Relation of the findings of the knee ultrasound, nuclear magnetic resonance and arthroscopy in meniscopathies

Introducción: según la literatura existen discrepancias entre los hallazgos en el ultrasonido, la resonancia magnética nuclear y la artroscopía, por lo que se considera a esta última como el patrón de oro para el diagnóstico de lesiones de estructuras internas de la rodilla. Objetivo: evaluar la relación entre el ultrasonido, la resonancia magnética nuclear y la artroscopía en lesiones meniscales. Método: se realizó un estudio descriptivo y observacional en el Hospital “Arnaldo Milián Castro” de la Provincia de Villa Clara entre enero de 2015 y marzo de 2017. Resultados: el 3,33% de los pacientes tenía entre 40 y 49 años y el 77,7% era masculino. En el 58,7% la rodilla afectada fue la derecha y en el 86,1% la causa fue no traumática. Según la localización de la ruptura meniscal el mayor número de lesiones del menisco medial se diagnosticó por RMN (61%) y US (58%), las del menisco lateral fueron diagnosticadas por US (41%) y artroscopía (39%). El ultrasonido y la resonancia mostraron una buena concordancia para la localización y la ubicación de la lesión. Conclusiones: la correlación fue muy buena para las variables analizadas entre los tres métodos diagnósticos, la mayor es entre la resonancia magnética y la artroscopía debido al índice de coincidencia detectado entre ellos.Introduction: according to the literature there are discrepancies between the findings on ultrasound, nuclear magnetic resonance and arthroscopy, which is why the latter is considered the gold standard for the diagnosis of lesions of internal structures of the knee. Objective: to evaluate the relationship between the echo, nuclear magnetic resonance and arthroscopy in meniscal lesions. Method: a descriptive and observational study was carried out at the “Arnaldo Milián Castro” Hospital in the Province of Villa Clara between January 2015 and March 2017. Results: 33.3% of the patients were between 40 and 49 years old and 77.7% were male. In 58.7% the affected knee was the right and in 86.1% the cause was nontraumatic. According to the location of the meniscal rupture, the greatest number of lesions of the medial meniscus was diagnosed by NMR (61%) and US (58%), those of the lateral meniscus were diagnosed by US (41%) and arthroscopy (39%). Ultrasound and resonance showed good agreement for the location and the exact point of the lesion. Conclusions: the correlation was very good for the variables analyzed between the three diagnostic methods, the largest being between magnetic resonance imaging and arthroscopy due to the coincidence index detected between them

Clinical Practice Guidelines for Bacterial Meningoencephalitis.

Clinical Practice Guidelines for Bacterial Meningoencephalitis. It has been defined as an acute inflammatory process caused by bacteria, often purulent, which involves the meninges, subarachnoid space around the brain, spinal cord and usually includes the ventricles. It is caused in the 80% of the patients by three bacteria: Haemophilus influenzae, Neisseria meningitides and Streptococcus pneumonia. Concepts, classification, diagnosis and treatment were reviewed. It includes assessment guidelines focused on the most important aspects to be accomplished

Clinical Practice Guidelines for Vascular Catheter Infections Treatment.

Clinical Practice Guidelines for Vascular Catheter Infections Treatment. It has been defined as the presence of local or systemic signs without other obvious infection site, plus the microbiologic evidence involving the catheter. This document includes a review and update of concepts, main clinical aspects, and treatment and stresses the importance of prophylactic treatment. It includes assessment guidelines focused on the most important aspects to be accomplished

Clinical Practice Guidelines for Severe Asthma Treatment.

Clinical Practice Guidelines for Severe Asthma Treatment. This disease is characterized by an overreaction of the tracheobronchial tree with hyperactivity after certain stimulus consisting of a diffuse narrowing of the respiratory ways related with an excessive contraction of the bronchial smooth muscle, hyper-secretion of mucus and mucosa edema. It is spontaneously reversible or reversible after treatment. We include a review of its definition, classification and development, stressing those elements related with ventilation. It includes assessment guidelines focused on the most important aspects to be accomplished

Infección hospitalaria en la Unidad de Cuidados Intensivos Polivalente de un hospital universitario cubano Hospital infection at the Polyvalent Intensive Care Unit of a Cuban university hospital

Se realizó un estudio retrospectivo, descriptivo a 212 pacientes con infección hospitalaria. Se revisaron actas y reportes estadísticos para obtener indicadores como: tasas de infección hospitalaria, tipos de infección hospitalaria, fallecidos y microorganismos aislados. El riesgo de infección de algunos procederes se expresó en tasas de incidencia acumulada por 100 pacientes y densidad de incidencia x 1 000 d del proceder. La tasa de infección hospitalaria promedio fue de 7,9 %. Se reportaron 247 infecciones hospitalarias, mostrando mayor incidencia la respiratoria con predominio en pacientes que recibieron ventilación mecánica. Este proceder presentó las mayores tasas de riesgo. Acinetobacter baumannii multirresistente y estafilococos predominaron en los 244 aislamientos. De los pacientes reportados, 28,3 % falleció asociado a infecciones hospitalarias y 6,7 %, por este motivo. La infección hospitalaria en esta unidad ha mantenido tasas generales aceptables con predominio de la infección respiratoria en pacientes sometidos a ventilación mecánica y la infección intravascular en pacientes con catéteres intravenosos insertados, procederes con alto riesgo demostrado. La presencia de Acinetobacter baumanni y estafilocococos como microorganismos más aislados demanda un mayor control y estrategias de prevención. El conocimiento del comportamiento de los indicadores del CPCIH constituye una herramienta de trabajo útil para desencadenar la toma de decisiones necesarias y mejorar continuamente la calidad del trabajo.Summary A retrospective descriptive study of 212 patients with hospital infection was undertaken. Acts and statistical reports were reviewed to obtain indicators such as hospital infection rates, types of hospital infections, deceased individuals and isolated microorganisms. The infection risk of some procedures was expressed by accumulated incidence rate per 100 patients and incidence density x 1 000 d of the procedure. The average hospital infection was 7.9 %. 247 hospital infections were reported. The respiratory infection showed the highest incidence with predominance in patients that receive mechanical ventilation. This procedure presented the greatest risk rates. Multiresistant Acinetobacter baumannii and staphylococcus prevailed in the 244 isolates. Of the reported patients, 28.3 % died associated with hospital infections and 6.7 for this reason. Hospital infection in this unit has maintained acceptable general rates with predominance of the respiratory infection in patients undergoing mechanical ventilation and of intravascular infection in patients with inserted intravenous catheters, procedures with a high risk proved. The presence of Acinetobacter baumanni and staphylococcus as the most isolated microorganisms demand a better control and prevention strategies. The knowledge of the behavior of the CPCIH indicators is a useful working tool to trigger the making of necessary decisions and to continuously improve the quality of work

Clinical Practice Guidelines for Acute Renal Failure.

Clinical Practice Guidelines for Acute Renal Failure. It a syndrome characterized by the abrupt deterioration of basal renal functions (abrupt reduction of glomerular filtration) and the consequent increase of nitrogenous products in the blood as well as the homeostasis of the body. It aetiological agents, clinical presentation, therapeutic and diagnostic methods are described. It includes assessment guidelines focused on the most important aspects to be accomplished.</span

Clinical Practice Guidelines for Ventilation Associated Pneumonia.

Clinical Practice Guidelines for Ventilation Associated Pneumonia. Conceptualized as the bacterial pneumonia that develops in patients receiving mechanical ventilation for more than 48 hours, which is not present at the beginning of the ventilation. We review the concept, prevention and treatment. It includes assessment guidelines focused on the most important aspects to be accomplished

Vibrio vulnificus specie isolation in series blood culture. A case report.

This papers contains a report of a case with Vibrio vulnificuls, gram negative micro organism that ferments carbohydrates and that is positive to the oxidase test and halophile in a patient with history of heart and liver disease who was assisted at the Intensive Care Emergency Unit ( ICU )of the ¨Dr. Gustavo Aldereguía Lima¨ University Hospital in July 2003. Thy symptoms were: oedema in lower limbs, orthopnea, chest pain that was interpreted as a case of pneumonia and a Myocardial Infarction. This patient progresses rapidly to cardiac arrest, is reanimated , and is admitted at the ICU with control pressuremetric ventilation. Vibrio Vulnificuls was isolated with a conventional diagnosis from hemo cultures. Anti microbial Susceptibility tests , the micro organism was susceptible to tetracycline, sulphaprim, aztreonam, ampicillin and was resistant to chloranphenicol.</span

Evolución por ultrasonido modo B y Doppler color del riñón trasplantado

Introduction: chronic kidney disease is a progressive damage of the kidney, its most advanced and irreversible manifestation is the terminal chronic kidney disease, with the consequent need of renal replacement therapy.Objective: to describe the evolution by B-mode ultrasound and color Doppler of the transplanted kidney.Methods: a descriptive, longitudinal and prospective development research was carried out. The study population was conformed by all the patients who received as substitute renal treatment a transplant of a new organ from April 2016 to October 2017 in the Hospital "Arnaldo Milián Castro" of Villa Clara. The sample was constituted in a non-probabilistic way by 39 patients.Results: patients with normal echogenicity of renal parenchyma, good cortical-medullary relationship, acute rejection, increased resistance index and drop of diastole predominated. Perirenal collection was the most frequent complication. At the end of the study there were 28 patients left, 11 lost the transplanted organ.Conclusions: ultrasound, due to its wide availability, its sensitivity, its innocuousness and its low cost, is the study of choice in the follow-up of patients with renal transplant because it allows characterizing, in an adequate way, the complications of renal transplant and it is a determining part in the evolution of the graft and the recipient.Introducción: la enfermedad renal crónica es un daño progresivo del riñón, su manifestación más avanzada e irreversible es la enfermedad renal crónica terminal, con la consiguiente necesidad de terapia de sustitución renal.Objetivo: describir la evolución por ultrasonido modo B y Doppler color del riñón trasplantado.Métodos: se realizó una investigación de desarrollo descriptiva, longitudinal y prospectiva. La población de estudio estuvo conformada por todos los pacientes que recibieron como tratamiento renal sustitutivo trasplante de un nuevo órgano de abril de 2016 a octubre de 2017 en el Hospital “Arnaldo Milián Castro” de Villa Clara. La muestra quedó constituida de manera no probabilística por 39 pacientes.Resultados: predominaron los pacientes con ecogenicidad normal del parénquima renal, relación córtico-medular buena, rechazo agudo, índice de resistencia aumentado y caída de la diástole. La colección perirrenal fue la complicación más frecuente. Al final del estudio quedaban 28 pacientes, 11 perdieron el órgano trasplantado.Conclusiones: el ultrasonido, debido a su amplia disponibilidad, su sensibilidad, su inocuidad y su bajo costo, es el estudio de elección en el seguimiento de los pacientes con trasplante renal porque permite caracterizar, de forma adecuada, las complicaciones del trasplante renal y es parte determinante en la evolución del injerto y del receptor