Expanding the field of acute care surgery: a systematic review of the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in cases of morbidly adherent placenta.

PURPOSE: Prophylactic placement of endovascular balloon occlusion catheters has grown to be part of the surgical plans to control intraoperative hemorrhage in cases of abnormal placentation. We performed a systematic literature review to investigate the safety and effectiveness of the use of REBOA during cesarean delivery in pregnant woman with morbidly adherent placenta. METHODS: A systematic review was performed. Relevant case reports and nonrandomized studies were identified by the literature search in MEDLINE. We included studies involving pregnant woman with diagnosis of abnormal placentation who underwent cesarean delivery with REBOA placed for hemorrhage control. MINORS' criteria were used to evaluate the risk of bias of included studies. A formal meta-analysis was not performed. RESULTS: Eight studies were included in cumulative results. These studies included a total of 392 patients. Overall, REBOA was deployed in 336 patients. Six studies reported the use of REBOA as an adjunct for prophylactic hemorrhage control in pregnant woman with diagnosis of morbidly adherent placenta undergoing elective cesarean delivery. In two studies, REBOA was deployed in patients already in established hemorrhagic shock at the moment of cesarean delivery. REBOA was deployed primarily by interventional radiologists; however, one study reported a surgeon as the REBOA provider. The results from our qualitative synthesis indicate that the use of REBOA during cesarean delivery resulted in less blood loss with a low rate complications occurrence. CONCLUSION: REBOA is a feasible, safe, and effective means of prophylactic and remedial hemorrhage control in pregnant women with abnormal placentation undergoing cesarean delivery.

Erratum to: The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections.

[This corrects the article DOI: 10.1186/s13017-017-0141-6.].

Surgery or stenting for colonic obstruction: A practice management guideline from the Eastern Association for the Surgery of Trauma

"BACKGROUND: Colonic obstruction is a surgical emergency, and delay in decompression results in added morbidity and mortality. Advances have led to less invasive procedures such as stenting as a bridge for definitive surgery. The aim of this article was to perform a systematic review regarding colon obstruction (malignant or benign) and to provide recommendations following the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. METHODS: A systematic literature review was conducted using the PubMed, EMBASE, and the Cochrane Library databases of published studies. The search was last performed on January 2, 2015. Two independent reviewers extracted the desired variables from the studies. For our meta-analysis, we used Review Manager X.6 (RevMan). Recommendations are provided using GRADE methodology. A single POPULATION, Intervention, Comparator, Outcome (PICO) question with two outcomes was addressed as follows: POPULATION: in adult patients with a colonic obstruction (malignant or benign). INTERVENTION: should surgery be performed.Comparator: versus endoscopic stenting. OUTCOMES: decreased mortality and decreased emergency, nonplanned procedures? RESULTS: The search yielded 210 results. Screening of the titles excluded 102 articles, leaving 108 for review. After abstract review, 71 additional articles were excluded because of failure to address the PICO questions of this guideline. Thirty-seven articles were reviewed in their entirety, of those six randomized control trials that evaluated the use of stents versus emergency surgery in colonic obstruction caused by malignant disease were included in the final qualitative review. CONCLUSION: We conditionally recommend endoscopic, colonic stenting (if available) as initial therapy for colonic obstruction. In our review, stent use was associated with decreased mortality and rates for emergency, nonplanned procedures to include reoperations. This conditional recommendation is limited to those with malignancy because of the lack of literature supporting this practice in benign colonic disease."

Cefalea en el niño: utilidad de la clasificación internacional (IHS) 1988 / Headache in children: the utility of the international classification of headache (IHS) 1988

El objetivo de este estudio prospectivo de cefalea en el niño fue conocer la prevalencia de consultas por cefalea en el policlínico de Neurología del Hospital Roberto del Río, las características clínicas, el tipo de cefalea y la utilidad en niños de la clasificación internacional de cefalea dadapor la Internacional Headache Society 1988. Entre enero y junio 1994, tuvimos 114 consultas por cefalea, de un total de 5 612, al policlínico de Neurología del Hospital de Niños Roberto del Río, lo que dio una prevalencia de 2 por ciento. Hubo 68 mujeres y 46 hombres, edades entre 3,5 y 14,8 años. Todos sufrían cefaleas recurrentes. La aplicación de la clasificación internacional nos permitió clasificar el 75 por ciento de los casos, con una distribución de 66 por ciento vascular, 8 por ciento tensional y 26 por ciento no definida

Disfunción neurológica aguda asociada a lesiones estriatales bilaterales en la infancia / Acute neurological dysfunction associated with bilateral striatal lesions in childhood

La disfunción neurológica aguda por daño a nivel del estriado en la infancia puede presentarse con diferentes formas clínica y en una amplia variedad de patología con diferentes pronósticos. Se presentan dos pacientes, y se revisa y discute la literatura

Neurofibromatosis tipo I: una enfermedad de manifestaciones heterogéneas / Neurofibromatosis type I: a disease of heterogeneous manifestations

La Neurofibromatosis tipo I es una enfermedad frecuente, multisistémica, autosómica dominante, que se presenta en la niñez con manifestaciones heterogéneas. Se describen 27 casos que consultaron entre los meses de junio 1991 y 1993 en una unidad de neurología pediátrica. Las manifestaciones más tempranas y frecuentes fueron manchas café con leche y efélides axilares. Los neurofibromas cutáneos o subcutáneos y los nódulos de Lisch o hamartomas del iris, patognomónicos de la enfermedad son más tardíos. En 68 porciento de los pacientes se registró algún problema neurológico en la evolución de la enfermedad. La distribución de los síntomas y signos o del compromiso multisistémico en el tiempo podría estar relacionada con el defecto en la proteína neurofibromina en las distintas etapas de diferenciación de las células afectadas

Migraña asociada a pleocitosis recurrente de líquido cefalorraquídeo / Migraine associated to recurrent cerebrospinal fluid pleocytosis

Se presenta un paciente de 15 años de sexo femenino con migraña, asociada en tres episodios a pleocitosis del LCR. Se revisaron las publicaciones sobre el tema y las posibles etiologías del cuadro. El conocimiento de este síndrome es importante en orden a evitar exámenes y tratamientos innecesarios