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La pandemia por SARS-CoV-2, fue un evento sin precedentes en la historia reciente, una crisis en salud pública que puso a prueba a la humanidad como especie; durante esta, destacan las acciones del personal científico, quien con esfuerzos conjuntos identificaron e iniciaron el estudio acucioso sobre su fisiopatología y medios para combatirla. Pero también, se presentaron durante las fases iniciales, y ante la ausencia de evidencia científica, manejos o recomendaciones basadas en la plausibilidad y el deseo de ofrecer una opción terapéutica y/o un manejo compasivo a pacientes con cursos clínicos inexorables. El curso posterior, con trabajos de investigación multicéntricos, demostró la limitación de muchas recomendaciones previas, descartando muchas opciones terapéuticas y confirmando las acciones primordiales para el manejo de esta crisis y dejando unas recomendaciones claras ante futuros brotes, epidemias y/o pandemias: personal de salud debidamente capacitado, recursos disponibles e idóneos, desarrollo de protocolos establecidos a partir de medicina basada en la evidencia y el planteamiento de estrategias gubernamentales en los servicios de salud, para modificar la evolución de la pandemia.

A tracheostomy performed on patients infected with SARS CoV-2 is one of the procedures with the highest risks of aerosolization. Safety recommendations for carrying out this procedure are not suitable for implementation in every hospital. Despite the use of Personal Protection Equipment, the suit leaves the submental area unprotected, and even the face mask may not provide a full seal. The use of additional biosafety isolation equipment increases safety, thus preventing exposure to infecting particles and allowing the surgeon to perform the technique with the use of the available equipment; it reduces the risks of further trans-surgical complications and increases the possibilities of handling them in case they arise. [ABSTRACT FROM AUTHOR]

Electrical burn injuries are one of the most severe forms of trauma. This study aims to investigate the infection complications in electrical burn patients in a referral hospital in Mexico City. A longitudinal retrospective study was conducted, involving electrical burn patients admitted from April 2011 to December 2016. Demographic and clinical data including type of electric burns, infection complications, and mortality was sought. Data were collected at admission and daily until discharge. Number and type of infections and microorganism isolations were sought. Risk factors for death were analyzed. A total of 111 patients were included, of which 96.4% were males, mean age of 31.6±16.22, most injuries were high voltage associated. The total body surface area average was 27.8% ± 19.63. The overall infection rate was 72.9 cases per 100 patients. Mortality was observed in 4 (3.6%) patients. About 59.1% (443/749) had growth for Gram-negative bacteria. Multidrug-resistant Pseudomonas aeruginosa was the most frequent microorganism isolated. Fungi were present in 4.9% of cases. Electrical burn injuries occurred in young males in our study. Infection was frequent, most of them caused by Gram-negative rods with an important rate of antimicrobial resistance; however, an important microbial diversity was present.

Las artroplastias de cadera y rodilla han demostrado ser el tratamiento óptimo para las articulaciones que no se benefician de intervenciones médicas o artroscópicas; sin embargo, la infección de la prótesis articular es la complicación más temida. Se estima que la incidencia de las infecciones no debe exceder del 2%.

Periprosthetic joint infection (PJI) is one of the leading cause of failure in prosthetic joint surgery regardless the implantation site, causing an important burden to hospitals and society. Diagnosis is challenging, as there is lack of a gold standard test. When it is diagnosed within 30 days of onset or if the etiology is hematogenous with either a susceptible or non-virulent microorganism, the recommended surgical management option is debridement and irrigation, followed with antimicrobial treatment in order to preserve the device, with different reported success rates. In those cases of delayed and late onset presentation, there are two treatment possibilities: (a) Two-stage exchange arthroplasty, the most common surgical procedure for the management of PJI. Once prosthesis is removed it is followed by pathogen-specific antimicrobial treatment. A period of 2–4 weeks without antimicrobial before reimplantation procedure is suggested. (b) One-stage exchange arthroplasty is considered in case of a known microorganism that is susceptible with effective antimicrobial options and lack of sepsis. In terms of antimicrobial treatment, length of intravenous antibiotics is at surgeon’s discretion because there is not a standard recommendation. Switching from intravenous to oral antimicrobial treatment reduces the hospital length of stay and health-care expenditures. Oral antimicrobial treatment length recommendation is variable, which can be from 2 to 6 weeks to 3–6 months. Suppressive antimicrobials for a long-term are an option when prostheses retention is decided because there is a high surgical risk, poor functional outcomes, and patient preferences. PJIs are ideally treated in referral hospitals with an experienced multidisciplinary team.

This work presents an experimental efficiency analysis of sugar cane bagasse boilers performed according to the first law of thermodynamics. The methodology employed to determine efficiency regarding the first law is the indirect or energy losses method, based on the energy balance method established in the most recent standards, ASME PTC 4-2008 and EN 12952-15:2003. Experimental data were obtained from boilers installed in sugar and ethanol mills in the state of São Paulo, Brazil. Calculation of heat losses through the boiler walls is presented in detail and compared with a previous calculation method recommended in an older standard (ASME PTC 4.1 1964). Moreover, calculation of the uncertainty of the efficiency determination is presented and discussed. On the basis of the obtained results, the main causes of energy losses are identified, and suggestions aimed at improving boiler efficiency are made.

El rabdomiosarcoma es el sarcoma de tejidos blandos más común en la infancia y adolescencia, con incidencia anual de 4 a 7 casos por millón de niños de 15 años de edad. El rabdomiosarcoma embrionario es común en adultos menores de 30 años, y se presenta usualmente como una masa indolora, palpable grande (> 5 cm). La sobrevida en el caso de hombres con sarcoma paratesticular es aproximadamente del 50%.

Among the WHO, goals for 2030 are to detect >90% of people with HCV and link >80% to treatment. Our institution serves an open population without social security. This study aimed to describe the detection strategy that was carried out in the open population, using two-step HCV detection tests at “Hospital General de México” from January to December 2021.

Aproximadamente el 25% de los pacientes se presentan con cáncer de células renales metastásico (CCRm) al momento del diagnóstico. Los inhibidores con actividad cinasa multitirosina han revolucionado el tratamiento del CCRm desplazando la terapia con citocinas. El sunitinib, inhibidor de la tirosina cinasa, ha mostrado eficacia en términos de supervivencia libre de progresión y supervivencia global, con tasas de respuesta completa de alrededor del 3%. Presentamos la remisión histológica completa posterior de sunitinib en CCRm.

La nefrectomía radical es considerada el estándar de oro para el tratamiento de tumores renales. Sin embargo, la cirugía preservadora de nefronas es una opción quirúrgica en pacientes con tumores renales menores de 7 cm, con riñón único, tumores renales bilaterales o con insuficiencia renal crónica.