RESUMO
BACKGROUND: COVID-19 pandemic varies greatly and has different dynamics in every country, city, and hospital in Latin America. Obesity increases the risk of SARS-CoV-2 infection, and it is one of the independent risk factors for the most severe cases of COVID-19. Currently, the most effective treatment against obesity available is bariatric and metabolic surgery (BMS), which further resolves or improves other independent risk factors like diabetes and hypertension. OBJECTIVE: Provide recommendations for the resumption of elective BMS during COVID-19 pandemic. METHOD: This document was created by the IFSO-LAC Executive Board and a task force. Based on data collected from a survey distributed to all IFSO-LAC members that obtained 540 responses, current evidence available, and consensus reached by other scientific societies. RESULTS: The resumption of elective BMS must be a priority maybe similar to oncological surgery, when hospitals reach phase I or II, treating obesity patients in a NON-COVID area, avoiding inadvertent intrahospital contagion from healthcare provider, patients, and relatives. Same BMS indication and types of procedures as before the pandemic. Discard the presence of SARS-CoV-2 within 72 h prior to surgery. Continues laparoscopic approach. The entire team use N95 mask. Minimum hospital stays. Implement remote visits for the follow-up. CONCLUSION: Resumption of elective BMS is crucial because it is not only a weight loss operation but also resolves or improves comorbidities and appears to be an immune restorative procedure of obese patients in the medium term, offering them the same probability of contracting COVID-19 as the regular population.
Assuntos
Cirurgia Bariátrica , Betacoronavirus , Infecções por Coronavirus , Obesidade Mórbida/cirurgia , Pandemias , Pneumonia Viral , COVID-19 , Procedimentos Cirúrgicos Eletivos , Humanos , América Latina , Guias de Prática Clínica como Assunto , SARS-CoV-2 , Inquéritos e QuestionáriosRESUMO
We review the clinical files of patients who entered the Regional General Hospital No. 20 IMSS in the City of Tijuana Mexico between May 1994 and May 2004 with diagnosis of primary acute pericardial disease. Patients diagnosed as having active tuberculous pericardial effusion were eligible for the study. Twenty-one were included in the study (14 men and 7 women). The aged ranged from 16 to 48 years (mean 36 years). The diagnosis was made by the following studies: identification of tubercle bacilli in the pericardial fluid or tissue (n = 4), identification of caseating granulomas in the pericardium or elsewhere (n = 2), positive culture for Mycobacterium tuberculosis in pericardial fluid (n = 8), in pleural fluid (n = 1), sputum culture (n = 3), gastric aspirate samples (n = 1), lymph node biopsy (n = 1), and pericardial effusion without obvious cause, responding to antituberculous therapy (n = 5). The clinical, laboratory, electrocardiography, radiographic, and echocardiography features were analyzed. We review in each patient follow-up, pericardial fluid cytology, and pericardial biopsy, if available. All patients had pericardial effusion; nine (42.8%) patients had cardiac tamponade. Pericardiocentesis was performed in 16 patients, "therapeutic" pericardiocentesis was performed in 43.7%, and "diagnostic" pericardiocentesis was performed in 56.2% all cases. Constrictive pericarditis developed in two patients, all required partial pericardiectomy. All patients received triple antituberculous chemotherapy. No patient died.
Assuntos
Pericardite Tuberculosa , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pericardite Tuberculosa/diagnóstico , Pericardite Tuberculosa/terapia , Estudos Retrospectivos , Fatores de TempoRESUMO
We review the clinical files of patients who entered the Regional General Hospital No. 20 IMSS in the City of Tijuana Mexico between May 1994 and May 2004 with diagnosis of primary acute pericardial disease. Patients diagnosed as having active tuberculous pericardial effusion were eligible for the study. Twenty-one were included in the study (14 men and 7 women). The aged ranged from 16 to 48 years (mean 36 years). The diagnosis was made by the following studies: identification of tubercle bacilli in the pericardial fluid or tissue (n = 4), identification of caseating granulomas in the pericardium or elsewhere (n = 2), positive culture for Mycobacterium tuberculosis in pericardial fluid (n = 8), in pleural fluid (n = 1), sputum culture (n = 3), gastric aspirate samples (n = 1), lymph node biopsy (n = 1), and pericardial effusion without obvious cause, responding to antituberculous therapy (n = 5). The clinical, laboratory, electrocardiography, radiographic, and echocardiography features were analyzed. We review in each patient follow-up, pericardial fluid cytology, and pericardial biopsy, if available. All patients had pericardial effusion; nine (42.8%) patients had cardiac tamponade. Pericardiocentesis was performed in 16 patients, [quot ]therapeutic[quot ] pericardiocentesis was performed in 43.7%, and [quot ]diagnostic[quot ] pericardiocentesis was performed in 56.2% all cases. Constrictive pericarditis developed in two patients, all required partial pericardiectomy. All patients received triple antituberculous chemotherapy. No patient died.