Abstract Acute aortic dissection is a medical emergency associated with high mortality, so an early diagnosis based on a detailed clinical history, physical examination findings, and imaging studies is essential for its diagnosis. The treatment depends on its location, with the recommendation of an urgent surgical approach for acute type A dissections and mainly pharmacological treatment in uncomplicated type B aortic dissection. We present the case of a Mexican male patient who developed uncomplicated type B aortic dissection, that was treated with pharmacological treatment and endovascular aortic repair, and presented an adequate clinical evolution without complications at discharge or during follow-up.

Resumen La disección aórtica aguda es una urgencia médica asociada a una alta mortalidad, por lo que es fundamental el diagnóstico precoz a partir de una historia clínica detallada, hallazgos a la exploración física y estudios de imagenología, pilares fundamentales para su diagnóstico. El tratamiento depende de su localización, con recomendación de abordaje quirúrgico urgente para las disecciones agudas de tipo A y principalmente el tratamiento farmacológico en la disección aórtica tipo B no complicada. Presentamos el caso de un paciente del sexo masculino, de origen mexicano, que desarrolló disección aórtica tipo B no complicada, a quien se decidió abordar con tratamiento farmacológico y reparación aórtica endovascular, y presentó una adecuada evolución del cuadro clínico, sin complicaciones al egreso ni durante su seguimiento.

Abstract Background: To date, Mexico has more than 1,280,000 confirmed cases and more than 116,000 deaths due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Limited information is available regarding Latin American patients with Guillain-Barré syndrome (GBS) and SARS-CoV-2. Objective: The objective is to describe the presentation, diagnosis, and outcome of patients with GBS associated with SARS-CoV-2 infection. Methods: We describe four cases of GBS associated with SARS-CoV-2 infection in Mexico. Results: Neurological symptoms initiated 2-17 days after the respiratory symptoms. The age group in or patients ranged from 26 to 41 years. Two patients presented with progressive, acute, and symmetric weakness and two with bilateral facial palsy. Patients with GBS diagnosis associated with SARS-CoV-2 infection have been reported to have a good outcome after IGIV or plasma exchange therapy. Conclusion: It is important to consider GBS as a potential manifestation of SARS-CoV-2 infection and recall that the diagnosis is based mainly on clinical evaluation. Laboratory and CSF analysis, as well as neurophysiologic studies, should be considered as a complement for diagnosis.

Resumen Antecedentes: A la fecha, México tiene más de 1,280,000 casos confirmados y más de 116,000 muertes por infección por SARS-CoV-2. Se dispone de información limitada sobre los pacientes latinoamericanos con síndrome de Guillain-Barré (GBS) y SARS-CoV-2. Objetivo: El objetivo es describir la presentación, el diagnóstico y la evolución de los pacientes con síndrome de Guillain-Barré asociado a la infección por SARS-CoV-2. Métodos: Describimos cuatro casos de SGB asociados a la infección por SARS-CoV-2 en México. Resultados: Los síntomas neurológicos se iniciaron 2-17 días después de los síntomas respiratorios. El grupo de edad de los pacientes osciló entre 26 y 41 años. Dos pacientes presentaron debilidad progresiva, aguda y simétrica y dos con parálisis facial bilateral. Se ha reportado que los pacientes con diagnóstico de GBS asociado con la infección por SARS-CoV-2 tienen un buen resultado después de la terapia de recambio plasmático o IGIV. Conclusión: Es importante considerar el SGB como una posible manifestación de la infección por SARS-CoV-2 y recordar que el diagnóstico se basa principalmente en la evaluación clínica. Los análisis de laboratorio y de LCR, así como los estudios neurofisiológicos, deben considerarse como un complemento del diagnóstico.

Abstract Objective: To develop and validate a simple self-administered questionnaire to evaluate ureteral stent discomfort. Material & Methods: A pilot instrument based on the USSQ was designed and structured using the Delphi method. It was applied to 72 patients with an indwelling ureteral stent after semirrigid ureteroscopy. The instrument was validated through the Cronbach’s alpha coefficient and Pearson’s correlation coefficient. Results: The ureteral stent discomfort test (USDT) utilizes a Likert scale model, with 6 domains: 1-urinary symptoms, 2-pain, 3-daily life, 4-sex life, 5-medical care / use of analgesics and 6-quality of life 6, 2, 1, 1, 2, 1 items, respectively. The more severe the symptoms, the higher the score, with a maximum score of 61 points. Validation studies made the questionnaire internally consistent (Cronbach 0.820) with good reliability (Pearson 0.850). The correlation of urinary symptoms (r = 0.929, p = 0.00), pain (r = 0.880, p = 0.00), daily life (r = 0.625, p = 0.00), quality of life (r = 0.768, p = 0.00) of both questionnaires was statistically significant. UDT application time (m = 1.8min SD = 0.76) VS USSQ (m = 8.3min SD = 0.76) was shorter than for the USSQ (m = 8.3min SD = 0.76). Limitants: The small sample size was a restriction. More patients are required to demonstrate the usdt’s effectiveness. Value: The questionnaire is an easy-to-use tool for the simple evaluation of ureteral stent discomfort. Conclusions: The USDT is a simple and rapid tool, comparable to the USSQ, for evaluating ureteral stent-related symptoms.

Ao contrário do que se poderia esperar devido à hegemonia histórica dos Estados Unidos na América Latina, a crescente influência chinesa na região não levou a uma disputa entre China e Estados Unidos. Apesar do ativismo de grupos linha-dura nos Estados Unidos, ambas as partes têm enfrentado a questão com pragmatismo perceptível. Essa atitude pode ser explicada por três variáveis: a negligência política americana para a América Latina no pós-Guerra Fria, o foco das relações sino-latino-americana sobre economia, em vez de assuntos geopolíticos ou ideológicos, e a relevância escassa da região no topo de prioridades das relações globais de Washington-Pequim.

Contrary to what could be expected given the United States' historical hegemony of Latin America, growing Chinese influence in this region has not led to a dispute between China and the US. Despite activism of hard-line groups in the United States, both parties have faced the issue with noticeable pragmatism. This attitude could be explained by three variables: the US political negligence towards Latin America in the Post-Cold War, the focus of Sino-Latin American relations on economic rather than geopolitical or ideological affairs, and the scanty relevance of the region in the top priorities of overall Washington-Beijing relations.

Male of 71 years with 10 years evolution of diabetes mellitus II, heavy smoker. The case began with pleural overflow and with X ray cavitation in the left upper lobe.

Hombre de 71 años de edad con diabetes mellitus tipo II de 10 años de evolución, con tabaquismo intenso. Inició con derrame pleural e imagen radiológica de cavitación en lóbulo superior izquierdo.