Cir Cir
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Rural telemedicine began in the 1950s in the Papago, Arizona Reservation with the program Starphac. The Anáhuac University began the program in 2002. In the Anáhuac, the project was developed to provide specialty consultations in a virtual way to a highly marginalized population, creating clinical fields of high technology and fulfilling social obligations. ⋯ The most frequent diagnoses in surgery were peptic ulcer disease, cholecystitis, diabetic foot and superficial venous insufficiency. The telemedicine program has allowed us to bring high specialty consults with great productivity, efficiency, less wait time and cost-benefit impact, along with a high quality of humane care. Resident physicians do their social service in a positive manner, with a permanent consultation office and a program of continuing medical education.
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Review Comparative Study
[Practice guidelines for the management of acute perioperative pain].
The inadequacy of perioperative management causes a severe adverse outcome, a prolonged time of hospitalization and unnecessary suffering. Therefore, it is important to provide an effective management approach to the patient with perioperative pain. A task force with experience in this field systematically develops practice guidelines and the primary goal is to facilitate, to health care professionals, decision-making regarding pain relief. ⋯ The best analgesic will be the one that shall provide the highest relief of pain with the fewest side effects. In the pediatric and obstetric populations, special considerations for the ambulatory patient must be taken. Finally, these practice guidelines could be the reference for future practice guidelines on pain management in Mexico.
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Historical Article
[Brief history of hospital care in Tapachula, Chiapas, Mexico].
This paper presents the history of hospital care in Tapachula, Chiapas. Hospital services began 100 years ago. At present there is one government hospital, hospitals of the Social Security systems, private hospitals and one hospital of the Mexican Red Cross. Hospital services have been oriented to attend labor and delivery, infectious diseases, malnutrition and accidents.
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Comparative Study
[Physiopathological alterations secondary to extracorporeal circulation in cardiac surgery].
Cardiopulmonary bypass (CPB) is one of the methods used in myocardial revascularization and can be associated with adverse events that are uncommon, but CPB induces high morbidity and mortality. Cardiac surgery and CPB activate a systemic inflammatory response characterized by tissular lesions, cells movements and blood flow toward the interstice where the harmful stimulus has begun, under the influence of the mediators. The systemic inflammatory response may be initiated during cardiac surgery by a number of processes, including blood contact with the foreign surface of the CPB apparatus, development of ischemia and reperfusion injury, and presence of endotoxemia. ⋯ A frequent complication of SIRS is the development of organ dysfunction, including acute lung injury, shock, renal failure, and multiple organ dysfunction syndrome. Finally, long-term survival in patients developing SIRS may also be adversely affected. The purpose of this review is to examine and understand the pathological mechanisms for inflammatory response that occur following cardiopulmonary bypass.
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It is uncommon that a complicated diverticular disease presents as an extraperitoneal manifestation, and it is also rare for diverticulitis to be the cause of a necrotizing fasciitis. Necrotizing fasciitis (NF) of the abdominal wall is not common and has a high mortality rate. ⋯ Computed tomography (CT) revealed a severe inflammatory process characterized by the presence of gas in the abdominal wall. The patient underwent emergency surgery with debridement of all necrotic tissue, exploratory laparotomy, sigmoidectomy and derivative colostomy, but due to her advanced age and multiple organ failure, the outcome was fatal.