Tracheal Bridge for Reconstruction of the Upper Airway in Double Tracheal Stenosis.

Tracheal reconstruction is a complex surgical procedure that requires a well-trained, multidisciplinary team to achieve optimal results. No reviews or case reports involving the use of a healthy tracheal bridge to achieve reconstruction after extensive tracheal resection (greater than 7 cm) are described. We present a clinical case of a patient with double tracheal stenosis secondary to prolonged intubation and tracheostomy for which a healthy, well-vascularized tracheal bridge was used to achieve a tracheal reconstruction without tension. The key point in performing this type of reconstruction is allowing a tension-free cervical and thoracic anastomosis.

Comparison of the QuantiFERON-TB and tuberculin skin test for detection of latent tuberculosis infection in cancer patients in a developing country.

Cancer patients have an increased risk of reactivation of latent tuberculosis infection. It is unknown which strategy on screening should be used in this population in developing countries. We aimed to determine the concordance between the tuberculin skin test (TST) and QuantiFERON®-TB (QFT) assay in order to diagnose latent tuberculosis infection in cancer patients. We conducted a cross-sectional study of the agreement of diagnostic tests. Prevalence and agreement between tests were calculated. A logistic regression to assess predictors of discordance was performed. The accuracy of the TST to predict QFT results by a receiver operating characteristic (ROC) curve was evaluated. We included 149 adults with cancer without active tuberculosis. Prevalence of latent tuberculosis infection was 21.5% (n=32), defined as positive results on either test. Test agreement was moderate for the diagnosis of latent tuberculosis infection (κ=0.43, 90% CI 0.26-0.6). No predictor was associated with the chance of discordant results. Agreement improved slightly using a cut-off point ≥8 mm (κ=0.5, 90% CI 0.35-0.66). In a moderate-incidence setting, a moderate agreement was found between tests in cancer patients. Modification of the cut-off points of test results achieved marginally better agreement between the TST and QFT.

An asbestos contaminated town in the vicinity of an asbestos-cement facility: The case study of Sibaté, Colombia.

INTRODUCTION: The asbestos industry began operations in Colombia in 1942, with an asbestos-cement facility located in the municipality of Sibaté. In recent years residents from Sibaté have been complaining about what they consider is an unusually large number of people diagnosed with asbestos-related diseases in the town. A study to analyze the situation of Sibaté started in 2015, to verify if the number of asbestos related diseases being diagnosed were higher than expected, and to identify potential asbestos exposure sources in the town. METHODS: A health and socioeconomic survey was implemented door-to-door to identify potential asbestos-related diseases. Several self-reported mesothelioma cases were identified, and for confirmation purposes, copies of the medical record with the histopathology report were obtained. A panel of six physicians analyzed the medical records. Information of validated cases was used to estimate the male and female age-adjusted incidence rate for Sibaté. Based on reports of the existence of potential asbestos-contaminated landfills, topographic maps, a digital elevation model, and current satellite images were crossed using a geographic information system to identify potential landfilled areas, and soils samples were collected in some of these areas. RESULTS: A total of 355 surveys were completed, and 29 self-reported mesothelioma cases were identified. Twenty-five of these cases have been persons who had lived at some moment of their lives in Sibaté. It was possible to obtain copies of the medical diagnosis for 17 cases. Of these, the panel of physicians classified 15 cases as certain pleural mesothelioma, one as probable, and one as not mesothelioma. Based on this information, the estimated age-adjusted incidence rate of mesothelioma in Sibaté was 3.1 × 105 persons-year for males and 1.6 × 105 persons-year for females. These rates are high in comparison to those reported in other cities, regions, and countries of the world. Using geographic information systems, landfilled zones in the urban area of Sibaté were identified, on top of which a school and different sports facilities were built. The analysis of four soil samples collected in landfilled zones, confirmed the existence of an underground layer of friable and non-friable asbestos. CONCLUSION: The collected evidence suggests the presence of a malignant pleural mesothelioma cluster in Sibaté.

Tumor carcinoide broncopulmunar / Bronchopulmonary carcinoid tumor

Los tumores carcinoides son tumores neuroendocrinos raros derivados de células enterocromafines. Han sido reportados en órganos como pulmón, bronquios y en el espacio tractogastrointestinal. La clasificación patológica de la Organización Mundial de la Salud (OMS) de 1999 los divide en tumores carcinoides típicos, tumores carcinoides atípicos y carcinoma de célula pequeña. Los hallazgos radiológicos incluyen masa hiliar o perihiliar, nódulos endobronquiales, hallazgos secundarios a obstrucción bronquial y nódulo solitario. Se presentan, así mismo, los hallazgos patológicos, clínicos, radiológicos y quirúrgicos del tumor carcinoide, y se revisan las características descritas en la literatura.

Hemangioendotelioma epiteloide / Ephitelioid haemangioendotheliom

El hemangioendotelioma epiteloide es una neoplasia poco común que ocurre en mujeres jóvenes, con menos de 50 casos descritos a nivel mundial. Describiremos el caso de un hombre de 54 años con historia de disnea, tos seca y dolor torácico, que consultó por historia de neumonía basal derecha un mes antes y dolor torácico derecho. En la radiografía de tórax se encontraron tractos fibrosos basales derechos y aumento de la arteria pulmonar derecha, diagnosticados inicialmente como tromboembolismo pulmonar no resuelto, evolución posterior con aparición de masa pulmonar que luego de múltiples estudios se diagnosticó como un hemangioendotelioma epiteloide metastásico originado posiblemente en la arteria pulmonar derecha. Describimos las radiografías de tórax, las tomografías, y las teorías actuales sobre el origen celular de esta neoplasia. Discutimos la apariencia citológica, presentación clínica y pronóstico de esta entidad. Este reporte puede contribuir para nueva información y hallazgos de esta poco común presentación de una neoplasia.