RESUMO
Resumen La pandemia por el coronavirus 2 del síndrome respiratorio agudo severo (SARS-CoV-2), (coronavirus disease-19 [COVID-19]), ha alterado por completo toda la realidad mundial con repercusiones económicas, sociales y grandes compromisos de los sistemas de salud. La enfermedad ha afectado a todos los países en los 5 continentes; y en nuestro país, desde el primer caso, se han venido tomando medidas para prepararnos mejor ante esta crisis. Pese a que se trata de un virus respiratorio, se ha documentado su presencia en diferentes tejidos y órganos de los seres humanos. Aunque la presentación clínica en su mayoría tiene síntomas leves, se sabe que un porcentaje importante tiene manifestaciones graves que pueden llevar a complicaciones graves y la muerte. El cáncer colorrectal es un tumor prevalente en nuestra población y obliga a tener una mejor preparación para tratarlo durante este período. Desde la Asociación Colombiana de Coloproctología, basados en los diferentes reportes de la literatura, en las recomendaciones de las diferentes asociaciones internacionales y en nuestra propia experiencia, se realiza una revisión del cáncer colorrectal durante la pandemia de COVID-19 y se comparten algunas recomendaciones para el manejo de los pacientes con esta patología revisando las diferentes opciones de manejo según la presentación de la enfermedad.
Abstract The economic and social repercussions and the enormous commitment required of health care systems by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic (coronavirus disease [COVID-19]) has completely altered world reality. The disease has affected all countries on all five continents. In Colombia, from diagnosis of the very first case, measures have been taken to better prepare ourselves for this crisis. Although it is a respiratory virus, its presence in various human tissues and organs has been documented. Despite the fact that its clinical presentation is most often in the form of mild symptoms, a significant percentage of those infected have severe manifestations that can lead to serious complications and death. Colorectal cancer is a prevalent tumor in our population, and this pandemic forces to prepare ourselves better to treat it during this period. The Colombian Coloproctology Association has reviewed reports in the literature and recommendations of various international associations and on our own experience with colorectal cancer during the COVID-19 pandemic. We present our recommendations for management of patients with this pathology and review management options according to disease presentation.
Assuntos
Humanos , Pacientes , Vírus , Neoplasias Colorretais , Coronavirus , Atenção à Saúde , Pandemias , LiteraturaRESUMO
Aunque el síndrome de Mirizzi fue descrito hace más de 100 años, su diagnóstico prequirúrgico sigue siendo un gran reto; usualmente es un hallazgo del acto quirúrgico lo cual puede generar no solo mayor tiempo de la cirugía sino complicaciones como fístula, lesiones de la vía biliar, etc. Para el diagnóstico existen muchas alternativas como: CPRE, TAC, RNM, etc., pero ninguna es ideal dado sus falsos negativos o riesgos. En este trabajo presentamos dos pacientes a las cuales se les diagnosticó este síndrome utilizando por primera vez la ecoendoscopia, y se realiza además una revisión de la literatura.
Although Mirizzi syndrome was first described more than a hundred years ago, pre-surgical diagnosis continues to pose a challenge. This syndrome is usually found during surgery. For that reason it has the potential for making the surgical procedure longer and for the development of complications such as fistula and biliary duct lesions. None of the procedures for diagnosis of the syndrome (including ERCP, CT, RNM, etc.) are ideal because of false negative results and the risks involved. This paper presents the cases of two patients who were diagnosed with Mirizzi syndrome with endoscopic ultrasound (EUS), and also presents a review of the literature.
Assuntos
Humanos , Feminino , Adulto Jovem , Pessoa de Meia-Idade , Colangiografia , Colelitíase , EndossonografiaRESUMO
Solvent abuse during pregnancy may cause "fetal solvent syndrome", which is characterized by mild brain atrophy and associated with behavioral, cognitive, and emotional abnormalities. The present study investigated whether solvent inhalation during the preweaning period (P2-P21) alters the morphological maturation of frontal, parietal, and occipital cortical neurons. Twelve hours after delivery (postnatal day 0, P0), litters were cross-fostered, culled to 8 pups/dam and housed together with a dam in standard laboratory cages. Litters were randomly assigned to the "air-only" group (n=64, 8 litters) and to the "solvent-sniffer" group (n=72, 9 litters). During P2-P21, each animal was exposed daily to either organic solvent vapors (75% toluene and 18% n-hexane, a solvent mixture commonly found in glues and adhesives) or clean air. To determine the impact of early solvent inhalation on cortical neuronal differentiation, brains were stained using the Golgi-Cox-Sholl procedure to quantitatively assess neocortical pyramidal cell dendrogenesis. Preweaning, solvent-exposed animals displayed dramatic impairments in dendritic growth as well as significant reductions in brain weight and size.