Medicina
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The aim of this study was to describe the long term prognosis of 34 patients with Takayasu arteritis and the results of surgical and endovascular treatment. A total of 5 central surgeries and 53 endovascular procedures were performed including 18 bypass surgeries (33.8%) and 35 angioplasties (66.2%). The median follow-up was 7.5 years, interquartile range [IQR] 2.6-12.5. ⋯ Surgery had higher mortality in patients with aortic and ascending aortic valve disease, combined coronary artery disease and carotid disease. In long term follow up Takayasu arteritis frequently requires revascularization and restenosis or new lesions are common. Surgical treatment had better results with less restenosis than angioplasty.
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Clear cell "sugar" tumor of the lung is a rare benign tumor arising from perivascular epithelioid cells (PECs). They belong to a group of mesenchymal neoplasms called PEComas. ⋯ We report the case of a 66-year-old man in whom a solitary pulmonary nodule was discovered during oncological staging for an adenocarcinoma of the prostate who underwent an anatomical pulmonary segmentectomy. The final pathology result was a perivascular epithelioid cell tumor (pulmonary PEComa or clear "sugar" cell tumor).
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The use of aesthetic procedures that improve body image is constantly growing, as well as infections associated with them, such as atypical mycobacteriosis. Mesotherapy is a minimally invasive aesthetic procedure that consists of the application of substances that seek to stimulate the dermis and subcutaneous cellular tissue, for the treatment of cellulite and skin rejuvenation. ⋯ Infections associated with mesotherapy have been reported in Spain, Latin America and the Caribbean, all possibly related to lack of health controls. We emphasize the importance of being aware of these infectious complications and the need to reinforce the necessary security measures to avoid them.
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The systematic registry of contacts with the objective of identifying and treating those with tuberculosis infection is one of the pillars established by the WHO in the end Tuberculosis Strategy. The risk of tuberculosis infection in school contacts, although lower than in households, is significant. ⋯ This paper addresses these issues and proposes, with updated evidence, a screening modality for contacts in higher education institutions. This screening proposes to identify those infected using the cut-off point of 5 mm in the tuberculin test, offering preventive treatment and active follow-up only to those with a positive test.
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Uncertainty is present in every medical activity and its inadequate management may have negative consequences. The Physicians' Reactions to Uncertainty (PRU) scale is used to quantify tolerance to uncertainty in medical doctors. Our objective was to carry out the translation into Spanish, cultural adaptation and validation of the PRU scale. ⋯ The a-Cronbach average value was 0.78. These findings indicate that younger physicians and surgical specialists have greater reluctance to disclose uncertainty and mistakes. Having this information and a validated tool can be helpful to study uncertainty in medical doctors in Latin America and drive strategies to appropriately deal with it.