Anterolateral Thoracotomy: A Novel and Simple Technique to Improve the Closure Using the Self Locking Knot.

Thoracotomy is defined as an incision made by the surgeon in the chest wall in order to allow visibility of the thoracic cavity content. This can be used by surgeons to treat thoracic cavity content diseases including the heart, lungs, esophagus, and other organs. Thoracic incision closure remains an item with no consensus. Therefore, we present an easy way and give a little tip for closure using the slipknot that will allow the correct approach of ribs and the successful closure of the intercostal space.

Long-Term Outcomes of Laparoscopic Common Bile Duct Exploration Through Diathermy, Choledochotomy, and Primary Closure: A 6-Year Retrospective Cohort Study.

Background and Objective: Choledocholithiasis is a frequent pathology, unfortunately when its endoscopic management fails, there is no consensus of how it should be addressed. The aim of this study was to evaluate the safety, feasibility, and long-term outcomes of laparoscopic common bile duct exploration (LCBDE) using electrosurgery (coagulation) for choledochotomy followed by primary closure after endoscopic treatment failure. Materials and Methods: A retrospective cohort study of patients who underwent LCBDE from 2013 to 2018 was conducted in Bogotá, Colombia. Clinical demographics, operative outcomes, recurrence rate of common bile duct stones, and long-term bile duct complications were analyzed. A descriptive analysis was performed. Results: A total of 168 patients were analyzed. Most of the patients were males (53.37%) with a median age of 73 years with no comorbidities (65%). Stone clearance was successful in 167 patients (99.4%). Nonlethal complications were noted in 3 patients during the surgery or in the immediate postoperative (1.79%) and managed with T-tube or endoscopically. No cases of mortality surgery related were observed. There were no signs of any type of biliary injury or stricture observed in any of the patients during the 24-month follow-up period. Conclusions: LCBDE with diathermy and primary closure is a safe and effective treatment option for choledocholithiasis for failed endoscopic retrograde cholangiopancreatography in terms of long-term outcome as well as short-term outcome.

Ocular Manifestations in Colombian Patients with Systemic Rheumatologic Diseases.

PURPOSE: To establish the prevalence of ocular involvement in a Colombian population with rheumatologic diseases. DESIGN: Observational cross-sectional study. METHODS: We included a probabilistic sample size of 797 patients who attended a rheumatologic disease center in Bogotá, Colombia. Statistical analysis with descriptive measures and Chi-square independence test between rheumatologic diseases and ophthalmological symptoms and diseases was performed. RESULTS: Eighty-four percent of the population were women, and the mean age was 54.61± 15.64 years. The most common condition was rheumatoid arthritis (33.37%), followed by fibromyalgia (22.71%), Sjögren Syndrome (19.72%), and systemic lupus erythematosus (9.91%). Almost 7% of the patients presented polyautoimmunity. Thirty-five percent of the patients reported one or more ophthalmological symptoms, being dry eye sensation the most common (30.86%), followed by ocular pain (2.76%), red-eye, and decreased visual acuity (both 2.63%). Similarly, 21.45% of the patients presented one or more ophthalmological diagnoses, being keratoconjunctivitis sicca the most common (15.93%), followed by cataract, uveitis (1.38% each), and scleritis (1.25%). CONCLUSION: Almost a third of the patients reported any ocular involvement. It is crucial to be aware of the most common ophthalmic manifestations among the different rheumatologic diseases in our population, to offer early specialist referral and timely treatment.

Un profesor clínico y pedagogo en el Aprendizaje Basado en Problemas / A clinician and pedagogy professor for problem-based learning

Introducción: Las cualificaciones requeridas a un profesor tienen implicaciones en la vinculación laboral, el desarrollo profesoral y la calidad de la formación del recurso humano en salud. Objetivo: Determinar la experticia de un profesor y si existe evidencia empírica de que sus antecedentes en Aprendizaje Basado en Problemas influyan en el aprendizaje de los estudiantes. Métodos: En esta revisión de alcance se buscaron artículos publicados en las bases de datos Medline, Scopus, PubMmed, Google Scholar, EBSCO y ScienceDirect. La búsqueda incluyó, inicialmente, artículos publicados entre 2015 y 2020; luego, se incluyeron los estudios citados en estos artículos para aumentar el número de la muestra. La evaluación fue realizada de manera independiente por dos investigadores. En total, 11 artículos cumplían con los criterios de inclusión. Se extrajeron y analizaron datos sobre las cualidades del profesor del ABP. Resultados: Los estudios que exploran las cualificaciones del docente del Aprendizaje Basado en Problemas son escasos y no existe un criterio unificado sobre la formación y la experiencia requeridas a ellos. Las evidencias empíricas encontradas son cuestionables y muestran vacíos en la comprensión de este problema, aunque sugieren como mejor opción a un profesor experto en medicina y pedagogía. Conclusiones: Estos hallazgos representan un serio defecto del Aprendizaje Basado en Problemas. Una posible solución es integrar la enseñanza de la pedagogía a los currículos médicos para contar con una mayor cantidad de profesores expertos tanto en medicina como en docencia(U)

Introduction: The qualifications required from a professor have implications for job placement, professional development and the quality of health human resource training. Objective: To determine a professor's expertise and whether there is empirical evidence that his or her background in problem-based learning (PBL) influences student learning. Methods: In this scoping review, published articles were searched for in the Medline, Scopus, PubMed, Google Scholar, EBSCO and ScienceDirect databases. The search initially included articles published between 2015 and 2020; then, studies cited in these articles were included to increase the sample number. The assessment was performed independently by two researchers. A sheer number of eleven articles met the inclusion criteria. Data about the qualities of the PBL professor were extracted and analyzed. Results: Studies exploring the qualifications of the PBL professor are scarce, while there is no unified criterion on the training and experience required from them. The empirical evidence found is questionable and shows gaps in the understanding of this problem, although it suggests a professor with expertise in medicine and pedagogy as the best option. Conclusions: These findings represent a serious shortcoming of PBL. A possible solution is to integrate the teaching of pedagogy into medical curricula in order to have a greater number of professors with expertise in both medicine and teaching(AU)

Síndrome de Guillain-Barré en un paciente con enfermedad de Chagas aguda / Guillain-Barre syndrome in a patient with acute Chagas disease

El compromiso neurológico de la enfermedad de Chagas que afecta el sistema nervioso suele ser una manifestación crónica de esta entidad con predominio de afectación del sistema nervioso autonómico. El presente artículo hace el reporte de un caso de síndrome de Guillain-Barré en un paciente con enfermedad de Chagas aguda y revisión de la literatura.

The neurological impairment of Chagas disease that affects the nervous system is usually a chronic manifestation of this condition and predominantly affects the autonomic nervous system. This article presents a case of Guillain-Barré syndrome in a patient with acute Chagas disease as well as a literature review.