Gallstone ileus, the forgotten one: a rare cause of intestinal perforation and a case report

Gallstone ileum represents an unusual cause of intestinal obstruction as a result of the presence of stones that cause mechanical obstruction. It has an incidence of less than 4%. Reaching mortality up to 25% of cases. It is a difficult suspicion, with characteristic signs that guide its presence such as pneumobilia, occlusion, and the presence of stone in radiological studies. Management should include surgical extraction as well as revision of the entire intestine with a suitable subsequent repair. Authors present the case of a 70-year-old patient with the presence of surgically resolved biliary ileum

Protocol of sterile personal protective equipment for surgical personnel against SARS-CoV-2 during the COVID-19 pandemic

Background: COVID-19 represents the major pandemic seen the last years generating morbidity and mortality around the world. It is well known the propagation of the virus occurs by air mostly, so it is needed a barrier when the medic personal is treating suspect or confirm patients. Personal protective equipment represents a barrier between the health personnel and the patient during the COVID-19 pandemic. The surgical team during a COVID-19 confirmed o suspicious case procedure requires using PPE to be protected and keep the sterility for the patient safety.Methods: A team of surgeons from a 100% COVID-19 hospital of the Mexican institute of social security developed an inner protocol of safe use PPE maintaining sterility for the surgery.Conclusions: The protocol described provides safety to surgical team and the patient minimizing risk of surgical infections

Rationale, design, and baseline characteristics in Evaluation of LIXisenatide in Acute Coronary Syndrome, a long-term cardiovascular end point trial of lixisenatide versus placebo

BACKGROUND: Cardiovascular (CV) disease is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Furthermore, patients with T2DM and acute coronary syndrome (ACS) have a particularly high risk of CV events. The glucagon-like peptide 1 receptor agonist, lixisenatide, improves glycemia, but its effects on CV events have not been thoroughly evaluated. METHODS: ELIXA (www.clinicaltrials.gov no. NCT01147250) is a randomized, double-blind, placebo-controlled, parallel-group, multicenter study of lixisenatide in patients with T2DM and a recent ACS event. The primary aim is to evaluate the effects of lixisenatide on CV morbidity and mortality in a population at high CV risk. The primary efficacy end point is a composite of time to CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. Data are systematically collected for safety outcomes, including hypoglycemia, pancreatitis, and malignancy. RESULTS: Enrollment began in July 2010 and ended in August 2013; 6,068 patients from 49 countries were randomized. Of these, 69% are men and 75% are white; at baseline, the mean ± SD age was 60.3 ± 9.7 years, body mass index was 30.2 ± 5.7 kg/m(2), and duration of T2DM was 9.3 ± 8.2 years. The qualifying ACS was a myocardial infarction in 83% and unstable angina in 17%. The study will continue until the positive adjudication of the protocol-specified number of primary CV events. CONCLUSION: ELIXA will be the first trial to report the safety and efficacy of a glucagon-like peptide 1 receptor agonist in people with T2DM and high CV event risk

Proceedings Of The 23Rd Paediatric Rheumatology European Society Congress: Part Two

PubMe