Fístula arteriovenosa femoral postraumática, tratamiento endovascular

ResumenAntecedentesLas fístulas arteriovenosas secundarias a arma de fuego han ido en incremento debido a las cuestiones bélicas, mostrando un beneficio en el manejo endovascular para pacientes hemodinámicamente estables.Caso clínicoSe presenta el caso de un paciente masculino 16años de edad con diagnóstico de fístula arteriovenosa femoral en miembro pélvico izquierdo, que ingresó al Servicio de Cirugía para manejo endovascular. Se realizó procedimiento con stent sin complicaciones, egresando del servicio sin complicaciones. Actualmente en tratamiento anticoagulante y antiagregante.ConclusiónLas fístulas arteriovenosas por debajo de la región inguinal pueden ser tratadas de manera segura con terapia endovascular (mediante stents o embolización) en pacientes hemodinámicamente estables. El objetivo del tratamiento es cerrar el defecto entre la arteria y la vena, obliterando el flujo que la nutre. Este fue el caso de este paciente, con buenos resultados tras la terapia endovascular, con lo que disminuyeron las complicaciones del tratamiento quirúrgico.AbstractBackgroundArteriovenous fistulas secondary to gunshot wounds have been increasing due to military activities, with endovascular treatment showing better results in haemodynamically stable patients.Clinical caseA 16 year-old male with diagnosis of femoral arteriovenous fistula in the left lower extremity was admitted to general surgery for endovascular management. A procedure with stent was performed without complications, and is currently on anticoagulant and antiplatelet treatment.ConclusionArteriovenous fistulas under the inguinal region can be safely treated with endovascular treatment (embolisation or stent) on stable patients. The objective of this therapy is to close the defect between artery and vein. This is the case of a patient with great results due to endovascular treatment, decreasing complications of the surgical treatment

Correlation of HbA1c with a basic math test in gestational diabetes

Background: A good metabolic control in Gestational Diabetes Mellitus (GDM) is crucial to avoid complications in the mother and the offspring. A limitation to reach a desired HbA1c in GDM is the education level of the mothers. Aims: The aim of this study was to determine the correlation between the HbA1c and the points obtained in a basic mathematical test. Study Design: cross-sectional study. Methods: This was a pilot study, prospective and cross-sectional. Pregnant women, older than 18 years old, diagnosed with GDM were invited to participate resolving a mathematical test of ten questions. HbA1c was done in the first consultation. Spearman correlation test was used between HbA1c and the punctuation of the mathematical test. Results: 31 patients with a mean age of 29 ± 6.7 years old accepted to participate. The education level was as follows: 5 (16.12%) with Primary School, 20 (64.51%) with High School, 2 (6.45%) with Preparatory School, 2 (6.45%) with technical studies and 1 (3.22%) that finished the University. The Spearman test showed a negative correlation between the mathematical test and the HbA1c (r2 = -0.395, P ≤ 0.001). Conclusion: A low mathematics knowledge limits the expectation to get an optimal metabolic control in GDM