Sonography of monkeypox cutaneous lesions.

The present global outbreak of monkeypox has reached more than 79,000 cases by November 2022. While clinical features have been extensively studied, ultrasound findings in monkeypox skin lesions have not been described to date. In our work, we performed a complete sonographic study with Doppler and elastography of 3 patients with polymerase chain reaction-proven monkeypox. The most characteristic findings in skin lesions were hyperechoic epidermal thickening, dermo-hypodermal thickening with focal hypoechogenicity and increased intralesional vascularization. Regarding lymphadenopathies, we found vascularization of hilar distribution and an increased cortical stiffness and shoft hiliar area.

Aspectos psicológicos del paciente con fibrosis quística: ¿qué ocurre cuando la enfermedad avanza? / Psychological aspects of the patient with cystic fibrosis: what happens when the disease advances?

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[Usefulness of urokinase in multilocular pleural effusion]. / Utilidad de la urocinasa en derrames pleurales multiloculados.

Recognizing the confirmed efficacy of urokinase as a thrombolytic and proteolytic agent, we assess its usefulness in the treatment of multiloculated pleural effusion, empyema and hematoma as a substitute of other more invasive procedures. Treatment with urokinase was applied in 18 consecutive cases. Inclusion criteria were a well-placed thoracic probe that did not drain and a radiological image showing occupation. Patients were excluded if they had bronchial fistulas or hemothorax of less than 7 days duration. Effusion in the included cases had developed after pneumonia, after surgery or after trauma. Treatment lasted 3 to 4 days ant was considered effective or not based on the volume of liquid drained and on radiological evidence of change. The amount of liquid drained was highly variable (mean 1,282 and S.D. 1,224; range 100-3,975). Radiological change was considered completely satisfactory in 10 cases, with 6 patients continuing to show occupation of the costophrenic sinus with no clinical repercussions. Two patients died of causes unrelated to administration of the drug. There were two mild relapses that did not require a second round of treatment with urokinase. Patients were followed for a least 30 days after discharge and no new recurrences were detected. We have found urokinase to be a useful fibrinolytic agent for treating multiloculated effusion. Contraindications are few and therefore urokinase should be considered the first-choice treatment to be applied before other more invasive measures are taken.

[Endoscopic treatment of bronchopleural fistula using fibrin biological adhesive]. / Tratamiento endoscópico de la fístula broncopleural mediante el uso de adhesivos biológicos de fibrina.

Three cases are reported of bronchopleural fistula successfully resolved by using biological adhesives through the intrabronchial way. In the three cases the rigid bronchoscope was used to prepare the field and the passage of the adhesive material. The results obtained allow the consideration of this procedure as useful for small fistulas and as a initial therapeutical approach for other fistulas due to the small morbidity rate associated with this procedure compared with others.

[Thoracic traumatism in a specialized unit. Its epidemiology and morbimortality]. / Traumatismos torácicos en una unidad especializada. Epidemiología y morbimortalidad.

Two hundred forty-eight cases of thoracic trauma arriving at our hospital between 1990 and 1992 are analyzed in this report. Injuries were only thoracic in 29% of the cases. The remaining patients presented associated lesions, mainly in the extremities, followed by head injuries. Single or multiple rib fracture, in 193 (77.8%) patients, was the most frequent thoracic injury, followed by 94 (37.6%) cases of hemothorax and 80 (30.2%) instances of pneumothorax. Pulmonary contusion in 57 (22.9%) cases was a serious consequence with a mortality rate of 35.7%. Eighty six (34.6%) chest tube were placed and 14 (5.6%) thoracotomies were performed. Death occurred in 34 (13.7%) cases and was mainly related to the presence of associated injuries, in 29 (16.7%) patients as opposed to 5 (6.9%) (p < 0.05), and to pulmonary contusion in 20 (35.7%) patients vs. 13 (6.8%) (p < 0.001).

A comparison of three different prophylactic parenteral antibiotic regimens in colorectal surgery: a prospective study.

A double-blind, prospective, randomized study was performed with 90 patients undergoing colorectal surgery, to ascertain the prophylactic effect of three different parenteral antibiotic programs. The patients were divided into three groups. The patients in group 1 received 80 mg Gentamycin and 600 mg Lincomycin intramuscularly, two hours preoperatively, and every eight hours postoperatively for three days. In group 2, the treatment was similar to group 1 but the Lincomycin was replaced by 600 mg Clindamycin. In Group 3, the treatment was also similar to group 1, but 500 mg Metronidazole given over 20 minutes replaced the Lincomycin. The present study, the first comparing three antianaerobic antibiotics and an aminoglycoside in the prophylaxis of infection in colorectal surgery, shows certain clinical and socioeconomic benefits, although not statistically significant to be found in the group 3 program (Gentamycin plus Metronidazole) as compared with the other programs. This advantage was no doubt due to the use of Metronidazole (used in group 3 only), because of its effectiveness against anaerobic bacteriae.

Systemic prophylaxis with gentamicin-metronidazole in appendicectomy and colorectal surgery: a prospective controlled clinical study.

A prospective, randomized, clinical study was carried out in 188 patients undergoing appendicectomy or colorectal surgery to test the efficacy of prophylactic, parenterally-administered antibiotics in the prevention of infection. The results show the effectiveness of the association gentamicin-metronidazole (9.4% of infections), compared to the control group with no antibiotics (39.1% of infections), X2 = 14.1; P less than 0.001).