Flores Morales Oscar Osbaldo Dr

10/10/2024

Cesar Delgado
Juan Zambrano Ruiz

A 13-year-old boy presented with recurrent fever and abdominal pain for 8 months, followed by a generalised seizure and persistent melaena. Significant findings on examination included severe thinness (BMI-for-age –5·2 standard deviation score), pallor, generalised muscle tenderness, and stage 2 hypertension (blood pressure 136/110 mm Hg).

Investigations identified normocytic normochromic anaemia (haemoglobin 85 g/L), acute kidney injury (serum creatinine 353·6 μmol/L), and elevated inflammatory markers (serum ferritin 3312 pmol/L, serum C-reactive protein 146 mg/L, and erythrocyte sedimentation rate 50 mm/h). Urinalysis revealed proteinuria (2+ on dipstick) and haematuria (4–5 red blood cells per high power field). Serum antinuclear and antineutrophil cytoplasmic antibodies were negative and C3 and C4 complement protein concentrations were normal.

A CT scan with angiography, performed for persistent gastrointestinal tract bleeding, is shown in the image. What is the likely diagnosis? Try our latest Clinical Picture quiz to find out more ▶️ https://hubs.li/Q02Rv-Z70

10/10/2024

03/09/2024

27/04/2024

In the latest Case Record of the Massachusetts General Hospital, a 58-year-old woman was transferred to this hospital because of progressively worsening confusion and evolving changes on magnetic resonance imaging (MRI) of the head.

Figure 1 from the case shows the MRI of the head and magnetic resonance spectroscopy on admission.

An axial T2-weighted fluid-attenuated inversion recovery image (Panel A) shows the presence of hyperintense signal abnormalities in both temporal lobes. An axial T1-weighted contrast-enhanced image (Panel B) shows the presence of abnormal subcortical enhancement in the insulae and in the left posterior gyrus re**us (arrows). Magnetic resonance spectroscopy targeting the signal hyperintensities in the left temporal lobe (voxel indicated by the blue box in Panel C) was performed with the use of a single voxel technique with a long echo time (270 msec) (Panel D). This technique shows the presence of a positive doublet at 1.3 ppm, which is compatible with a lactate peak (Panel D, arrow). Magnetic resonance spectroscopy targeting the central brain parenchyma and lateral ventricles was performed with the use of a multivoxel technique with a short echo time (30 msec) (Panel F); the spectroscopy grid (green grid), volume of interest (white box), and a small target voxel (blue box) are shown in Panel E. This technique also shows a marked elevation in the lactate level, with a positive doublet at 1.3 ppm (Panel F, arrow), in the chosen voxel in the anterior splenium and adjacent right ventricular atrium. Cho denotes choline, Cr creatine, and NAA N-acetylaspartate.

27/04/2024

A new technique to preserve the uterus in patients with placenta accreta spectrum disorders - Zhukovsky double balloon tamponade at the Cesarean section: insertion and mechanism of action
A, Insertion of the Zhukovsky vaginal balloon tamponade before cesarean delivery. B, Expansion of the vaginal balloon tamponade during surgery. C, Insertion of the Zhukovsky uterine balloon tamponade. D, Expansion of the Zhukovsky uterine balloon tamponade and vaginal balloon tamponade after surgery. E, Zhukovsky double-balloon tamponade. https://ow.ly/XMk150RnY8N

27/04/2024

23/03/2024

11/03/2024

01/11/2023

Join us for our next F&S Journal Club Global on November 3rd at 10:00 am EDT

We will discuss the topic of recurrent implantation failure: Is it a reality or just a statistical mirage?

Register here 👇
https://www.workcast.com/register?cpak=1995681990029950

01/11/2023

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31/10/2023

ACOG (2019) addresses the role of opportunistic salpingectomy in reducing ovarian cancer risk for women undergoing hysterectomy (benign conditions) or cesarean section