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Background: Extubation is a critical process in the ICU. Pulmonary USG has different applications, those that predict success in extubation, such as the diaphragmatic excursion time index (DEIT)., Objective: To determine the diaphragmatic excursion time index is a predictor of the success of weaning off mechanical ventilation in patients in the intensive care unit., Material and Methods: Diagnostic performance study in patients in the ICU and in the extubation protocol. Diaphragmatic measurement by USG, evaluating DEIT; cut-off point of 2.42 ± 1.55 cm/s. In the hypothesis test, a JI square was carried out between the two qualitative variables, in order to accept or reject H0, with a statistical significance of p < 0.05 to determine if there is dependence between the dependent and independent variables., Results: Total of 200 patients from the population, with successful extubation in 52.5% and extubation failure in 47.5%. Prognostic values of the DEIT were: S: 77.1% (68.2-84.1%), E: 56.8% (46.8-66.3%). ROC curve for ITED, AUC of 0.665 (0.58-0.74; p = 0.001). In secondary objectives, a correlation was made between ventilatory and demographic variables for successful extubation; with FvT (Rho: 0.680, p = 0.0001)., Conclusions: The DEIT for withdrawal of mechanical ventilation has low sensitivity and specificity as a result of successful extubation. The finding that DEIT is not an adequate predictor determining the outcome of successful extubation., (Licencia CC 4.0 (BY-NC-ND) © 2024 Revista Médica del Instituto Mexicano del Seguro Social.)

Background: COVID-19 disease (coronavirus disease 2019) has multiple potentially fatal cardiovascular complications and pericarditis is one of them; however, if prompt treatment is given, fatal events associated to this complication decrease. Its frequency and presentation characteristics are unknown, which is why its early diagnosis is important., Objective: To know the frequency of pericarditis secondary to COVID-19 and its presentation characteristics., Material and Methods: Cross-sectional study in patients with a diagnosis of pericarditis after COVID-19 disease (with a positive test). Symptoms, age, sex, comorbidities, and electrocardiogram (ECG) and transthoracic echocardiogram (TTE) results were obtained., Results: A total of 3364 patients positive for COVID-19 were registered, out of which 10 met criteria for pericarditis, which represented a frequency of 0.30%. The average age of the sample was 46.1 years and 60% predominated in the male gender with a 1.5:1 ratio. The most frequent clinical characteristics were the presence of retrosternal pain (90%), absence of comorbidity (50%), and absence of electrocardiographic changes (40%)., Conclusions: Pericarditis has a low frequency in patients with COVID-19. The predominant clinical presentation is chest pain. Almost half will not have electrocardiographic changes, and half will not have comorbidities., (Licencia CC 4.0 (BY-NC-ND) © 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

Background: The most widely used fixation system for transtrochanteric fractures is the dynamic hip screw system, which has a failure prevalence of 10 to 17% and it is associated with the presence of clinical and radiographic factors., Objective: To evaluate the association of clinical and radiographic factors with the failure of the screw system in post-operative patients for transtrochanteric hip fracture., Material Y Methods: A case-control study was carried out. The inclusion criteria were: patients > 18 years, who underwent surgery due to transtrochanteric fracture, were treated with the hip screw system, and who attended the Trauma Service. The patient with failure of the hip screw system was selected as the case and the patient without failure of the system as control. The variables analyzed in these groups were: age, gender, body mass index and radiographic variables. Statistical analysis was performed with chi-squared and Mann-Whitney U., Results: 163 patients (median 73 years), 20 cases and 143 controls, were included. The radiographic factors with a significant association with hip screw system failure were the AO classification of fractures (p < 0.001), the tip apex distance (p = 0.03), the calcar-referenced tip apex (p = 0.02), the position of the screw (p < 0.001), and quality of reduction (p < 0.003). Clinical factors did not show a significant association., Conclusions: Radiographic factors are associated with failure in the hip screw system in patients in post-operative care due to transtrochanteric fracture., (Licencia CC 4.0 (BY-NC-ND) © 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

Background: The World Health Organization (WHO) declared COVID-19 a pandemic on March 11, 2020. Patients who tested positive for COVID-19 experienced a higher overall rate of post-surgical complications and hospital mortality., Objective: To compare the asociation of post-surgical complications presented in post-surgical hip patients with and without history of COVID-19 infection., Material and Methods: Prospective cohort study. The inclusion criteria were: post-hip surgery adults with and without a history of COVID-19 infection who attended their post-surgical follow-up consultation. The association of post-surgical complications in both groups was studied. The association of complications was analyzed with the chi-squared statistical test, and the effect size with Cramer's V test., Results: The association of complications and a history of COVID-19 infection was moderate, with a chi-squared of 2.55, V Cramer of 0.23. The most frequent complication was aseptic loosening of prosthetic components. The pre-surgical diagnosis and its association with both groups had a chi-squared of 10.07, and a V Cramer of 0.45, at the expense of hip fracture., Conclusions: A history of COVID-19 infection may be associated with the presence of post-surgical complications. Aseptic loosening of prosthetic components was the most frequent complication in both groups of patients, and hip fracture was the main pre-surgical diagnosis., (Licencia CC 4.0 (BY-NC-ND) © 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

Background: Rotator cuff injuries result in impaired functionality of the shoulder. The difference in shoulder functionality in patients treated with arthroscopy who required open surgery is still unknown., Objective: To determine if there is a difference in the functional evolution of the shoulder in patients who underwent surgery due to rotator cuff lesion which began with arthroscopy and ended in open surgery., Material and Methods: A cohort, longitudinal, observational and comparative study was carried out. The Constant scale was applied to measure the functionality of the shoulder in patients who underwent surgery due to rotator cuff injury, prior to surgery, 3 and 6 months after it, from August 2021 to April 2022. Functionality between patients who started with arthroscopy and required surgery and with those who only underwent arthroscopy was compared., Results: 30 patients were included. Shoulder functionality in the preoperative period had a mean of 42.2 ± 18 (95% confidence interval [95% CI] 35.5-49.0), at 3 months of 48.18 ± 14 (95% CI 42.9-53.4) and at 6 months of 66.7 (95% CI 60.1-73.4), with a p = 0.001. The difference between the patients who required surgery was not significant (p = 0.3)., Conclusions: The functional evolution of the shoulder in patients who underwent surgery due to rotator cuff injury improves over time. The type of surgery does not influence the functional evolution., (Licencia CC 4.0 (BY-NC-ND) © 2023 Revista Médica del Instituto Mexicano del Seguro Social.)

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Competing Interests: The authors declare that they have no conflict of interest