Cir Cir
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Thromboprophylaxis in surgical patients requires specific measures to implement regional anesthesia techniques. In this regard the current clinical practice guidelines of anesthesiology summarizes the recommendations of the review of current evidence. ⋯ the coagulation status should be evaluated and optimized at the time of placement of a needle anesthesia or continue either epidural, spinal or peripheral nerve blockade to continue prophylaxis as a priority without minimizing the risk of serious complications such as spinal bleeding.
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Use of totally implantable central venous access ports in cancer patients is a common practice for chemotherapy not excluding early and late morbidity. ⋯ The combination of a trained surgical team and careful monitoring reduces morbidity and prevents infections. Access through the external jugular is recommended for its accessibility and low morbidity.
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Acute lymphoblastic leukemia initially shows osteoarticular manifestations. However, it is rare that it shows juvenile idiopathic arthritis (JIA) symptoms. ⋯ This case initially showed typical signs of arthritis, and a diagnosis of acute lymphoblastic leukemia was ruled out, since the those clinical features and hematologic alterations characterizing this hematologic neoplasia.