International Journal of Medical and Surgical Sciences
International Journal of Medical and Surgical Sciences, (IJMSS) is a serial and peer-review publication, edited by the Universidad Autónoma de Chile. IJMSS has an international scope and is open access. The contents are available immediately after being published. Until 2024, the journal used the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). Starting in 2025, all publications are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). Objective: To publish original research papers within the medical and surgical sciences, on all basic scientific aspects of structure, chemistry, developmental biology, physiology and pathology of relevant tissues, microbiology, biomaterials, and behavioral sciences. In general, analytical studies are preferred to descriptive ones. Vision: IJMSS seeks to be a space for academic discussion and multidisciplinary dialogue in the area of biomedical, medical and surgical sciences in all its aspects, which contributes to scientific communication between research peers and academics in the area. Aimed to professionals and academics in the field of medical and surgical sciences, health administration, and related specialties. The Journal Publishes in continuous publication schema (four issues per year), original articles, reviews, short communications and letters to the editor in English and Spanish. The IJMSS has no article processing charges (APC) or article submission charges for any of the editorial processes or publication. e-ISSN 0719-532X p-ISSN 0719-3904
The publication is distributed under the Creative Commons Attribution-4.0 International (CC BY 4.0) license. The rights to the works published in this journal are the property of the author, who is free to distribute and disseminate them, provided that the source is correctly cited.
Lichen sclerosus and thyroid autoimmunity: a timely call for routine TSH and anti-TPO screening
Copyright (c) 2025 Jesús Manuel Gómez De Ávila, Rita Maria Carballo Velasco, Laura Isabel Sanchez Zapata, María Camila Arredondo, Michael Ortega Sierra https://creativecommons.org/licenses/by/4.0
Word recognition under simplified optimal presentation level: a scoping review of oral vs. digital word lists
The evaluation of word recognition plays a key role in contemporary audiology, amid a growing debate on the advantages of digitized testing compared with traditional live-voice presentation. This scoping review analyzed studies published between 2020 and 2025, following the PRISMAScR methodology, to compare both modalities and to examine the use of the simplified optimal presentation level (PTA + 30 dB). Findings indicate that digitized word lists provide greater reliability, repeatability, and interexaminer consistency than live-voice presentation. Significant technological progress has been observed, including the development of mobile applications that promote automation and standardization of evaluations. However, major limitations persist, such as the limited adoption of the fixed-intensity criterion (PTA + 30 dB) and the absence of robust statistical analyses, including Bland-Altman plots and intraclass correlation coefficients. Although digitalization has solid methodological foundations, further research employing rigorous comparative designs, advanced reliability analyses, and validation through neurophysiological correlates is required to consolidate its implementation as a clinical standard.
Copyright (c) 2025 Genesis Olguin Hurtado, Mariano Guillermo Blake https://creativecommons.org/licenses/by/4.0
Eating Disorders in University Students and Their Relationship with Body Image
University students are a population at particular risk for developing eating disorders, influenced by body image dissatisfaction and lifestyle factors. Despite this, little is known about how eating disorder risk relates to objective body composition measures and perceived body image in this group. The aim was to assess the risk of developing eating disorders in university students using the SCOFF questionnaire and correlate the findings with body composition and body image perception. A total of 500 students, both male and female, aged 18 to 30 years old, were evaluated anthropometrically using the InBody 270 device. Body image perception was assessed using Stunkard’s silhouettes, and participants completed the five-question SCOFF questionnaire. A high prevalence of eating disorders risk (44 %) was observed, with a significant association with sex (chisquare, p < 0.01), as women showed a higher frequency of risk (63 %). Individuals at risk of EDs had higher weight, BMI, body fat, and lower muscle mass (t-test, p = 0.001, p = 0.000, p = 0.0001, and p = 0.01, respectively). A significant relationship was also found between eating disorder risk and body image dissatisfaction (chi-square, p < 0.0001). Risk analysis revealed that females are 2.5 times more likely to develop eating disorders, and body image dissatisfaction increases this risk by fourfold. The most common condition identified was binge eating disorder, affecting 63 % of at-risk individuals. The high frequency of eating disorders observed among university students is notable, with associated risk factors, such as sex and body image perception, aligning with previous findings. The results highlight that female sex, body image underestimation, and dissatisfaction are key risk factors for developing eating disorders. These findings support the development of targeted interventions to prevent this condition.
Copyright (c) 2025 Maitte Orellana, Mónica Andrews https://creativecommons.org/licenses/by/4.0
Does supine positioning improve the surgical treatment of shaft fractures of the clavicle?
Surgical management of diaphyseal clavicle fractures has increased in recent years. It is well established that upright radiographs more accurately assess fracture displacement compared to those taken in the supine position. This study investigates the influence of the supine position during surgical treatment of these fractures. A retrospective study was conducted on 22 patients: 11 operated in the supine position (Group A) and 11 in the beach chair position (Group B). Demographic data, quality of fracture reduction, surgical time, and operative room occupancy time were analyzed. Patients were comparable in terms of age, sex, and fracture type. The median follow-up was 7 months (range: 3-12). The operative room occupancy time was 120 minutes (range: 85-140) in Group A versus 180 minutes (range: 170-185) in Group B, showing a statistically significant difference (p < 0.01). Surgical time was 80 minutes (range: 58-95) in Group A compared to 100 minutes (range: 90-125) in Group B (p < 0.05). Satisfactory fracture reduction was achieved in all 11 patients in Group A and in 8 patients in Group B (p = 0.0104). Supine positioning for osteosynthesis of diaphyseal clavicle fractures appears to be a favorable option due to advantages in fracture reduction and patient positioning, without an observed increase in complications.
Copyright (c) 2025 Patricia Crespo Lastras https://creativecommons.org/licenses/by/4.0
Morpho-spiro-voice-acoustic differences between smokers and non-smokers
The organs most impacted by tobacco smoke are primarily those of the respiratory system, along with the vocal cords. This study aims to determine the significant differences in morphospirometric and voice-acoustic variables between non-smokers and smokers, emphasising the substantial effects of smoking on health and vocal quality. Two morphometric variables, eight spirometric variables, and thirteen voice-acoustic variables were measured in 117 male Albanian subjects from Kosovo (78 non-smokers and 39 smokers). Statistical analysis was performed using SPSS version 20. The data were examined using descriptive statistics (arithmetic means, minimum and maximum values, and standard deviation), independent samples t-test, and discriminant canonical analysis. Discriminant statistical parameters indicate that the group of non-smokers significantly (p < 0.00- 0.05) differs from the group of smokers, showing lower body weight (within normal limits), higher spirometric parameters (within normal limits), and greater voice amplitude. No significant differences were observed between the groups in variables such as stature, PIF (peak inspiratory flow), jitter variables (voice period variability), and the fundamental frequency of the voice sample. Based on the Wilks’ Lambda value, it can be concluded that spirometric variables (Wilks’ Lambda = 0.56) provide better discrimination between smokers and non-smokers compared to voice-acoustic variables (Wilks’ Lambda = 0.66).
Copyright (c) 2025 Behlul Brestovci, Agron Rexhepi https://creativecommons.org/licenses/by/4.0
Prevalence of musculoskeletal disorders in clinical laboratory personnel in the city of Riobamba, Ecuador
Introduction: Clinical laboratory personnel are exposed to multiple occupational hazards. However, most studies have focused on biological, physical and chemical risks, with little information on ergonomic risks and their relationship with musculoskeletal disorders (MSDs) in this population. Objective: To determine the prevalence of MSDs in clinical laboratory personnel in the city of Riobamba, Ecuador, and their association with personal and organizational factors. Methodology: Descriptive, observational, cross-sectional study conducted between June and November 2024. The Standardized Nordic Questionnaire to assess the presence of musculoskeletal symptoms in nine body regions: neck, shoulders, elbows, wrists/hands, upper back, lower back, hips/thighs, knees and ankles/feet, together with a survey on sociodemographic and organizational variables, was applied to 40 technicians and professionals from four private clinical laboratories in the city of Riobamba, Ecuador. A descriptive analysis was performed using absolute and relative frequencies, and Pearson’s Chi-square test was used to evaluate associations between variables. GraphPad Prism software version 8.0 was used, considering a value of p < 0.05 as statistically significant. Results: 71.3 % of the participants reported musculoskeletal symptoms. The most affected body areas were the trunk (37.15 %), neck (15.33 %), shoulders (14.46 %) and wrists (10.02 %). The highest prevalence was observed in the age group 26 to 50 years. A significant association was found between the presence of MSDs and female sex (p = 0.007), as well as with shift work (p = 0.049). Conclusion: The results show a high prevalence of MSDs in clinical laboratory personnel, which highlights the need to implement preventive measures aimed at the ergonomic redesign of the work environment, as well as training programs focused on the specific risks associated with these functions.
Copyright (c) 2025 Diego Tene Salcán https://creativecommons.org/licenses/by/4.0
Therapeutic revolution in the management of metastatic prostate cancer
Copyright (c) 2025 Aracelli Barría-Alfaro, Javiera Gajardo-Von Kunowsky, Andrés Vega-Avalos, Francisco Vidangossy https://creativecommons.org/licenses/by/4.0
Cancer research in Chile: beyond universities, contributions from The National Cancer Institute
Copyright (c) 2025 Juvenal A. Ríos Leal, MD, PhD, Ximena González, Berta Cerda, Ana María Ciudad, Isabel Abarca, Diego Rojas, Rossana Guerrero, Carmen Gloria San Martin https://creativecommons.org/licenses/by/4.0
Clinical utility of point-of-care ultrasonography in the patient on shock: A narrative review
Shock, a medical emergency characterized by inadequate perfusion and organ dysfunction, can be classified as distributive, hypovolemic, cardiogenic and obstructive. Point-of-care ultrasound (POCUS) has established itself as a fundamental tool in the differential diagnosis and therapeutic guidance in patients with shock. This article reviews the clinical utility of POCUS, highlighting its high diagnostic accuracy in differentiating types of shock, with sensitivities and specificities greater than 90% in scenarios such as hypovolemic and obstructive shock. In addition, the use of POCUS has been shown to improve diagnostic accuracy in the emergency department, optimize hydric resuscitation and reduce mortality in critical patients. Its implementation strengthens clinical decision making, integrating a rapid and effective diagnostic approach that favors interdisciplinary management to prevent multiorgan failure and death.
Copyright (c) 2025 Juan Santiago Serna - Trejos, Stefanya Geraldine Bermúdez – Moyano, Manuela Castaño – Orozco, Vanessa Montoya – Valencia, Juan Camilo Diaz – Beltrán, Melissa Martínez – Garcia, Henry Fernando Botero – Suárez https://creativecommons.org/licenses/by/4.0
Reel’s syndrome, an unusual cause of lead displacement
Background: Ventricular capture failure could be a sign of macrodisplacement. Electrode displacement is one of the complications related to cardiac pacing. Knowing the different production mechanisms of macrodisplacements is not just for a nominal distinction. It is important to understand that the mechanisms are different, that´s why each type of macrodisplacement requires different form of therapy. Case report: A 79-year-old male patient. On physical examination, the heart rate was 38 beats per minute. The 12-lead electrocardiogram (ECG-12) showed a second-degree 2:1 atrioventricular block. It was decided to implant a VVIR pacemaker. On follow-up, the ECG-12 review showed ventricular capture failure without spike and 2:1 atrioventricular block. The fluoroscopic study showed electrode displacement. The distal tip of the electrode was in the area of the pacemaker pocket with radiological appearance of thread wound on a reel. Reintervention was immediately decided, during surgery, the diagnosis of reel type macrodisplacement was corroborated. The lead was repositioned in the right ventricle. Conclusions: Knowledge of the risk factors allows us to avoid macrodisplacement syndromes of the electrode. Knowing the different mechanisms of production of the three syndromes described is of great importance to finally carry out the appropriate therapy.
Copyright (c) 2025 Armando E. Hernández Castellón, Fernando Rodríguez González, Juan Miguel Cruz Elizundia, Elibet Chávez-González https://creativecommons.org/licenses/by/4.0
From Anatomy to Algorithm: Scope of AI-Assisted Diagnostic Competencies in Health Sciences Education
The article explores the evolution of medical knowledge from its anatomical and functional foundations to the integration of advanced technological tools, focusing on the impact of artificial intelligence (AI) on the development of diagnostic competencies. Initially, medical training relied on direct observation and clinical judgment based on anatomical and surgical knowledge. Subsequently, the inclusion of physiology and pathology enabled a functional understanding of the human body, transforming diagnosis into a systematic skill supported by objective data such as laboratory tests and medical imaging. The integration of AI in recent decades has revolutionized this process, offering unprecedented capabilities to analyze complex clinical data. Tools such as machine learning algorithms and predictive systems have enhanced diagnostic precision, allowing for the identification of previously unnoticed patterns. This data-driven approach strengthens physicians’ ability to correlate clinical symptoms and signs with specific pathological entities. However, the incorporation of AI presents challenges in medical education. Future physicians must combine learning traditional clinical foundations with mastering advanced technologies, all while maintaining an ethical and patient-centered approach. Furthermore, excessive reliance on technology and biases inherent in algorithms underscore the need to balance technological innovation with human clinical judgment. The article highlights that medical education must adapt to include critical competencies such as digital literacy, ethical reasoning, and critical thinking. AI-based simulators and educational platforms are playing a key role in preparing physicians for a more digitized clinical environment, while research remains essential to ensure transparency and fairness in these technologies.
Copyright (c) 2024 Iván Suazo Galdames https://creativecommons.org/licenses/by-nc-nd/4.0
Effect of Orijin Bitters, Aqueous Extracts of Hibiscus Sabdariffa and Zingiber Officinale Roscoe on the Kidney of Adult Wistar Rats
Orijin bitters, Hibiscus sabdariffa and Zingiber officinale roscoe have been reported to possess various medicinal properties. The aim of the study is to evaluate their effects on the kidney of adult wistar rats. Methodology: thirty rats were randomly divided into 6 groups, each having 5 rats. Group 1 received distilled water, group 2, 70cl/70kg/bw orijin bitters, group 3, orijin bitters and 200mg/kg/bw Hibiscus sabdariffa calyx aqueous extract, group 4, orijin bitters and 500mg/kg/bw Hibiscus sabdariffa calyx aqueous extract, group 5, orijin bitters and 200mg/kg/bw officinale rhizome aqueous extract, group 6, orijin bitters and 500mg/kg/bw Zingiber officinale rhizome aqueous extract over a 21- day period. After administration, the rats were sacrificed and the kidney harvested for biochemical and histological analysis. Results: Orijin bitters altered renal function, indicated by elevated level of malondialdehyde and decreased level of superoxide dismutase, catalase and glutathione, along with histopathological changes such as glomerular atrophy and tubular degeneration compared to the control. The result was not statistically significant (P < 0.05). Conversely, aqueous extracts of Hibiscus sabdariffa calyx and Zingiber officinale rhizome exhibited antioxidant properties, reducing oxidative stress and mitigating renal damage compared to the orijin bitters group only. Although the result was not statistically significant (P < 0.05). Conclusion: Orijin bitters may have nephrotoxic effects, while Hibiscus sabdariffa and Zingiber officinale may offer protective benefits, due to their antioxidant properties.
Copyright (c) 2024 Sarah I. David, Godfrey Duru, Abigail Abraham, Samuel Victor Ita https://creativecommons.org/licenses/by-nc-nd/4.0
Subjective and objective evaluation of nasal obstruction in patients treated at the Hospital de Clínicas, Paraguay
Nasal obstruction is characterized by insufficient airflow and increased resistance in the nasal cavities, affecting patients’ quality of life and sleep. This study aims to compare the efficacy of medical and surgical treatment in patients with Nasal obstruction, using subjective evaluations (NOSE and VAS scales) and objective evaluations (active anterior rhinomanometry). This is an experimental and prospective longitudinal study conducted at the Hospital de Clínicas, Paraguay. Forty patients with Nasal obstruction were included, divided into medical treatment (nasal corticosteroids) and surgical treatment (turbinoplasty, septoplasty, or both) groups. Pre- and post-treatment evaluations were performed using the NOSE and VAS scales, and active anterior rhinomanometry. The sample included 52.5% men and 47.5% women, with an average age of 32.18±11.59 years. The main cause of Nasal obstruction was chronic rhinitis (62.5%). Treatments showed significant improvements in subjective and objective evaluations. In the medical group, VAS improved by 2.63 points in women and 2.00 in men, while the surgical group showed more pronounced improvements. The NOSE also showed significant reductions, especially in patients undergoing combined turbinoplasty and septoplasty. Active anterior rhinomanometry reflected an increase in overall nasal flow in all treated groups. Both medical and surgical treatments are effective in improving Nasal obstruction, with greater benefits observed in surgical treatments. Subjective and objective evaluations are valuable and complementary tools for assessing treatment in patients with Nasal obstruction. These results highlight the importance of a comprehensive evaluation in the management of Nasal obstruction.
Copyright (c) 2024 Rodrigo David González Insfrán, Ana Alicia María Benítez, Carlos Mena Canata, Enrique Pérez, Julio Heinichen https://creativecommons.org/licenses/by-nc-nd/4.0
Could glycated hemoglobin be considered a marker of inflammation in patients with diabetes mellitus?
La fisiopatología de la diabetes incluye la persistencia de un estado inflamatorio de bajo grado caracterizado por el incremento de citocinas proinflamatorias, proteínas de fase aguda y alteraciones en la respuesta inmunitaria que conllevan al desarrollo de complicaciones macrovasculares y microvasculares. Los mecanismos involucrados en la activación del estado inflamatorio no están totalmente esclarecidos, pero se sabe que la hiperglucemia juega un rol determinante. La hemoglobina glicada es en la actualidad el marcador biológico por excelencia utilizado para evaluar la evolución de los niveles de glucemia en los pacientes diabéticos debido a su formación irreversible y acumulativa, proporcionando información retrospectiva sobre el equilibrio glucémico durante dos a tres meses anteriores a su medición. Sin embargo, poco se conoce sobre su asociación con la respuesta inflamatoria en estos pacientes. El objetivo de esta investigación es recopilar evidencias que permitan establecer una asociación entre los niveles de HbA1c y el estado inflamatorio en pacientes con diabetes mellitus, lo que permitiría considerar a la HbA1c no sólo como una medida fiable para evaluar el control glucémico retrospectivo. Sino además, como un biomarcador asociado al estado inflamatorio y por consiguiente al riesgo de desarrollar complicaciones propias de esta enfermedad.
Copyright (c) 2024 Pablo Aguirre-Villegas, Adriana Pedreañez https://creativecommons.org/licenses/by-nc-nd/4.0
Syncope as a clinical presentation of cardiac lymphoma: a case report
Primary cardiac lymphoma, an extremely rare type of B-cell non-Hodgkin lymphoma, has an incidence of approximately 0.02-2% among malignant cardiac tumors. It is frequently associated with manifestations such as cardiac rhythm disturbances, refractory pericardial effusion and cardiac masses. Definitive diagnosis is achieved by biopsy, being essential to rule out hematogenous dissemination with PET-CT. The literature indicates a predominance of right chamber involvement and survival that varies significantly according to left ventricular involvement and the presence of arrhythmias. Therapeutic options are not well defined, but chemotherapy such as R-CHOP has shown efficacy, although the prognosis is generally poor due to complications such as disease progression, arrhythmias and sepsis. This case underscores the importance of considering cardiac lymphoma in patients with unexplained cardiac symptoms, highlighting the need for a multidisciplinary and specific diagnostic and therapeutic approach.
Copyright (c) 2024 Juan Santiago Serna–Trejos, Carlos Andrés Castro–Galvis, Stefanya Geraldine Bermúdez–Moyano, Laura Catalina Rodríguez–Fonseca, Jaqueline Paola Tipas–Cuespud, Isabella Caicedo–Ortiz, Juan David López–Ponce de León https://creativecommons.org/licenses/by-nc-nd/4.0
Protective Effects of Tigernut (Cyperus esculentus) on Bisphenol A- Induced Testicular Toxicity in Wistar Rats
Bisphenol A (BPA) have been reported to induced reprotoxicity in rats. This study was conducted to find out the ameliorative properties of aqueous extract of Cyperus esculentus (tigernut) on BPA induced testicular toxicity in Wistar rats. Methods: Twenty male rats were divided randomly into 4 groups (n=5): group A: (Control); group B: Bisphenol A (BPA) (25 mg/kg b.w/day); group C: tigernut (200 mg/kg b.w); group D: (25 mg/kg of BPA+ 200 mg/kg of tigernut extract. 25 mg/kg of BPA was dissolved in 0.2 ml of olive oil as vehicle and administration was given by oral gavage for 4 weeks. The body weights were measured. Blood were collected for the testosterone (T) and luteinizing hormone (LH) assays; the epididymis were processed for sperm count, sperm motility, sperm viability and sperm abnormality test; while the testes were harvested for histology Results: There was a significantly (p < 0.05) decreased in body weight; reduced (sperm count, motility, viability, serum testosterone and luteinizing hormone) in BPA compared with control group. These parameters however increased significantly (p < 0.05) in tigernut (200mg) and BPA + tigernut (200mg) compared with BPA. Also, histological examination showed widened interstitial spaces, some distorted seminiferous tubules, degeneration of basement membrane, scanty Leydig cells, fewer spermatozoa and vacuolation While BPA + tigernut (group D); showed improved testicular architecture (preserved interstitial spaces and interstitial cells. restoration of the loss of the basement membrane and closely packed seminiferous tubules with well-arranged germinal epithelium. Supplementation with tigernuts following BPA administration produces a reversal of the deleterious effect of BPA on the testis.
Copyright (c) 2024 Abraham Abigail , Idaguko Chika Anna https://creativecommons.org/licenses/by-nc-nd/4.0
Pediatric Patients with Acute Lymphoblastic Leukemia in Honduras: Demographic Characteristics, Clinical Features, and Laboratory Findings.
Approximately 90% of confirmed cancer cases annually are reported in low to middleincome countries. In Honduras, the incidence of pediatric cancer has been steadily increasing, accompanied by a higher cancer mortality rate attributed to diagnostic errors, limited access to healthcare, and management challenges. Diagnostic pitfalls, such as failure to recognize signs of malignancy, inadequate assessment of persistent symptoms, and misinterpretation of diagnostic tests, significantly impede effective cancer care. This retrospective case study collected data from 68 pediatric patients diagnosed with Acute Lymphoblastic Leukemia (ALL) at the Honduran Social Security Institute in Tegucigalpa between January 2015 and December 2022. Data retrieval encompassed demographic features, clinical characteristics, and laboratory findings. We used SPSS Statistics version 29.0.2.0 to perform all statistical analysis. The cohort comprised patients of equal gender distribution, with 42.6% (N: 29) belonging to the age group of 1 to 4 years. The hospital diagnosed an average of 8.5 cases each year. Fever was the most prevalent symptom, affecting 80.9% of patients (N: 55). Hemoglobin levels were below 10 mg/dL in 67.6% of patients, with 33.8% exhibiting levels below 7 mg/dL (N: 23) and equal proportion falling within the 7-10 mg/dL range (N: 23). Platelet levels were below 150,000/μL, with 48.5% experiencing severe thrombocytopenia (platelet levels <50,000/μL). Additionally, most patients presented phosphorus levels exceeding 4.5 mg/dl (N: 33, 48.5%), along with elevated LDH levels surpassing 500 U/l (N: 34, P: 50%). The presence of persistent fever should trigger suspicion of cancer, necessitating thorough assessment. Implementing guidelines outlining common symptoms and referral protocols could significantly reduce mortality in Honduran children with ALL.
Copyright (c) 2024 Isabel Ramos, Andrea María Sierra Barahona, Sarah Angelly Membreño Soto, Andrea Jacqueline Inés Rodas Figueroa , Clarissa Lizeth Aguilar Molina https://creativecommons.org/licenses/by-nc-nd/4.0
Chronic granulomatous intestinal disease: case report
Chronic intestinal granulomatous disease is a disorder that directly compromises the entire immune system. The estimated incidence is one in a million inhabitants. Among the associated risk factors, the presence of chronic and recurrent infections stands out. In the present case, it is a 39-year-old female patient with a history of intestinal obstruction and endometriosis, who presents abdominal pain in the left abdomen and recurrent abdominal pain without an identifiable cause. Laboratory tests revealed leukocytosis and mild neutrophilia. The tomography showed intestinal dilation at the jejunoileal level without transition zones, and the serological tests were negative. Exploratory laparoscopy was performed and the presence of tumor implants was found in the omentum, extending to the abdominal, uterine, intestinal, and peritoneal regions, as well as sallow fluid at the abdominal level. Tumor markers are normal. Histopathology details fungal colonization with eosinophilic necrosis and presence of granulomas, negative immunohistochemistry for Aspergillus and negative Lowestein-jensen culture. Antifungal and antituberculous treatment was started, with a decrease in symptoms and improvement in the clinical picture.
Copyright (c) 2024 Jesús Larco, Nicolás Larco, Byron Salgado, Nathalie Pungacho, Lizbeth Mayorga https://creativecommons.org/licenses/by-nc-nd/4.0
Case Reports on Anatomical Variations of the Hepatic Arteries: Implications for Laparoscopic Cholecystectomy and Surgical Safety
A laparoscopic surgeon’s understanding of embryology, anatomy, and potential anatomical variations of the bile duct is crucial for safely performing gallbladder removal using this minimally invasive technique. In conducting two medical-legal autopsies, we identified a previously undocumented anatomical variant where the liver’s blood supply originates from the common hepatic artery, branching into a trident formation to form the right, left, and cystic hepatic arteries. Notably, the right hepatic artery is situated within Calot’s triangle, whereas the cystic artery is located anomalously outside the triangle. This anatomical anomaly poses significant surgical risks, including the potential for morbidity and mortality due to ischemic necrosis of the liver from vascular injury. The success of laparoscopic surgery under these circumstances relies heavily on the surgeon’s expertise in managing an atypical surgical field, adherence to a culture of safety, and a critical approach to safety in laparoscopic cholecystectomy.
Copyright (c) 2024 Oscar Alonso Plaza-Patino, Luis Felipe Dorado-Ramírez, Yolibeth Rodríguez-Morales, Juan Pablo Zambrano-Zorrilla https://creativecommons.org/licenses/by-nc-nd/4.0
Giant Solitary Pulmonary Fibrous Tumor: Case Report
The giant pulmonary solitary fibrous tumor is a mesenchymal tumor of rare fibroblastic differentiation, preferably intrathoracic and intraoral. Not associated with specific risk factors. Non-specific clinical presentation and slow growth. The present case is of a 54-year-old patient with dyspnea on medium exertion with the presence of abolished left vesicular murmur. He developed refractory hypoglycemia leading to Doege Potter syndrome. A total occupying mass was evident in the left chest on computed axial tomography. A modified approach was performed by sternotomy plus left thoracotomy to improve exposure and hemodynamic control with access to the tumor’s nutritional vessels and total tumor excision. Histopathology revealed a heavier tumor reported in the medical literature. Microscopy presence of mesenchymal neoplasia composed of spindle-shaped and oval cells and positive immunohistochemistry of giant solitary pulmonary fibroma.
Copyright (c) 2024 Jesús Nicolás Larco Coloma, Marco Valenzuela Cifuentes, Milton Araujo Parra, Nathalie Estephania Pungacho Espin, Patricio Bucheli Proaño, Byron Salgado, Nicolás Larco Noboa https://creativecommons.org/licenses/by-nc-nd/4.0
Evaluation of wheat (Triticum aestivium L) diet on reproductive functions of adult female rats
Introduction: The relationships between wheat diet, sex hormone and the estrous cycle are important from the perspective of fertility. Aim: This study aims to investigate the effect of wheat diet on weight, estrous cycle, reproductive hormones and histology of the ovary of female Sprague-Dawley rats. Methods: Prior to the test, vaginal smear was monitored daily for 16 days period to select females with normal (regular) estrous cycle. A total of twenty rats with regular estrous cycle weighing between 170-200 g were randomized into four sets of 5 animals each. Group A is the female control and was fed with rat chow, group B, C and D was given 40%, 60%, 100% of wheat diet respectively. The wheat diet was giving respectively for a period of 4 weeks. Estrous cycle pattern was monitored using the vaginal smear for 16 days. At the end of the experiment, the rats were sacrificed and the blood sample were taken for follicle stimulating hormone, luteinizing hormones, estradiol, and progesterone analysis. The histology of the ovary were carried out. Results: The result showed that there was an increase in the weight of the rats that was fed with wheat and the increase was diet dependent. The wheat diets disrupt the order of appearance of normal estrous cycle stages, hence; there was no constancy in the frequency of all cycle stages in the wheat groups, mostly the 100% wheat group. No significant endocrine or histological differences noticed between control and wheat diets groups. Therefore photomicrograph of wheat diet shows large corpus luteum, thick germinal epithelium, zona granulosa and oocyte. Conclusion: Wheat diets disrupt the estrous cycle of the rats; however no adverse effect was noticed on the circulating reproductive hormones and histology of the ovary. However, high consumption of wheat should be taken with precaution.
Copyright (c) 2024 Chika Anna Idaguko, Gladys Agoreyo https://creativecommons.org/licenses/by-nc-nd/4.0
Sphenoid intraosseous meningioma associated with monostotic hyperostosis “a diagnostic challenge”: case report
Sphenoidal intraosseous meningioma is included within the extradural brain tumors which constitute less than 2% of the total meningiomas. We describe the case of a 39-year-old female patient who presented with symptoms typical of the location of this lesion, was taken to resection of the lesion, where later was diagnosed by biopsy and immunohistochemistry of sphenoid intraosseous meningioma associated with monostotic hyperostosis, the importance of this case lies in a timely recognition of sphenoid intraosseous meningioma, as its epidemiological, clinical, radiological and differential considerations of other entities present in chronic headaches.
Copyright (c) 2024 Juan Santiago Serna-Trejos, Stefanya Geraldine Bermúdez–Moyano, María Elena Candia-Garzón, Juan Pablo Lenis-González, Wendy Tatiana Ibarguen-Gómez, Mónica Lucía Vergara-Portocarrero https://creativecommons.org/licenses/by-nc-nd/4.0
Clinical characteristics and response to therapeutic plasma exchange in patients diagnosed with Guillain Barré syndrome in a third level clinic in the city of Cali - Colombia during the years 2016-2022.
Abstract Introduction: Guillain Barré syndrome (GBS) presents a non-negligible incidence rate in low-income countries. Intravenous human immunoglobulin (IVIG) and therapeutic plasma exchange (TPR) are the first-line treatments. Aim: The aim of this work is to describe the clinical characteristics and the response to RPT in patients with GBS. Materials and methods: Observational, descriptive, cross-sectional study with analytical scope of patients diagnosed with GBS who were managed with RPT, in two service-providing institutions (IPS) in the city of Cali-Colombia, between 2016 and 2022. outcomes: 33 patients with a mean age of 57+/-16 years were included. After a median stay of 10 days in the intensive care unit (ICU), 75.5% decreased at least one grade on the Hughes scale, 12.1% required mechanical ventilation (MV), 27.3% presented some complication, and there were no fatal outcomes. Prolonged stay in the ICU was significantly associated with an unfavorable clinical evolution. Conclusion: The results suggest that RPT management in an institution with highly complex standards, with early diagnosis and early medical intervention, can contribute to an adequate clinical evolution. Prolonged time in the intensive care unit (ICU) is a prognostic factor to consider in the clinical evolution of these patients. Studies with an analytical design and a larger sample are required to support these findings. Keywords Guillain-Barré syndrome, plasma exchange, clinical evolution, intravenous immunoglobulin, early diagnosis, early medical intervention.
Copyright (c) 2024 Diego Gerardo Prado- Molina , Esteban Agudelo-Quintero, José Mauricio Cárdenas-Prieto, Juan Santiago Serna Trejos, Stefanya Geraldine Bermúdez – Moyano, Isabella Vernaza-Gutiérrez, Luis Felipe Cortez-Sanabria, Catherine Caceres-Campo https://creativecommons.org/licenses/by-nc-nd/4.0
Telemedicine from the perspective of health personnel in a public hospital in Paraguay, 2023Telemedicine from the perspective of health personnel in a public hospital in Paraguay, 2023
The study investigates the adoption of telemedicine in a public hospital in Paraguay in 2023, from the perspective of healthcare personnel. A quantitative, descriptive, and cross-sectional analysis was conducted through 23 interviews with healthcare staff who were selected based on their voluntary participation, excluding maintenance, administration, finance, and cleaning staff. An 11-question guide focused on the evaluation, implementation, usage, and economic, technological, and legal aspects of telemedicine was used. Key findings highlight the feasibility of telemedicine, its more frequent application in the private sector, and benefits such as ease of access, resource optimization, and time management. The security of medical information emerged as a paramount concern. The conclusion is that there is a positive acceptance of telemedicine among professionals, underscoring the need for institutional, governmental, and user support for its effective implementation.
Copyright (c) 2024 Chap Kau Kwan Chung, Rafael Riquelme Benítez https://creativecommons.org/licenses/by-nc-nd/4.0
Chatbots for Promoting Healthy Habits and Scientific Culture
Chatbots are emerging as promising tools in promoting healthy habits and medical education. Research has shown their ability to provide personalized guidance, support in managing chronic diseases, and enhance the quality of patient care. While their benefits are recognized, addressing the need for further research to understand their effectiveness and user experience is essential.
Copyright (c) 2023 Iván Suazo Galdames https://creativecommons.org/licenses/by-nc-nd/4.0
Acute Appendicitis situs inversus totalis, Case Report
Acute appendicitis with situs inversus totalis is a rare type of acute abdominal pathology, with a prevalence of 1 in 10,000 births in the population. It has several embryological causes, with the most common being intestinal antirotation due to the involvement of the gene on chromosome 14. This clinical report describes the case of a 15-year-old adolescent patient who experienced 12 hours of abdominal pain, initially starting in the umbilical region and then migrating to the left iliac fossa. The pain was accompanied by an elevated temperature, nausea, and vomiting. During clinical examination, right cardiac auscultation, uncertain appendiceal signs, and peritoneal irritation were noted. Additionally, there was evidence of leukocytosis with neutrophilia. Tomography confirmed the complete dextroposition of abdominal and thoracic organs. An exploratory laparoscopy was performed, revealing macroscopic evidence of dextroposition of abdominal organs and uncomplicated appendicitis in the suppurative phase. The diagnosis of Acute Appendicitis with situs inversus totalis can be challenging due to its low prevalence and the presence of uncertain clinical signs. Therefore, the use of complementary examinations, such as computed axial tomography, is of utmost importance, along with visualization through diagnostic laparoscopy.
Copyright (c) 2023 Jesús Nicolás Larco Coloma, Galo Enrique Jiménez Sánchez, Nicolás Larco Noboa, Gabriel Molina Proaño, Karen Daniela Núñez Medina, Kevin Alexander Díaz Zumba, Giovanny Israel Silva Patiño https://creativecommons.org/licenses/by-nc-nd/4.0
Global overview of monkeypox: An epidemiological and clinical update
Mpox (viruela símica) es una enfermedad viral que puede producir síntomas como erupción cutánea, adenomegalias y fiebre. Pese a su baja tasa de mortalidad, se relaciona con complicaciones que pueden comprometer la calidad de vida de las personas. Fue identificada por primera vez en humanos en 1970, desde entonces se mantenía una distribución geográfica y una incidencia controladas. No obstante, desde el año 2022 su incidencia ha aumentado al igual que su distribución geográfica alcanzando un total de 89.596 casos confirmados por laboratorio y 663 casos probables, incluidas 157 muertes, reportados al 28 de agosto de 2023; llegando incluso a países no endémicos. A continuación, se presenta una revisión narrativa con base en información recolectada en bases de datos como UpToDate, Google Scholar, Medline, ClinicalKey, Scopus, Embase, Pubmed; con el objetivo de describir los aspectos más relevantes de Mpox en humanos desde una perspectiva epidemiológica actual, además de presentar datos fisiopatológicos, de diagnóstico, tratamiento, pronóstico y rehabilitación.
Copyright (c) 2024 Diego Gerardo Prado-Molina, Juan Santiago Serna Trejos, Stefanya Geraldine Bermúdez–Moyano, Esteban Agudelo-Quintero , Juan Pablo Rojas-Hernández https://creativecommons.org/licenses/by-nc-nd/4.0
Resilience and quality of life in a group of older adults displaced by violence in Colombia
Introduction: Resilience is an element that promotes the psychological well-being of people displaced by violence. The quality of life related to health focuses on an individual’s assessment of their quality of life, which becomes essential in evaluating health outcomes in the displaced population. Methodology: This is a qualitative study with a narrative-interpretive design that aims to understand the factors that generate psychological resilience and some connotations or perceptions of quality of life in a group of older adults displaced by violence in Colombia that belong to a support program called “income generation”. Results: Living conditions, such as physical and social-spiritual well-being, affected the groups’ quality of life. Resilience processes favour coping and tolerance to conditions of social vulnerability caused by displacement. Conclusions: The phenomena that help explain psychological resilience in the participants mainly correspond to individual differences, with self-perception of competence, positive perspectives, and projection towards the future as the factors that most boldly explain the resilience characteristics of older adults.
Copyright (c) 2023 Cindy Paola Parra - Santacruz, Gemelly Sánchez - Valencia, Tomás-León, Heidi Martínez -Sánchez, María Cristina Palacio-Valencia, Erika Natalia Muñoz-Ávarez, Juan Santiago Serna-Trejos https://creativecommons.org/licenses/by-nc-nd/4.0
¿Why did extubation fail in my patient with spinal cord trauma?: Considerations to keep in mind
La parálisis diafragmática es una entidad poco descrita dentro de las secuelas del paciente con trauma raquimedular, ya que a menudo pasa inadvertida. En casos particulares, donde estos pacientes se someten a ventilación mecánica invasiva y no toleran el retiro de esta, se debe sospechar afectaciones ligadas al nervio frénico. Los avances en el manejo de esta entidad incluyen diferentes medidas como reconstrucción del nervio frénico, plicatura del diafragma, uso de marcapasos frénico, uso de traqueostomía y rehabilitación pulmonar. La parálisis diafragmática es una entidad poco descrita dentro de las secuelas del paciente con trauma raquimedular, ya que a menudo pasa inadvertida. En casos particulares, donde estos pacientes se someten a ventilación mecánica invasiva y no toleran el retiro de esta, se debe sospechar afectaciones ligadas al nervio frénico. Los avances en el manejo de esta entidad incluyen diferentes medidas como reconstrucción del nervio frénico, plicatura del diafragma, uso de marcapasos frénico, uso de traqueostomía y rehabilitación pulmonar.
Copyright (c) 2023 Juan Santiago Serna - Trejos, Stefanya Geraldine Bermúdez – Moyano, Diego Gerardo Prado - Molina, Lina María Salazar- Rodríguez, Carlos Julián Devia - Santacruz https://creativecommons.org/licenses/by-nc-nd/4.0
Initial antimicrobial therapy and case fatality in patients with community-acquired pneumonia
The health importance of community-acquired pneumonia is an unquestionable fact given its relationship with hospital and overall mortality. The objective of the investigation was to evaluate the relationship between selected antimicrobials used in the initial treatment (amoxicillin/sulbactam, cefuroxime, ceftriaxone and cefotaxime) and mortality from pneumonia. An observational study was carried out, with a descriptive design and a population of 1,809 patients with pneumonia hospitalized between 2012 and 2019; the necessary information was obtained from the clinical history. Statistical processing was performed using bivariate and multivariate analysis (logistic regression); the ratio of cross products (odds ratio) and its 95% confidence interval were used as a statistician. Among the results, the following stand out: significantly higher lethality values were found in those treated with cefotaxime (33%) than in those who received amoxicillin/sulbactam (24%, OR 1.6[1.0001;2.6]), as well as in those treated with ceftriaxone (30%) compared with those treated with amoxicillin/sulbactam (24%, OR 1.3[1.05;1.8]) and with cefuroxime (24%, OR 1.3[1.04;1.7]). A higher frequency of patients with extensive pneumonia, of patients in a critical state on admission, and of bedridden occurrence during hospitalization were identified in those treated with cefotaxime. In patients with “moderate pneumonia and high probability of unfavorable outcome”, treatment with ceftriaxone or cefotaxime was associated with death; as well as ceftriaxone treatment for all subjects. It is concluded that the initial treatment with amoxicillin/ sulbactam or cefuroxime was more favorable than the use of third generation cephalosporins. Also in the global analysis, the absence of differences in lethality between those treated with amoxicillin/sulbactam and with cefuroxime was recognized.
Copyright (c) 2023 Luis Alberto Corona Martínez, Iris González Morales, María Caridad Fragoso Marchante https://creativecommons.org/licenses/by-nc-nd/4.0