Contralateral traumatic hemopneumothorax

Reporte de caso1-4Paciente adultoPneumothorax is the entry of air into the virtual space between the visceral and the parietal pleurae, which can occur spontaneously or to a greater extent in a traumatic way. In daily clinical practice it is frequent to fnd injuries that generate traumatic pneumothorax that is ipsilateral to the lesion. However, there are case reports of contralateral pneumothorax that occurred in procedures such as insertion of pacemakers, or in cases of pneumonectomy. Te following is the case report of a 37-year-old man who was admitted with a sharp wound to the right paravertebral region who developed a lef haemopneumothorax due to a tangential course of the injuring agent. Adequate clinical judgment was followed, and several imaging studies were carried out, leading to the diagnosis of traumatic pneumothorax that was contralateral to the described injury

Clinical factors associated with brain neoplasms de novo in patients with headache to the emergency department

La cefalea constituye uno de los principales síntomas de consulta en el servicio de urgencias y constituye un desafío para el médico. Objetivo: Determinar los factores clínicos que están asociados con la presencia de masa cerebral en pacientes que debutan con cefalea. Metodología: Estudio retrospectivo de casos y controles. Se definió como caso cada paciente que consultó por cefalea con evidencia imagenológica por tomografía axial computarizada (TAC) o resonancia nuclear magnética (RMN)de masa cerebral. Los controles fueron pacientes con cefalea sin evidencia imagenológica de masa cerebral. El tamaño de muestra fue de 272 pacientes (62 casos y 210 controles). Para determinar los factores asociados al desenlace se realizó un análisis de regresión logística binaria, incluyendo variables plausibles con p<0,2 en el análisis bivariado y aquellas biológicamente plausibles. Se calcularon los odds ratio ajustados (ORA) y sus respectivos intervalos de confianza. Se consideró significativo un valor de p<0,5. Resultados: Las variables clínicas asociadas con la presencia de masa cerebral fueron: 1) antecedente de cáncer fuera del sistema nervioso central, 2) cefalea que empeora con las maniobras de Valsalva, 3) alteraciones en el examen motor y 4) cefalea que despierta al paciente en la noche. Conclusiones: Se encontró que las variables mencionadas constituyen signos de alarma predictivos de la presencia de cefalea secundaria a masa cerebral y son importantes en la evaluación de todo paciente que consulta por cefalea en el servicio de urgencias y pueden orientar para la toma de decisiones.Artículo original22-33Headache is one of the main symptoms of consultation in the emergency department, on average 1.2 - 4.5% of all queries. Objective: To determine the clinical factors associated with the presence of brain neoplasms in patients presenting with headache. Methodology: A retrospective case-control study was conducted. Case was defined as each patient with headache and radiographical evidence by computed tomography (CT) or magnetic resonance imaging (MRI) of brain neoplasms and controls were patients with headache without radiographical evidence (CT or MRI) of brain neoplasms and meeting diagnostic criteria for primary headache. A sample size of 272 patients (62 cases and 210 controls) was determined. To determine factors associated with outcome analysis binary logistic regression was performed, including the plausible variables with p<0.2 in the bivariate analysis and those biologically plausible. The adjusted odds ratio (AOR) and their respective confidence intervals were calculated. A p<0.5 was considered significant. Conclusions: Despite the limitations of the study, it was found that the variables mentioned above are signs of predictive alarm in the presence of secondary headache to brain neoplasms and are of great importance in the primary evaluation of any patient who complains of headache in service emergency as they can guide the physician for decision making

Contralateral Traumatic Hemopneumothorax

Pneumothorax is the entry of air into the virtual space between the visceral and the parietal pleurae, which can occur spontaneously or to a greater extent in a traumatic way. In daily clinical practice it is frequent to find injuries that generate traumatic pneumothorax that is ipsilateral to the lesion. However, there are case reports of contralateral pneumothorax that occurred in procedures such as insertion of pacemakers, or in cases of pneumonectomy. The following is the case report of a 37-year-old man who was admitted with a sharp wound to the right paravertebral region who developed a left haemopneumothorax due to a tangential course of the injuring agent. Adequate clinical judgment was followed, and several imaging studies were carried out, leading to the diagnosis of traumatic pneumothorax that was contralateral to the described injury

Spatio-temporal dynamics of Plasmodium falciparum transmission within a spatial unit on the Colombian Pacific Coast.

As malaria control programmes concentrate their efforts towards malaria elimination a better understanding of malaria transmission patterns at fine spatial resolution units becomes necessary. Defining spatial units that consider transmission heterogeneity, human movement and migration will help to set up achievable malaria elimination milestones and guide the creation of efficient operational administrative control units. Using a combination of genetic and epidemiological data we defined a malaria transmission unit as the area contributing 95% of malaria cases diagnosed at the catchment facility located in the town of Guapi in the South Pacific Coast of Colombia. We provide data showing that P. falciparum malaria transmission is heterogeneous in time and space and analysed, using topological data analysis, the spatial connectivity, at the micro epidemiological level, between parasite populations circulating within the unit. To illustrate the necessity to evaluate the efficacy of malaria control measures within the transmission unit in order to increase the efficiency of the malaria control effort, we provide information on the size of the asymptomatic reservoir, the nature of parasite genotypes associated with drug resistance as well as the frequency of the Pfhrp2/3 deletion associated with false negatives when using Rapid Diagnostic Tests