International Journal of Medical and Surgical Sciences

Reel’s syndrome, an unusual cause of lead displacement

Tue, 25 Feb 2025 00:00:00 +0000

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.

Therapeutic revolution in the management of metastatic prostate cancer

Fri, 06 Jun 2025 00:00:00 +0000

not applicable

Cancer research in Chile: beyond universities, contributions from The National Cancer Institute

Wed, 02 Apr 2025 00:00:00 +0000

Clinical utility of point-of-care ultrasonography in the patient on shock: A narrative review

Fri, 17 Jan 2025 00:00:00 +0000

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.

Prevalence of musculoskeletal disorders in clinical laboratory personnel in the city of Riobamba, Ecuador

Diego Tene Salcán — Thu, 12 Jun 2025 00:00:00 +0000

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.