Cir Cir
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Multicenter Study
[Epidemiological study of sepsis in Mexican intensive care units].
Consistent data about sepsis in Mexico are lacking. The objective of this epidemiological study is to better define the incidence, characteristics and outcome of sepsis in Mexican intensive care units (ICUs). ⋯ This study documents the high incidence of sepsis in Mexican ICUs, with high mortality rate and low adherence to Surviving Sepsis Campaign. Our data suggest that sepsis is a public health problem in Mexico.
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Pulmonary ultrasonography (PUSG) is a new diagnostic tool for pleuropulmonary disease in the critically ill patient. Images obtained in this study result from the interaction between the ultrasound shaft with the pleura, the pulmonary parenchyma and the air/liquid interface. These images are classified as horizontal and vertical. ⋯ Sensitivity and specificity are high for pneumothorax, alveolar-interstitial syndrome and pleural effusion diagnosis. PUSG practiced in the ICU is one of the most promising diagnostic procedures in intensive care medicine, and the practice and indications of this tool will surely extend in the coming years. The objective of this study is to make known the general principles of PUSG and their use in the critically ill patient, based on cases of hospitalized patients in the ICU of the Medica Sur Clinical Foundation that were studied with PUSG.
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Recurrence of breast cancer has been defined as the presence of a new local or distant tumor after a year of initial treatment. The aim of this study was to assess the prevalence and characteristics of breast cancer recurrence in women diagnosed with breast cancer in northwestern Mexico. ⋯ In the late stage of breast cancer, HER2-positive expression in women with ER positive, axillary node involvement and metastases is associated with a higher frequency of recurrence and death.
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Case Reports
[Lumboscopic adrenalectomy for pheochromocytoma in a patient with multiple endocrine neoplasia type 2B].
Multiple endocrine neoplasia type 2B (MEN 2B) is an autosomal dominant syndrome characterized by medullary thyroid carcinoma, pheochromocytoma, a marfanoid habitus and mucosal ganglioneuromatosis. We present a case of a 35-year-old male with MEN 2B with right adrenal pheochromocytoma diagnosed biochemically and radiologically and treated by laparoscopic adrenalectomy. Diagnosis of pheochromocytoma includes detection of catecholamines in urine and plasma and radiological tests such as computed axial tomography, nuclear magnetic resonance imaging and metaiodobenzylguanidine scintigraphy. Laparoscopic techniques have become standard for treatment of tumors of the adrenal glands.