COVID-19 Pneumonia Presenting As Solitary Pulmonary Lesion.

Common findings of COVID-19 pneumonia on chest CT images include ground-glass opacities and organizing pneumonia. Here, we present a patient with a history of lung cancer who came to our center for re-staging CT studies, which showed a solitary peripheral lung mass suggestive of lung cancer. While being evaluated for the mass, the patient developed respiratory failure due to COVID-19 pneumonia. After treatment for COVID-19 and recovery, CT showed complete resolution of the solitary peripheral lung mass. This case highlights that COVID-19 can, on occasion, present with CT findings that mimic those of lung cancer.

Allergic Bronchopulmonary Aspergillosis Mimicking Lung Cancer: A Case Report.

Patients with allergic bronchopulmonary aspergillosis (ABPA), a hypersensitivity reaction to Aspergillus fumigatus, typically present with asthma; the common imaging findings are central bronchiectasis, mucoid impaction, and tree-in-bud opacities. In this report, we discuss the case of a heavy smoker who presented with a large pulmonary mass that was initially presumed to be primary lung cancer and who was ultimately diagnosed with ABPA, which responded favorably to steroid treatment.

Multi-center validation of the Bowel Injury Predictive Score (BIPS) for the early identification of need to operate in blunt bowel and mesenteric injuries.

INTRODUCTION: The Bowel Injury Prediction Score (BIPS) is a tool for identifying patients at risk for blunt bowel and mesenteric injury (BBMI) requiring surgery. BIPS is calculated by assigning one point for each of the following: (1) WBC ≥ 17,000, (2) abdominal tenderness, and (3) injury grade ≥ 4 (mesenteric contusion or hematoma with bowel wall thickening or adjacent interloop fluid collection) on CT scan. A total score ≥ 2 is associated with BBMI requiring surgery. We aimed to validate the BIPS as a predictor for patients with BBMIs requiring operative intervention in a multi-center prospective study. MATERIALS AND METHODS: Patients were prospectively enrolled at 15 U.S. trauma centers following blunt trauma with suspicion of BBMI on CT scan between July 1, 2018 and July 31, 2019. The BIPS was calculated for each patient enrolled in the study. RESULTS: Of 313 patients, 38% had BBMI requiring operative intervention. Patients were significantly more likely to require surgery in the presence of abdominal tenderness (OR, 3.6; 95% CI, 1.6-8.0) and CT grade ≥ 4 (OR, 11.7; 95% CI, 5.7-23.7). Patients with a BIPS ≥ 2 were more than ten times more likely to require laparotomy than those with a BIPS < 2 (OR, 10.1; 95% CI, 5.0-20.4). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of a BIPS ≥ 2 for BBMI requiring surgery was 72% (CI 0.6-0.8), 78% (CI 0.7-0.8), 67% (CI 0.6-0.8), and 82% (CI 0.8-0.9), respectively. The AUROC curve for BIPS ≥ 2 was 0.75. The sensitivity, specificity, PPV, and NPV of a BIPS ≥ 2 for BBMI requiring surgery in patients with severe alteration in mental status (GCS 3-8) was 70% (CI 0.5-0.9), 92% (CI 0.8-1.0), 82% (CI 0.6-1.0), and 86% (CI 0.7-1.0), respectively. CONCLUSION: This prospective multi-center trial validates BIPS as a predictor of BBMI requiring surgery. Calculation of BIPS during the initial evaluation of trauma patients is a useful adjunct to help general surgeons taking trauma call determine operative versus non-operative management of patients with BBMI including those with severe alteration in mental status.

Avances en el manejo de infecciones de piel y sus estructuras / Advances in the management of infections of the skin and theirs structures

De julio 1984 a junio de 1986, se trataron 299 infecciones de la piel y sus estructuras con diferentes esquemas de antibióticos en combinación o como monoterapia. Algunos nuevos fármacos como las quinolonas y cefalosporinas de tercera generación ofrecen algunas ventajas sobre sistemas ya establecidos. La enfermedad concomitante más frecuente fue diabetes mellitus no insulino-dependiente (43.1%); estos pacientes necesitaron en forma usual debridación y terapéutica combinada. Durante la evolución bajo tratamiento y postratamiento, algunos esquemas no eliminaron ciertas bacterias grampositivas. El análisis de todas estas variantes así como un comentario global del problema se presenta en este trabajo