Pulmonary embolism is one of the leading causes of precordial pain in the hospital setting. We present the case of a 31-year-old male patient who reported sudden precordial pain and dyspnea with minor exertion, a significant elevation of D-dimer and, as revealed by computed tomography angiography (CTA), the presence of a thrombus in the main, segmental and subsegmental pulmonary branches. He underwent an embolectomy, with subsequent recovery and good progress. Pulmonary embolism produces pathophysiological interference with gas exchange and circulation, and the cause of death in these patients is right ventricular failure due to acute pressure overload. The most frequent clinical manifestations and signs are dyspnea, palpitations, chest pain, syncope and hemoptysis, tachycardia, tachypnea and jugular venous distension. The McGinn-White pattern consists of an electrocardiographic trace sh...

Systemic Lupus Erythematosus (SLE) is an autoimmune disease caused by an autoreactive B and T cell response with loss of immune tolerance to self-antigens. It manifests with asthenia, fever, myalgias, arthralgias, skin rash and fatal organ damage. Dengue is a zoonotic disease caused by the dengue virus (DENV), transmitted by mosquitoes of the Aedes aegypti species. Diagnostic suspicion is made in the presence of acute febrile syndrome with clinical manifestations and demographic history. Confirmation is by detection of the virus by PCR-RT, or of the structural protein NS1. The present case report is a 58-year-old woman with data of lupus exacerbation and with clinical manifestations suggestive of Dengue fever, with a history of travel to an endemic area. The confirmatory PCR-RT test leads to appropriate medical treatment. The importance of the case lies in differentiating the diagnosis i...

Objective: To determine the prevalence of anatomical variations of the circle of Willis (CoW) andtheir association with cerebrovascular malformations detected on cerebral computed tomographyangiography (CTA). Materials and methods: A descriptive, observational, cross-sectional studywas conducted at a tertiary-care hospital involving a Mexican population. Patients of all ages andboth sexes, with complete medical histories and a cerebral CTA scan, were included. Patientswith incomplete CTA studies or missing data were excluded. Descriptive statistics and the phicoefficient were used to assess the relationship between cerebrovascular malformations andanatomical variations of the CoW. A p value ≤ 0.05 was considered significant. All personal datawere handled with strict confidentiality and used exclusively for research purposes. Results:The sample consisted of 97 patients, with a mean age ...

Objective: To compare the effectiveness of stratifying high cardiovascular disease (CVD) risk inpatients diagnosed with rheumatoid arthritis (RA) using the Framingham Risk Score (FRS), modifiedSystematic Coronary Risk Evaluation (mSCORE), 2013 American College of Cardiology/AmericanHeart Association (2013 ACC/AHA) guidelines and QResearch Risk Estimator version 3 (QRISK3),with carotid ultrasound (CUS) serving as the gold standard for detecting subclinical atherosclerosis.Materials and methods: A comparative, observational and cross-sectional diagnostic study was conducted in patients aged 40 to 75 years, of both sexes, with RA and without CVD, at a tertiarycare hospital in Puebla, Mexico. Patients on treatment with one or more disease-modifying antirheumatic drugs (DMARDs) for at least three months were included. Patients with chronic diseases and those who did not undergo a CUS were exc...