{"title":"Research activity during the residency program. Are we in the good way?","authors":"E. Esteban-Zubero, C. García-Muro","doi":"10.53986/ibjm.2022.0021","DOIUrl":"https://doi.org/10.53986/ibjm.2022.0021","url":null,"abstract":"","PeriodicalId":13190,"journal":{"name":"Iberoamerican Journal of Medicine","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85555476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maximiliano Gabriel Castro, L. Ubiergo, Macarena Vicino, G. Cuevas, F. Argarañá
Introduction: During COVID-19 outbreaks, disproportionate use of antibiotics, high Intensive Care Units burden and longer in-hospital stays may have aggravated the emergency posed by carbapenem-resistant isolates. Therefore, we set out to determine whether the incidence of carbapenem-resistant isolates rose in a tertiary care center in Santa Fe, Argentina during the period with active cases of COVID-19. Material and methods: In this retrospectively designed analytic epidemiologic study, two periods were defined: Period 1 (without active cases of COVID-19) from September 2019 to August 2020 and Period 2 (starting at the onset of the first wave of COVID-19 in this Institution) from September 2020 to June 2021. All clinically relevant microbiological samples taken during these periods in the Internal Medicine, Surgical and Intensive Care Unit wards were included. The primary analysis of interest was the differential incidence between the two periods, overall and in the Intensive Care Units wards in particular. Results: 9,135 hospitalizations, 50,145 patient-days of analysis. 7,285 clinical samples were taken, with an overall positivity for carbapenem-resistant isolates of 12.1% (n=883). Overall carbapenem-resistant isolates incidence during Period 2 was 2.5 times higher than in Period 1 (2.52 vs 0.955/100 patient-days, p<0.001). Intensive Care Units’ carbapenem-resistant isolates incidence raised from 6.78 to 8.69/100 patient-days in Period 2 (p=0.006). Conclusions: We found alarming rates of carbapenem-resistant isolates in our center, 2.5 times higher in the period following the first wave of COVID-19. This rise was due to a higher amount of clinically relevant microbiological samples taken and to a higher carbapenem resistance among Enterobacteria and non-fermentative Gram-negative bacilli. To our knowledge, this is one of the few Latin-American reports on the effect of the COVID-19 pandemic on carbapenem-resistant isolates incidence.
在2019冠状病毒病暴发期间，过度使用抗生素、重症监护病房负担沉重和住院时间较长可能加剧了碳青霉烯耐药分离株造成的紧急情况。因此，我们着手确定在COVID-19活跃病例期间，阿根廷圣达菲一家三级保健中心的碳青霉烯类耐药分离株的发病率是否上升。材料和方法:在这项回顾性设计的分析流行病学研究中，定义了两个时期:第1期(2019年9月至2020年8月无COVID-19活动性病例)和第2期(从该机构第一波COVID-19开始)，从2020年9月至2021年6月。在此期间，在内科、外科和重症监护病房采集的所有临床相关微生物样本都被包括在内。主要分析的兴趣是两个时期之间的发病率差异，总体而言，特别是在重症监护病房。结果:9135例住院，50145例患者日分析。共采集临床样本7285份，碳青霉烯类耐药菌株总体阳性12.1% (n=883)。第2期耐碳青霉烯类分离株的总发生率是第1期的2.5倍(2.52 vs 0.955/100患者-天，p<0.001)。重症监护病房碳青霉烯耐药分离株的发病率在第二阶段从6.78 /100患者-天上升到8.69/100患者-天(p=0.006)。结论:我们发现本中心碳青霉烯类耐药分离株的发生率令人担忧，在第一波COVID-19之后的时期高出2.5倍。这一上升是由于临床相关微生物样本的数量增加，以及肠杆菌和非发酵革兰氏阴性杆菌对碳青霉烯的耐药性增加。据我们所知，这是关于COVID-19大流行对碳青霉烯耐药分离株发病率影响的少数拉丁美洲报告之一。
{"title":"Rising incidence of carbapenem resistant isolates: an Argentinian hospital’s experience. More trouble in the aftermath of the COVID-19 pandemic","authors":"Maximiliano Gabriel Castro, L. Ubiergo, Macarena Vicino, G. Cuevas, F. Argarañá","doi":"10.53986/ibjm.2022.0020","DOIUrl":"https://doi.org/10.53986/ibjm.2022.0020","url":null,"abstract":"Introduction: During COVID-19 outbreaks, disproportionate use of antibiotics, high Intensive Care Units burden and longer in-hospital stays may have aggravated the emergency posed by carbapenem-resistant isolates. Therefore, we set out to determine whether the incidence of carbapenem-resistant isolates rose in a tertiary care center in Santa Fe, Argentina during the period with active cases of COVID-19. Material and methods: In this retrospectively designed analytic epidemiologic study, two periods were defined: Period 1 (without active cases of COVID-19) from September 2019 to August 2020 and Period 2 (starting at the onset of the first wave of COVID-19 in this Institution) from September 2020 to June 2021. All clinically relevant microbiological samples taken during these periods in the Internal Medicine, Surgical and Intensive Care Unit wards were included. The primary analysis of interest was the differential incidence between the two periods, overall and in the Intensive Care Units wards in particular. Results: 9,135 hospitalizations, 50,145 patient-days of analysis. 7,285 clinical samples were taken, with an overall positivity for carbapenem-resistant isolates of 12.1% (n=883). Overall carbapenem-resistant isolates incidence during Period 2 was 2.5 times higher than in Period 1 (2.52 vs 0.955/100 patient-days, p<0.001). Intensive Care Units’ carbapenem-resistant isolates incidence raised from 6.78 to 8.69/100 patient-days in Period 2 (p=0.006). Conclusions: We found alarming rates of carbapenem-resistant isolates in our center, 2.5 times higher in the period following the first wave of COVID-19. This rise was due to a higher amount of clinically relevant microbiological samples taken and to a higher carbapenem resistance among Enterobacteria and non-fermentative Gram-negative bacilli. To our knowledge, this is one of the few Latin-American reports on the effect of the COVID-19 pandemic on carbapenem-resistant isolates incidence.","PeriodicalId":13190,"journal":{"name":"Iberoamerican Journal of Medicine","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81479611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Musacchio, Florencia Cogliano, Hugo J Miño, G. Romagnoli, Florencia Debona, Delfina Godano, F. Barbone
Introduction: With the increase of COVID-19 cases, an unusual manifestation for this type of virus began to appear anosmia and dysgeusia, which could indicate a neurologic alteration. In this context, it seems likely that subclinical manifestations of baroreflex involvement occur. The vegetative nervous system carries out the regulation of the baroreflex through the balance between sympathetic and parasympathetic activity. The objective of this study is to verify whether patients with COVID-19 present alteration of this equilibrium. Material and methods: Patients included had a confirmed diagnosis of COVID-19 admitted to the Internal Medicine Department of JB Iturraspe Hospital. A Holter recording was performed at rest for 5 minutes, determining the variables in the frequency domain using Fourier transform analysis. We excluded patients with diabetes, medicated with drugs that modify heart rate or with a history of irradiation to the neck. Results: 68 patients were studied. The mean age was 49±13 years. The median systolic blood pressure was 120 mmHg and the diastolic blood pressure 80 mmHg. The heart rate was 76±13 beats per minute and the median respiratory rate was 24 (16 to 40). Anosmia was observed in 22% and dysgeusia in 19% The variables in the frequency domain were: Low-frequency power (LF) 135.8ms2 (13.7-2861.7); High-frequency power (HF), 89.04ms2 (4.1-5234.4), LFnu 57.5±22.3, HFnu 43.1±22.6. LF:HF 2.1±2. 41.2% of the patients had a high LF:HF. Conclusions: LF and HF components can be obtained through frequency analysis. The relationship between these two elements would thus represent the sympathovagal balance and is expressed as the LF/HF ratio. We observed that 41.2% of the studied patients showed elevated LF/HF ratio. The 41.2% of the patients presented an increased LF:HF ratio, which could be interpreted as an alteration in autonomic function.
{"title":"Sympathovagal equilibrium analysis in patients with COVID-19","authors":"H. Musacchio, Florencia Cogliano, Hugo J Miño, G. Romagnoli, Florencia Debona, Delfina Godano, F. Barbone","doi":"10.53986/ibjm.2022.0019","DOIUrl":"https://doi.org/10.53986/ibjm.2022.0019","url":null,"abstract":"Introduction: With the increase of COVID-19 cases, an unusual manifestation for this type of virus began to appear anosmia and dysgeusia, which could indicate a neurologic alteration. In this context, it seems likely that subclinical manifestations of baroreflex involvement occur. The vegetative nervous system carries out the regulation of the baroreflex through the balance between sympathetic and parasympathetic activity. The objective of this study is to verify whether patients with COVID-19 present alteration of this equilibrium. Material and methods: Patients included had a confirmed diagnosis of COVID-19 admitted to the Internal Medicine Department of JB Iturraspe Hospital. A Holter recording was performed at rest for 5 minutes, determining the variables in the frequency domain using Fourier transform analysis. We excluded patients with diabetes, medicated with drugs that modify heart rate or with a history of irradiation to the neck. Results: 68 patients were studied. The mean age was 49±13 years. The median systolic blood pressure was 120 mmHg and the diastolic blood pressure 80 mmHg. The heart rate was 76±13 beats per minute and the median respiratory rate was 24 (16 to 40). Anosmia was observed in 22% and dysgeusia in 19% The variables in the frequency domain were: Low-frequency power (LF) 135.8ms2 (13.7-2861.7); High-frequency power (HF), 89.04ms2 (4.1-5234.4), LFnu 57.5±22.3, HFnu 43.1±22.6. LF:HF 2.1±2. 41.2% of the patients had a high LF:HF. Conclusions: LF and HF components can be obtained through frequency analysis. The relationship between these two elements would thus represent the sympathovagal balance and is expressed as the LF/HF ratio. We observed that 41.2% of the studied patients showed elevated LF/HF ratio. The 41.2% of the patients presented an increased LF:HF ratio, which could be interpreted as an alteration in autonomic function.","PeriodicalId":13190,"journal":{"name":"Iberoamerican Journal of Medicine","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85116572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aluminum phosphide (ALP) is a highly toxic compound most commonly available as Celphos in Nepal. Suicidal ingestion is common in developing countries like Nepal as it is easily available and has a high mortality rate. Farmers to protect crops from rodents and pests use it. Here we present a case of a 24-year-old female with suicidal ingestion of one and a half-tablet of ALP presented with abdominal pain and vomiting. The patient developed metabolic acidosis, hyperkalemia, acute respiratory distress, and hypotension during the Intensive Care Unit stay. Supportive treatment with gastric lavage (coconut oil), intravenous magnesium sulfate, sodium-bicarbonate infusion, adequate vasopressor and close monitoring of hemodynamic parameters helped in the survival of the patient.
{"title":"A case of Aluminum Phosphide poisoning managed successfully in Nepal: A Case Report","authors":"S. Jha, Angela Basnet, Sabin Chaulagain, S. Ojha","doi":"10.53986/ibjm.2022.0018","DOIUrl":"https://doi.org/10.53986/ibjm.2022.0018","url":null,"abstract":"Aluminum phosphide (ALP) is a highly toxic compound most commonly available as Celphos in Nepal. Suicidal ingestion is common in developing countries like Nepal as it is easily available and has a high mortality rate. Farmers to protect crops from rodents and pests use it. Here we present a case of a 24-year-old female with suicidal ingestion of one and a half-tablet of ALP presented with abdominal pain and vomiting. The patient developed metabolic acidosis, hyperkalemia, acute respiratory distress, and hypotension during the Intensive Care Unit stay. Supportive treatment with gastric lavage (coconut oil), intravenous magnesium sulfate, sodium-bicarbonate infusion, adequate vasopressor and close monitoring of hemodynamic parameters helped in the survival of the patient.","PeriodicalId":13190,"journal":{"name":"Iberoamerican Journal of Medicine","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81749279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiac implantable electronic device (CIED) infections have been rising around the world. Many microorganisms can lead to this disease. Corynebacterium species are catalase-positive Gram-positive bacilli, also known as "diphtheroids" or "coryneform" bacteria, were once almost universally dismissed as contamination when recovered from patients, but they are now increasingly being linked to serious infections and have the ability to form biofilms and rarely cause CIED infections and this can be complicated as infective endocarditis. Corynebacterium spp. are frequently overlooked as contaminants in blood cultures, yet they can cause a serious infective endocarditis (IE). Antibiotic resistance is increasing among Corynebacterium spp., and this makes treatment more challenging. There are few reports of IE caused by Corynebacterium spp., and more research is needed. Here, we report a case of 55- year old man with Corynebacterium spp. cardiac device-related infective endocarditis.
{"title":"Corynebacterium endocarditis in a patient with a cardiac implantable electronic device","authors":"S. Alkan, U. Küçük, S. Şahin, T. Önder","doi":"10.53986/ibjm.2022.0017","DOIUrl":"https://doi.org/10.53986/ibjm.2022.0017","url":null,"abstract":"Cardiac implantable electronic device (CIED) infections have been rising around the world. Many microorganisms can lead to this disease. Corynebacterium species are catalase-positive Gram-positive bacilli, also known as \"diphtheroids\" or \"coryneform\" bacteria, were once almost universally dismissed as contamination when recovered from patients, but they are now increasingly being linked to serious infections and have the ability to form biofilms and rarely cause CIED infections and this can be complicated as infective endocarditis. Corynebacterium spp. are frequently overlooked as contaminants in blood cultures, yet they can cause a serious infective endocarditis (IE). Antibiotic resistance is increasing among Corynebacterium spp., and this makes treatment more challenging. There are few reports of IE caused by Corynebacterium spp., and more research is needed. Here, we report a case of 55- year old man with Corynebacterium spp. cardiac device-related infective endocarditis.","PeriodicalId":13190,"journal":{"name":"Iberoamerican Journal of Medicine","volume":"186 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80633189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Dash, R. Mody, Sugandhna Malan, Naveed Ahmed, Bhavya Mody
Peripartum cardiomyopathy (PPCM) is a rare but life-threatening condition defined by left ventricular dysfunction and heart failure (HF), occurring in late pregnancy or, more commonly, the early postpartum period. In African American women, women with pre-eclampsia, advanced maternal age, and numerous gestation pregnancies, there is a greater incidence. Although the pathophysiology of PPCM is still undetermined, the importance of vasculo-hormonal pathways has been suggested in research over the past decades. Sarcomere genetic polymorphisms are found in at least some women with the disorder. More than 50% of the patients recover systolic function, albeit some are left with chronic cardiomyopathy, and a small minority of patients requires mechanical support or cardiac transplantation, or both. For the diagnosis of PPCM, electrocardiographic findings of decreased myocardial function are essential. Currently, the management of PPCM is limited to standard treatments for HF with reduced ejection fraction, with attention to minimizing the potential adverse effects on the fetus in women who are still pregnant. As a result, the outcome might range from full recovery to persistent HF, arrhythmia, thromboembolic events, or death. Research on PPCM is examined in this review, as are potential future paths for further study.
{"title":"Peripartum cardiomyopathy: A 2022 update","authors":"D. Dash, R. Mody, Sugandhna Malan, Naveed Ahmed, Bhavya Mody","doi":"10.53986/ibjm.2022.0016","DOIUrl":"https://doi.org/10.53986/ibjm.2022.0016","url":null,"abstract":"Peripartum cardiomyopathy (PPCM) is a rare but life-threatening condition defined by left ventricular dysfunction and heart failure (HF), occurring in late pregnancy or, more commonly, the early postpartum period. In African American women, women with pre-eclampsia, advanced maternal age, and numerous gestation pregnancies, there is a greater incidence. Although the pathophysiology of PPCM is still undetermined, the importance of vasculo-hormonal pathways has been suggested in research over the past decades. Sarcomere genetic polymorphisms are found in at least some women with the disorder. More than 50% of the patients recover systolic function, albeit some are left with chronic cardiomyopathy, and a small minority of patients requires mechanical support or cardiac transplantation, or both. For the diagnosis of PPCM, electrocardiographic findings of decreased myocardial function are essential. Currently, the management of PPCM is limited to standard treatments for HF with reduced ejection fraction, with attention to minimizing the potential adverse effects on the fetus in women who are still pregnant. As a result, the outcome might range from full recovery to persistent HF, arrhythmia, thromboembolic events, or death. Research on PPCM is examined in this review, as are potential future paths for further study.","PeriodicalId":13190,"journal":{"name":"Iberoamerican Journal of Medicine","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83387806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. F. Setubi, Esther Nakoya, Annie-Flore K. Tchougene, X. Fopokam
Introduction: SARS-CoV-2 continues to raise health and socio-economical concerns globally. The recent discovery of the B.1.1.529 (Omicron) variant with its critical mutations has heightened the debate about the need for a better global vaccination rollout to prevent the emergence of new SARS-CoV-2 strains. Optimizing vaccine rollout in Africa is crucial for the management of the pandemic and preventing the rise of new strains. To better direct efforts and interventions it is important to know what parts of the continent necessitate more attention. Material and Methods: 30 African countries were grouped in five geographical subregions, six countries for each subregion. Data on confirmed cases, doses administered, fully vaccinated, and deaths were extracted from the Johns Hopkins Coronavirus Resource Center database. The ANOVA test evaluated differences in means for these variables classified by subregions. The correlation test and the linear regression examined the relationship between these independent variables and total deaths. Results: There was a significant regional difference in confirmed cases (P<0.0001), and in fully vaccinated (P=0.01) across the five subregions. The overall model showed that there is a significant regional difference in the three variables’ effect on total deaths (P<0.0001). The linear regression indicated an association between the total number of deaths in relation to the confirmed cases, doses administered, and fully vaccinated (P<0.0001). Discussion: This study indicates that a relation exists between total deaths and the variables confirmed cases, doses administered, and fully vaccinated. More importantly, African countries grouped in geographical subregions perform differently in terms of vaccine rollout, and that offers insights for better and oriented interventions.
{"title":"The Impact of COVID-19 Vaccine Coverage on Deaths Outcome in Africa, Subregional Differences and the need for a Renewed Multi-level Effort","authors":"A. F. Setubi, Esther Nakoya, Annie-Flore K. Tchougene, X. Fopokam","doi":"10.53986/ibjm.2022.0015","DOIUrl":"https://doi.org/10.53986/ibjm.2022.0015","url":null,"abstract":"Introduction: SARS-CoV-2 continues to raise health and socio-economical concerns globally. The recent discovery of the B.1.1.529 (Omicron) variant with its critical mutations has heightened the debate about the need for a better global vaccination rollout to prevent the emergence of new SARS-CoV-2 strains. Optimizing vaccine rollout in Africa is crucial for the management of the pandemic and preventing the rise of new strains. To better direct efforts and interventions it is important to know what parts of the continent necessitate more attention. Material and Methods: 30 African countries were grouped in five geographical subregions, six countries for each subregion. Data on confirmed cases, doses administered, fully vaccinated, and deaths were extracted from the Johns Hopkins Coronavirus Resource Center database. The ANOVA test evaluated differences in means for these variables classified by subregions. The correlation test and the linear regression examined the relationship between these independent variables and total deaths. Results: There was a significant regional difference in confirmed cases (P<0.0001), and in fully vaccinated (P=0.01) across the five subregions. The overall model showed that there is a significant regional difference in the three variables’ effect on total deaths (P<0.0001). The linear regression indicated an association between the total number of deaths in relation to the confirmed cases, doses administered, and fully vaccinated (P<0.0001). Discussion: This study indicates that a relation exists between total deaths and the variables confirmed cases, doses administered, and fully vaccinated. More importantly, African countries grouped in geographical subregions perform differently in terms of vaccine rollout, and that offers insights for better and oriented interventions.","PeriodicalId":13190,"journal":{"name":"Iberoamerican Journal of Medicine","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75990756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Uzdenov, Sukhrob Atakhadzhaev, M. Asim, S. Covantev
A diverticulum is a limited saccular protrusion of the esophageal wall, communicating with its lumen. Anatomically, esophageal diverticula are classified into pharyngoesophageal, median, and epiphrenic. Treatment of esophageal diverticula is based on several basic pathophysiological principles. Small and asymptomatic diverticula do not require specific treatment. Large and symptomatic diverticula require surgical intervention, consisting of diverticulectomy combined with myotomy. Operations for symptomatic epiphrenic diverticula make up no more than 2% of all operations on the esophagus. We describe a case of an epiphrenic diverticulum with the dimensions 88x60x90 mm in a 54-year-old patient. Surgical treatment of this disease was performed according to the Lewis method. The article also describes methods of dealing with concomitant postoperative complications and a brief review of the literature on epiphrenic diverticula.
{"title":"Giant Epiphrenic Diverticulum: A Challenging Case","authors":"R. Uzdenov, Sukhrob Atakhadzhaev, M. Asim, S. Covantev","doi":"10.53986/ibjm.2022.0014","DOIUrl":"https://doi.org/10.53986/ibjm.2022.0014","url":null,"abstract":"A diverticulum is a limited saccular protrusion of the esophageal wall, communicating with its lumen. Anatomically, esophageal diverticula are classified into pharyngoesophageal, median, and epiphrenic. Treatment of esophageal diverticula is based on several basic pathophysiological principles. Small and asymptomatic diverticula do not require specific treatment. Large and symptomatic diverticula require surgical intervention, consisting of diverticulectomy combined with myotomy. Operations for symptomatic epiphrenic diverticula make up no more than 2% of all operations on the esophagus. We describe a case of an epiphrenic diverticulum with the dimensions 88x60x90 mm in a 54-year-old patient. Surgical treatment of this disease was performed according to the Lewis method. The article also describes methods of dealing with concomitant postoperative complications and a brief review of the literature on epiphrenic diverticula.","PeriodicalId":13190,"journal":{"name":"Iberoamerican Journal of Medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85729805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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