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1
artículo
Publicado 2023
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Extrauterine gestation is called ectopic pregnancy, this is an obstetric emergency of the first trimester, which is having an increasing incidence. One of the locations in which these pregnancies can be generated is the scar from a previous cesarean section, which is a challenge for the treating gynecologist due to its diagnostic difficulty and therapeutic options. We report the case of a 37-year-old patient who was admitted to the emergency service with 6 weeks of amenorrhea, and with a history of 2 cesarean sections. She underwent a uterine curettage that was complicated and ended in a hysterectomy. Ectopic pregnancy in cesarean section scar is rare, however, it is important to consider this diagnostic option in pregnant women with bleeding in the first trimester with a history of cesarean section to be able to look for ultrasound signs in the evaluation.
2
artículo
Publicado 2023
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Extrauterine gestation is called ectopic pregnancy, this is an obstetric emergency of the first trimester, which is having an increasing incidence. One of the locations in which these pregnancies can be generated is the scar from a previous cesarean section, which is a challenge for the treating gynecologist due to its diagnostic difficulty and therapeutic options. We report the case of a 37-year-old patient who was admitted to the emergency service with 6 weeks of amenorrhea, and with a history of 2 cesarean sections. She underwent a uterine curettage that was complicated and ended in a hysterectomy. Ectopic pregnancy in cesarean section scar is rare, however, it is important to consider this diagnostic option in pregnant women with bleeding in the first trimester with a history of cesarean section to be able to look for ultrasound signs in the evaluation.
3
artículo
Publicado 2018
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Cesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy that should be diagnosed early in order to seek the best therapeutic option. We present a case of CSP initially misdiagnosed as a non-viable pregnancy that undergone curettage. Patient was referred to our institution where conservative medical management with methotrexate failed, and the only option was surgical resection of CSP. CSP should be suspected and diagnosed as early as possible. In low-income countries the prevention of massive blood loss along with serious maternal morbidity should be priorized. The use of minimally invasive approach should be planned as a first-line treatment over medical management.
4
artículo
Publicado 2015
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Ectopic pregnancy is a gestation that nests outside of the uterus endometrial lining. Incidence is estimated at 0.94-2.6% of all pregnancies. Its location in a previous cesarean section uterine scar is a rare (0.15%) presentation of this disease, accounting for 6.15% of ectopic pregnancy cases occurring in women with previous cesarean section. A case of a 28 year-old woman G: 5 P: 0412, with history of 3 cesarean sections was hospitalized in Hospital Nacional Docente Materno Infantil (HONADOMANI) San Bartolomé in February 2013 because of transvaginal ultrasound diagnosis of ectopic pregnancy located in previous uterine cesarean scar; it was successfully resolved by laparoscopic management. Cases of ectopic pregnancy located in the uterine scar from previous cesarean are increasing due to the rising cesarean section rate. Transvaginal ultrasonography is crucial for diagnosis. There is no...
5
artículo
Publicado 2015
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Ectopic pregnancy is a gestation that nests outside of the uterus endometrial lining. Incidence is estimated at 0.94-2.6% of all pregnancies. Its location in a previous cesarean section uterine scar is a rare (0.15%) presentation of this disease, accounting for 6.15% of ectopic pregnancy cases occurring in women with previous cesarean section. A case of a 28 year-old woman G: 5 P: 0412, with history of 3 cesarean sections was hospitalized in Hospital Nacional Docente Materno Infantil (HONADOMANI) San Bartolomé in February 2013 because of transvaginal ultrasound diagnosis of ectopic pregnancy located in previous uterine cesarean scar; it was successfully resolved by laparoscopic management. Cases of ectopic pregnancy located in the uterine scar from previous cesarean are increasing due to the rising cesarean section rate. Transvaginal ultrasonography is crucial for diagnosis. There is no...
6
artículo
A female patient with a history of ductal carcinoma in situ in the left breast, status-post bilateral mastectomy with deep inferior epigastric perforator artery flap reconstructive surgery, presented with a right breast asymmetry concerning for fat necrosis. Histological analysis revealed the presence of benign glands and associated stroma within fibroadipose tissue, confirmed as endometriosis by immunohistochemical analysis. Further investigation revealed that the patient had a previous diagnosis of endometriosis associated with a cesarean section scar that likely seeded the ectopic endometrial glands into a tertiary site by utilizing abdominal tissue that may have harbored endometriosis.
7
artículo
Carbon dioxide (CO2), is found in nature in a gaseous state. It is a colorless, odorless, and is a key part of the carbon cycle, its concentration in the air is 0.03%. CO2 is one of the basic components in the homeostasis of human body and is a result of cellular metabolism. CO2 is 20 times more soluble in water than in air and according to many scientific studies do not leading to no clinically significant embolism. In the blood circulation the carbon dioxide is transported to the lungs by three routes: 65% as bicarbonate ion, 25% as Co2 bound to proteins, especially the hemoglobin and plasma CO2 dissolved in 10%. [1]. In European countries like France and Germany, from the Middle Ages, are known the healing properties of carbon dioxide on circulation problems and skin, and since 1920 has been applied subcutaneous CO2 for medical treatment [2]. Current studies demonstrate the effect of ...
8
artículo
Uterine rupture is an obstetric emergency that can have catastrophic results. Intraperitoneal prolapse of the amniotic sac, also known as amniocele, is a unique initial manifestation of silent or complete uterine rupture during pregnancy. It can occur as a result of preexisting injury, uterine abnormalities or alterations in uterine scarring. Ultrasound plays an important role in the diagnosis of this condition: it is essential for the management of these patients and optimizes maternal and perinatal outcome. We present the case of a 22-year-old patient with acute abdominal pain at 34 weeks’ gestation. Ultrasound showed a viable fetus inside the amniotic cavity along with oligohydramnios and an echogenic cystic lesion of 8 x 6 centimeters. Doppler and tridimensional ultrasound confirmed the diagnosis as intraperitoneal prolapse of the amniotic sac through a uterine rupture. During cesa...
9
artículo
Publicado 2021
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Quality of life after thyroid gland surgery is as important as disease control. To improve cosmetic results and patient satisfaction, endoscopic approaches are used using incisions outside the cervical region. Endoscopic transoral thyroidectomy does not leave any visible scarring on the skin. We present the case of a 29-year-old female patient with a benign thyroid gland tumor with compressive symptoms and aesthetic concerns, who underwent a right hemithyroidectomy by means of an endoscopic transoral vestibular approach in a time of 150 minutes and minimal bleeding, without complications in the postoperative period. The transoral endoscopic vestibular approach for endoscopic resection of the thyroid gland is safe and the results are comparable with the open surgical technique, with a better cosmetic result and improved quality of life.
10
artículo
Publicado 2024
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Peripartum cardiomyopathy (PPCM) is a potentially life-threatening condition that can occur during the late pregnancy or puerperium. A 31-year-old woman with a recent twin pregnancy presented with heart failure symptoms nine days postpartum. On admission, she had volume overload and hemodynamic compromise, which was rapidly reversed with inotropic levosimendan support. Echocardiography revealed a left ventricular ejection fraction (LVEF) of 20% with global hypokinesia. Once stabilized, she was discharged on heart failure medication, bromocriptine, and warfarin. Cardiac magnetic resonance imaging at five weeks demonstrated a preserved LVEF of 57% and no evidence of myocardial scarring or edema. During the 4-year follow-up, the patient remained stable with no new pregnancies. This case highlights the importance of considering PPCM in the differential diagnosis of heart failure in the perip...
11
artículo
Publicado 2018
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The Meek technique is useful in patients with limited donor sites. It is a relatively efficient technique due to its ability to expand the skin up to nine times its original size. Scarring was assessed using two tissue expansion techniques, i.e. the Meek technique and the conventional mesh technique, which achieved an expansion ratio of 1:3. It should be noted that, with advances in bioengineering, the Meek technique is integrated as a complete method for autografting.1,2 We present the case of a 34-year-old male patient with a polymicrobial infectious disease called "necrotizing fasciitis". He had lost tissues of the thorax, abdomen and inguinal-perineal region, affecting 14% of his total body surface area. A qualitative assessment using the Vancouver scale and the Patient Objective Scar Assessment Scale (POSAS) showed better scarring results with the Meek technique.
12
artículo
Publicado 2014
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Introduction: The anatomy of bilateral cleft lip is different for each patient, and many authors have described modifications of the traditional repairing techniques in order to achieve more individualized designs and better results. The techniques described by Millard and Mulliken are probably the most commonly used all over the world for repairing bilateral cleft lip; however, there are some short-comings when trying to repair asymmetric forms of bilateral cleft lip. So, we designed this technique aiming to correct asymmetry in bilateral cleft lip. This technique is based on a double advancement and lateral rotation concept placing the scars over the natural lines between the esthetic subunits of the upper lip. Matherial and Methods: This is a retrospective and descriptive study based on a case series. We present a new technique used for surgical repair of bilateral cleft lip in 125 pa...
13
artículo
Publicado 2023
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Oronasal communication (OC) is a rare muco-osseous defect, especially in adults. This defect communicates the oral cavity directly with the nasal cavity. There are multiple surgical options for treatment, among which are the local palatal flaps, characterized by receiving their blood supply through the greater palatine artery. We present a case of closure of a OC of traumatic origin in an adult female patient, who had undergone surgery on three previous occasions without achieving definitive closure of the OC. The surgical technique used in this case was a palatoplasty through a double palatal flap plus the use of platelet-rich fibrin as a scar adjuvant, as it has the characteristic of reducing the healing time in lesions. A successful long-term closure of the OC was obtained, achieving an airtight closure, without tissue tension and maintaining the blood supply of the flap. This surgica...
14
artículo
Publicado 2003
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Objectives: 1) To determine the association between maternal characteristics and the microbial flora of the vagina in pregnancies with high risk of prematurity; and, 2) To determine the association between the microbial flora of the vagina and the maternal and perinatal outcome in pregnancies with high risk of prematurity. DESIGN: Case-control study, between January 1994 and December 1995. Material and methods: Case group comprised 238 singleton-pregnant women who were admitted because of preterm premature contractions, preterm labor, increased vaginal fluid, acute pylonephritis and arterial hypertension. All cases underwent a wet preparation to establish the microbial flora. The control group included 3 850 singleton pregnant women who delivered a term neonate at the same institution. Case group was further divided into women with bacterial vaginitis (n=136), bacterial vaginosis (BV, n=...
15
artículo
Publicado 2025
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Objective: To compare scar formation between regenerated nanocellulose dermal substitutes and xenografts in patients with deep second-degree thermal burns. Materials and methods: A comparative, interventional, analytical, prospective and longitudinal study was conducted. We present the report of 60 cases evaluated in a private clinic in Lima, Peru, between January 2022 and July 2023. Patients aged 1 to 60 years without comorbidities were evaluated for scar formation from deep second-degree thermal burns within the first 24 hours of the accident. Both dermal substitutes were used in all patients. The study was authorized with informed consent. Results: An evaluation was conducted at 90 days, showing better scar formation with the synthetic dermal substitute made of nanocellulose compared to the xenograft. The results were evaluated using the Vancouver Scar Scale (VSS) (vascularization, pi...
16
artículo
Publicado 2021
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Objective: To identify and describe the adverse reactions to the Bacillus Calmette - Guerin vaccine in children under 1 year of age and to identify and analyze maternal care at home against adverse reactions. Method: Qualitative research, with a case study approach. The participants were 15 mothers who take care of their children at the Toribia Castro Chirinos Health Center and 7 nurses who work in said establishment; The sampling was non-probabilistic, for convenience and the size was determined with the saturation and redundancy technique, the data were collected with the prior informed consent of the participants, with a semi-structured interview guide, validated by expert judgment and pilot test and processed through content analysis. The execution of the research was prior approval of the project by an Institutional Research Ethics Committee. Main Results: Two categories were obtain...
17
tesis de grado
Objetivos: Presentar un caso acerca de endometriosis de pared abdominal secundario a cicatriz de la incisión de Pfannenstiel o cesárea y realizar una revisión sistemática de literatura sobre el diagnóstico, tratamiento y pronóstico. Materiales y métodos: Se presenta el caso de una paciente mujer de 30 años, con antecedente de 3 cesáreas, atendida en clínica particular ubicada en la ciudad de Trujillo en La Libertad, por presentar tumoración con aumento de volumen progresivamente desde hace 4 años, asociado a dolor con cada ciclo menstrual. Se realizó una revisión de la literatura publicada en las bases de datos Medline en PubMed, Scielo, Upto Date y Google Académico. Resultados: Se encontraron reportes de casos y revisiones del tema, teniendo en común el estándar de oro para el diagnóstico positivo de esta enfermedad es el examen anatomopatológico. El tratamiento farma...
18
artículo
This article explores the State and its units of conflict management’s capacitiesand limitations to transform social environmental conflicts. The analysis focuses on the type of intervention that Peruvian governments had been using in the media arena in response to the escalation of public conflicts. Furthermore, the article also focuses on how the government can use the information to play a role in the transformation and prevention of conflicts. Lastly, the discussion considers how the government handles its communication engagement and strategy with the citizens through conflict management -from a governance and public value perspective. The article concludes that the communication dimension is part of any government conflict management approach; therefore, it should be embedded within a national system for conflict management that puts the priority in the prevention and trans...
19
Publicado 2020
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At present, there has been a high percentage of cesarean sections in our country in recent years, both in the public and private sectors, this leads to a greater number of women with a previous uterine scar in their second pregnancy and its termination due to Caesarean section. Some time ago it was an indication for an absolute cesarean section to have a previous cesarean section; however, today it is possible to attempt a vaginal delivery in the second if they wish. After a cesarean section, the study of the scar through the measurement of the thickness of the lower uterine segment by transvaginal ultrasound during the third trimester of pregnancy, would become a fundamental tool to identify those pregnant women with high risk, allowing us to reduce complications such as cases of uterine rupture in pregnant women with a previous cesarean section, which consider vaginal delivery as a mea...
20
tesis de grado
Publicado 2020
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La esporotricosis es una micosis subcutánea causada por el Sporothrix schenkii. De presentación clínica variada, la que nos ocupa posee forma cutánea fija de evolución polimorfa, lo que ocasiona un diagnóstico tardío y tratamientos incorrectos que conllevan a complicaciones. Se presenta el caso de una paciente pediátrico, sin antecedentes de inoculación traumática. Con historia de lesión de inicio nodular tipo picadura en región interescapular. Dos meses después se ulcera en la región central y se cubre de costras. El paciente se automedica con betametasona, clotrimazol y gentamicina crema, generando remisión temporal de la lesión. Posteriormente, la lesión reaparece y es diagnosticada como cicatriz queloide, infiltrándose con corticoides. Un mes y medio después, se agrava además con dolor y prurito, y es tratada con antibióticos. Sin presentar mejoría, acude a cons...
