Endovascular Treatment of Acute Lower Limb Ischemia Associated with Cocaine Use: A Scoping Review.

The endovascular treatment of acute lower limb ischemia associated with cocaine use is an underexplored topic. This scoping review aims to map existing information and point out potential knowledge gaps for future research. We searched databases with a strategy of terms and keywords (Cocaine, Acute, Lower Limb, and Ischemia) for articles related to acute ischemia in the lower limbs and cocaine use. We established eligibility and exclusion criteria and searched without restrictions on language or date of publication. We obtained five case reports published between 2004 and 2015. Most of the patients were men with an average age of 38 years. Treatments were heterogeneous. Most patients showed improvement after surgical thrombectomy. The sample size and variety of interventions limit the generalizability of the results, so it is necessary to do more studies with robust methodologies to standardize treatments and improve the understanding of the condition.

"Six-and-Twelve" Prognostic Score in Transarterial Chemoembolization-Treated Hepatocellular Carcinoma Patients.

OBJECTIVE: This study aimed to evaluate the overall survival of hepatocellular carcinoma patients who qualify for transarterial chemoembolization (TACE) using the "six-and-twelve" prognostic score. The research was conducted on a patient cohort between 2009 and 2019. MATERIALS AND METHODS: A retrospective cohort study was conducted, involving patients diagnosed with unresectable hepatocarcinoma, Barcelona Clinic Liver Cancer (BCLC) staging A or B, and Child-Pugh staging A or B. Exclusion criteria included patients with spontaneous tumor rupture, other neoplasms, decompensated liver cirrhosis, and a lack of reference images. The study assessed the size of the largest nodule and the number of tumors based on imaging studies. Overall survival was defined as the time from initial TACE to death from any cause, with telephonic follow-up conducted. Patients were categorized into three groups based on tumor burden: ≤6, >6-≤12, and >12. Mortality rates at 12, 24, and 36 months were compared using the chi-square test for categorical variables and the ANOVA and Kruskal-Wallis tests for continuous variables, depending on their distribution. RESULTS: A total of 90 patients were included in the study, with a median age of 69 years (interquartile range (IQR): 62-77). Among the patients, 61.1% had a tumor burden of six or less. The overall survival rate was found to have a median of 28.4 months (IQR: 26.3-30.5), with survival rates at one, two, and three years being 84.7%, 55.2%, and 29.4%, respectively. It was observed that mortality increased in proportion to tumor burden, and this difference was statistically significant. CONCLUSION: The use of tumor burden, with cut-off points of six and 12, as a prognostic score proved to be a valuable tool for predicting mortality in the studied cohort.

Transjugular Intrahepatic Portosystemic Shunt Creation in Children Weighing <10 kg Using an Unconventional Technique.

Transjugular intrahepatic portosystemic shunt (TIPS) creation is a standard therapeutic procedure for the management of complications of portal hypertension. However, in small children, this procedure is infrequently performed because of technical difficulties owing to their small size and scarce information on outcomes. This article presents the results of treatment of variceal bleeding with TIPS creation in 8 children weighing <10 kg, along with the description of the unconventional techniques and materials required. Technical and clinical success rates were 100%. Although this was a small cohort of patients, the results obtained suggest that this is a safe and technically and clinically effective treatment option for complications of portal hypertension in this age group.

Revascularización de arteria poplítea con arteria ciática persistente bilateral: presentación de un caso / Popliteal Revascularization in Bilateral Persistent Sciatic Artery: Case Report

La arteria ciática persistente (ACP) es una anomalía vascular congénita, poco frecuente, secundaria a una alteración en el desarrollo embriológico. La mayoría de los casos son asintomáticos y se detectan cuando se asocian con aneurismas o embolias. Se presenta el caso de una mujer de 81 años con factores de riesgo cardiovascular quien consulta por isquemia del miembro inferior

The persistent sciatic artery is a rare congenital vascular anomaly secondary to an alteration in embryological development. Most cases are asymptomatic and they are detected when they are associated with the presence of aneurysms or embolisms. We present the case of an 81-year-old woman with cardiovascular risk factors who consulted for ischemia of the lower limb.

Fibrosis congénita de los músculos extraoculares / Congenital fibrosis of the extraocular muscles

La fibrosis congénita de los músculos extraoculares (CFEOM por sus siglas en inglés) es un síndrome de estrabismo caracterizado por oftalmoplejía restrictiva no progresiva y blefaroptosis. Se presenta el caso de una paciente con diagnóstico de CFEOM con base en la historia clínica, examen físico y soportado por los hallazgos en la imagen de resonancia magnética (RM). Esta entidad corresponde al grupo de los trastornos de denervación craneal congénita y no a una miopatía primaria, como se creía anteriormente.

Congenital Fibrosis of the extra ocular muscles (CFEOM) is a congenital strabismus syndrome characterized by non-progressive restrictive ophthalmoplegia and blepharoptosis. We report the case of a patient in whom the diagnosis was made based on the history, clinical findings and supported by the magnetic resonance imaging findings. This entity is part of a group of congenital cranial denervation syndromes and not due to a primary myopathy as originally though.

[Chest wall mesenchymal hamartoma: a case report]. / Hamartoma mesenquimatoso de la pared torácica: presentación de un caso.

Chest wall mesenchymal hamartoma is an extremely rare benign tumor. Approximately 80 cases have been reported in the literature. Most tumors are manifested at birth with a painless palpable mass of the chest wall, usually unilateral. Respiratory symptoms result from extrinsic compression of the pulmonary parenchyma, and the severity of the symptoms will depend on the size and location of the lesion. Imaging features are characteristic, but definitive diagnosis is histological. Herein, a case is described of a four month old infant with diagnosis of chest wall mesenchymal hamartoma, manifested at birth. Different treatment options are described, including expectations from tumor management, the possibility of spontaneous regression, and the morbidity associated with the surgical option.

Arco aórtico interrumpido: reporte de caso / Interrupted aortic arch: case report

En este artículo se presenta el caso de un neonato de 14 días de vida, quien fue llevado al servicio de urgencias por hipoactividad, mala succión y tinte ictérico generalizado; así como una corta revisión sobre la patología encontrada. En el examen físico se encontró con cianosis peribucal, hipotonía, tiraje, llenado capilar lento y un soplo mesosistólico II/IV en C2-2 y C2-3. Una ecografía prenatal había reportado una comunicación interventricular y un arco aórtico no observado. Mediante una ecocardiografía y una angiotomografía de tórax se diagnosticó un arco aórtico interrumpido tipo B, cardiopatía congénita de rara ocurrencia, que además se asociaba a comunicación interventricular, comunicación interauricular y conducto arterioso persistente. Al niño se le corrigieron quirúrgicamente todos los defectos, sin complicaciones y con adecuada evolución.

A 14-day-old newborn was brought to the emergency room by his parents whonoticed hypoactivity, poor suction, and jaundice. On physical examination he was found to have respiratory distress, perioral cyanosis, hypotonia, slow capillary fill, and a grade II / IV mid-systolic murmur was heard over C2-2 and C2-3. A prenatal ultrasound reported a ventricular septal defect and the aortic arch was not seen. Type B interrupted aortic arch, a rare congenital cardiovascular anomaly, was diagnosed by echocardiogram and angioCT . The VSD was also seen; an arterial septal defect and persistent ductus arteriosus were also diagnosed. The child underwent corrective surgery of all the defects, with uneventfulrecovery. A short revision of this infrequent cardiovascular anomaly is presented.

Lesiones focales hepáticas en niños / Focal hepatic lesions in children

Las lesiones focales del hígado en niños incluyen neoplasias, lesiones metastásicas, masas inflamatorias y quistes (congénitos o adquiridos); las neoplasias primarias —tanto benignas como malignas— representan del 1% al 2% de todos los tumores pediátricos. La mayoría de niños con tumores hepáticos benignos o malignos se presentan al examen físico con masa palpable. Dentro del estudio por imágenes de ésta se encuentran incluidas múltiples modalidades, como ultrasonido, tomografía computarizada, resonancia magnética, angiografía y medicina nuclear. Debido a que la resección quirúrgica es la principal opción de tratamiento para muchas de dichas lesiones, la descripción detallada de la extensión de la masa y sus relaciones anatómicas es esencial. En este artículo realizamos una revisión de las características imaginológicas de algunas lesiones focales hepáticas en niños.

Hamartoma mesenquimatoso de la pared torácica: presentación de un caso / Hamartoma mesenquimatoso de la pared torácica: a case report

El hamartoma mesenquimatoso de la pared torácica es un tumor benigno extremadamente raro. Hasta el momento hay, aproximadamente, 80 casos reportados en la literatura mundial; la mayoría se manifiesta desde el nacimiento por la presencia de una masa palpable, no dolorosa, usualmente unilateral, en la pared torácica. Los síntomas respiratorios son secundarios a la compresión extrínseca sobre el parénquima pulmonar y su gravedad depende del tamaño y la localización de la lesión. Los hallazgos radiológicos son característicos pero el diagnóstico definitivo es histológico. Describimos el caso de un paciente de cuatro meses de edad, en quien se realizó diagnóstico de hamartoma mesenquimatoso de la pared torácica; el paciente presentaba las manifestaciones desde el nacimiento. Se hace énfasis en las opciones de tratamiento, considerando el manejo expectante como una alternativa válida por las características benignas de este tumor, por la considerable morbilidad posterior a grandes tratamientos quirúrgicos y por la alta probabilidad de presentar regresión espontánea.

Chest wall mesenchymal hamartoma is an extremely rare benign tumor. Approximately 80 cases have been reported in the literature. Most tumors are manifested at birth with a painless palpable mass of the chest wall, usually unilateral. Respiratory symptoms result from extrinsic compression of the pulmonary parenchyma, and the severity of the symptoms will depend on the size and location of the lesion. Imaging features are characteristic, but definitive diagnosis is histological. Herein, a case is described of a four month old infant with diagnosis of chest wall mesenchymal hamartoma, manifested at birth. Different treatment options are described, including expectations from tumor management, the possibility of spontaneous regression, and the morbidity associated with the surgical option.