Thoracic spinal surgery has many complications ranging from surgical site infection, chronic pain, periarticular arthrosis, displacement of spinal screws and hardware migration to a lesser degree. ...Reports of spinal implants penetrating the aorta have been described in the literature, however to our knowledge, lower airway obstruction due to spinal hardware migration has not been reported. Here we describe a case of a patient presenting with a right main stem bronchial obstruction and pneumonia secondary to the migration of the surgical spinal hardware into the lower airway 18 years after his initial intervention. We describe our surgical approach, management and outcomes using bronchoscopy and open thoracotomy. Bronchial obstruction is not a common complication of thoracic spinal surgery, however in remote cases patients may present with rare consequences, it is therefore important to pay close attention to patients' clinical and surgical history since surgical complications may appear years after.
CASE DESCRIPTIONA 72-year-old woman with primary Sjögren Syndrome (SS) was diagnosed during an inpatient hospital stay with dry symptoms. The patient had respiratory and constitutional symptoms, ...requiring a pulmonary imaging evaluation by high-resolution computed tomography (HRCT) of the thorax. CLINICAL FINDINGSMultiple cavitary pulmonary nodules, halo sign, and focal areas of ground-glass opacity with predominance in both bases were found in the images. Complementary studies were done where a neoplastic focus was ruled out. The diagnosis of nodular pulmonary amyloidosis was confirmed with a pulmonary biopsy performed by videothoracoscopy for histopathological study, which reported the formation of nodules in the parenchyma with amyloid deposits and positive immunohistochemical markers for CD3, CD20, and CD38 lymphocytic infiltration. TREATMENT AND OUTCOMEInitial inpatient management with intravenous cyclophosphamide and methylprednisolone was given. Subsequent outpatient management was given with high dose glucocorticoids. CLINICAL RELEVANCEWe presented a case of nodular pulmonary amyloidosis in a female patient with primary SS, which is a rare pulmonary manifestation of this syndrome.
Salivary gland tumors are scarce during the first and second decades of life; when they appear in these age ranges, they are generally found in the parotid gland. Minor salivary gland tumors are even ...more scarce, being the pleomorphic adenoma the most common one. Most authors define the pleomorphic adenoma as an oval or round suhrnucous tumoration, unique, well delimitated, non -infiltrated, hard - elastic and painless. The covering mucous membrane remains undamaged; however secondary ulceration may occur, either due to intrinsical growth of the tumor or because of trauma; its growth is slow. When the pleomorphic adenoma shows up in the palate, a diterential diagnosis should he made along with other patologies such as those of infectious type, the non - odontogenic cysts and tumors, the odontogenic cysts and tumors and finally, the pseudotumoral lesions. Treatment for the pleomorphic adenoma is the total enucleation; Most authors suggest a wide local excision that extends at least r in outside the visible margin of the tumor. Fenestration of the soft palate may be necessary in order to obtain the required surgical margins. Only eight cases of palate pleomorphic adenoma in children have been reported in the world literature,- here we present 3 cases of pleomorphic adenoma found in palate minor salivary glands of male sex patients: one in an 8 year old child and two in 15 year old youngsters.
El presente plan estratégico está enfocado en el Departamento del Meta, estableciendo;
como visión que en el año 2032 el departamento será un referente nacional de la competitividad,;
fundamentándose ...en los pilares de la educación, salud, e innovación tecnológica, impulsado por;
el desarrollo de las actividades económicas del sector agropecuario y de turismo, generando así;
mayores beneficios a su población.;
El óptimo aprovechamiento de los potenciales de desarrollo del país, y la reducción de los;
desequilibrios regionales exige el uso de instrumentos potentes, como la planificación estratégica;
con visión de largo plazo, que permita a las entidades territoriales posicionarse de manera;
competitiva en los escenarios nacionales e internacionales y constituirse en autogestores de su;
futuro, a través de la consolidación del proceso de descentralización.;
El Departamento del Meta se encuentra en un proceso de mejora de su competitividad,;
entendida esta como la capacidad de organización para tener una economía y sociedad, cuyo;
desarrollo se considera atractivo en términos de crecimiento y competencia económica.;
Desde dicha perspectiva, el reto que se impone el plan estratégico consiste en lograr;
movilizar las potencialidades y ventajas comparativas locales para elevar la productividad y;
competitividad, simultáneamente con la multiplicación de los efectos sobre el mejoramiento de;
la calidad de vida y la sustentabilidad ambiental. De tal manera que se pueda transformar el;
crecimiento en desarrollo sostenible con una integración equilibrada del territorio departamental,;
basada en los preceptos de la nueva geografía económica
The present strategic plan is focused on the Department of Meta, establishing as vision that;
by 2032 the department will be a national benchmark of competitiveness, based on the pillars of;
education, health, and technological innovation, driven by the development of Economic;
activities of the agricultural and tourism sector, thus generating greater benefits to its population.;
The optimum utilization of the country's development potential and the reduction of;
regional imbalances require the use of powerful instruments, such as strategic planning with a;
long-term vision that allows the territorial entities to position themselves competitively in the;
national and International organizations and to become self-managers of their future, through the;
consolidation of the decentralization process.;
The Department of Meta is in a process of improving its competitiveness, understood as;
the organizational capacity to have an economy and society whose development is considered;
attractive in terms of growth and economic competition.;
From that perspective, the challenge imposed by the strategic plan is to mobilize the local;
potential and comparative advantages to increase productivity and competitiveness,;
simultaneously with the multiplication of the effects on the improvement of quality of life and;
environmental sustainability. In such a way that growth can be transformed into sustainable;
development with a balanced integration of the departmental territory, based on the precepts of;
the new economic geography
Tesis
El presente plan estratégico está enfocado en el Departamento del Meta, estableciendo;
como visión que en el año 2032 el departamento será un referente nacional de la competitividad,;
fundamentándose ...en los pilares de la educación, salud, e innovación tecnológica, impulsado por;
el desarrollo de las actividades económicas del sector agropecuario y de turismo, generando así;
mayores beneficios a su población.;
El óptimo aprovechamiento de los potenciales de desarrollo del país, y la reducción de los;
desequilibrios regionales exige el uso de instrumentos potentes, como la planificación estratégica;
con visión de largo plazo, que permita a las entidades territoriales posicionarse de manera;
competitiva en los escenarios nacionales e internacionales y constituirse en autogestores de su;
futuro, a través de la consolidación del proceso de descentralización.;
El Departamento del Meta se encuentra en un proceso de mejora de su competitividad,;
entendida esta como la capacidad de organización para tener una economía y sociedad, cuyo;
desarrollo se considera atractivo en términos de crecimiento y competencia económica.;
Desde dicha perspectiva, el reto que se impone el plan estratégico consiste en lograr;
movilizar las potencialidades y ventajas comparativas locales para elevar la productividad y;
competitividad, simultáneamente con la multiplicación de los efectos sobre el mejoramiento de;
la calidad de vida y la sustentabilidad ambiental. De tal manera que se pueda transformar el;
crecimiento en desarrollo sostenible con una integración equilibrada del territorio departamental,;
basada en los preceptos de la nueva geografía económica
The present strategic plan is focused on the Department of Meta, establishing as vision that;
by 2032 the department will be a national benchmark of competitiveness, based on the pillars of;
education, health, and technological innovation, driven by the development of Economic;
activities of the agricultural and tourism sector, thus generating greater benefits to its population.;
The optimum utilization of the country's development potential and the reduction of;
regional imbalances require the use of powerful instruments, such as strategic planning with a;
long-term vision that allows the territorial entities to position themselves competitively in the;
national and International organizations and to become self-managers of their future, through the;
consolidation of the decentralization process.;
The Department of Meta is in a process of improving its competitiveness, understood as;
the organizational capacity to have an economy and society whose development is considered;
attractive in terms of growth and economic competition.;
From that perspective, the challenge imposed by the strategic plan is to mobilize the local;
potential and comparative advantages to increase productivity and competitiveness,;
simultaneously with the multiplication of the effects on the improvement of quality of life and;
environmental sustainability. In such a way that growth can be transformed into sustainable;
development with a balanced integration of the departmental territory, based on the precepts of;
the new economic geography
We have retrospectively evaluated the results of two cycles of mobilization and collection of peripheral blood progenitor cells (PBPC) from 46 healthy donors included in the Spanish National Donor ...Registry. Mobilization involved the administration of granulocyte colony-stimulating factor (G-CSF) at a median dose of 10 microg/kg per day, and apheresis was begun after the fourth dose of G-CSF in both cycles. The median interval between both mobilizations was 187 days (range, 7-1428 days). The incidence and types of side-effects were similar after both donations, with 25 and 26 donors developing some toxicity after the first and second donations, respectively. The median number of CD34(+) cells collected was higher after the first mobilization than after the second (5.15 versus 3.16 x 10(6)/kg, respectively; p = 0.05), and 29 donors yielded fewer CD34(+) cells after the second mobilization (p = 0.018). A lower proportion of donors yielded CD34(+) cell counts >4 x 10(6)/kg after the second cycle than after the first (52% versus 76%, respectively; p = 0.057). Our study shows that second rounds of PBPC collection from normal donors are well tolerated but are associated with a significantly reduced number of CD34(+) cells collected when the same mobilization scheme is used.
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