Drainage of the hepatic cyst by laparoscopy - clinical case

Liver cysts are formations of serous content surrounded by normal liver parenchyma, without communication with the bile duct. The cyst wall is generally lined with cuboidal epithelium surrounded by layers of connective tissue. They are rare entities in adult patients, generally, they are asymptomatic in 3%, and between 10-15% of all patients will generate symptoms that lead them to consult. A 38-year-old man with an external abdominal tomography study that reported a giant hepatic cyst. Laboratory blood tests: hemoglobin 7.9 g/dl; leukocytosis 11,000/ul; serum electrolytes, liver transaminases, and bilirubin were normal, alkaline phosphatase, and gamma glutamyl-transpeptidase 94 U/l and 241 U/l, respectively. Non-reactive anti-human immuno-deficiency virus (HIV 1) and two antibodies, venereal disease research laboratory (VDRL), cancer antigen (CA) 19-9 antigen, hepatitis B-C surface antigen, and carcinoembryonic antigen were negative. He underwent surgery by laparoscopic drainage of the liver cyst, through a median infraumbilical incision with the Hasson technique and placement of three 12 mm trocars, hepatomegaly was observed without finding an exit site for purulent material, it was punctured through liver segment V, and 2000 ml of citrine fluid was extracted. The hepatic wound is addressed with a 1-0 caliber chromic catgut thread, placing a Penrose-type drain. At 48 hours postoperatively, it evolves favorably, so it is decided to discharge. Hepatic cysts are fluid-filled cavities lined by a single-layered cuboidal or columnar biliary epithelium in the liver. A majority of hepatic cysts are found incidentally on liver imaging, such as abdominal ultrasonography, computed tomography, or magnetic resonance imaging

Risk Factors that Increase Maternal Morbidity in Pregnant Women Between 30 to 34 Years of Age

Introduction. According to the World Health Organization (WHO), the prevalence of obesity worldwide has nearly tripled since 1975. According to 2016 data, 39% of the global adult population was overweight, and 13% was obese. A recent study, including 20 European countries, concluded that 53% of adults were overweight or obese. Increase in overweight and obesity among women of childbearing age (15 to 44 years). Overweight and obesity during pregnancy are associated with many complications, including increased risk of gestational hypertension, preeclampsia, gestational diabetes mellitus, cesarean delivery, preterm delivery, large-for-gestational-age infants, and stillbirths. Additionally, gestational weight gain is associated with diabetes, pregnancy-induced hypertension, cesarean delivery, postpartum weight retention, macrosomia, and childhood obesity. Materials and Methods. An observational, cross-sectional study in 15 pregnant women in 2022 at the Playa del Carmen General Hospital. Results. Were completed variables of interest in prenatal control. Discussion. The short interval between pregnancies is a public health problem because it leads to adverse perinatal outcomes such as postpartum hemorrhage, anemia, preterm delivery, low birth weight, and perinatal deaths. Ineffective or no contraception after one pregnancy contributes to a subsequent pregnancy. Conclusion. It is essential to detect gestational Diabetes mellitus as well as gestational hypertension, and prenatal control should be improved because although pregnant women report carrying it out, it is not reflected in cases of preeclampsia that remains high in pregnant women.&nbsp

Incidence of hypertension in a high-risk workgroup (Police officers) - Observational study

Introduction: Hypertension is a silent pathology in a way that affects all four spheres to be considered as such; magnitude, transcendence vulnerability, and feasibility. The World Health Organization estimates that 45% of deaths from heart disease and 51% of deaths from stroke globally are caused by hypertension. Material and method: A longitudinal, descriptive and quantitative observational study was carried out on the personnel of high-risk public service providers. Results: The total population sampled was 550 people where it was possible to determine the sex where the disease predominates, since 92% of the hypertensive population belong to the male sex, while 8% of the female population. 57% of the total population were classified as normotensive, while 21% were classified as High Normal, Grade I Hypertension, and Grade II Hypertension. Discussion: AHT is the result of a series of interactions between endogenous and exogenous factors in an organism that tries to adapt to the increase of the cardiac output and the peripheral resistance of the blood vessels, which is manifested by the increase in blood pressure figures. Physical activity has been shown to have a lower risk of hypertension compared to sedentary individuals. The daily stress these workers face predisposes them to suffer their manifestations as headache, muscle pain, fatigue, digestive disorders and constant elevations of blood pressure

Infection by SARS-CoV-2 in healthcare workers of a second level hospital

Background: From the first COVID-19 case in Playa del Carmen, 370 cases of infection have been reported in our staff until December 31, 2020. Material and methods: Study in workers of the General Hospital who developed SAR-CoV-2 infection during the pandemic. A sample of 30 cases of both sexes with laboratory-confirmed infection was obtained. Descriptive statistics were used with measures of central tendency, dispersion and percentages. Results: In a sample of 30 workers there were 13 doctors, 6 nurses and 11 support workers. The age was obtained as a mean of 38.8 years and SD = 10.4. Only four risk factors were found. Of the 30 infected health workers, 27 were treated on an outpatient basis and three required hospitalization. Discussion: The main symptoms in health workers are alterations in the sensation of taste and smell, but unlike our study, was headache, fever and myalgia. Likewise, it has been observed that medical are the most affected, but in this study it was support and the least affected was nursing personnel. There is no doubt that asymptomatic carriers are a serious disease transmission problem such that transmission between health workers by asymptomatic carriers is possible as was observed in this analysis

Body mass index in a group of security forces (policemen). Cross-sectional study

Introduction: Most police officers work long hours in day and night shifts and this exposure can harm your health. Objective: Know the Body Mass Index (BMI) of a group of policemen of both sexes chosen at random to calculate the degree of overweight / obesity of the observed population. Material and Method: An cross-sectional study was carried out on 75 elements of the municipal police of sexes, obtaining age, height, and weight with which the corresponding Body Mass Index was obtained. Descriptive statistics were used. Results: Measurements were taken at 75 (100%) policemen of both of them sexes, 60 (80%) male and 15 (20%) female. And the following results were obtained: ideal weight 5 (6.6%), overweight 21 (28.0%) elements and obesity 49 (65.3%). Discussion: Obese workers are prone to getting sick, missing work, disability and early retirement when compared to non-obese workers. Obesity can be a predictor of early mortality; therefore, with a BMI of 30-35, life expectancy decreases from 2 to 4 years and with a BMI of 40-45 it decreases from 8 to 10 years. In our study we found 70 (93.3%) policemen were overweight and obese BMI> 25). Conclusions: Our findings recommend the implementation of diverse programs for the improvement of the health of this labor group with a multidisciplinary team as well as the adequate physical spaces for the practice of the corresponding activities

Risk Factors that Increase Maternal Morbidity in Pregnant Women Between 30 to 34 Years of Age

<p>Introduction. According to the World Health Organization (WHO), the prevalence of obesity worldwide has nearly tripled since 1975. According to 2016 data, 39% of the global adult population was overweight, and 13% was obese. A recent study, including 20 European countries, concluded that 53% of adults were overweight or obese. Increase in overweight and obesity among women of childbearing age (15 to 44 years). Overweight and obesity during pregnancy are associated with many complications, including increased risk of gestational hypertension, preeclampsia, gestational diabetes mellitus, cesarean delivery, preterm delivery, large-for-gestational-age infants, and stillbirths. Additionally, gestational weight gain is associated with diabetes, pregnancy-induced hypertension, cesarean delivery, postpartum weight retention, macrosomia, and childhood obesity. Materials and Methods. An observational, cross-sectional study in 15 pregnant women in 2022 at the Playa del Carmen General Hospital. Results. Were completed variables of interest in prenatal control. Discussion. The short interval between pregnancies is a public health problem because it leads to adverse perinatal outcomes such as postpartum hemorrhage, anemia, preterm delivery, low birth weight, and perinatal deaths. Ineffective or no contraception after one pregnancy contributes to a subsequent pregnancy. Conclusion. It is essential to detect gestational Diabetes mellitus as well as gestational hypertension, and prenatal control should be improved because although pregnant women report carrying it out, it is not reflected in cases of preeclampsia that remains high in pregnant women.</p&gt

A Colocolonic intussusception in an adult secondary to an inflammatory polyp of the transverse colon - clinical case

There are multiple causes of colocolonic intussusception in adults, such as tumors, autoimmune pathologies, previous abdominal surgeries, and gynecological conditions. Associated complications are small bowel obstruction, ischemia, necrosis, perforation with peritonitis, and sepsis that require urgent attention. A 78-year-old woman who started with colic in the mesogastrium of 5 months of evolution and changes in bowel habits. She went to the emergency room due to intense pain in the mesogastrium. On physical examination, she presented dehydration of the mucous membranes and pale integuments, pain on superficial and deep palpation in the mesogastrium. Admission laboratories: leukocytosis 17,110/ul, neutrophilia 67.9%, hydroelectrolyte imbalance: mild hyponatremia, mild hypochloremia, slightly prolonged coagulation times, normal blood chemistry. Abdominal ultrasound with "pseudokidney" image. Computed tomography reports an image of the introduction of a segment of the transverse colon into a contiguous segment of the same, with data of associated intestinal pneumatosis. Due to the previous findings, an emergency exploratory laparotomy was performed. Invagination of the transverse colon is located, accompanied by dilation of the vessels of the greater omentum; it is reduced manually, an enterotomy is performed and a tumor dependent on the wall is located, for which a 25 cm transverse colon resection, end colostomy and mucous fistula are decided. Pathology report reports inflammatory polyp. In the postoperative period, the patient improved and was discharged. Abdominal pain is the common presentation of intussusception; however, given its rarity in adults, the possibility of missing the finding on abdominal imaging leads to misdiagnosis