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Escrutinio para el cáncer de colon: ¿cuál fue el impacto en los primeros 2 años de la pandemia de COVID-19? Experiencia en una clínica privada ambulatoria. 结肠癌筛查:COVID-19大流行前两年的影响是什么?在私人门诊诊所的经验。
IF 0.5 4区 医学 Q4 SURGERY Pub Date : 2023-01-01 DOI: 10.24875/CIRU.22000564
Óscar T Teramoto-Matsubara, Sergio Sobrino-Cossío, Juan M Abdo-Francis, Francisco De la Vega-González, Gualberto Mateos-Pérez

Background: COVID-19 pandemic had a negative impact on colorectal cancer (CRC) screening programs.

Objective: The care strategy was modified throughout the pandemic, this paper evaluates its impact and short-term consequences.

Methods: A retrospective, descriptive and cross-sectional study was carried out in a private ambulatory endoscopic center, in average risk subjects. The study compared two periods: pre-pandemic and pandemic (subdivided into pre-vaccination and vaccination).

Results: During this period, 54.4% of scheduled colonoscopies were due to the screening program. The average age was 60.4 ± 7 years. Women were 52.0%. The overall cancellation rate was 41.1%, higher during pre-vaccination period. There were no differences in the degree of colonic cleansing, colonoscope exit time, and patient satisfaction. The adenoma detection rate (38.4% vs. 42.8% vs. 36.4%; p = 0.8) and the total number of adenomas (p = 0.02) was statistically significant during the pre-vaccination period. The rate of adenoma/patient showed a higher trend during this period (p = 0.06). The number of colorectal cancers was 10, without differences between periods.

Conclusion: In conclusion, the impact of the decrease in screening colonoscopy procedures for CRC detection was similar to what was seen worldwide. In this period no increase in cancer cases, although this effect may be observed in the long term.

背景:COVID-19大流行对结直肠癌(CRC)筛查计划产生了负面影响。目的:在大流行期间对护理策略进行了修改,本文评估了其影响和短期后果。方法:回顾性,描述性和横断面研究在私人门诊内镜中心进行,在平均风险受试者。该研究比较了两个时期:大流行前和大流行(细分为疫苗接种前和疫苗接种)。结果:在此期间,54.4%的结肠镜检查是由于筛查计划。平均年龄60.4±7岁。女性占52.0%。总体取消率为41.1%,在接种前阶段较高。两组在结肠清洁程度、结肠镜检查结束时间和患者满意度方面均无差异。腺瘤检出率(38.4% vs. 42.8% vs. 36.4%;P = 0.8)和腺瘤总数(P = 0.02)在接种前有统计学意义。腺瘤/患者发生率在此期间呈上升趋势(p = 0.06)。结直肠癌病例数为10例,两期无差异。结论:总之,减少结肠镜筛查结直肠癌的影响与世界范围内的情况相似。在此期间,癌症病例没有增加,尽管这种影响可能会长期观察到。
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引用次数: 0
MSH-5: malignant knee tumors timely detection index. MSH-5:膝关节恶性肿瘤及时发现指标。
IF 0.5 4区 医学 Q4 SURGERY Pub Date : 2023-01-01 DOI: 10.24875/CIRU.21000907
Gustavo Rivera-Saldívar, Rubén Torres-González, Alejandra Cario-Méndez, Romeo Técualt-Gómez, Rubén A Amaya-Zepeda, Armando Alcántara-Corona, Silvestre Fuentes-Figueroa

Background: Bone neoplasms are usually misdiagnosed causing a delay in their treatment. Bone neoplasms are usually confused with tendinitis, 31% of the cases corresponds to osteosarcomas and in 21% to Ewing's sarcomas.

Objective: To create a clinical-radiographic instrument of high diagnostic suspicion of knee bone neoplasms to prevent a delay in diagnosis.

Method: A clinimetric study (sensitivity, consistency and validity) was performed in the bone tumor service, Hospital de Ortopedia de la Unidad Médica de Alta Especialidad Dr. Victorio de la Fuente Narváez, Instituto Mexicano del Seguro Social, in México City.

Results: Characteristics of 153 patients were collected. For the sensitivity phase, 3 domains (signs, symptoms, and radiology) and 12 items were included. Consistency was evaluated with ICC (0.944), 95%CI (0.865-0.977), p < 0.001 and a-Cronbach (0.863). Index obtained a sensitivity of 0.80 and a specificity of 0.882 were obtained. The positive predictive value of the test was 66.6% and the negative predictive value was 93.75%. The positive likelihood ratio was 6.8 and the negative likelihood ratio was 0.2. Validity was evaluated using r-Pearson (0.894; p < 0.001).

Conclusions: A high suspicion clinical-radiographic index was designed to detect malignant knee tumors with adequate sensitivity, specificity, appearance, content, criteria, and construct validity.

背景:骨肿瘤通常被误诊,导致治疗延误。骨肿瘤通常与肌腱炎混淆,31%的病例对应骨肉瘤,21%对应尤文氏肉瘤。目的:研制一种膝关节骨肿瘤高诊断怀疑度的临床x线仪,防止诊断延误。方法:采用临床计量学研究(敏感性、一致性和效度),在姆萨梅斯科市姆萨梅斯卡阿尔塔联合骨科医院(Hospital de la unidia de Alta especita)的vicio de la Fuente博士Narváez、墨西哥社会医学研究所(Instituto Mexicano del Seguro Social)骨肿瘤科进行研究。结果:收集了153例患者的特征。敏感期包括3个领域(体征、症状和放射学)和12个项目。一致性评价采用ICC(0.944)、95%CI(0.865 ~ 0.977)、p < 0.001和a-Cronbach(0.863)。该指标敏感性为0.80,特异性为0.882。阳性预测值为66.6%,阴性预测值为93.75%。阳性似然比为6.8,阴性似然比为0.2。效度采用r-Pearson (0.894;P < 0.001)。结论:设计了一种高怀疑度的临床放射学指标,以检测膝关节恶性肿瘤,具有足够的敏感性、特异性、外观、内容、标准和结构效度。
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引用次数: 0
Inteligencia artificial en la colonoscopia de tamizaje y la disminución del error. 人工智能在结肠镜筛查和减少误差中的应用。
IF 0.5 4区 医学 Q4 SURGERY Pub Date : 2023-01-01 DOI: 10.24875/CIRU.22000446
Elymir Galvis-García, Francisco J de la Vega-González, Fabian Emura, Óscar Teramoto-Matsubara, Juan C Sánchez-Robles, Gonzalo Rodríguez-Vanegas, Sergio Sobrino-Cossío

Artificial Intelligence (AI) has the potential to change many aspects of healthcare practice. Image discrimination and classification has many applications within medicine. Machine learning algorithms and complicated neural networks have been developed to train a computer to differentiate between normal and abnormal areas. Machine learning is a form of AI that allows the platform to improve without being programmed. Computer Assisted Diagnosis (CAD) is based on latency, which is the time between the captured image and when it is displayed on the screen. AI-assisted endoscopy can increase the detection rate by identifying missed lesions. An AI CAD system must be responsive, specific, with easy-to-use interfaces, and provide fast results without substantially prolonging procedures. AI has the potential to help both, trained and trainee endoscopists. Rather than being a substitute for high-quality technique, it should serve as a complement to good practice. AI has been evaluated in three clinical scenarios in colonic neoplasms: the detection of polyps, their characterization (adenomatous vs. non-adenomatous) and the prediction of invasive cancer within a polypoid lesion.

人工智能(AI)有可能改变医疗保健实践的许多方面。图像识别和分类在医学中有许多应用。机器学习算法和复杂的神经网络已经被开发出来,用来训练计算机区分正常和异常区域。机器学习是人工智能的一种形式,它允许平台在没有编程的情况下进行改进。计算机辅助诊断(CAD)基于延迟,即从捕获图像到显示在屏幕上的时间。人工智能辅助内镜可以通过识别漏诊病变来提高检出率。一个人工智能CAD系统必须反应灵敏,具体,具有易于使用的界面,并提供快速的结果,而不会大大延长程序。人工智能有潜力帮助训练有素和见习的内窥镜医师。它不应该作为高质量技术的替代品,而应该作为良好实践的补充。人工智能在结肠肿瘤的三种临床情况下进行了评估:息肉的检测,其特征(腺瘤性与非腺瘤性)以及息肉样病变内浸润性癌症的预测。
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引用次数: 0
Postoperative complications and predictors of mortality in patients with COVID-19. COVID-19患者术后并发症及死亡率预测因素
IF 0.5 4区 医学 Q4 SURGERY Pub Date : 2023-01-01 DOI: 10.24875/CIRU.22000512
Katya Bozada-Gutiérrez, Mario Trejo-Ávila, Mucio Moreno-Portillo

Background: There are limited data about the perioperative outcomes of coronavirus disease 2019 (COVID-19) patients that needed emergency general surgery. The aim of the present study was to describe the perioperative outcomes and mortality of patients with COVID-19 who underwent emergency surgery.

Materials and methods: Retrospective study of COVID-19 patients symptomatic versus asymptomatic from March 2020 to February 2022 that needed an emergency surgery in a national referral hospital.

Results: Forty-four patients were included in this study. Patients with symptomatic COVID-19 have higher ICU admissions and prolonged length of stay (LOS) as compared with asymptomatic COVID-19 patients. The 90-day survival probability of the entire cohort was 70.1% (60.3-79.9) and was significantly lower in patients with COVID-19 symptomatic 63.4% (50.5-76.2). The cut-off preoperative values for the prediction of mortality: Ferritin ≥ 438.5 ng/mL (Area under the curve [AUC] = 0.908), C-reactive protein (CRP) ≥ 12.5 mg/dL (AUC = 0.715), leukocyte ≥ 13.8 × 103/mL (AUC = 0.706), and albumin ≤ 2.78 g/dL (AUC = 704). Furthermore, a cut-off value of CRP of ≥ 12.5 mg/dL yielded an accuracy of 82.9% for the prediction of postoperative complications (p < 0.001).

Conclusion: Patients with symptomatic COVID-19 who needed emergency surgery have higher ICU admissions, prolonged LOS, and decreased 90-day survival as compared with asymptomatic COVID-19 patients. Preoperative ferritin, CRP, leukocytes, and albumin could be used as predictors of mortality.

背景:关于冠状病毒病2019 (COVID-19)患者需要急诊普通手术的围手术期结局的数据有限。本研究的目的是描述接受急诊手术的COVID-19患者的围手术期结局和死亡率。材料与方法:回顾性研究2020年3月至2022年2月在某国家级转诊医院急诊手术的COVID-19有症状和无症状患者。结果:44例患者纳入本研究。有症状的COVID-19患者比无症状的COVID-19患者有更高的ICU入院率和更长的住院时间。整个队列的90天生存率为70.1%(60.3-79.9),有COVID-19症状的患者的90天生存率为63.4%(50.5-76.2),显着降低。预测死亡率的术前截止值:铁蛋白≥438.5 ng/mL(曲线下面积[AUC] = 0.908)、c反应蛋白(CRP)≥12.5 mg/dL (AUC = 0.715)、白细胞≥13.8 × 103/mL (AUC = 0.706)、白蛋白≤2.78 g/dL (AUC = 704)。此外,CRP临界值≥12.5 mg/dL预测术后并发症的准确率为82.9% (p < 0.001)。结论:有症状的COVID-19患者与无症状的患者相比,需要急诊手术的患者ICU入院率更高,LOS延长,90天生存率降低。术前铁蛋白、CRP、白细胞和白蛋白可作为死亡率的预测因子。
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引用次数: 0
Breve comentario sobre el origen de la toracotomía anterolateral para el tratamiento quirúrgico de las heridas cardíacas. 在这篇文章中,我们介绍了一种用于心脏损伤手术治疗的前外侧胸切开术的起源。
IF 0.5 4区 医学 Q4 SURGERY Pub Date : 2023-01-01 DOI: 10.24875/CIRU.21000540
Yoandy López-De la Cruz, Rodolfo Morales-Valdés
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引用次数: 0
Exposición a radiación ionizante en médicos residentes de ortopedia en un hospital de referencia. 参考医院骨科住院医生的电离辐射暴露。
IF 0.5 4区 医学 Q4 SURGERY Pub Date : 2023-01-01 DOI: 10.24875/CIRU.21000644
Suemmy Gaytán-Fernández, Rodolfo G Barragan-Hervella, Jorge Quiroz-Williams, Carlos L Rodríguez Palacios, Gilberto Sánchez-González

Objective: To describe and analyze the exposure to ionizing radiation of orthopedic residents.

Method: A prospective study was carried out to evaluate the degree of exposure to ionizing radiation with a bandage dosimeter placed under the lead apron for medical residents for 10 months. An online survey measured the degree of knowledge about radiation safety.

Results: 54 resident physicians participated. 55.6% report having knowledge of the existence of radiological protection equipment and 40.7% report that they had previous training in its use. 77.8% use the leaded apron and 31.5% use thyroid protection. 81.5% were positioned less than 1 meter from the source of the X-ray production of the arc in C. The total mean radiation exposure was 2.9 ± 2.17 mSv (95% confidence interval: 1.25-14.28; p = 0.424).

Conclusions: Orthopedic residents present radiation doses below the International Commission on Radiological Protection recommended limit. However, there is a lack of knowledge of radiation protection and as well as a lack of interest and ignorance of the adverse effects of radiation.

目的:描述和分析骨科住院医师电离辐射暴露情况。方法:采用前瞻性研究方法,对住院医师在铅围裙下放置的绷带剂量计进行为期10个月的电离辐射暴露程度评估。一项在线调查测量了人们对辐射安全的了解程度。结果:54名住院医师参与。55.6%的人表示他们知道放射防护设备的存在,40.7%的人表示他们以前接受过放射防护设备的使用培训。77.8%的人使用含铅围裙,31.5%的人使用甲状腺防护。81.5%的人位于距离c区x射线弧产生源不到1米的位置,总平均辐射暴露为2.9±2.17 mSv(95%可信区间:1.25-14.28;P = 0.424)。结论:骨科住院医师的辐射剂量低于国际放射防护委员会推荐的限值。然而,人们缺乏辐射防护知识,对辐射的不良影响也缺乏兴趣和无知。
{"title":"Exposición a radiación ionizante en médicos residentes de ortopedia en un hospital de referencia.","authors":"Suemmy Gaytán-Fernández,&nbsp;Rodolfo G Barragan-Hervella,&nbsp;Jorge Quiroz-Williams,&nbsp;Carlos L Rodríguez Palacios,&nbsp;Gilberto Sánchez-González","doi":"10.24875/CIRU.21000644","DOIUrl":"https://doi.org/10.24875/CIRU.21000644","url":null,"abstract":"<p><strong>Objective: </strong>To describe and analyze the exposure to ionizing radiation of orthopedic residents.</p><p><strong>Method: </strong>A prospective study was carried out to evaluate the degree of exposure to ionizing radiation with a bandage dosimeter placed under the lead apron for medical residents for 10 months. An online survey measured the degree of knowledge about radiation safety.</p><p><strong>Results: </strong>54 resident physicians participated. 55.6% report having knowledge of the existence of radiological protection equipment and 40.7% report that they had previous training in its use. 77.8% use the leaded apron and 31.5% use thyroid protection. 81.5% were positioned less than 1 meter from the source of the X-ray production of the arc in C. The total mean radiation exposure was 2.9 ± 2.17 mSv (95% confidence interval: 1.25-14.28; p = 0.424).</p><p><strong>Conclusions: </strong>Orthopedic residents present radiation doses below the International Commission on Radiological Protection recommended limit. However, there is a lack of knowledge of radiation protection and as well as a lack of interest and ignorance of the adverse effects of radiation.</p>","PeriodicalId":50990,"journal":{"name":"Cirugia Y Cirujanos","volume":"91 1","pages":"64-72"},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10732235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prevalencia de glucosa alterada en ayuno y dislipidemia entre pacientes mexicanos con VIH naïve a tratamiento antirretroviral. 墨西哥naive hiv患者接受抗逆转录病毒治疗时禁食血糖改变和血脂异常的患病率。
IF 0.5 4区 医学 Q4 SURGERY Pub Date : 2023-01-01 DOI: 10.24875/CIRU.21000594
César I Elizalde-Barrera, Carlos V Juárez-Mendoza, Andrea Maliachi-Díaz, Ismar A Rosado-Arenas, Stephania Sandoval-Ocampo, Luis E Tinoco-Montes

Background: Metabolic complications have become more relevant in the care of patients with HIV. However, little is known about the incidence and risk factors for these disorders among HIV-infected antiretroviral treatment naïve (ARTn) patients.

Objective: To recognize the prevalence of Impaired Fasting Glucose (IFG) and dyslipidemia among HIV-infected ARTn Mexican individuals and identify associated risk factors.

Method: A retrospective study was conducted in HIV-1-infected ART-N patients, referred for attention to a general hospital in Mexico City, between 2009 and 2019. We collected information for anthropometric, clinical, biochemical and HIV status variables.

Results: We included 221 patients, 97% were males, mean age 30 years (interquartile range [IQR]: 25-38); median CD4 count was 250 cells/mm3 (IQR: 120.25-391) and median log10 HIV viral load was 4.69 HIV-1 RNA copies/ml (IQR: 3.64-5.25). Prevalence of IFG was 22.6% and was associated with overweight-obesity (odds ratio [OR]: 2.75; 95% confidence interval [95% CI]: 1.36-5.55; p-value < 0.05). Hypoalphalipoproteinemia was the most frequent dyslipidemia: 69.46%. An association between count CD4 < 250 and lower HDL cholesterol levels was found (OR: 3.23; 95CI%: 1.61-6.5; p-value < 0.05).

Conclusions: IFG and dyslipidemia are highly prevalent among HIV-infected ART-naïve Mexican patients, therefore, screening for glucose and lipids abnormalities always should be considered among ARTn patients.

背景:代谢并发症在HIV患者的护理中变得越来越重要。然而,对艾滋病毒感染抗逆转录病毒治疗naïve (ARTn)患者中这些疾病的发生率和危险因素知之甚少。目的:了解墨西哥hiv感染者中空腹血糖受损(IFG)和血脂异常的患病率,并确定相关的危险因素。方法:对2009年至2019年在墨西哥城一家综合医院转诊的hiv -1感染ART-N患者进行回顾性研究。我们收集了人体测量、临床、生化和HIV状态变量的信息。结果:纳入221例患者,97%为男性,平均年龄30岁(四分位数间距[IQR]: 25-38);中位CD4计数为250个细胞/mm3 (IQR: 120.25-391),中位log10 HIV病毒载量为4.69 HIV-1 RNA拷贝/ml (IQR: 3.64-5.25)。IFG患病率为22.6%,与超重肥胖相关(优势比[OR]: 2.75;95%置信区间[95% CI]: 1.36-5.55;p值< 0.05)。低脂蛋白血症是最常见的血脂异常,占69.46%。计数CD4 < 250与较低的HDL胆固醇水平之间存在关联(OR: 3.23;95 ci %: 1.61 - -6.5;p值< 0.05)。结论:IFG和血脂异常在hiv感染ART-naïve墨西哥患者中非常普遍,因此,在ARTn患者中始终应考虑筛查葡萄糖和血脂异常。
{"title":"Prevalencia de glucosa alterada en ayuno y dislipidemia entre pacientes mexicanos con VIH naïve a tratamiento antirretroviral.","authors":"César I Elizalde-Barrera,&nbsp;Carlos V Juárez-Mendoza,&nbsp;Andrea Maliachi-Díaz,&nbsp;Ismar A Rosado-Arenas,&nbsp;Stephania Sandoval-Ocampo,&nbsp;Luis E Tinoco-Montes","doi":"10.24875/CIRU.21000594","DOIUrl":"https://doi.org/10.24875/CIRU.21000594","url":null,"abstract":"<p><strong>Background: </strong>Metabolic complications have become more relevant in the care of patients with HIV. However, little is known about the incidence and risk factors for these disorders among HIV-infected antiretroviral treatment naïve (ARTn) patients.</p><p><strong>Objective: </strong>To recognize the prevalence of Impaired Fasting Glucose (IFG) and dyslipidemia among HIV-infected ARTn Mexican individuals and identify associated risk factors.</p><p><strong>Method: </strong>A retrospective study was conducted in HIV-1-infected ART-N patients, referred for attention to a general hospital in Mexico City, between 2009 and 2019. We collected information for anthropometric, clinical, biochemical and HIV status variables.</p><p><strong>Results: </strong>We included 221 patients, 97% were males, mean age 30 years (interquartile range [IQR]: 25-38); median CD4 count was 250 cells/mm<sup>3</sup> (IQR: 120.25-391) and median log10 HIV viral load was 4.69 HIV-1 RNA copies/ml (IQR: 3.64-5.25). Prevalence of IFG was 22.6% and was associated with overweight-obesity (odds ratio [OR]: 2.75; 95% confidence interval [95% CI]: 1.36-5.55; p-value < 0.05). Hypoalphalipoproteinemia was the most frequent dyslipidemia: 69.46%. An association between count CD4 < 250 and lower HDL cholesterol levels was found (OR: 3.23; 95CI%: 1.61-6.5; p-value < 0.05).</p><p><strong>Conclusions: </strong>IFG and dyslipidemia are highly prevalent among HIV-infected ART-naïve Mexican patients, therefore, screening for glucose and lipids abnormalities always should be considered among ARTn patients.</p>","PeriodicalId":50990,"journal":{"name":"Cirugia Y Cirujanos","volume":"91 1","pages":"100-106"},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10732240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Incidencia y factores asociados con las reacciones adversas tras la primera dosis de la vacuna Pfizer-BioNTech en trabajadores de la salud. 卫生工作者第一次注射辉瑞生物技术疫苗后不良反应的发生率和相关因素。
IF 0.5 4区 医学 Q4 SURGERY Pub Date : 2023-01-01 DOI: 10.24875/CIRU.21000749
José E López-Contreras, Patricia Paredes-Casillas, Jaime Morales-Romero, Francisco E Castillo-Vélez, Juan C Lona-Reyes, Martín Bedolla-Barajas

Objective: To determine the incidence of adverse reactions (AR) after the first dose of Pfizer-BioNTech vaccine, and to identify some factors associated with AR.

Method: A retrospective cohort study was conducted. Data were obtained through an epidemiological survey answered online. Multivariate analyses were performed to identify factors associated with early (< 2 h) and late (≥ 2 h) AR.

Results: A total of 2295 health care workers were included; in them, the cumulative incidence of AR was 18.2% (95% confidence interval: 16.6-19.8), where the majority were late (78.2%). The associated factors that increased the risk of early AR were being female (odds ratio [OR]: 2.23, p = 0.002) and belonging to the medical staff (OR: 1.56; p = 0.041). In late AR were being female (OR: 1.94; p < 0.0001); on the other hand, diabetes (OR: 0.46; p = 0.021), asthma (OR: 0.53; p = 0.040) and smoking (OR: 0.44, p = 0.002) were inversely associated factors. Interestingly, history of COVID-19 was not associated with either early or late AR.

Conclusions: The risk of presenting some type of AR due to the Pfizer-BioNTech vaccine in health care workers is < 20%.

目的:了解辉瑞- biontech疫苗首剂后不良反应(AR)的发生率,并探讨与AR相关的因素。方法:采用回顾性队列研究。数据是通过网上回答的流行病学调查获得的。通过多因素分析确定早期(< 2小时)和晚期(≥2小时)急性呼吸道感染的相关因素。结果:共纳入2295名医护人员;其中,累计发生AR的发生率为18.2%(95%可信区间:16.6 ~ 19.8),其中以晚期发病为主(78.2%)。增加早期AR风险的相关因素是女性(比值比[OR]: 2.23, p = 0.002)和医务人员(比值比:1.56;P = 0.041)。晚期为女性(OR: 1.94;P < 0.0001);另一方面,糖尿病(OR: 0.46;p = 0.021),哮喘(OR: 0.53;p = 0.040)和吸烟(OR: 0.44, p = 0.002)为负相关因素。有趣的是,COVID-19病史与早期或晚期AR均无关。结论:卫生保健工作者因辉瑞- biontech疫苗而出现某种类型AR的风险< 20%。
{"title":"Incidencia y factores asociados con las reacciones adversas tras la primera dosis de la vacuna Pfizer-BioNTech en trabajadores de la salud.","authors":"José E López-Contreras,&nbsp;Patricia Paredes-Casillas,&nbsp;Jaime Morales-Romero,&nbsp;Francisco E Castillo-Vélez,&nbsp;Juan C Lona-Reyes,&nbsp;Martín Bedolla-Barajas","doi":"10.24875/CIRU.21000749","DOIUrl":"https://doi.org/10.24875/CIRU.21000749","url":null,"abstract":"<p><strong>Objective: </strong>To determine the incidence of adverse reactions (AR) after the first dose of Pfizer-BioNTech vaccine, and to identify some factors associated with AR.</p><p><strong>Method: </strong>A retrospective cohort study was conducted. Data were obtained through an epidemiological survey answered online. Multivariate analyses were performed to identify factors associated with early (< 2 h) and late (≥ 2 h) AR.</p><p><strong>Results: </strong>A total of 2295 health care workers were included; in them, the cumulative incidence of AR was 18.2% (95% confidence interval: 16.6-19.8), where the majority were late (78.2%). The associated factors that increased the risk of early AR were being female (odds ratio [OR]: 2.23, p = 0.002) and belonging to the medical staff (OR: 1.56; p = 0.041). In late AR were being female (OR: 1.94; p < 0.0001); on the other hand, diabetes (OR: 0.46; p = 0.021), asthma (OR: 0.53; p = 0.040) and smoking (OR: 0.44, p = 0.002) were inversely associated factors. Interestingly, history of COVID-19 was not associated with either early or late AR.</p><p><strong>Conclusions: </strong>The risk of presenting some type of AR due to the Pfizer-BioNTech vaccine in health care workers is < 20%.</p>","PeriodicalId":50990,"journal":{"name":"Cirugia Y Cirujanos","volume":"91 1","pages":"34-41"},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9297160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Botulinum toxin A (IncobotulinumtoxinA) and pneumoperitoneum image-guided for hernia repair with loss of dominance. 肉毒毒素A (IncobotulinumtoxinA)和气腹图像引导下疝修补丧失优势。
IF 0.5 4区 医学 Q4 SURGERY Pub Date : 2023-01-01 DOI: 10.24875/CIRU.21000616
Sergio E López-Juárez, Alberto Medina-Benítez, Ricardo Durán-Reyes, Bernardo I Bagundo-Pérez, Oscar I Fortuna-Sandoval, Mariana S Trejo-García

Post-incisional ventral hernia is estimated at 5-30%, when the content of the abdominal cavity migrates to the hernial sac (HSV), with a HSV/abdominal cavity volume ratio > 25%, conditioning systemic changes defined as "loss of domain". A 27-year-old male presented with ventral hernia with loss of domain that required pre-operative preparation techniques, using application of botulinum toxin A (IncobotulinumtoxinA) and pneumoperitoneum, both guided by image. A ventral plasty was performed with adequate return of the viscera to the abdominal cavity. The combination of both techniques seems to be a safe procedure to carry out a tension-free repair.

切口后腹疝估计为5-30%,腹腔内容物迁移到疝囊(HSV), HSV/腹腔体积比> 25%,调节全身性改变,定义为“失域”。一位27岁的男性患者因腹侧疝失去区域,需要术前准备技术,使用肉毒杆菌毒素A (IncobotulinumtoxinA)和气腹,均在图像引导下进行。腹侧成形术使脏器充分返回腹腔。两种技术的结合似乎是进行无张力修复的安全程序。
{"title":"Botulinum toxin A (IncobotulinumtoxinA) and pneumoperitoneum image-guided for hernia repair with loss of dominance.","authors":"Sergio E López-Juárez,&nbsp;Alberto Medina-Benítez,&nbsp;Ricardo Durán-Reyes,&nbsp;Bernardo I Bagundo-Pérez,&nbsp;Oscar I Fortuna-Sandoval,&nbsp;Mariana S Trejo-García","doi":"10.24875/CIRU.21000616","DOIUrl":"https://doi.org/10.24875/CIRU.21000616","url":null,"abstract":"<p><p>Post-incisional ventral hernia is estimated at 5-30%, when the content of the abdominal cavity migrates to the hernial sac (HSV), with a HSV/abdominal cavity volume ratio > 25%, conditioning systemic changes defined as \"loss of domain\". A 27-year-old male presented with ventral hernia with loss of domain that required pre-operative preparation techniques, using application of botulinum toxin A (IncobotulinumtoxinA) and pneumoperitoneum, both guided by image. A ventral plasty was performed with adequate return of the viscera to the abdominal cavity. The combination of both techniques seems to be a safe procedure to carry out a tension-free repair.</p>","PeriodicalId":50990,"journal":{"name":"Cirugia Y Cirujanos","volume":"91 1","pages":"117-121"},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10732237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Apendicitis aguda dentro de una hernia de Spiegel: un caso infrecuente de una patología infrecuente. 明镜疝中的急性阑尾炎:一种罕见病理的罕见病例。
IF 0.5 4区 医学 Q4 SURGERY Pub Date : 2023-01-01 DOI: 10.24875/CIRU.21000783
Guadalupe K Peña-Portillo, Aarón Zaraín-Rodríguez, Victoria Rendón-Camarillo, Gabriela Ayala-Hernández, Iván Marín-Pardo, Elías Ballesteros-Suárez

Introduction: Spigelian hernia is a rare entity, with higher improbability of acute appendicitis within it.

Case report: A 75-year-old female with a 30-year evolution hernia, abdominal pain, and fever of 1 week of onset, in whom was found an acute appendicitis within a Spigelian hernia.

Discussion: Spigelian hernia comprises 0.12-2% of all abdominal hernias. Presurgical diagnosis is stablished only in 50% of cases, with an hernial ring less than 2 cm and hidden localization. There isn't statistics of this complication because of the lack of case reports.

简介:Spigelian疝是一种罕见的实体,其内发生急性阑尾炎的可能性更高。病例报告:一名75岁的女性,患有30年的演进性疝,腹痛,发病1周后发烧,在Spigelian疝气内发现急性阑尾炎。讨论:Spigelian疝占所有腹部疝的0.12-2%。术前诊断只有50%的病例是稳定的,疝环小于2厘米和隐藏的定位。由于缺乏病例报告,没有关于这种并发症的统计数据。
{"title":"Apendicitis aguda dentro de una hernia de Spiegel: un caso infrecuente de una patología infrecuente.","authors":"Guadalupe K Peña-Portillo,&nbsp;Aarón Zaraín-Rodríguez,&nbsp;Victoria Rendón-Camarillo,&nbsp;Gabriela Ayala-Hernández,&nbsp;Iván Marín-Pardo,&nbsp;Elías Ballesteros-Suárez","doi":"10.24875/CIRU.21000783","DOIUrl":"10.24875/CIRU.21000783","url":null,"abstract":"<p><strong>Introduction: </strong>Spigelian hernia is a rare entity, with higher improbability of acute appendicitis within it.</p><p><strong>Case report: </strong>A 75-year-old female with a 30-year evolution hernia, abdominal pain, and fever of 1 week of onset, in whom was found an acute appendicitis within a Spigelian hernia.</p><p><strong>Discussion: </strong>Spigelian hernia comprises 0.12-2% of all abdominal hernias. Presurgical diagnosis is stablished only in 50% of cases, with an hernial ring less than 2 cm and hidden localization. There isn't statistics of this complication because of the lack of case reports.</p>","PeriodicalId":50990,"journal":{"name":"Cirugia Y Cirujanos","volume":"91 3","pages":"432-436"},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9803991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Cirugia Y Cirujanos
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