Published: 2021-04-11

Editorial

Guatemalan doctors at the top

Authors:
Roberto Elfidio Orozco Florián
Pages:
1
Abstract:
The top of science is constantly rising, the researchers who come closest to it have the privilege of seeing it move away from them again. That unattainable end is the passion that drives them to pursue her, they can't even take a break from trying to break through on their way to her.
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Original Articles

Tomographic findings in patients with COVID-19

Authors:
Samuel Villeda, Elvis López, José Echeverría, Mary Cotí-de-Xicará
Pages:
2-5
Abstract:
Introduction: due to the constant increase in SARS-Cov2 infection, it is essential to know the radiological findings of this disease, since it plays a very important role in the approach and management of these patients. Objective: to establish the main radiological findings in thoracic tomography (TT) of patients with a diagnosis of SARS Cov2 infection, who attend a private diagnostic center in Quetzaltenango, Guatemala. Material and methods: TT findings in patients with a positive RT-PCR test for SARS-Cov2, from patients who attended a center for Imaging diagnosis, Quetzaltenango, from March to August 2020. Results: of the 82 TTs analyzed, 56% were from male patients. The most prevalent age group was 41-50 years (27%). The predominant tomographic pattern was ground glass image (41%); the most frequent location was bilateral (90%); the most frequently affected lung lobe was the lower lobe (71%). Discussion: our results are in keeping with those of the literature.
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Symptoms of Attention Deficit Hyperactivity Disorder in college students

Authors:
Rocío Godínez, Juan Mack, Christian Moll, David Alvarez, Brenda Archila, Mario Cavaradossi, Guillermo Domínguez, Andrea Morales, Adrián Salatino
Pages:
6-10
Abstract:
Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by alterations in attention, impulsivity, and motor overactivity that misconduct to academic performance. Objective: To determine the presence of symptoms of Attention Deficit Hyperactivity Disorder (ADHD) in university students from first to third year of the Medical Degree of the Facultad de Ciencias Médicas of the Universidad de San Carlos de Guatemala, during the year 2020. Material and methods: A descriptive cross-sectional study was carried out in a sample of 382 medical students. The Adult Self-Report Scale (ASRS-v1.1) and Wender Utah Rating Scale (WURS-25) were applied to assess the presence of ADHD symptoms in childhood and currently. Results: Of the population studied (n=366): 14% (N=51) presented symptoms of ADHD and 6% (n=3) had a history of failing a grade in school. Conclusion: One in ten students of the Faculty of Medical Sciences presents symptoms of ADHD, the majority between the 17-19 years, in the second year of studies and female gender. Most college students with ADHD symptoms have a grade retention of one or more years.
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Prevalence of depressive, anxiety and suicidal ideation symptoms in medical students

Authors:
Andrea Rodas, André Deutschmann, Selena Nij, Oneida Castellanos, Guillermo Domínguez, Andrea Morales
Pages:
11-17
Abstract:
Objective: To determine the prevalence of depressive, anxiety and suicidal ideation symptoms in medical students from first to sixth year, enrolled at Facultad de Ciencias Médicas, Universidad de San Carlos de Guatemala, Guatemala, during August 2019. Material and Methods: Descriptive cross-sectional study carried out on 2,503 students chosen with simple random sampling per academic year, the Beck Anxiety Inventory and the Patient Health Questionnaire were used to collect data. A univariate statistical analysis was applied. Results: 49.78% (1,246) presented symptoms of depression, 75.23% (1883), anxiety and 23.97% (600), suicidal ideation. 34.67% (868) had mild anxiety symptoms and 24.89% (623), moderate depressive symptoms. The mean age was 21.28 years ± 4.96 SD with a predominance of females 55.69% (1397), catholic religion 54.17%, residents of the Guatemala department 70.40% (1762), of student category A 34.96% (875) and coursing the second academic year 26.25% (657). Conclusions: Five out of every ten students presented depressive symptoms and seven, anxiety symptoms, of which the majority was classified as moderate and mild, respectively; two out of every ten medical students presented suicidal ideation. The sample of students is between 18 to 22 years old, female, Catholics, who live in the department of Guatemala and are of student category A.
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Pulmonary function in sawmill workers in Guatemala

Authors:
Ana Toledo, Miguel Vela, Juan Velásquez, Otto Miranda, Maynor Palma
Pages:
18-23
Abstract:
Introduction: wood dust directly affects lung function. Occupational health is of utmost importance, sawmill workers are at greater risk of contracting respiratory diseases. Objective: to describe the lung function in workers with exposure to wood dust in sawmills in zones 1 and 12 of Guatemala City. Material and methods: descriptive, cross-sectional study, carried out on 88 workers exposed to wood dust in sawmills. An interview, physical evaluation and forced spirometry were carried out with a portable spirometer. Descriptive and analytical analysis were performed using the χ2 test and Student's t test. Results: 94.3% were men. The mean age was 36.5 years. 72% did not present a pathological history. 95% (82/86) had normal spirometry. 56% use a mask. Discussion: the majority of workers were males, young compared with the working age of the Guatemalan population. Two thirds do not have a pathological history. Lung function was normal in most of them. Half of the workers use a mask.
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Prevalence of Demodex on the face of female patients Hospital Roosevelt, Guatemala

Authors:
Melanie Figueroa-Menéndez, Eva Oliva-Catalán, José Chacón-Montiel
Pages:
24-28
Abstract:
Introduction: The mites of the genus Demodex spp inhabit the skin of humans and are considered pathological when they are present in excessive numbers or if they penetrate the dermis. Its presence has been associated with various dermatological diseases. This study estimates the prevalence of Demodex spp on the face of female patients.
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Microbiological quality of water in the urban area of the municipality of Escuintla

Authors:
Jocelyne Fuentes-Osorio, Rodolfo Nájera-Peralta, Stephany Rivara-Contreras, Daryl Hernández-Cox, Rony Ríos-Guzmán
Pages:
29-33
Abstract:
Objective: d etermine the microbiological quality of water in the urban area of ​​the municipality of Escuintla, in 2020. Material and methods: descriptive cross-sectional study in which microbiological water analysis was carried out, using the multiple tube fermentation method expressed in terms of the most probable number for the detection of Escherichia coli and total coliforms in 63 water samples, from storage tanks in the urban area of ​​the municipality of Escuintla. Microbiological water analysis using as a reference the compliance values ​​established by the Guatemalan Standard COGUANOR NTG 29001. Results: the79% (50) of the storage tanks provide sanitary safe water for human consumption and the 21% (13) of the storage tanks provide water with Echerichia coli and total coliforms indicating that it is not suitable for human consumption. Conclusions: the fifth part of the storage tanks in the town of Escuintla, shows the presence of water contaminated with Escherichia coli and total coliforms.
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Epidemiological, clinical and histopathological characterization of basal cell carcinoma of the skin in Guatemala

Authors:
Hector Robledo-Méndez, Orlando Rodas-Pernillo, Eddy Rodríguez-González
Pages:
34-37
Abstract:
Objective: to establish epidemiological, clinical and histopathological characteristics of patients with a histological diagnosis of basal cell carcinoma. Material and methods: 86 patients with histopathological diagnosis of basal cell carcinoma were identified from January to October 2018. Clinical and histopathological data were collected. Results: 534 patients underwent a skin lesion biopsy during the study period. 32.77% were diagnosed as basal cell carcinoma. 60% of the cases were female. The average age was 57 years. The age range was between 51-60 years old. The most frequent site was the palpebral area (26%). Epidermoid differentiation was appreciated in 21%. Discussion: the prevalence of basal cell carcinoma of the skin, its predominance in women and in patients older than 50 years, greater frequency of the nodular/solid subtype, are results similar to those reported in the literature.
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Case Report

Intussusception in a child with COVID-19

Authors:
Gladis Garcia, Juan Zaldaña
Pages:
38-40
Abstract:
In infants, intussusception is the most common cause of intestinal obstruction, and in children, up to 30% of cases have a previous viral disease. It occurs more frequently between 4 and 10 months of age. The incidence ranges from 0.24 to 2.4 per 1000 live births. The mortality rate is 2.1 per million live births in the US. We present the case of an infant with a positive test for SARS-CoV-2.
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Lung biopsy findings in a COVID-19 re-hospitalized patient

Authors:
Hector de-Paz, Fernando Solares, Emerson de-la-Rosa, Pebbles Medina, Roberto Orozco
Pages:
41-43
Abstract:
The COVID-19 pandemic has changed the general landscape of current medicine.[1,2] In most cases of pneumonia, this has a bilateral presentation, and its acute-phase histopathologic findings are well described.[3] We present the case of a 56-year-old woman with a diagnosis of COVID-19 confirmed by PCR, and underwent a lung biopsy.
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Facial reconstruction with rotation of the pectoralis major muscle flap

Authors:
Yolanda Herrera, Brandon Hernández, Carlos Valladares
Pages:
44-47
Abstract:
The case of a 17-year-old male patient, admitted to the adult surgery emergency service, with a gunshot wound (shotgun to the face). On physical examination, he presented loss of continuity in the left cheek of full thickness, 12 x 7 cm, involving the maxillary bone and the left mandibular branch. Facial reconstruction was performed with rotation of a pedicled flap of the pectoralis major muscle. Patient is discharged in good condition.
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Flap rotation in ying-yang. Scalp correction fronto-parieto-occipital

Authors:
Jimmy Guillén, Jorge Isaacs-Vargas, Alfredo Longo-Calderón
Pages:
48-51
Abstract:
The scalp is a unique structure. The superficial layers are completely independent of the skull and move as a unit with the contraction of the frontal and occipital muscles. The Ying-Yang flap receives its name from the shape it takes after closure of the defect. We present the case of an 18-year-old male with a history of high tension burn in both parietals of the skull. The patient is operated several times, including the Ying-Yang flap close the SCALP, and finally, a partial thickness graft was taken and placed.
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Partial thickness graft in the regions of face and skull

Authors:
René Villatoro, Joselin Marull, Diego Guerra, Lourdes Santizo
Pages:
52-54
Abstract:
A 16-year-old female patient who consulted for soft tissue avulsion secondary to a mill accident of 1 hour evolution. On physical examination, she showed soft tissue avulsion in cervical region, skull, face and eyelids. Washing and debridement plus collection and placement of a partial thickness graft is performed.
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Resection of invasive basal cell carcinoma from the nose

Authors:
Jimmy Guillén, Douglas Miranda, Alfredo Longo
Pages:
55-57
Abstract:
Cellular carcinoma is observed in a high percentage of patients. Sometimes, they appear in complex anatomical regions such as the nose, area of great aesthetic compromise for the patient. The standard treatment for large lesions at this site consists of resection of the tumor with subsequent correction of the defect with grafts or flaps. The case of a 64-year-old man with a 2-year history of ulcerated lesion on the nose is presented. The ulcer was 2 cm in diameter and had ragged edges. Tumor resection and flap transposition were performed.
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Massive cardiac tamponade as a complication of battered child syndrome

Authors:
Alejandro Barrón-Balderas, Silvia Álvarez-Corona, Juan Lona-Reyes, Mireya Robledo-Aceves, Luis Orozco-Alatorre
Pages:
58-60
Abstract:
Assault with sharp-pointed or blunt-force objects is a rare form of child abuse and is categorized in society as attempted infanticide or homicide. The purpose of this report is to present a case of cardiac tamponade caused by repetitive thoracic trauma as a consequence of physical aggression.
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Bowel in bucket loop

Authors:
Adolfo Arreaga-Castillo, Eddy Peréz-Batres, Miguel Siguantay-Chanas
Pages:
61-63
Abstract:
A 47-year-old male patient who consulted with a history of mechanical compression between two vehicles is presented. With indication of blunt abdominal trauma, the patient was approached as damage control surgery, showing a lesion in bucket loop of the small intestine. 48 hours later, intestinal resection and anastomosis were performed. Patient evolved adequately.
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Inverted nasal papilloma resection using Caldwell-Luc approach

Authors:
Douglas Miranda, Stephanie López, Walter Ruyan
Pages:
64-66
Abstract:
Inverted nasal papilloma is a rare entity of the nasal passages and paranasal sinuses, with an incidence of 0.5 to 1.5 cases per 100 thousand inhabitants, it develops due to a growth of superficial epithelial cells that penetrate the tissue downwards. of support, it presents as a slow-growing tumor with a tendency to bone absorption and high recurrence. We present the case of a 17-year-old patient treated using the Caldwell-Luc approach.
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Open heminephrectomy in the treatment of the incomplete double collector system

Authors:
Allan Molina, Gustavo González
Pages:
67-69
Abstract:
We present the case of a 56-year-old patient, treated in Urology at Roosevelt Hospital, with a history of right low back pain and dysuria associated with urinary tract infections. Renal and urinary tract USG suggestive of right renal pole cyst. Urotomography showing a double incomplete right collecting system. Intraoperative retrograde pyelogram confirms the collecting system defect. Right Open Heminephrectomy is performed. Duplication of the collecting systems is a common congenital anomaly of the upper urinary tract, 1 in 160 live births, has a family association, predominantly in women (6: 1), is benign and manifests with obstructive or infectious problems of the urinary tract. They are discovered as an incidental radiological finding. The most frequently used and effective surgical treatment is Partial Heminephrectomy.
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Priapism

Authors:
Jorge Isaacs-Vargas, Jimmy Guillén-Aguilar, Gustavo González-Reynoso
Pages:
70-71
Abstract:
PPriapism is a penile erection lasting four hours or more in the absence of sexual stimulation or after it has ended. It is a rare condition, but can become a true urological emergency. We present the case of a 28-year-old patient who consulted with a 7-day history of erection, who underwent lavage of the corpora cavernosa and Winter procedure.
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Invasive intracystic papillary carcinoma in the breast of a 91-year-old man

Authors:
Ana Orantes, Marisol Gramajo
Pages:
72-73
Abstract:
Invasive intracystic papillary carcinoma is a rarely diagnosed neoplasm in the male mammary gland. The diagnosis is usually late and requires complete resection of the lesion. The case of a 91-year-old man with a three-year history of a mass in the right mammary gland is presented.
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Hemoptysis: Chest trauma with late onset of symptoms

Authors:
Jennifer Serrano, José Arriola-Navas, Alfredo Longo, Joselin Marull
Pages:
74-76
Abstract:
A 28-year-old woman presented with hemoptysis as a late manifestation of penetrating chest trauma. History of trauma 9 years before consultation and hemoptysis of 3 years of evolution. Radiological studies showed a cavitated lesion in the right lower lobe. A right lower lobectomy was performed, with the finding of a foreign body (wood fragment) in lung tissue. Patient with good evolution.
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Serous microcystic cystadenoma of the pancreas

Authors:
Walter Vasquez-Bonilla, Victor Argueta, Roberto Orozco, Rolando Noriega
Pages:
77-79
Abstract:
Serous cystadenomas of the pancreas are benign epithelial neoplasms. We present two cases of Microcystic serous cystadenomas of the pancreas, diagnosed in intraoperative consultation and managed with excision of the neoplasm. Both patients are alive and disease free.
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Resection of perforated Meckel diverticulum

Authors:
Jimmy Guillen-Aguilar, Douglas Miranda-Ochoa, Fernando Gonzales-Arreache
Pages:
80-81
Abstract:
Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, corresponding to the remnant of the omphalomesenteric duct. It is located on the antimesenteric border of the ileum. We present the case of a 4-day-old patient with abdominal distention. Plain abdominal X-ray showed free gas in the peritoneal cavity. An exploratory laparotomy was performed, finding a perforated Meckel diverticulum. Simple diverticulectomy was performed.
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Surgical Treatment in Myasthenia Gravis

Authors:
Jennifer Serrano-Cubur, José Arriola-Navas
Pages:
82-84
Abstract:
A 15-year-old male patient with a diagnosis of Myasthenia Gravis is presented. The patient received several treatments, acetylcholinesterase inhibitors, immunotherapy with steroids and replacement with immunoglobulins, without having satisfactory results, during which time he had two myasthenic crises. Video thoracoscopic thymectomy was performed with good postoperative results. Therefore, thymectomy should be considered as a surgical treatment for myasthenia gravis when medical treatment fails.
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Meningeal mesenchymal chondrosarcoma

Authors:
Javier Morán, Rosario Velásquez, Hesler Morales
Pages:
85-87
Abstract:
Mesenchymal chondrosarcoma is a malignancy of bone tissue and soft parts, but can occur in rare places such as meningogens and orbit. This is the case of a 16-year-old female patient, single with a history of long-evolving headache. The MRI study showed tumor injury in the mixed-density left cerebellar hemisphere with necrosis zones. Histopathological diagnosis was mesenchymal meningeal chondrosarcoma.
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Diaphragmatic eventration

Authors:
Johselyn Illescas, Erwin Mejicanos
Pages:
88-90
Abstract:
The case of a 64-year-old female patient is presented. She was treated at the chest clinic at Roosevelt Hospital. She consulted for progressive dyspnea and fatigue from small efforts of 3 years of evolution, associated with difficulty breathing, especially when eating. Antecedent of arterial hypertension. Chest X-ray and tomography showed elevation of the left diaphragm and presence of intestinal loops, stomach and spleen in the thoracic cavity. On auscultation of the left hemithorax, there was hypoventilation and bowel sounds in the thoracic cavity. With a diagnosis of diaphragmatic eventration, a left posterolateral thoracotomy, diaphragmatic plicature and placement of a left intercostal tube were performed.
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Giant fibrolipoma resection

Authors:
Jimmy Guillén-Aguilar, Adolfo Arreaga-Castillo, Alfredo Longo-Calderón
Pages:
91-93
Abstract:
Lipoma is a benign fatty tissue tumor that can develop in almost any organ of the body. It generally grows slowly and forms a painless, soft, and mobile mass. It typically occurs in patients between the ages of 30 and 50 years. Surgical excision is the treatment of choice. The case of a resection of a giant fibrolipoma in a 46-year-old female is presented.
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Malignant pleural mesothelioma

Authors:
Maynor Palma, Juan de-León, José Arreola
Pages:
94-96
Abstract:
Malignant Pleural Mesothelioma (MPM) is a rare and aggressive cancer of the pleural surface associated with asbestos exposure. The incidence and prevalence worldwide are unknown. The clinical data are progressive and include dyspnea, cough, and severe chest pain, associated or not with pleural effusion. It is diagnosed by histology, although there are currently serum help markers. Therapeutic strategies include surgery associated with chemo and radiotherapy, however the survival is approximately 8-14 months. We present the case of a 61-year-old man diagnosed with MPM.
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Semblance

Dr. Igor Slowing

Authors:
Carlos Chúa
Pages:
97
Abstract:
Igor Slowing is 51 years old and Guatemalan. He is a Chemist from the University of San Carlos de Guatemala. He worked 8 years in university teaching in Guatemala. He is a Doctor of Organic Chemistry from Iowa State University. In 2018, he was included in the Web of Science list of the first 100,000 scientists (top 1%) who were cited the most in the world during that year.
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