ABSTRACT
Rabies in pregnancy is rare with a high mortality. We report a pregnant woman who developed urban rabies from the bite of an infected dog. An emergency Cesarean section was performed at 31 weeks of gestation, and a premature baby was delivered who survived and did not develop rabies. The mother, however, suffered a rapid clinical deterioration and was admitted to intensive care where a Milwaukee protocol was followed. The patient survived 19 months but developed severe neurological sequelae secondary to rabies encephalitis and finally died of respiratory failure.
Subject(s)
Bites and Stings , Rabies , Animals , Bites and Stings/complications , Cesarean Section , Dogs , Female , Humans , Peru , Pregnancy , Pregnant Women , Rabies/diagnosisABSTRACT
Se presenta un dispositivo diseñado con el obje-tivo de impedir la interposición lingual en un caso con una severa mordida abierta esqueletal, re-suelta con tratamiento ortodóncico no quirúrgico. La terapéutica se complementa con la extracción de los cuatro segundos molares permanentes, con el objetivo tanto de resolver la discrepancia dentoalveolar, como la anomalía basal.
It is presented a device designed with the purpose of preventing tongue interposition in a severe skeletal open bite case, resolved by non-surgical orthodontic treatment. All four second permanent molars extraction complements the therapeutics, with the objective of solving both the dentoalveolar discrepancy as well as the basal anomaly.
Subject(s)
Adolescent , Tooth Extraction , Orthodontic Appliance Design , Open Bite/therapy , MolarABSTRACT
Mexican specialists in oncology, oncologic surgery, thoracic surgery, pneumology, pathology, molecular biology, anesthesiology, algology, psychology, nutrition, and rehabilitation (all of them experts in lung cancer treatment) in order to develop the National Consensus on Lung Cancer. The consensus has been developed as an answer to the need of updated Mexican guidelines for the optimal treatment of the disease, as well as to the requirements that such guidelines be established by multidisciplinary panel, depicting the current attention given to cancer lung cases in Mexico. Thus, this paper analyses the epidemiological review, screening, diagnosis, staging, pathology, translational medicine, and the suitable therapies for early, locally advanced, and metastatic disease in the first, second, and third lines of management, as well as rehabilitation and palliative measures.
Subject(s)
Carcinoma, Non-Small-Cell Lung/diagnosis , Carcinoma, Non-Small-Cell Lung/therapy , Lung Neoplasms/diagnosis , Lung Neoplasms/therapy , Algorithms , Carcinoma, Non-Small-Cell Lung/complications , Carcinoma, Non-Small-Cell Lung/etiology , Carcinoma, Non-Small-Cell Lung/secondary , Decision Trees , Humans , Lung Neoplasms/complications , Lung Neoplasms/etiology , Mexico , Neoplasm Staging , Smoking/adverse effectsABSTRACT
Introducción. La aspiración de cuerpos extraños es un problema común en el paciente pediátrico y representa una causa importante de morbilidad y mortalidad. En Estados Unidos se considera la causa de 7% de las muertes accidentales de niños de entre 1 y 3 años de edad. La presentación clínica requiere de un alto grado de sospecha diagnóstica por el médico, sobre todo cuando el antecedente del evento de atragantamiento no es claro en la historia clínica debido a que la exploración física y los hallazgos radiológicos son inespecíficos en la mayoría de las ocasiones. Caso clínico. Se presenta el caso de un adolescente de 14 años que, a pesar de tener el antecedente de la aspiración de un cuerpo extraño, no se le dio importancia y sus síntomas se confundieron con otras entidades. Recibió diversos tratamientos pero sus síntomas se mantuvieron por un año. Fue remitido a la Unidad de Neumología Pediátrica Fernando Katz del Instituto Nacional de Enfermedades Respiratorias donde se realizó el estudio broncoscópico y la extracción del cuerpo extraño del bronquio intermedio. Conclusiones. El diagnóstico tardío ocasiona problemas respiratorios que van desde la obstrucción de las vías aéreas (que pone en riesgo la vida) hasta síntomas respiratorios crónicos como sibilancias e infecciones recurrentes de las vías respiratorias. Es común también que estos síntomas se confundan con otras entidades patológicas como el asma, el reflujo gastroesofágico y la disfunción laríngea.
Background. Aspiration of foreign bodies in the central airway is a common problem in the pediatric population, representing a major cause of morbidity and mortality in our country. In the U.S., foreign body aspiration is the cause for 7% of accidental deaths in children between 1 and 3 years of age. Clinical diagnosis requires a high degree of suspicion in the medical history especially when the choking event is unclear in the clinical history because physical examination and radiological findings have a low sensitivity. Case report. We present the case of a 14-year-old male with a history of foreign body aspiration. The patient's symptoms were given little importance. A 1-year delay in diagnosis occurred due to symptoms mimicking other pathologies. The patient was referred to the Pediatric Pulmonology Unit "Fernando Katz" of the National Institute of Respiratory Diseases where bronchoscopic exploration was performed with removal of foreign body (plastic object) from the intermediary bronchus. Conclusions. Delayed diagnosis causes respiratory problems ranging from life-threatining airway obstruction to chronic respiratory symptoms such as wheezing and recurrent respiratory infections. It has been shown that these symptoms can be confused with other pathologies such as asthma.