Menetrier's disease

A clinical case of a 57-year-old female patient with history of epilepsy diagnosed in childhood, currently being treated with magnesium valproate, she presented with oral intolerance, ascites and weight loss. The initial laboratory workup was significant for hypoalbuminemia (serum albumin 18 g/L), but her liver and renal function were normal and urinalysis was negative. Panendoscopy was performed with a microscopic report: histopathology reporting findings related to hypertrophic gastropathy, gastric foveolar hyperplasia, with chronic diffuse moderate edematous gastritis without data of acute activity, with Helicobacter pylori bacilli in small quantity (+), negative for metaplasia, dysplasia and/or malignancy compatible with Menetrier disease. The patient was evaluated by the general surgery service to perform a jejunostomy and/or total gastrectomy as an adjuvant treatment for the patient. The extent of the gastrectomy to be performed is the subject of debate. The patient refused surgical treatment, so she was voluntarily discharged to an outpatient clinic to begin monoclonal treatment. The patient died 3 weeks before starting monoclonal treatment. Therefore, untreated patients have a high mortality rate due to complications.

DIMENSIONAMIENTO DE CRISTALES DE AZÚCAR A PARTIR DE PROCESAMIENTO DE IMÁGENES (SIZING OF SUGAR CRYSTALS BY IMAGE PROCESSING)

Resumen En este trabajo se determinaron las áreas superficiales y los volúmenes de cristales de azúcar capturados en un microscopio. El área superficial se determina a partir del análisis de imágenes, para ello se determinan los bordes de los cristales que se muestren completos y ortorrómbicos en la pantalla. Con la determinación de las áreas de los cristales se crea una relación dentro del programa para generar el valor del volumen. El procesamiento aquí mostrado puede ser empleado en línea o procesando un video pregrabado. En este caso, para grabar se utilizó un celular que grababa a través de la mirilla de un microscopio mientras los cristales pasabas por una celda de cristal. El análisis cuenta con un error del 0.8016% en comparación al método mie, utilizado en un MasterSizer. Palabras clave: Procesamiento imagen, cristales, dimensionamiento. Abstract In this work, the surface areas and volumes of sugar crystals captured under a microscope were determined. The surface area is determined from image analysis by determining the edges of the crystals that appear complete and orthorhombic on the screen. With the determination of the crystal areas a relation is created within the program to generate the volume value. The processing shown here can be employed online or by processing a pre-recorded video. In this case, a cell phone was used to record through a microscope scope while the crystals were passing through a crystal cell. The analysis has an error of 0.8016% compared to the mie method used in MasterSizer. Keywords: Image processing, crystals, sizing.>/em

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care