Background The COVID-19 pandemic outbreak has set the emergency services in developing countries on major alert, as the installed response capacities are easily overwhelmed by the constantly increasing high demand. The deficit of intensive care unit beds and ventilators in countries like Peru is forcing practitioners to seek preventive or early interventional strategies to prevent saturating these chronically neglected facilities. Case presentation A 64-year-old patient is reported after presenting with COVID-19 pneumonia and rapidly progressing to deteriorated ventilatory function. Compassionate treatment with a single 1-Gy dose to the bilateral whole-lung volume was administered, with gradual daily improvement of ventilatory function and decrease in serum inflammatory markers and oxygen support needs, including intubation. No treatment-related toxicity developed. Procedures of transport, disinfection, and treatment planning and delivery are described. Conclusion Whole-lung low-dose radiotherapy seems to be a promising approach for avoiding or delaying invasive respiratory support. Delivered low doses are far from meeting toxicity ranges. Ongoing prospective trials will elucidate the effectiveness of this approach.
Objetivo: Describir los resultados de la biopsia prostática transperineal por fusión de la resonancia magnética cognitiva y ultrasonido en la detección del cáncer. Materiales y métodos: Estudio de serie de casos, retrospectivo, realizado en Clínica Delgado entre julio del 2019 y octubre del 2021. Se incluyó pacientes con examen digital de próstata y/o Antígeno Prostático Específico anormal e imágenes de Resonancia Magnética de próstata con lesiones categoría PI-RADS 4 o 5. Excluyendo a pacientes con trastorno de coagulación, lesiones rectales, imposibilidad para abducción, comorbilidades para anestesia. Registramos las características clínicas, demográficas, datos de antígeno prostático específico, volumen de la próstata, lesiones PI-RADS, tasas de cáncer, complicaciones. Resultados: Se evaluaron 18 pacientes, con edad media de 69,33 ± 7,67 años. La media del antígeno prostático específico de 14,94 ± 12,42 ng/mL. La media del volumen de próstata de 57,72 ± 28,68 cc. Al examen digital de la próstata 16/18 (88.88 %) pacientes tenían sospecha de cáncer. Biopsias en pacientes con lesiones PI-RADS 4 en 6/18 (33,33%) y 5 en 12/18 (66,67%). Biopsia con 19 núcleos a 6/18 (33,33%) y 16 núcleos a 12/18 (66,67%) pacientes. Pacientes con cáncer 15/18 (83,33%), todos Adenocarcinoma Acinar, con Gleason 6 en 2/18 (11,11%) y Gleason ≥ 7 en 13/18 (72,22%) pacientes. Complicaciones leves como hematuria 1/18 (5,6%), disuria terminal 8/18 (44,4%) y molestia perineal 7/18 (38,8%) y ninguna infecciosa. Conclusiones: la biopsia prostática transperineal por fusión de imágenes de resonancia magnética cognitiva y ultrasonido es factible, segura, con tasas altas de positividad y sin infecciones.
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