La mordedura de perro es un padecimiento común en nuestro medio. La mayoría de los casos son atendidos por el Servicio de Urgencias, y de éstos sólo un porcentaje de pacientes que presentan complicaciones amerita hospitalización. Se debe realizar una adecuada exploración debido a que el tipo de herida y los hallazgos clínicos modifican nuestra conducta terapéutica. Los exámenes de laboratorio y gabinete nos ayudan a confirmar los casos en los que se sospechen lesiones asociadas y complicaciones. Actualmente, se encuentran en discusión las indicaciones y contraindicaciones para el cierre de la herida. El tratamiento antibiótico profiláctico no disminuye la incidencia de complicaciones infecciosas y los esquemas terapéuticos sólo deben de iniciarse una vez confirmada la infección.
Background: Dialyzable leukocyte extracts (DLE) are heterogeneous mixtures of peptides less than 10 kDa in size that are used as immunomodulatory adjuvants in immune-mediated diseases. Transferon TM is DLE manufactured by National Polytechnic Institute (IPN), and is registered by Mexican health-regulatory authorities as an immunomodulatory drug and commercialized nationally. The proposed mechanism of action of Transferon TM is induction of a Th1 immunoregulatory response. Despite that it is widely used, to date there are no reports of adverse events related to the clinical safety of human DLE or Transferon TM. Objective: To assess the safety of Transferon TM in a large group of patients exposed to DLE as adjuvant treatment. Methods: We included in this study 3844 patients from our Clinical Immunology Service at the Unit of External Services and Clinical Research (USEIC), IPN. Analysis was performed from January 2014 to November 2014, searching for clinical adverse events in patients with immune-mediated diseases and treated with * Corresponding author. Transferon TM as an adjuvant. Results: In this work we observed clinical nonserious adverse events (AE) in 1.9% of patients treated with Transferon TM (MD 1.9, IQR 1.7-2.0). AE were 2.8 times more frequently observed in female than in male patients. The most common AE were headache in 15.7%, followed by rash in 11.4%, increased disease-related symptomatology in 10%, rhinorrhea in 7.1%, cough in 5.7%, and fatigue in 5.7% of patients with AE. 63% of adverse event presentation occurred from day 1 to day 4 of treatment with Transferon TM , and mean time resolution of adverse events was 14 days. In 23 cases, the therapy was stopped because of adverse events and no serious adverse events were observed in this study. Conclusion: Transferon TM induced low frequency of nonserious adverse events during adjuvant treatment. Further monitoring is advisable for different age and disease groups of patients.
The persistence or recurrence of symptoms after antireflux surgery is associated with poor study and initial approach, failures in surgical technique and risk factors specific to the patient. In order to describe the symptoms that lead to a new intervention, time since the first procedure, the technique used and the characteristics of the patients, a retrospective systematic review of 100 clinical records of cases undergoing reintervention of antirreflux surgery during the last four years was carried out in Angeles Pedregal Hospital in Mexico City. Cases with up to three previous surgeries were found, the results showed that heartburn (65%), regurgitation (58%) and epigastric pain (28%) were the most frequent symptoms. The most important isolated risk factor was obesity (23%). More than 50% underwent reoperation within the first 10 years, with slippage of the fundoplication being the most common failure mechanism (71%). Although the results largely coincide with the literature, the systematic comparison of cases with two or more surgeries as in our sample has been reported in few studies in the laparoscopic era, so the present work contributes to the analysis of cases with multiple anti-reflux surgical treatments.
Introduction: Vascular malformations are anomalies of the vascular system, constituted by a network of vessels with mature endothelium, with normal cell replacement without proliferation capacity. Case Report: We report the clinical case of a 25-year-old man who came to the hospital for left pelvic limb edema and lumbar pain. An ultrasonography (USG) and positron emission tomography-computed tomography (PET-CT) revealed deep vein thrombosis of the inferior vena cava (IVC) and left iliac vein and a 9.5 cm × 5 cm retroperitoneal nometabolic tumor compatible with perivascular lymphadenopathies. Exploratory laparotomy was performed, transperitoneum exploration of the retroperitoneum and resection of the tumor arising from the IVC and left iliac vein. Pathological examination revealed a 10 cm retroperitoneal tumor filled with venous vessels and fibrotic septa. Postoperative diagnosis was venous malformation of the IVC. Conclusion: Cavernous hemangiomas are not true vascular tumors, but rather a
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