Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Intra-abdominal sepsis is one of the most important causes for which patients are treated in emergency services, regardless of their etiology. A bibliographic review of the databases of pubMed, Cochrane Library, UpToDate related to intra-abdominal sepsis, as well as trauma-related injury control books, in addition to the request for the Biostatistics database of the Hospital México, of the patients with a diagnosis of acute appendicitis with generalized peritonitis and acute diverticulitis with acute peritonitis in the years from 2015-2018; and a questionnaire of 8 questions related to the topic. The objective is to have a correlation of international and national information, to provide a current perspective of the management of patients with abdominal emergencies that require damage control.  

La enfermedad pélvica inflamatoria corresponde a un desorden ginecológico inflamatorio con repercusiones potenciales en el sistema reproductor femenino. Se define como la inflamación del aparato genital superior, con compromiso que va desde el endometrio hasta las trompas uterinas, ovarios, anexos y hasta peritoneo. Se debe principalmente al ascenso de microorganismos patógenos, en su mayoría relacionados a enfermedades de transmisión sexual, que generan una disrupción de las barreras naturales con posterior propagación de microbios. A pesar de que su diagnóstico continúa siendo un reto, la pronta instauración de medidas terapéuticas se considera vital para reducir complicaciones a largo plazo.

Nowadays, a large number of tests use contrast media. These are part of the daily routine of medicine, since they are key in the diagnosis, staging and treatment of a large number of pathologies. In consequence, there has been an increase  in the complications derived from their use, one of them, extravasation of contrast media. This adverse event, although rare, can have serious implications. This article reviews the general characteristics of contrast media as well as current information about the prevention and management of extravasation of contrast media.

Primary Sjögren's syndrome is a systemic autoimmune disease that mainly affects exocrine glands and confers an increased risk of developing lymphomas compared with the general population and even with other autoimmune diseases. It is the most severe comorbidity that occurs in this entity, which increases its mortality. Clinical, serological and histological characteristics have been studied to predict the development of these lymphoproliferative disorders. The most common symptom in this group is unilateral parotid enlargement and they are mainly non-Hodgkin's lymphomas, extranodal marginal lymphoma, derived from mucosa-associated lymphoid tissue or MALT type being the most common between them. It is believed that its development is due to antigenic stimulation of reactive and polyclonal B cells which causes expansion and transition to monoclonal B cells, and together with activation of signaling pathways perpetuates cell proliferation; currently, target therapy directed against the activation of these cells is being studied. Most of these lymphomas have an indolent course and are localized, so they just need surveillance, in case of aggressive or disseminated disease the use of polychemotherapy plus rituximab is preferred.

La tuberculosis (TB) es una de las enfermedades más antiguas que ha afectado a seres humanos y es una causa importante de muerte a nivel mundial. La tuberculosis es una enfermedad frecuente en nuestro país cuya incidencia ha aumentado a través de los años debido a las migraciones poblacionales, deterioro de las condiciones económicas, tratamientos inmunosupresores y aumento en la incidencia de pacientes VIH positivos.   Se presenta el caso de una paciente de 27 años con diagnóstico previo de quiste de Bartholino recurrente, posteriormente diagnosticada con Granuloma vulvar persistente con formación de fistula y lesión verrugosa al tacto rectal, finalmente se diagnostica con TB intestinal con fistula en vulva.   La TB intestinal es un reto diagnóstico ya que carece de manifestaciones clínicas y analíticas específicas.  Además, las lesiones endoscópicas son muy parecidas a las de otras enfermedades más frecuentes, como la enfermedad de Crohn. En el caso de esta paciente fue necesario un equipo interdisciplinario y múltiples estudios para lograr un diagnóstico certero. Sin duda un reto diagnóstico.

A 65-year-old male attended the emergency department with acute onset constitutional symptoms and fever. Acute kidney injury and a mixed pattern on liver function test were documented, oral antibiotic therapy was started and the patient was discharged, nonetheless, he reattended the emergency department a week later due to neurological symptoms; a third and ninth nerve palsies were diagnosed. Further studies confirmed the diagnosis of Leptospirosis.

Polymorphous light eruption (PLE) is a skin disease related to ultraviolet radiation, and thus it is usually present in anatomical areas that are exposed to sunlight. Its morphology can vary from one person to another; however, it usually presents itself with only one form on a single patient; the most common of which is the papular variant. There is a higher prevalence of this disorder in people with white skin and in females, while climate and latitude are also contributing factors.

Abstract: In the forensic evaluation of body damage, it´s frequent for patients to simulate pain without a real organic cause. Malingering can be defined as the intentional production of physical or psychological symptoms, for an identifiable secondary gain, usually economic. The purpose of this paper is to study chronic lumbar pain malingering in workers, in order to provide guidelines in reference to its assessment. Thus, a systematic review of scientific articles was done, using the BINASS databases and consulting textbooks from the Legal Medicine Department Library. The results indicate that the evaluating doctor should suspect malingering, whenever there are discrepancies between the symptoms the patient is referring and the present objective findings. There are some tools available for the forensic doctor to detect malingering, which involve a complete and detailed clinical history and a straightforward and thorough physical exam, including tests and signs (Waddell´s signs for example) that can help identify inconsistencies. There is no specific test that can detect simulation on its own, but rather a combination of diagnostic tools that can allow to perform a more objective evaluation.

Counseling and providing adolescence contraception must be a pediatrician's competence, reversible long-acting contraception (LARC) is the safest and most appropriate way to prevent teenage pregnancy. Etonogestrel subdermal contraceptive implant (ISAeto) offers contraception for three years through the inhibition of ovulation and thickening of the cervical mucus, the application of this method requires adequate training, which can be offered with simulation models. Resident physicians of the postgraduate of pediatrics of the University of Costa Rica who have a medical rotation in the Clinic of Adolescents of the Hospital Dr. R.A. Calderón Guardia conducted an ISAeto application training practice in simulation models, after which the perception of their ability to provide contraceptive counseling and administer the ISAeto was evaluated, which was generally assessed as excellent.