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A partir de la emergencia del SARS-CoV-2 en el mundo se desató la pandemia por COVID-19 que afectó a 185 países; aparecieron numerosas publicaciones científicas presentando datos epidemiológicos, clínicos, estadísticos y microbiológicos. La elevada mortalidad ha implicado la necesidad de contar con datos cada vez más precisos con relación al virus y a su comportamiento en el medio y, por otro lado, enfrentó a los equipos de salud con un grave problema con relación al manejo seguro de cadáveres y a los riesgos de transmisión que ello implica. El objetivo del presente estudio ha sido detectar la presencia de ARN del SARS-CoV-2 en cadáveres remitidos a la Morgue Judicial de la Nación que no estuvieran comprendidos en la definición de caso sospechoso propuesta por el Ministerio de Salud de la Nación de la República Argentina. Se realizaron hisopados nasofaríngeos a 101 cadáveres elegidos aleatoriamente y basándose en criterios de inclusión para la detección de ARN viral mediante técnica RT-PCR. Se detectó ARN viral en el 16,8% de los cadáveres incluidos en el estudio. (AU)

Following the emergence of SARS-CoV-2 in the world, the COVID-19 pandemic broke out, affecting 185 countries. There have been numerous scientific publications presenting epidemiological, clinical, statistical, and microbiological data. The high mortality has implied the need for increasingly accurate data regarding the virus and its behaviour in the environment and, on the other hand, faced health teams with a serious problem in relation to the safe handling of corpses and the risks of transmission that this implies. The objective of this study was to detect the presence of SARS-CoV-2 RNA in corpses sent to the National Judicial Morgue that were not included in the definition of a suspected case submitted by the Argentine Ministry of Health. Nasopharyngeal and oropharyngeal swabs were taken from 101 cadavers chosen randomly and based on inclusion criteria for detection of viral RNA using the RT-PCR technique. Of the cadavers included in the study, 16.8%, not classified as suspected cases of COVID-19, were tested for the presence of viral RNA in the samples collected. (AU)

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INTRODUCTION: The main objective of this article is to describe ureterolysis and ovarian vein resection laparoscopic technique. SURGICAL TECHNIQUE: With the patient in a 45o flank position, 3 trocars are used, 1 of 12 mm in the umbilicus for the optic passage, and 2 of 5 and 10 mm inserted in right hypochondrium and iliac fossa, respectively, for the forceps and stapler passage. The ureter and ovarian vein are identified after the mobilization of the colon. Both structures are dissected, with one ovarian vein segment is resected between metallic clips. COMMENTS: the ureteral approach by transperitoneal laparoscopy and colon mobilization facilitates its dissection, identify its relation to other structures, as well as making possible the concomitant treatment of gynecological diseases. For the ovarian syndrome treatment, ureterolysis and ovarian vein resection are performed, using only 3 trocars. Owing to its simplicity, low morbidity, and good results obtained, this procedure represents a good option for the surgical management of this syndrome

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Major terrorist attacks in Argentina since 1990 have been limited to two bombings in Buenos Aires, which together caused 115 deaths and left at least 555 injured. Following these attacks, national, regional, and local institutions responsible for emergency response in Argentina sought to improve their planning and preparedness for terrorism-related events. In 1996, the national government enacted legislation, which launched the Sistema Federal de Emergencias (SIFEM) or Federal Emergency System under the direction of the president. Since 1997, several of Argentina's major cities have developed emergency plans for terrorism-related events, including intentional biological and chemical releases. Institutional participants in emergency preparedness for terrorism-related events include Emergency Medical Services, hospitals, and the public health system. Remaining challenges include: (1) Improving intra-agency coordination; (2) Improving intra-agency communication; and (3) Improving and expanding emergency response training programs for responders and the general population.

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INTRODUCTION: The main objective of this article is to describe ureterolysis and ovarian vein resection laparoscopic technique. SURGICAL TECHNIQUE: With the patient in a 45o flank position, 3 trocars are used, 1 of 12 mm in the umbilicus for the optic passage, and 2 of 5 and 10 mm inserted in right hypochondrium and iliac fossa, respectively, for the forceps and stapler passage. The ureter and ovarian vein are identified after the mobilization of the colon. Both structures are dissected, with one ovarian vein segment is resected between metallic clips. COMMENTS: the ureteral approach by transperitoneal laparoscopy and colon mobilization facilitates its dissection, identify its relation to other structures, as well as making possible the concomitant treatment of gynecological diseases. For the ovarian syndrome treatment, ureterolysis and ovarian vein resection are performed, using only 3 trocars. Owing to its simplicity, low morbidity, and good results obtained, this procedure represents a good option for the surgical management of this syndrome.

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Antecedentes: El manejo médico de los incidentes con víctimas múltiples constituyen un capítulo importante dentro de la medicina actual, en el cual el cirujano cumple un importante papel. Objetivo: Analizar una serie de casos asistidos en dos incidentes con víctimas múltiples (hecho N§ 1: recital de rock, y hecho N§ 2: manifestación popular contra el gobierno), y actualizar los conceptos fundamentales para su manejo clínico y quirúrgico. Lugar de aplicación: Servicios de Emergencias pre e intra hospitalarios. Diseño: estudio observacional retrospectivo basado en criterios básicos y descripción de hallazgos clínicos (serie de casos). Población: Muestra consecutiva de 310 casos de pacientes asistidos en dos incidentes urbanos con víctimas múltiples. Métodos: Se analizaron los registros clínicos de los pacientes de la población en estudio para determinar el sexo y la edad de los mismos, los diagnósticos que presentaron, el número de pacientes que requirió traslado a los distintos centros hospitalarios (y de ellos el número que debió ser intervenido quirúrgicamente), y el número de muertos observados en ambos hechos. Resultados: Hecho N§ 1 (recital de rock): Se asistieron a 125 pacientes. Se detallan los diversos diagnósticos realizados en los pacientes asistidos, de los cuales 69 (55,2 por ciento) requirieron traslado a centros hospitalarios y a sólo uno se le efectuó cirugía mayor (1,6 por ciento), falleciendo el mismo. Hecho N§ 2 (manifestación popular): Se asistieron a 185 pacientes. Se detallan los diversos diagnósticos realizados en los pacientes asistidos, de los cuales 68 (36,75 por ciento) requirieron ser trasladados a centros hospitalarios, efectuándose cirugía mayor a 38 (20,54 por ciento). Se observó mortalidad en 6 casos (3,24 por ciento). Conclusiones: Es muy importante que ante situaciones con víctimas múltiples, los cirujanos actuantes conozcan los conceptos fundamentales de la respuesta médico-quirúrgica que se debe llevar a cabo en éste tipo de situaciones, tanto en la atención inicial como durante el manejo secundario de los pacientes resultantes de las mismas

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Antecedentes: El manejo médico de los incidentes con víctimas múltiples constituyen un capítulo importante dentro de la medicina actual, en el cual el cirujano cumple un importante papel. Objetivo: Analizar una serie de casos asistidos en dos incidentes con víctimas múltiples (hecho Nº 1: recital de rock, y hecho Nº 2: manifestación popular contra el gobierno), y actualizar los conceptos fundamentales para su manejo clínico y quirúrgico. Lugar de aplicación: Servicios de Emergencias pre e intra hospitalarios. Diseño: estudio observacio

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A 20 year-old white man was admitted with fever and weight loss since 60 days previous to his admission and cardiac failure (functional class IV). The heart was enlarged in the echocardiographic examination without valvular involvement. Liver biopsy showed granulomatous hepatitis with a necrosis focus. The patient was treated with a combination of venous dilators and digital. Serum agglutination test for Brucella showed a titer of 1/250, and complement fixation 1/40. Seven days later, agglutination titer was 1/4000. He was treated with rifampin and trimethoprimsulfametoxazol. He got better; fever disappeared, and the signs of cardiac failure improved. Brucellosic myocarditis is an uncommon complication of brucellosis in the absence of endocarditis. In our knowledge, this case would be the first reported in Argentina and the third in adult patients out of the five cases reported worldwide.(Au)

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A 20 year-old white man was admitted with fever and weight loss since 60 days previous to his admission and cardiac failure (functional class IV). The heart was enlarged in the echocardiographic examination without valvular involvement. Liver biopsy showed granulomatous hepatitis with a necrosis focus. The patient was treated with a combination of venous dilators and digital. Serum agglutination test for Brucella showed a titer of 1/250, and complement fixation 1/40. Seven days later, agglutination titer was 1/4000. He was treated with rifampin and trimethoprimsulfametoxazol. He got better; fever disappeared, and the signs of cardiac failure improved. Brucellosic myocarditis is an uncommon complication of brucellosis in the absence of endocarditis. In our knowledge, this case would be the first reported in Argentina and the third in adult patients out of the five cases reported worldwide.

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