and superficial body liposculpture also included anterior abdominal wall. The surgical technique is based on the use of small incisions at the suprapubic region up to 18 cm long, with dissection of a supraaponeurotical tunnel of 10 cm approximately, with desinsertion of the navel, plication of the rectus abdominis muscle diastasis and subsequent inferior reinsertion of the umbilicus. We use a plaster splint for postoperatory time. We evaluated 64 lipoabdominoplasties, all in women with a mean age of 41.9 years. The average operative time was of 3 hours and a half, with an average aspirated volume of 1000 ml of the anterior abdominal wall. In 14,1 % of the patients we observed seroma as a complication. As a conclusions, this technique allows good body aesthetics results, to obtain a shorter scar, a thin anterior abdominal flap and the absence of umbilical scar.
Authors: Centurion, Patricio; Olivencia C.; Romero C.; Gamarra García R.
Source: Cirugía Plástica Iberolatinoamericana
URL:  http://hdl.handle.net/10757/320973

Laserlipólise com diodo 980 nm: experiência com 400 casos

Introduction: Liposuction has undergone several improvements since its first description, including changes in the cannulas, variation in the concentration of the infiltrating solution, and the use of different devices and technologies. The use of laser technology devices for lipolysis and stimulation of skin retraction has contributed to the procedure. This article presents the authors’ experience with laser lipolysis in 400 patients, within a 5-year period, and discusses the principles of the technology and its effect on tissues. Methods: This is a study performed between July 2007 and July 2012 and included 400 patients who underwent laser lipolysis. All procedures were performed following the original protocol – infiltration of cold saline, passage of the cannula with an optic fiber for conducting the energy needed for laser lipolysis, skin retraction, and finally, conventional liposuction. Results: Hospitalization type ranged from outpatient to overnight surgery. Approximately 45% (180 of 400) of patients had minimal bruising, with involvement of 2% or more of the affected body surface. Hematoma, seroma, and dehiscence occurred in a total of 9% (36 of 400) of patients. We did not find any case of thermal burn of the skin. Conclusions: Laser lipolysis performed according to the described technique was safe and reproducible.
Authors:Valle Dornelles, Rodrigo de Faria; De Lima e Silva, Adriano; Missel, Juarez; Centurion, Patricio
Source: Revista Brasileira de Cirurgia Plástica

URL: http://hdl.handle.net/10757/320972