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1.
Rev. cir. (Impr.) ; 71(2): 173-177, abr. 2019. graf
Artigo em Espanhol | LILACS | ID: biblio-1058252

RESUMO

OBJETIVO: Se presentan 3 casos de obstrucción intestinal por hernia obturatriz atascada, su manejo y una breve revisión de la literatura. MATERIALES Y MÉTODOSles y Métodos: Discusión del cuadro clínico, imágenes y manejo. Todos los casos fueron operados dentro del mismo día del diagnóstico y se confirmó la presencia de hernia obturatriz. El manejo de la hernia y su contenido fue ajustado a la situación de cada paciente. RESULTADOS: Los tres casos de hernia obturatriz aquí discutidos tienen la presentación clásica del cuadro, cuando se los revisa en forma retrospectiva y con imagenología compatible. Los tres pacientes evolucionaron en forma satisfactoria con alta precoz y control posoperatorio sin incidentes. Discusión: Nuestros 3 casos se condicen tanto en hallazgos clínicos, imagenológicos y en manejo con lo descrito en la literatura internacional. CONCLUSIÓN: La hernia del agujero obturatriz siendo infrecuente, se presenta en un tipo particular de pacientes y con sintomatología clásica. La tomografía axial computada es de gran ayuda y suele hacer el diagnóstico preciso en el preoperatorio. Es importante recordar este diagnóstico diferencial al momento de estudiar pacientes con obstrucción intestinal.


OBJECTIVE: 3 cases of intestinal obstruction that resulted in diagnosis of obturator hernia, their management and a brief international literature review are presented. MATERIAL AND METHODS: Discussion of the presentation, images, and management. In all cases surgery was performed the same day from the diagnosis of intestinal obstruction and confirmation of obturator hernia. The management of the hernia and it's content was adjusted to each patient's situation. RESULTS: Our 3 patients, when reviewed retrospectively, had the classic presentations and images of obturator hernia. All of them had a favourable evolution with an early discharge and no complications on follow up. DISCUSSION: Our 3 cases had clinical presentations and imaging studies that correlated well with international literature. CONCLUSION: Obturator hernia is an infrequent pathology, but appears in a particular type of patient and with classic presentation. Axial computed tomography is an important tool and usually makes the diagnosis previously to surgical exploration. It is important to consider this diagnosis when being faced with patients with intestinal obstruction.


Assuntos
Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Hérnia do Obturador/cirurgia , Hérnia do Obturador/complicações , Obstrução Intestinal/cirurgia , Obstrução Intestinal/etiologia , Hérnia do Obturador/diagnóstico por imagem , Obstrução Intestinal/diagnóstico por imagem
2.
Rev. chil. cir ; 70(4): 362-366, ago. 2018. ilus
Artigo em Espanhol | LILACS | ID: biblio-959397

RESUMO

Objetivo: Presentar un caso clínico y discutir el manejo del trauma de arteria axilar y revisar la literatura actual. Caso Clínico: se presenta el caso de un paciente con lesión de arteria axilar, que es traído en shock hipovolémico al Servicio de Emergencias de nuestro hospital. En pabellón, se aprecia sección incompleta de la segunda porción de la arteria axilar. Se controla y repara con anastomosis primaria término-terminal. En su posoperatorio evoluciona de forma satisfactoria. Discusión: El manejo del trauma vascular debe ser metódico y multidisciplinario. Los signos duros de trauma vascular son indicación de exploración quirúrgica inmediata. Los pacientes con signos blandos pueden complementarse con imágenes. En una sección incompleta de arteria axilar, la anastomosis término-terminal ha mostrado buenos resultados. Conclusiones: las lesiones de arteria axilar en el contexto de traumas son infrecuentes. Su manejo necesita de un alto índice de sospecha, un enfoque multidisciplinario y un acceso quirúrgico adecuado al contexto.


Objective: To present a clinical case and discuss the management of axillary artery trauma and to review current literature. Clinical case: Male patient with axillary artery injury, who is brought in hypovolemic shock to the Emergency Department. Surgical findings demonstrated an incomplete section of the second portion of the axillary artery which was repaired with primary end-to-end anastomosis. Postoperatively, the patient evolves without pain and is discharged. Discussion: The management of vascular trauma should be methodical and multidisciplinary. Hard signs of vascular trauma mandate immediate surgical exploration. Patients with soft signs may need further evaluation with images. In an incomplete section of the axillary artery the end-to-end anastomosis has shown good results. Conclusions: Axillary artery lesions in the context of trauma are infrequent. Its management requires a high index of suspicion, a multidisciplinary approach and adequate surgical access.


Assuntos
Humanos , Masculino , Adulto , Artéria Axilar/cirurgia , Artéria Axilar/lesões , Procedimentos Cirúrgicos Vasculares/métodos , Ferimentos Perfurantes/cirurgia , Vasos Sanguíneos/lesões , Anastomose Cirúrgica/métodos
3.
New Microbes New Infect ; 22: 30-36, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29556406

RESUMO

'Candidatus Neoehrlichia mikurensis' is an uncultured emerging bacterium that is provisionally included in the family Anaplasmataceae. In Europe, it is transmitted by Ixodes ricinus ticks. Rodents are the reservoirs. It is widely distributed in mammals (both wild and domestic) and birds. It causes an inflammatory disease in humans with underlying diseases, but the microorganism also affects immunocompetent individuals in which asymptomatic infection has been recognized. A high degree of suspicion and the use of molecular tools are needed for the correct diagnosis. Efforts to cultivate it and to investigate its pathogenesis should be a priority.

4.
Med Vet Entomol ; 29(3): 349-53, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26111122

RESUMO

The genus Anaplasma (Rickettsiales: Anaplasmataceae) includes species of medical and veterinary importance. The presence of Anaplasma spp. in ticks from birds, as well as in Haemaphysalis punctata (Ixodida: Ixodidae) specimens collected from cattle and vegetation in northern Spain was investigated. A total of 336 ticks from birds [174 Ixodes frontalis (Ixodida: Ixodidae), 108 H. punctata, 34 Hyalomma marginatum (Ixodida: Ixodidae), 17 Ixodes ricinus (Ixodida: Ixodidae) and three Ixodes spp.], and 181 H. punctata specimens collected from cattle (n = 71) and vegetation (n = 110) were analysed. Anaplasma bovis was detected in five H. punctata, including two from birds (1.9%) and three from vegetation (2.7%). Four I. frontalis (2.3%) (one co-infected with 'Candidatus Midichloria mitochondrii') and one I. ricinus (5.9%) removed from birds, as well as four H. punctata (5.6%) collected from cattle showed Anaplasma phagocytophilum infection. In addition, Anaplasma centrale was found in two H. punctata, one from a cow (1.4%) and the other from vegetation (0.9%). This study represents the first evidence of the presence of A. bovis in European ticks, and reports the first detection of A. bovis and A. centrale in H. punctata, and the first finding of A. phagocytophilum and 'Ca. Midichloria mitochondrii' in I. frontalis.


Assuntos
Anaplasma/fisiologia , Doenças das Aves/epidemiologia , Doenças dos Bovinos/epidemiologia , Ixodidae/microbiologia , Doenças Transmitidas por Carrapatos/epidemiologia , Anaplasma centrale/fisiologia , Anaplasma phagocytophilum/fisiologia , Anaplasmose/epidemiologia , Anaplasmose/microbiologia , Animais , Doenças das Aves/microbiologia , Bovinos , Doenças dos Bovinos/microbiologia , Ehrlichiose/epidemiologia , Ehrlichiose/microbiologia , Feminino , Ixodes/crescimento & desenvolvimento , Ixodes/microbiologia , Ixodidae/crescimento & desenvolvimento , Larva/crescimento & desenvolvimento , Larva/microbiologia , Masculino , Ninfa/crescimento & desenvolvimento , Ninfa/microbiologia , Espanha/epidemiologia , Doenças Transmitidas por Carrapatos/microbiologia
5.
Clin Microbiol Infect ; 18(11): E482-4, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22967271

RESUMO

Cardiovascular implantable electronic devices (CIEDs) are frequently related to endocarditis. Most cases of intravascular CIED infections are usually related to skin flora, but a few cases may occur with negative blood culture. Coxiella burnetii is one of the main causes of blood culture-negative endocarditis in native and prosthetic valves, but to date no cases related to CIED have been published. Herein we report two cases of Q fever endocarditis related to these non-valvular cardiovascular devices.


Assuntos
Coxiella burnetii/isolamento & purificação , Endocardite Bacteriana/diagnóstico , Próteses e Implantes/efeitos adversos , Infecções Relacionadas à Prótese/diagnóstico , Febre Q/diagnóstico , Idoso , DNA Bacteriano/química , DNA Bacteriano/genética , Endocardite Bacteriana/microbiologia , Endocardite Bacteriana/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Infecções Relacionadas à Prótese/microbiologia , Infecções Relacionadas à Prótese/patologia , Febre Q/microbiologia , Febre Q/patologia , Análise de Sequência de DNA
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