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Abordaje quirúrgico del hueco poplíteo 腘窝的外科治疗
Pub Date : 2023-06-09 DOI: 10.18004/rdn2023.jun.01.082.087
Hugo Ojeda Fiore, Daniel Arias Penayo
El leiomiosarcoma de bajo grado es una neoplasia poco común en el hueco y su abordaje terapéutico sigue siendo un desafío. La elección de una cirugía compartimental, basada en los elementos anatómicos de esta región, se mostró como una estrategia efectiva para abordar el tumor de partes blandas, preservando la integridad de las estructuras neurovasculares. Los resultados obtenidos respaldan la viabilidad de la cirugía compartimental en el tratamiento de leiomiosarcomas de bajo grado en el hueco poplíteo, lo cual puede guiar futuras decisiones terapéuticas y mejorar los resultados clínicos en pacientes con condiciones similares.
低级别平滑肌肉瘤是一种罕见的肿瘤,其治疗方法仍然是一个挑战。根据该区域的解剖特征,选择隔室手术被证明是一种有效的策略来处理软组织肿瘤,同时保持神经血管结构的完整性。本研究的目的是评估在腘窝平滑肌肉瘤治疗中使用室隔术的有效性,并评估在腘窝平滑肌肉瘤治疗中使用室隔术的有效性。
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引用次数: 0
Update on systemic lupus erythematosus 系统性红斑狼疮研究进展
Pub Date : 2019-06-30 DOI: 10.18004/RDN2019.0011.01.001-004
Patricia Sobarzo de Vysokolan
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引用次数: 0
Splenic abscess post-traumatic 创伤后脾脓肿
Pub Date : 2019-06-30 DOI: 10.18004/RDN2019.0011.01.080-088
Lorenzo Diosnel Acosta Brunaga, Víctor Escandriolo, M. Ramírez
Splenic abscesses are infrequent conditions, but with high mortality attributed to a late diagnosis, mainly due to the absence of specific symptoms and signs. We present a patient with a history of trauma 6 months earlier in the abdominal thorax region, who was admitted with a prolonged febrile syndrome of unknown origin. The existence of palpation pain in the left hypochondrium region was confirmed by abdominal ultrasound, the presence of a hypo-echogenic lesion in an enlarged spleen and in the angio tomography no evidence of contrast leakage. Antibiotic therapy and percutaneous Caso Clínico Absceso esplénico post traumático Splenic abscess post-traumatic Lorenzo Diosnel Acosta Brunaga, Víctor Escandriolo, Marcelo Ramírez Rev. Nac. (Itauguá) 2019;11(1):80-88 10.18004/rdn2019.0011.01.080-088 drainage were applied under tomography with good clinical response, with favorable evolution and splenectomy was avoided.
脾脓肿是一种罕见的疾病,但由于诊断晚,死亡率高,主要是由于缺乏特定的症状和体征。我们提出一个病人的创伤史6个月前,在腹胸区域,谁是入院的长期发热综合征不明来源。腹部超声证实左胁肋区有触诊疼痛,脾肿大处有低回声病灶,血管断层扫描未见造影剂渗漏。抗生素治疗和经皮Caso Clínico脓肿esplacimnico后traumático创伤后脾脓肿Lorenzo Diosnel Acosta Brunaga, Víctor Escandriolo, Marcelo Ramírez Rev. Nac。(itaugu) 2019;11(1):80-88 10.18004/rdn2019.0011.01.080-088 ct下引流,临床反应良好,进展良好,避免脾切除术。
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引用次数: 0
Hematological manifestations in adult patients with systemic lupus erythematosus 成人系统性红斑狼疮患者的血液学表现
Pub Date : 2019-06-30 DOI: 10.18004/RDN2019.0011.01.005-016
Enrique García Bello, E. Taboada
RESUMEN Introducción: el lupus eritematoso sistémico (LES) puede afectar las tres series celulares de la sangre. Objetivo: describir las alteraciones hematológicas y los marcadores de actividad en pacientes adultos con LES. Metodología: estudio observacional descriptivo realizado en pacientes con LES del Hospital Nacional en 2017-2018. Se excluyeron a los pacientes con inmunosupresores (ciclofosfamida, rituzimab), pacientes con LES medicamentoso, pacientes con síndrome de superposición, pacientes con otras enfermedades autoinmunes. Resultados: se incluyeron 88 pacientes, con edad media 27±15 años. Hubo predominio de mujeres (89%). Se detectó anemia en 55%, leucopenia en 13%, linfopenia en 32%, plaquetopenia en 11%. Los valores de ANA estaban elevados en 92% y anti DNA en 22%. Conclusión: la afectación hematológica más frecuente en pacientes adultos con LES fue la anemia, seguida por la leucopenia y la plaquetopenia.
摘要导言:系统性红斑狼疮(SLE)可影响血液中的三种细胞系。目的:描述成人SLE患者的血液学改变和活动性标志物。方法:2017-2018年对国立医院SLE患者进行描述性观察研究。免疫抑制剂(环磷酰胺、利妥昔单抗)患者、药物性红斑狼疮患者、重叠综合征患者、其他自身免疫性疾病患者被排除在外。结果:纳入88例患者,平均年龄27±15岁。女性占主导地位(89%)。贫血55%,白细胞减少13%,淋巴细胞减少32%,血小板减少11%。ANA值高达92%,抗DNA值高达22%。结论:成人SLE患者最常见的血液系统损害是贫血,其次是白细胞减少和血小板减少。
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引用次数: 0
Cecum blind ischemia as an unexpected finding 盲肠盲缺血是一个意外发现
Pub Date : 2019-06-30 DOI: 10.18004/RDN2019.0011.01.089-098
Andrés Gustavo Toscano Ponce, Carlos Miguel Rios González, Ginno Alessandro De Benedictis Serrano, M. J. Tello, Alexander Bolivar Palacios Gallegos
The colon ischemic pathologies have scare clinical features and are difficult to diagnose. We report a case of a with history of arterial hypertension, who presents with abdominal pain of 12 hours in the right iliac fossa without radiation, colic type, of moderate intensity, without other accompanying symptoms. On physical examination the abdomen was soft depressible, painful to deep palpation, signs of Mc Burney, Rovsing and Blumberg were positives. The hemogram reported leukocytosis 12900 with neutrophilia 82.9%. It is diagnosed as acute appendicitis and was planned an appendectomy. The surgeon reported an cecal appendix grade II, good appendicular base, distended bowel loops and ischemia on the anterior face of the cecum, being the cast finding an important one to change the planned surgery to an ileostomy urgent. We consider an important to fact know the evolution patterns of colon ischemia and factors that predict its unfavorable course and mortality.
结肠缺血性病变具有可怕的临床特征,难以诊断。我们报告一例有动脉高压病史的患者,其右髂窝腹痛12小时,无放射,绞痛型,中等强度,无其他伴随症状。体检时,腹部柔软、可压、疼痛至深部触诊,Mc Burney、Rovsing和Blumberg的体征为阳性。血象报告白细胞增多12900,中性粒细胞增多82.9%。诊断为急性阑尾炎,计划进行阑尾切除术。外科医生报告盲肠阑尾为II级,阑尾基底良好,肠环扩张,盲肠前表面缺血,是将计划手术改为紧急回肠造口术的重要手段。我们认为了解结肠缺血的演变模式以及预测其不良过程和死亡率的因素是很重要的。
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引用次数: 0
Ohtahara syndrome: a case presentation associated with Pierre Robin syndrome Ohtahara综合征:一例与Pierre-Robin综合征相关的病例
Pub Date : 2019-06-30 DOI: 10.18004/RDN2019.0011.01.099-115
Gladys Maribel Godoy Torales, Rocio Raquel Rienzi Grassi, Alicia Carolina Aldana Amabile, Héctor Cano Arrieta
Ohtahara syndrome is an epileptic encephalopathy that starts early in life, characterized by intractable seizures, wave-suppression tracing, both in the sleep and a waking phases of the electroencephalogram, and associated with delayed motor and cognitive development. We present the case of a child, to the fifteen days of life referred to the Hospital Nacional, Paraguay, with is the days of like to rule out congenital heart disease, due to oxygen dependence. On admission, the facial appearance was coincident with Pierre Robin syndrome, laryngeal stridor, cervical hypotonia and micropenis was observed. Once admitted congenital heart disease was excluded by echocardiography. Respiratory failure and need for oxygen secondary to respiratory obstruction due to glossoptosis are assumed. Transfontanelar ultrasound reveals grade II intraventricular hemorrhage, cystic image in the posterior fossa, megacisternal versus neuroepithelial cyst. At 47 days, he presented tonic-clonic seizures in the limbs opisthotonos and position of, he was treated with valproic acid, then Vigabatrina, with no response. Electroencephalographic trace shows discharge-suppression pattern. Develops infection associated with health care from respiratory origen, presents poor management of secretions and torpid evolution, dying at 110 days. The case is characterized by epileptic syndrome in a patient with a Rev. Nac. (Itauguá) 2019;11(1):99-115 10.18004/rdn2019.0011.01.099-115 phenotype corresponding to Pierre Robin syndrome; but also has micropene. The presence of the three mentioned fatures could not be included in a previously described syndrome. In newborns with dysmorphia and seizures it is important to rule out the presence of structural alteration in the nervous system as responsible for the syndrome.
Ohtahara综合征是一种早期开始的癫痫性脑病,其特征是在睡眠和清醒阶段的脑电图中出现顽固性癫痫发作、波抑制追踪,并与运动和认知发育迟缓有关。我们介绍了一个儿童的案例,将其15天的生命转诊到巴拉圭国家医院,这是由于氧气依赖,需要排除先天性心脏病的日子。入院时,面部外观与Pierre-Robin综合征一致,观察到喉鸣音、颈部张力减退和微阴茎。超声心动图排除了一次入院的先天性心脏病。假设由于舌下垂引起的呼吸阻塞继发呼吸衰竭和对氧气的需求。经颅多普勒超声显示II级脑室内出血,后颅窝囊性图像,大池与神经上皮囊肿。第47天,他出现四肢强直阵挛性癫痫发作,位置为,他接受了丙戊酸治疗,然后接受了Vigabatrina治疗,没有任何反应。脑电图描记显示放电抑制模式。从呼吸道起源发展为与医疗保健相关的感染,表现为分泌物管理不善和缓慢进化,在110天时死亡。该病例的特点是一名患有Rev.Nac的患者出现癫痫综合征。(意大利)2019;11(1):99-115 10.18004/rdn2019.0011.01.099-115表型对应Pierre-Robin综合征;而且还具有微烯。上述三种脂肪的存在不能包括在先前描述的综合征中。对于有畸形和癫痫发作的新生儿,重要的是要排除神经系统结构改变是导致该综合征的原因。
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引用次数: 0
Hypertension secondary to primary hyperaldosteronism 原发性高醛固酮增多症继发高血压
Pub Date : 2019-06-30 DOI: 10.18004/RDN2019.0011.01.116-123
Nelson Gonzalez, M. Bogado, Héctor Cano Arrieta
Hypertension is a pandemic worldwide, being responsible for several cardiovascular, neurological and renal complications. The vast majority is due to essential or primary hypertension, but more and more cases of secondary arterial hypertension are diagnosed, either due to endocrinological, renal or neurological causes. Caso Clínico Hipertensión arterial secundaria a hiperaldosteronismo primario Hypertension secondary to primary hyperaldosteronism Nelson Rodrigo González González, Miguel Ferreira Bogado, Héctor Cano Arrieta 3 Rev. Nac. (Itauguá) 2019;11(1):116-123 10.18004/rdn2019.0011.01.116-123 Next, an hypertension case of secondary to primary hyperaldosteronism is presented.
高血压是世界范围内的一种流行病,可导致几种心血管、神经和肾脏并发症。绝大多数是由于原发性或原发性高血压,但越来越多的继发性动脉高血压病例被诊断出来,要么是由于内分泌、肾脏或神经系统原因。Caso Clínico Hipertensión动脉继发性高醛固酮增多症原发性高血压Nelson Rodrigo González González, Miguel Ferreira Bogado, hcv . tor Cano Arrieta 3 Rev. Nac。(itaugu) 2019;11(1):116-123 10.18004/rdn2019.0011.01.116-123接下来,报告1例继发至原发性高醛固酮增多症高血压病例。
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引用次数: 0
Comorbidities of nervous anorexia and bulimia in pediatrics 神经性厌食症和小儿贪食症的合并症
Pub Date : 2019-06-30 DOI: 10.18004/RDN2019.0011.01.017-026
L. Sanchez, Wilian Rene Albrecht Roman, Mirta Noemí Mesquita Ramírez
Introduction: eating disorders should be considered in mental health plans, since it is one of the problems that has experienced the greatest growing in the young population. It is a multifactorial disease that is associated with psychiatric comorbidities such as depression, anxiety, obsessive-compulsive disorder, substance use or substance abuse disorder, and suicide attempts. Objectives: to describe the comorbidities of anorexia and bulimia nervosa in patients older than 10 years, at a Hospital General Pediátrico Niños de Acosta Ñu (San Lorenzo, Paraguay). Methodology: observational, descriptive, retrospective, cross-sectional study of patients older than 10 years who come to a consulted at a Hospital General Pediátrico Niños de Acosta Ñu with diagnosis of anorexia and bulimia nervosa, period 2011-2016. Variables studied: age, sex, origin, years of schooling, reason for consultation, height, body mass index, comorbidity, type of comorbidity. Data analyzed with Epi Info 7 using descriptive statistics. Study was approved by the Institutional Ethics Committee with the release of informed consent. Results: 59 patients with diagnosis of anorexia and/or bulimia nervosa were included. The mean age was 14.7 years, with predominance of females (91.5%), from the Central Department (86.4%). Median age of schooling: 9 years. Main reason for consult irritability (58/59). Presented with risk of short stature and Rev. Nac. (Itauguá) 2019;11(1):17-26 10.18004/rdn2019.0011.01.017-026 short stature of 57.6%. The body mass index was normal in 47.5%. The psychiatric comorbidity was found in 98.3% and depression being the most frecuent (88.1%). Conclusions: the frequency of comorbidity in children was high (98.3%) and the most important was depression (88.1%).
导言:饮食失调应该在心理健康计划中考虑,因为它是在年轻人口中经历了最大增长的问题之一。这是一种多因素疾病,与精神合并症有关,如抑郁、焦虑、强迫症、物质使用或物质滥用障碍以及自杀企图。目的:描述Pediátrico Niños de Acosta Ñu总医院(San Lorenzo,巴拉圭)10岁以上患者厌食症和神经性贪食症的合并症。方法:观察性、描述性、回顾性、横断面研究,对2011-2016年期间在Pediátrico Niños de Acosta Ñu总医院就诊的10岁以上诊断为厌食症和神经性贪食症的患者进行研究。研究变量:年龄、性别、出身、受教育年限、就诊原因、身高、体重指数、合并症、合并症类型。Epi Info 7使用描述性统计对数据进行分析。研究得到了机构伦理委员会的批准,并发布了知情同意书。结果:共纳入59例诊断为厌食症和/或神经性贪食症的患者。平均年龄14.7岁,以女性居多(91.5%),来自中科(86.4%)。平均受教育年龄:9年。咨询烦躁的主要原因(58/59)。有身材矮小的危险,还有Nac牧师。(itaugu) 2019;11(1):17-26 10.18004/rdn2019.0011.01.017-026身材矮小57.6%。47.5%的体重指数正常。精神合并症占98.3%,其中以抑郁症最常见(88.1%)。结论:患儿合并症发生率较高(98.3%),其中以抑郁症发生率最高(88.1%)。
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引用次数: 1
Clinical features of in-hospital anemia 院内贫血的临床特点
Pub Date : 2019-06-30 DOI: 10.18004/RDN2019.0011.01.056-067
A. A. M. Díaz, A. Aveiro
Introduction: in-hospital anemia is the decrease in hemoglobin values (Hb) during hospital stage below the admission values, not associated with objective blood loss. This is a frequent phenomenon that can affect the clinical evolution. Objective: to determine the clinical characteristics of intrahospital anemia in patients hospitalized in the Department of Internal Medicine of the Hospital Nacional de Itauguá from February to November 2018. Methodology: observational, prospective, descriptive study of transverse cut made in patients of both sexes, older than 15 years admitted in the Department of Internal Medicine. Anemia was considered to be any decrease in Hb of more than 2 mg / dL after 15 days of hospitalization. Results: 80 patients were studied, from which 44% were women and 56% were male. The mean age was 52 ± 17 years. 72% presented anemia. The patients admitted with a mean Hb value of 13 ± 1 g / dL and a hematocrit (Hct) of 38 ± 8%. After 15 days, a decrease in the mean Hb value was at 11 ± 2 g / dL and Hto at 33 ± 5%. At 30 days the mean Hb was 10 ± 2 g / dL and Hto 31 ± 5%. The amount of blood extracted for studies was an average of 348 ± 214 cc. The presence of infection and the use of antibiotics during hospitalization were detected in 83% of the patients studied. Conclusion: intrahospital anemia had a high frequency (72%) in the sample studied. It is multifactorial and is usually an underestimated diagnosis, a situation that should change given the implications in intra and extra hospital morbidity and mortality.
简介:院内贫血是指住院期间血红蛋白值(Hb)低于入院值,与客观失血无关。这是一种常见的影响临床发展的现象。目的:了解2018年2 - 11月国立伊塔古医院内科住院患者院内贫血的临床特点。方法:观察性、前瞻性、描述性研究在内科收治的年龄大于15岁的男女患者中横切。住院15天后Hb下降超过2 mg / dL被认为是贫血。结果:共纳入80例患者,其中女性44%,男性56%。平均年龄52±17岁。72%出现贫血。入院患者的平均Hb值为13±1 g / dL,红细胞压积(Hct)为38±8%。15天后,平均Hb值下降11±2 g / dL, Hto下降33±5%。30天平均Hb为10±2 g / dL, Hto为31±5%。研究的采血量平均为348±214毫升,83%的患者在住院期间检测到感染和抗生素的使用。结论:院内贫血发生率高(72%)。它是多因素的,通常被低估的诊断,考虑到院内和院外发病率和死亡率的影响,这种情况应该改变。
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引用次数: 0
Uses of information and communication technologies in the Career of Nursing, UNA, Paraguay 2017 信息和通信技术在护理职业中的应用,联合国,巴拉圭,2017年
Pub Date : 2019-06-30 DOI: 10.18004/RDN2019.0011.01.027-038
Cornelia Bernal Céspedes
Introduction: the introduction of Information and Communication Technologies is a challenge for the teaching-learning process, however, its inclusion is fundamental to the education success. Objetive: this work objective raises to describe the teachers competencies in the using of Information and Communication Technologies, Career Nursing, Headquarters, School of Nursing and Obstetrics of the National University of Asuncion, during the year 2017, arranged in three cognitive, procedural and attitudinal components. It is an observational descriptive study, with a quantitative approach, cross-sectional, probabilistic sampling approach. Metodology: it includes 109 teachers as a sample, an instrument with 40 reagents was applied, for the cognitive measurement and procedural components, a closed structured questionnaire was used, and for the Attitudinal component was applied a questionnaire with measurement according to Likert scale with values from 1 to 5. Results: the result reflects that teachers have basic level cognitive competence, that audiovisual and computer media are the most used by teachers and a positive attitudinal component for the integration of Information and Communication Technologies in the teaching-learning process. Conclusion: it is recommended to create spaces to develop knowledge and progressively incorporate Information and Communication Technologies in the practice of teaching, ensure accessibility to a network and program ongoing training plans. Rev. Nac. (Itauguá) 2019;11(1):27-38 10.18004/rdn2019.0011.01.027-038
导言:信息通信技术的引入对教学过程是一个挑战,然而,信息通信技术的引入是教育成功的基础。目的:本工作目的提出描述教师在2017年使用信息和通信技术,职业护理,总部,亚松森国立大学护理和产科学院的能力,分为三个认知,程序和态度组成部分。这是一项观察性描述性研究,采用定量方法,横断面,概率抽样方法。研究方法:以109名教师为样本,采用40种试剂,认知测量和程序成分采用封闭式结构化问卷,态度成分采用李克特量表(Likert scale) 1 ~ 5分测量问卷。结果:教师具有基本的认知能力,视听媒体和计算机媒体是教师使用最多的媒体,是教师在教学过程中整合信息通信技术的积极态度组成部分。结论:建议创建发展知识的空间,逐步将信息和通信技术纳入教学实践,确保网络的可访问性,并制定持续的培训计划。启南汽。(itaugu) 2019;11(1):27-38 10.18004/rdn2019.0011.01.027-038
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引用次数: 0
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Revista del Nacional Itaugua
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