Hypospadias: a review

Hypospadias is a congenital malformation of the male external genitalia, which includes: anomalous location proximal to the urethral meatus, in any portion of the glans penis and perineum, hooded dorsal foreskin, and inverted penile curvature on the dorsal side of the foreskin. The etiology has been considered multifactorial, secondary to the interaction of environmental factors with specific genetic background. It represents the second most frequent congenital defect in male newborns. It has increasing prevalence rates of 0.25 new cases per 10,000 newborns per year. Risk factors that have been identified include infants small for gestational age with weight below the 10th percentile, head length and/or circumference, intrauterine growth restriction, and placental insufficiency. Regarding environmental risk factors, maternal exposure to pesticides has been linked. Prenatal diagnosis has been described, however proximal hypospadias is usually detected, making it difficult to diagnose distal hypospadias using this method. So usually the diagnosis is made after birth during the physical examination. To date, more than 300 surgical techniques are known for the correction of hypospadias. The treatment of distal hypospadias is currently performed in one time; the management of proximal hypospadias is controversial; one group favors the one-stage procedure, while other groups choose to perform the two-stage procedure

Pseudoaneurysm due to femoral artery puncture: a review

The femoral artery is the most used percutaneous access site for different endovascular therapeutic options, this being an excellent anatomical site to achieve adequate compression after its puncture, which frequently makes it the site with the highest incidence of complications associated with posterior to arterial puncture. The most frequent complications related to arterial puncture are: hematoma, pseudoaneurysm, retroperitoneal hematoma, and arterial occlusion. The pseudoaneurysm is defined as the interruption in the wall of the artery, product of the lesion of the wall, which causes blood leakage towards the surrounding tissues, remaining contained in a fibrin sac, therefore, the importance of an adequate diagnosis and treatment lies above all in the high risk of rupture or thromboembolism.

Xanthogranulomatous pyelonephritis: a review

Xanthogranulomatous pyelonephritis (XP), first described in 1916, is a rare form of chronic granulomatous inflammation. The etiology is still unclear; however, the development of the disease is associated with chronic urinary obstruction secondary to lithiasis, tumors and urological malformations, among others. This leads to the destruction of the renal parenchyma and its replacement by solid sheets of lipid-laden macrophages. Female gender, diabetes and obesity are attributed as predisposing factors to the development of XP. It is estimated that the incidence presents a maximum peak between 50 and 70 years, with a ratio of 2:1 women-men respectively. Computed tomography (CT) is described as the mainstay in the evaluation. However, the definitive diagnosis is made by histopathological study, where a mixture of lipid-laden foamy macrophages, lymphocytes, neutrophils, giant cells, and plasma cells can be seen. Nephrectomy (open or laparoscopic) continues to be the first-line treatment. The laparoscopic approach is associated with an increase in operating time; however, the recovery time is shorter compared to the open approach. Given the natural history of the disease and the associated complications, this makes it a challenging approach for the surgeon. Therefore, a surgeon experienced in laparoscopic skills is necessary. This review seeks to synthesize existing information regarding the appropriate surgical approach in conjunction with the clinical context

Biliary atresia: a review

Bile duct atresia (BA) is a severe, progressive cholangiopathy characterized by fibrous and inflammatory obliteration of the intrahepatic and extrahepatic bile ducts. It leads to liver failure, scarring, and end-stage cirrhosis if timely treatment is not achieved. It represents the number one indication for pediatric liver transplantation as a single disease worldwide. Various etiological factors have been associated with BA, such as structural malformations, viral, immune-mediated, and genetic infections. The incidence of BA varies around the world. Untreated BA patients have a 2-year mortality of nearly 100%. The clinical picture is characterized by jaundice, acholia, and jaundice that persists beyond the first 2 weeks of life. Direct or conjugated bilirubin remains the primary screening laboratory test for BA; elevated values ​​occur within the first 2 days of life. Currently, the primary treatment of choice is the Kasai portoenterostomy; the success of surgery has been based on the restoration of bile flow and the elimination of jaundice. However, more than 70% of patients develop liver cirrhosis secondary to persistent liver inflammation, which will require liver transplantation. The following review of the literature aims to collect relevant information from what has been published in recent years on bile duct atresia; focused on the study of etiology, pathophysiology, advances in genetics and immunology. As well as the results associated with surgical treatment and the requirement for liver transplantation

Staghorn renal stones: a review

Staghorn lithiasis is described as the presence of stones in the urinary tract that create a mold of the renal collecting system, with the characteristic of being branched. It has a strong association with urinary tract infections caused by urea-splitting organisms. The composition of the stone usually consists of pure magnesium ammonium phosphate (struvite), or a mixture of struvite and calcium carbonate apatite. It is classified as complete and partial. In the complete one, the stones occupy the renal pelvis and the calyceal system, or more than 80% of the collecting system; unlike the partial ones that occupy the renal pelvis and at least two calyces. Computed tomography without intravenous contrast is the imaging method of choice for diagnosis and planning of surgical intervention. Allowing an accurate assessment of the morphology and location of the stones; that will set the standard for guiding percutaneous access. Complete stone cleaning is the cornerstone of staghorn lithiasis treatment. The guidelines of the European Association of Urology and the American Association of Urology mention that percutaneous nephrolithotomy continues to be the treatment of choice for large stones. Conservative management is related to renal loss and urosepsis, reporting a mortality of 28 % up to 30% within 10 years, as well as a 36% risk of developing chronic kidney disease

Purification of Rainwater Using a Photocatalysis Technique to be Applied to Communities in Ciudad del Carmen, Campeche, Mexico

Small communities far from the municipal seat do not have access to drinking water, so many children suffer from various gastrointestinal diseases, which cause these children to grow up with nutritional deficiencies. In the state of Campeche, there are 300 sunny days. This energy can be used to install water treatment systems to make it drinkable. Therefore, a treatment system with heterogeneous photocatalysis was proposed using a zinc oxide catalyst doped with silver nanoparticles. The reactor has a metal structure with a flat plate where clay plates support the catalyst. Samples were taken every 2 h to carry out the corresponding analyses and in a period of 8 h of reaction. For the characterization of rainwater adhered to Mexican regulations. The results showed that there was 6400 NMP/100 mL for fecal coliforms at the beginning, and after 4 h, this parameter goes to <2 NMP/100 mL. Initially, the same happened for fecal coliforms; 9200 NMP/100 mL was determined. After 4 h, this parameter drops to <2 NMP/100 mL. The same behavior was observed with chlorides, hardness, and total alkalinity, which showed a tendency to decrease significantly. This confirms that the system works properly to eliminate organic compounds and purify rainwater

Hidradenitis suppurativa: a review

Hidradenitis suppurativa (HS) is a chronic inflammatory disorder that is characterized by recurrence, as well as the characteristic location of skin lesions. Patients usually develop very painful inflammatory nodules that generally end in the formation of multiple abscesses and fistulas that typically occur in the skin of the axillary, inguinal, buttock, and perianal folds. It significantly affects the quality of life of patients, leaving physical, economic and psychological sequelae. There is a wide therapeutic arsenal available, but each patient must be individualized and the best possible treatment determined. Early assessment and intensive treatment of the disease can prevent and even avoid significant sequelae and permanent deformities

Current strategies for the reconstruction of the nipple-areola complex: a review

The reconstruction of the nipple-areola complex after a mastectomy is essential for the bio-psycho-social recovery of the patient, it is generally performed 4 to 6 months after surgery and there are multiple surgical reconstruction techniques depending on the experience of the surgeon and of the individual characteristics of the patients. The most widely used for its safety and for having shown the best results is the local flap technique combined with the use of autologous, alloplastic and allograft grafts. However, currently there is still no technique that shows long-term lasting results. For this reason, in this article we describe the five categories of reconstruction techniques for the nipple-areola complex that currently exist, their advantages and disadvantages, as well as the lines of research in tissue engineering in which the world is working to find a therapeutic strategy that can reproduce a nipple-areola complex with the characteristics of the biologic.

Biodegradable electrospun scaffolds for skin wound regeneration: a review

Over the years, skin substitutes have been sought as an alternative for the treatment of different pathologies. In this article, we focus on describing the use of different biodegradable nanofibrillar polymers as skin substitutes in the treatment of acute and chronic wounds, obtained by the electrospinning technique. Electrospinning is a tissue engineering technique used to generate nanofibers of different polymers that are characterized by having a high surface area, low molecular weight, high resistance rates, and nanoporosity, which is why they are particularly interesting for biomedicine, with potential applicability. in the replacement of skin and tubular organs. In this context, the skin created by tissue engineering has high expectations of application in the study of treatment of skin wounds

Insulinoma de páncreas que imita epilepsia

El insulinoma es una neoplasia endocrina funcional rara, que provoca un estado hiperinsulínico hipoglucémico derivado de la ausencia de regulación endocrina de la secreción de insulina. Su incidencia es de 1 a 5 caso por millón de personas al año a nivel mundial. Es la sintomatología más comúnmente manifestada por síntomas neuroglucopénicos y simpaticoadrenales. El diagnóstico se establece por la tríada de Whipple, los niveles elevados de insulina, el péptido C, la proinsulina y los niveles disminuidos de betahidroxibutirato, además de descartar el uso de sulfonilureas. El manejo de elección es la resección quirúrgica, dado su alto nivel de benignidad y curación total. Se presenta el caso de un hombre en manejo anticonvulsivante por epilepsia con refractariedad de síntomas, quien debutó con cuadro de hipoglucemia grave necesaria para el diagnóstico de insulinoma, con manejo quirúrgico y resolución del cuadro de base